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REDUCING FOOD LOSSES THROUGH POSTHARVEST TRAINING Once harvested, 30-80 percent of fruits and vegetables in Sub-Saharan Africa are lost to poor handling. Food quality, safety and nutritional value are also affected by poor postharvest practices. In an effort to improve postharvest handling of horticultural crops, Feed the Future partners opened a model postharvest center in Tanzania and deployed newly trained experts from seven countries to train farmers. In October 2012, 36 professionals from Tanzania, Rwanda, Kenya, Uganda, Ethiopia, Ghana, and Benin completed a year-long training in postharvest practices, led by an international team under the Feed the Future Innovation Lab for Collaborative Research on Horticulture. Through online learning and mentoring, the trainer candidates each completed a series of 10 assignments ranging from assessing commodity systems to developing training programs. The trainings were led by Lisa Kitinoja of the World Food Logistics Organization, with Diane Barrett of the University of California, Davis, and additional training support from the University of Georgia, AVRDC-The World Vegetable Center, Amity University, UC Davis, and the Postharvest Education Foundation. These 36 new postharvest trainers became the first graduates of the new Horticulture Innovation Lab Postharvest Training and Services Center, located at AVRDC-The World Vegetable Center in Arusha, Tanzania. The trainers learned about a variety of postharvest technologies, including the use of shade, harvesting tools, packaging, containers, grading, washing, cooling technologies, drying, and processing. They learned how to use various tools, including sizing rings, color charts, chlorine test strips, and refractometers, to measure postharvest quality. Then new trainers officially opened the center by leading more than 100 local farmers through a day of postharvest instruction and demonstrations. Upon graduating, each of the trainers received a postharvest toolkit to help them get started with their next task—training farmers in their own countries. Ultimately, they are tasked with opening up their own postharvest training and service centers, each offering training, research, equipment retail and fee-based services. In 12 months following their graduation, the 36 trainers have directly trained 7,474 farmers in postharvest practices and technologies across seven countries, with a potential multiplier effect of an additional 8,900 practitioners. Designs for more than 80 additional Postharvest Training and Services Centers—including suitable sites, partners and costs—have been developed by trainers who took the year-long course. Experts affiliated with the Horticulture Innovation Lab also continued to offer training through the center in Arusha for small-scale growers, marketers and processors. Over a two-year period that included the train-the-trainers, more than 16,000 farmers were trained in improved postharvest practices through this project. “Many of our new ‘postharvest specialists’ are already working together on postharvest research projects or writing new proposals for training programs,” Kitinoja said. “Others have been hired for consulting assignments in the region or awarded fellowships that will allow them to continue their postharvest studies and/or extension work in their own countries.” REDUCING DRUDGERY, IMPROVING SOIL FOR VEGETABLE FARMERS Most commonly used with field crops, conservation agriculture combines three practices that help farmers invest in soil health, specifically: - minimal soil disturbance (“no till”), - continuous mulch cover, and - rotating diverse crops. These practices can also reduce labor and reduce water evaporation from the soil. Manuel Reyes, professor at North Carolina Agricultural and Technical State University, has helped farmers in many countries improve their soil and use water efficiently. In doing so, he has also partnered with three Feed the Future Innovation Labs, funded by the U.S. Agency for International Development. Beginning in 2010, Reyes started working with farmers in Cambodia on conservation agriculture for field crops, with an international team supported by the SANREM Innovation Lab. Two years later, the team worked with 56 households over 149 hectares to use conservation agriculture principles. After testing conservation agriculture practices with vegetable crops in the United States, Reyes expanded his conservation agriculture work in Cambodia to focus on vegetable farmers. Now with additional funding from the Horticulture Innovation Lab, he added drip irrigation to conservation agriculture practices for vegetable farmers. This research sought to find whether combining these practices could reduce labor needs, increase yield, increase income and ultimately receive support from vegetable farmers. For field trials in Cambodia, women farmers grew a variety of vegetables, including string beans, cucumber, Chinese cabbage, kale, tomatoes and eggplant. Unlike the first few years of using conservation agriculture with field crops, this trial with vegetables found no significant differences in yields or income between the various treatments. But what did change with the new practices was the farmers’ labor. The researchers estimate that growing vegetables on 100 square meters with traditional methods and hand watering requires hauling about 1,300 pounds of water per day during the dry season — and even twice as much during very dry seasons. Drip irrigation and conservation agriculture freed the women farmers from carrying water, tilling and weeding. Many of the women farmers were so pleased with the new practices that they asked to end the experiment early, to avoid the extra labor of tilling, hand-watering and weeding required to maintain the field tests. The next step? Reyes is working with these Cambodian women farmers on a new Horticulture Innovation Lab project, this time on marketing their vegetables and building a local brand that promotes their conservation practices. This article is made possible by the generous support of the American people through the United States Agency for International Development. The contents are the responsibility of the Horticulture Innovation Lab and do not necessarily reflect the views of USAID or the United States Government. 06/15 In many developing countries, more than half of all fruits and vegetables are never eaten, but instead are damaged or spoiled after harvest. These post-harvest losses can mean that farmers need to sell their fresh produce immediately at whatever price they can get, before they lose the crops that represent investments of labor, water, and agricultural inputs. Improving how fruits and vegetables are handled after harvest can significantly prolong freshness — and cooling is key. “The three most important aspects of postharvest handling are: temperature, temperature, temperature,” said Michael Reid, postharvest specialist with the Horticulture Innovation Lab. “In the developing world in particular, affordable cooling technology is mostly absent.” Cooling can be an expensive challenge — even for American farmers. As a farmer in upstate New York, Ron Khosla knew this problem too well and could not afford to buy a walk-in cooler for his small farm. So he invented a solution: an electrical device called a CoolBot that tricks an air conditioner into getting colder, turning a well-insulated room into a cold room for less than it costs to buy a refrigeration unit. “I was hoping for a cheap, do-it-yourself solution that I could maintain, but mostly I just needed to keep my leafy greens and strawberries cold,” Khosla said. He later started a small business to sell the CoolBot called Store It Cold, LLC. Khosla’s CoolBot invention caught the eye of postharvest researchers, including Reid who in 2010 first partnered with agricultural scientists from Uganda, Honduras, and India to test this new device in their climates and with local materials. Since that first project, the Horticulture Innovation Lab has tested CoolBots for cold storage in Tanzania, Zambia, Uganda, Thailand, Cambodia, Bangladesh, India and Honduras. Reid has also tested options for solar-powered CoolBots. One Horticulture Innovation Lab partner — Jane Ambuko of the University of Nairobi — received a grant to pilot this technology among horticultural farmers for the Kenya Feed the Future Innovation Engine. “I see the CoolBot making a whole lot of difference,” Ambuko said during a TEDxNairobi speech. “But for it to make that desired difference we have to make it cost-effective and affordable for the smallholder farmers.” In the wake of these successes, Feed the Future Partnering for Innovation also chose to invest in scaling up the CoolBot among exporters and agricultural associations in Honduras. And Khosla’s small business has been growing. In early 2016, it had grown to employ six people and had sold more than 27,500 CoolBots in 51 countries. “I’m thrilled and so grateful to be a part of helping lots of people. Working with USAID has gotten us known in other countries, and I’m looking forward to the day when we have enough in-roads in India and Africa where we can work directly with farmers there,” Khosla said. “People didn’t believe the CoolBots worked at first. But now we get the most amazing letters from people whose business has doubled or quadrupled. Good postharvest care makes such a difference. Once they try it, then they see.” INVENTING A LOW-COST SOLUTION TO REDUCE MOLDY FOODS ‘DryCard’ wins Africa postharvest prize, takes guesswork out of drying How do you see dryness? Drying food is one way many farmers preserve their harvest, but knowing when food is dry enough to store can be difficult — and mold growth on dried foods is a pervasive problem. For farmers, mold growth can mean postharvest losses and lowered market value. For consumers, aflatoxins from moldy foods can suppress the immune system, increase disease rates, and cause lifelong stunting in children. To that end, researchers from the University of California, Davis researchers Michael Reid and James Thompson invented a low-cost, easy-to-use tool that farmers can use to measure food dryness, called the DryCardTM. The DryCard is the size of a business card and combines cobalt chloride paper, which indicates dryness by changing color, with a color guide on a laminated piece of paper. Repackaging the cobalt chloride paper with the color guide increases the usability of the strips and allows farmers to access this dryness indicator at just pennies per card. To check that food is dry enough for safe storage, farmers can seal a DryCard and a sample of dried product in an airtight container. After a brief wait, the card indicator changes color based on relative humidity within the container. Matching the color of the indicator with the guide on the card shows whether food is dry enough to prevent mold growth. The DryCard is reusable as long as it is stored safely away from water. In March, the DryCard was selected as a top emerging technology for improving postharvest practices in Africa — beating more than 200 technologies to win the grand prize at the All Africa Postharvest Technology and Innovation Challenge. Top technologies and innovations were invited to pitch to an audience of about 600 participants, including researchers, investors, extension agents, government executives, and farmers. “I have never seen such strong interest in a technology like this,” said Elizabeth Mitcham, director of the Horticulture Innovation Lab, who represented the card during the competition. “This technology has high potential to make an impact—and not only with dried produce and vegetable seeds, which was our original intent. A lot of the interest we have seen is from organizations that work with staple crops too.” In the wake of the competition and resulting publicity, interest in the DryCard has been high. In response to requests for samples, the Horticulture Innovation Lab has distributed more than 1,400 cards to organizations in 17 countries. The team is also in talks with local entrepreneurs who are interested in manufacturing and marketing the cards in their own countries. Bertha Mjawa is one of the first researchers to test out and promote the DryCard in Africa, with her Postharvest Consult and Capacity Building Company in Tanzania. Over the course of 5 months, Mjawa and her team sold 2,500 DryCards to 500 local farmers and organizations. “The DryCard makes a promising solution for African farmers due to its cost effectiveness, clear indicators and ease of use,” Mjawa said. “Both farmers and agricultural experts can benefit from this technology.” For updates, samples and more information about the DryCard, visit http://drycard.ucdavis.edu. This article is made possible by the generous support of the American people through the United States Agency for International Development. The contents are the responsibility of the Horticulture Innovation Lab and do not necessarily reflect the views of USAID or the United States Government. 10/17 In a classroom in Ghana, graduate student Dev Paudel from the University of Florida bent over computers with students and research assistants as they learned the basics of R, a free, open-source programming language for statistical analysis that he had installed on the computers earlier that week. As participants in this Kayaba Management Foundation training, the class members would next analyze the results of a needs survey of more than 300 farmers and vegetable vendors from nearby communities. Their goal? “If we can use state-of-the-art statistical tools (including R) in Ghana, we can generate research findings that would be accepted by both policy makers and the international investor community,” said Hussein Yunus Alhassan, CEO of the Kayaba Management Foundation and chief instructor at Tamale Polytechnic. His new foundation is laying the groundwork for locally led research that supports the horticulture sector in northern Ghana, markets for horticulture value chains, and women’s empowerment. As a doctoral graduate student, Paudel uses statistical analysis software frequently. His previous experience as a horticulture development officer in Nepal was an early step in his international development career. Paudel’s work in Ghana — including his first trip to Africa — is supported by the Trellis Fund, an innovative program that pairs U.S. graduate students with organizations engaged with local farmers in developing countries. The Trellis Fund is part of the Feed the Future Innovation Lab for Collaborative Research on Horticulture, led by the University of California, Davis. The Horticulture Innovation Lab’s two main goals for the Trellis Fund are complementary: strengthen smaller organizations with the horticultural expertise that a graduate student can offer, and provide experience to the graduate student that could expand their career horizons toward international development. The connections with smaller organizations and young professionals also strengthen the Horticulture Innovation Lab’s network for future projects. “Trellis promotes horticultural science to organizations that are often smaller than we might otherwise work with. They become part of our Horticulture Innovation Lab family, and many become good partners for us in the future,” said Elizabeth Mitcham, director of the Horticulture Innovation Lab. The first 47 completed Trellis projects included 7,400 farmer participants, 219 demonstration plots and 238 training meetings. Those projects involved 47 students from five U.S. universities, who served as consultants for projects spanning 15 Feed the Future focus countries in Africa, Asia and Central America. Though their 6-month Trellis Fund project is officially complete, Paudel, Alhassan and the Kayaba Management Foundation team continued to work together remotely with the goal of publishing a journal article based on their robust analysis of farmer needs from the survey. “Working with students and research assistants is great because they are really open to new ideas and grasp things very easily,” Paudel said. “This was a challenging course for some of them, particularly those who did not have training in basic programming skills. However, they are practicing their skills with the survey analysis now. I believe this training will be advantageous to the students as they leap into their new careers.” SUPPORTING POSTHARVEST IN TANZANIA’S HORTICULTURE SECTOR In Tanzania horticulture is one of three value chains that Feed the Future activities focus on for greatest impact. Horticultural crops are particularly sensitive to poor postharvest practices, with estimates that half of fruits and vegetables grown in many sub-Saharan Africa countries are lost during postharvest phases. To enable Feed the Future partners—including educators, industry professionals, and government employees—to better support horticultural development, the Horticulture Innovation Lab led a project to increase training infrastructure and provide training-of-trainers for improved postharvest practices of fruits and vegetables. At the Horticultural Research and Training Institute in Tengeru (HORTI Tengeru), Horticulture Innovation Lab team members designed a field packing shed and charcoal cooler, which were later built and installed by partners at the World Vegetable Center. The site had an insulated room, which the Horticulture Innovation Lab converted into a working cold room, with the addition of a CoolBot and air conditioner. These postharvest facilities now allow for packing, cooling and storage of crops harvested from HORTI Tengeru’s acres of field trials, for improved sales at a market nearby. In July, the Horticulture Innovation Lab provided a five-day course in postharvest handling of horticultural crops to more than 40 professionals from all over Tanzania, including university professors, technical trainers, industry leaders, and government representatives. The course was led by Michael Reid and Angelos Deltsidis of the Horticulture Innovation Lab, with Marita Cantwell of the UC Davis Postharvest Technology Center, and Ngoni Nenguwo of the World Vegetable Center. The course was hosted at the Postharvest Training and Services Center on the World Vegetable Center campus in Arusha. Juma Shekidele of HORTI Tengeru also provided assistance in organizing the course. Each day the course started with lectures covering postharvest principles and practices for crops with commercial potential in Tanzania, including eggplants, tomatoes, bananas, mango, papaya, citrus, avocado, leafy greens, green beans, cherimoya, onions, cut flowers, cucumber, potatoes and carrots. Hands-on activities were also part of the course. Participants conducted exercises to examine maturity, produce quality, cooling, packaging, and water loss. Each participant also received a postharvest toolkit and learned how to use the tools with different fruits and vegetables through the exercises. The course included a module on solar drying, in which attendees constructed and tested the UC Davis-designed chimney solar dryer. The dryer proved its effectiveness in demonstrations; despite heavily overcast conditions, products dried rapidly. The class also took a couple of short field trips, visiting the local wholesale market, an export packing operation and HORTI Tengeru to see the postharvest facilities and horticultural field trials. After the course’s conclusion, evaluations included many positive comments from participants. Weeks later participants also reported incorporating the chimney solar dryer and other demonstrations into farmer field days in other parts of Tanzania. “I will use and teach this course to my farmers who produces tomatoes and onion,” reported one participant. Many commented that the course should be offered repeatedly in the future. GROWING THE SCIENCE BEHIND NUTRITIOUS, LEAFY VEGETABLES As part of Feed the Future, an international team of researchers has been strengthening the value chain of African indigenous vegetables—with nutrition always in mind. Their work began in western Kenya with a food and farm training program established by the AMPATH health system. Doctors there knew patients who were well-nourished would respond better to medical treatment for HIV/AIDS, so the program sought to encourage clients to grow, eat and sell nutritious crops. Three common leafy African indigenous vegetables—amaranth, black nightshade and spider plant—were identified as promising crops for the training program. “We realized the potential was enormous to expand African indigenous vegetable production and meet increasing consumer demand, while addressing important nutrition and income deficiencies,” said Stephen Weller, project leader and horticulture professor at Purdue University. Assumptions about these vegetables were many, but confirmed science was limited. With funding from USAID, the Feed the Future Innovation Lab for Collaborative Research on Horticulture built a project team to address research gaps in production practices, seed availability, storage, value addition, market linkages and nutritional evaluation. Led by Purdue University, the team includes partners from Rutgers University, ASNAPP, the World Vegetable Center, Eldoret University, Sokoine University, Kenya Agricultural Research Institute and Horti Tengeru. To measure available nutrients, the team developed protocols for sampling the vegetables from field experiments at different stages of maturity, with testing at Sokoine University in Tanzania. “Knowing the best stage to harvest these vegetables is crucial,” said John Msuya, associate professor at Sokoine University. “While African indigenous vegetables are said to be rich in micronutrients, they also consist of substantial amounts of anti-nutritional factors—phytate, nitrate and oxalate—which can occur naturally.” Results showed most of the nutrients tested increased as plants aged from 21 to 35 days, and the anti-nutritional factors never reached critical thresholds. Dried leaf samples were also analyzed at Rutgers University for nutritional composition. “We were pleased to find that nightshade, amaranth and spider plant are indeed rich in vitamins and minerals,” said Jim Simon, professor at Rutgers University. “These leafy greens are as nutritionally dense as spinach in iron, calcium and potassium—and rich in vitamins such as provitamin A.” Food processing companies in Kenya and Zambia have used the results in nutrition labeling on packaging aimed at American and European markets, as they add these vegetables to their product lines. Program results have been incorporated into training modules for more than 1,700 farmers, including USAID’s Kenya Horticulture Competitiveness Project. How to better grow more African indigenous vegetables—and the value of eating them too—has been shared continuously with AMPATH’s clients. “So many of the vulnerable AMPATH clients, who are both nutritionally and economically at risk, have had an opportunity to be directly involved in production, consumption and marketing of these crops,” said Pam Obura, senior researcher with Purdue University and AMPATH. “Even the landless have been able to produce them in sack gardens for their own consumption.” CAMBODIAN FARMERS REACH NEW BUYERS WITH A FRESH APPROACH Leaning into her tuktuk in Siem Reap, Eang Chakriya opens a cooler and takes out fresh wax gourds and other vegetables that have been carefully packed and chilled, showing them to a group of neighbors. Emblazoned on the tuktuk (a kind of motorized rickshaw) are images of farmers and the marketing motto, “Grown Right, Handled Right, Community Right.” Chakriya sells nutritious vegetables directly to consumers in Cambodia as part of a farmers’ cooperative working with the Feed the Future Innovation Lab for Horticulture, led by the University of California, Davis. The project’s research team is examining incentives that help farmers improve their agriculture practices. The researchers’ hunch is that farmers will adopt conservation agriculture practices (or “Grown Right” practices) if the team also helps them to adopt two other types of profitable practices that will increase their success: improved postharvest handling techniques and novel marketing practices. So far, the idea seems to be working. Leading this project, researchers from Kansas State University introduced farmers to conservation agriculture practices: mulch use, diverse crop rotation, and no tillage. Combined with drip irrigation, conservation agriculture can help farmers grow vegetables on small plots with reduced time and labor. With researchers from Cambodia’s Royal University of Agriculture, the World Vegetable Center and UC Davis, the project team also provided consultation and farmer training in improved postharvest handling — to harvest, sort, pack, transport and store the vegetables to maintain freshness longer. A team from the Horticulture Innovation Lab’s Regional Center at Kasetsart University in Thailand also helped the farmers construct a packing shed to prepare and store their produce, complete with a cold room, evaporative cooler and sorting table. Eang Chakriya, above and left, sells vegetables grown using conservation agriculture practices under the “Grown Right, Handled Right, Community Right” banner on behalf of a local farmers cooperative. “We’ve increased yields per unit area because of conservation agriculture and the number of times they can plant in the year — from two plantings to up to six plantings per year,” said Manuel Reyes, a Kansas State University research professor who also works with the Feed the Future Innovation Lab for Sustainable Intensification. “Before they finish harvesting, the farmers are already planting the next crop’s seedlings, so they are saving a lot of time overall.” Confident in their ability to sell high-quality vegetables directly to consumers at higher prices, the cooperative has offered to buy vegetables from its members at a 10 percent premium over other buyers. Today, farmers are enjoying increased incomes from vegetables grown on their conservation agriculture plots, with earnings as high as $1,323 over 10 months. Finding reliable vegetable seed in humid Bangladesh can be a challenge — a situation that can ruin a crop before a farmer’s hard work even begins. But Bangladesh seed companies are rapidly adopting a new technology that can improve seed germination and plant vigor, through improved seed processing and storage. Called “drying beads,” this reusable tool can help seed companies provide farmers with higher quality seed, improving the local seed industry and helping farmers maximize the potential of their own hard work. Many of the country’s leading vegetable seed companies have adopted drying beads through a multi-part training led by Rhino Research and supported by the Feed the Future Innovation Lab for Horticulture, based at the University of California, Davis. Participating organizations include Lal Teer Seed Limited, Metal Seed, Getco, A. R. Malik & Co., Ispahani Agro Limited, Bangladesh Agricultural Development Corporation and others. “We concluded that these beads are drying our seeds faster and deeper, obtaining a better quality that results in a longer storage potential, and all this with lesser costs,” said Tabith M. Awal of Lal Teer Seed Limited in Bangladesh. “Therefore Lal Teer made the executive decision to move ahead with implementing these beads for all our seeds and crops as soon as possible.” This year, more than 200 tons of vegetable seed have been dried and stored with drying beads—helping an estimated 100,000 farmers in Bangladesh access quality seed. The in-depth training, offered for a week at a time and repeated 3-7 times over several months, has focused on 14 seed leaders in Bangladesh. They have trained more than 70 employees, who in turn have trained more than 500 seed production farmers in how to use drying beads and maintain seed quality. In a sealed container, the zeolite-based drying beads can dry seeds to very low moisture contents—preventing mold growth, restricting insect habitation, and preserving seed quality. The beads can be regenerated in an oven for repeated use. Seed farmers in Bangladesh first dry their seed in the sun — and that’s where many of them stop (a survey showed about 22% also used fan drying and 8% used heated air). Companies that have adopted drying beads use them in containers to transport the seed from the farmer to company storage, where they can collect the fully dried seeds and return a container with fresh drying beads to the field. Horticulture Innovation Lab researchers have previously shown drying beads are effective for seed storage, and developed an overarching “dry chain” concept. “Make it dry, keep it dry” is the motto of the dry chain, which specifies how to maintain quality and safety of dried products — not just seed. “What is really remarkable is the explosion of different ideas in how to use the drying beads,” said Johan Van Asbrouck of Rhino Research. “But we are starting with seeds, maximizing the potential of the crop at a farmer’s level. If you don’t have quality seed, you start penalized and will not have the crop you could.” ‘DRY CHAIN’ PARTNERSHIP HELPS FARMERS STORE SEED BETTER A partnership between university scientists and a private technology company has sprouted both new concepts and new tools that can help vegetable farmers in developing countries access better seeds. For many smallholder farmers, buying and trading vegetable seeds can be risky. The benefits of purchasing seed can be high, with improved crop varieties offering disease resistance, increased vigor and improved taste. But the risks of receiving poor-quality seed are also significant, particularly in tropical climates. Seed will deteriorate rapidly if it is not properly dried and stored. The resulting poor germination reduces yields, which for vegetable farmers can mean staggered harvests and inconsistent crop quality. “If you buy seed and it’s all dead, you aren’t going to buy very much more seed,” says Kent Bradford, seed biologist at the University of California, Davis. “To get improved varieties into farmers’ hands, you must have a system where people can buy and trade seed successfully.” Under the Horticulture Innovation Lab, Bradford and an international team have partnered with Rhino Research, a seed technology company in Thailand, to improve the science and tools available for drying and storing vegetable seed. The team initially sought to better maintain seed quality by exploring zeolite-based “drying beads.” Produced by Rhino Research, the drying beads absorb moisture from the air. When sealed with seeds in an airtight container, the beads reduce the seeds’ moisture content to very low levels. They can be re-used repeatedly, after being reactivated in an oven. In Thailand, India, Nepal and Bangladesh, the team developed protocols for how to best use drying beads with vegetable seed and trained more than 3,600 people in their use. The team’s preliminary economic analyses showed that using drying beads could increase earnings within the onion seed industry in Nepal by an additional $5.85 million per year. But working with smallholders in developing countries presented additional challenges. While the cost of drying beads can be recovered through repeated use, the up-front costs were not reasonable for many small-scale farmers. Accustomed to working with seed companies, the team also assumed the importance of drying seeds was “fairly common knowledge,” but quickly learned that was not the case. “But when we started talking in terms of the ‘dry chain’ for seeds, then the idea clicked,” Bradford says. “When we compare the importance of drying seeds and keeping them dry throughout storage to the ‘cold chain’ [i.e. keeping perishable goods cold during storage and transport], then our ability to communicate with people goes up.” A “dry chain” requires that seed be dried, and the dryness monitored and maintained throughout all stages of storage. Many actors along the seed dry chain—from seed production to storage, transportation, sales and on-farm use—need to maintain that dryness to ensure seed quality. Following the new dry chain concept, the Horticulture Innovation Lab team also developed a suite of tools appropriate for the different participants along the chain, using what they learned from working with the drying beads. The team’s next steps will begin with a commercial-scale drying system—the FlexiDry, which also uses drying beads—and continue down the dry chain to small containers with inexpensive sensors that enable farmers to maintain and monitor dryness during seed storage. MOSQUITO NET CO PARTNERS WITH RESEARCHERS AGAINST AG PESTS Bed nets are nothing new to international development, but a leading company in mosquito netting has turned its attention—and its nets—to improving agriculture. Under Feed the Future, a collaborative research project has brought together A to Z Textile Mills in Tanzania with agricultural researchers to test its nets for growing fruits and vegetables. The project is funded through the Feed the Future Innovation Lab for Collaborative Research on Horticulture, with researchers from Michigan State University, CIRAD of France, Egerton University in Kenya, Abomey-Calavi University in Benin, the Kenya Agricultural Research Institute (KARI) and the National Agricultural Research Institute in Benin (INRAB). The team is fine-tuning how smallholder farmers can use the nets to reduce insect pests and improve micro-climates in vegetable plots. Similar to its long-lasting insecticidal bed nets, A to Z’s “AgroNets” were developed with and without chemical treatments and for re-use over multiple seasons. “This technology is, for the first time, adapted to smallholder farmers and available in Africa because of the mosquito net industry,” said Thibaud Martin, a CIRAD scientist based in Kenya. “This technology is truly an effective alternative to chemical use.” In the project’s first six months, A to Z provided and delivered 1.5 tons of netting to Benin, Kenya and CIRAD partners. “Partnership with A to Z was critical to the success of this project,” said Mathieu Ngouajio, professor at Michigan State University and a leader of the Horticulture Innovation Lab project. “They have made all the fine-tuning that we needed on the nets and supplied our team with the material for field studies. Without that type of support, it would have been impossible to achieve project goals.” After two years of research, results in Kenya show the nets can indeed reduce pests and increase yields in tomato, cabbage, kale, onion, French bean, melon and carrot crops. Farmers have also tried the nets with other crops such as sweet peppers, amaranth, spider plant and strawberries. “Use of AgroNets on cabbages, tomatoes (both field and nursery), French beans, and melons is not only efficacious against pests, but also offers great business potential for A to Z,” said Hubert Coffi, agronomist with A to Z’s research unit, the Africa Technical Research Centre. In Benin, adoption of the nets by farmers has been particularly high. More than 75 percent of farmers in the project adopted the nets for use with nursery production. Since the project started, the team has received additional funding from CIRAD, INRAB, Ecohort, Katarina University, SupAgro Foundation, and the French embassies in Benin and Kenya. “Moving toward agriculture is for us a key strategic pillar for the coming years because it will help us to expand and diversify our operations and revenue stream while creating more jobs,” said Dr. Johnson Odera, director of the Africa Technical Research Centre. “We still believe in the future of agriculture in Africa, and we want to be part of this success story,” he said. How do you teach innovation? A partnership under Feed the Future is empowering university students to solve real-world agricultural problems while learning the nuts and bolts of how to innovate. “We set out to teach the students some skills in metal work, the design process and appropriate technology—and they end up learning empowerment and teamwork,” explained Jorge Espinosa, with the Panamerican Agricultural School, Zamorano, in Honduras. Espinosa is an instructor for Zamorano’s version of D-Lab, a concept course originally started at the Massachusetts Institute of Technology. Now replicated and adapted for students at multiple universities, the D-Lab model focuses on “Development through Dialogue, Design and Dissemination.” Espinosa’s work with D-Lab started at the University of California, Davis, where Kurt Kornbluth leads students through two D-Lab classes each year that result in feasibility studies and prototypes, with a focus on external clients’ needs. One of Kornbluth’s clients was the Horticulture Innovation Lab, which was seeking solutions for smallholder farmers, such as ways to keep fruits and vegetables cool during transport to market. “After serving as a D-Lab client, we saw potential value in offering D-Lab courses to students at universities in Honduras and Thailand where we have Regional Centers that act as hubs for our work,” said Britta Hansen, of the Horticulture Innovation Lab. “Not only could D-Lab provide skills to students—tomorrow’s agricultural leaders—but it could also support our partners in adapting new solutions to local farming challenges.” Each university that offers D-Lab must adapt the course to meet its needs and standards. With its learn-by-doing ethos, Zamorano seemed like a good match for D-Lab. “Instructor Jorge Espinosa discusses how to recycle an old saw blade with college students studying agriculture at the Panamerican Agricultural School, Zamorano, for a project during a D-Lab course in Honduras.” “[Zamorano] is very hands-on, but it can be mechanical, like a recipe. I think that is the magic of D-Lab, that the students are not given recipes,” Espinosa said. “We have adapted it to not be a class, but a work experience—a learn-by-doing module, Zamorano style.” So far 70 Zamorano students have participated in six D-Lab modules, intended to foster student creativity and provide a space to make mistakes and learn from them. In a curriculum review, 71 percent of Zamorano’s D-Lab students reported they would “definitely respond more creatively” when approaching future problems, and 87 percent reported being very comfortable with presenting new ideas in D-Lab. Overcoming an aversion to failure proved to be an essential component of the course. On average, students built more than three prototypes for every one prototype that worked as expected, with 80 percent learning “very much” from failed prototypes. “What I am taking [from D-Lab] is the magnificent experience of practically inventing something,” reported one student. “Like [Espinosa] said to us once: There are no mistakes, there are only opportunities to develop… You always learn in the end.” In addition to the D-Lab course at Zamorano, the Horticulture Innovation Lab team has started a D-Lab at Kasetsart University in Thailand, with 29 students in its first class. The Horticulture Innovation Lab Regional Centers continue to support and improve D-Lab courses at these universities. In Ghana, white-fleshed sweet potatoes already play an important role in food security, but orange-fleshed varieties have the potential to alleviate vitamin A deficiency while being incorporated into familiar foods. Vitamin A deficiency is the leading cause of preventable blindness in children and increases the risk of severe infections. In Ghana, vitamin A deficiency affects 72 percent of the country’s children under 5 years of age. Though interest in orange-fleshed sweet potato has been on the rise, widespread production and consumption of these vitamin A-rich varieties in Ghana still remains limited due to lack of awareness, limited availability of clean-planting materials and limited inclusion in the diet. As part of Feed the Future, Dr. Eunice Bonsi of Tuskegee University leads an international team working to increase the consumption of orange- and purple-fleshed sweet potatoes in Ghana, through activities that strengthen the crops’ value chain in three of Ghana’s sweet potato growing regions. Other team members include the University of Ghana, Pennsylvania State University, the Savannah Agriculture Research Institute (SARI), Ghana’s University for Development Studies and a number of other organizations. The team established sweet potato vine multiplication sites at SARI and at research facilities in the Northern and Upper East regions in Ghana. Lead farmers have planted the clean vines for demonstration and now serve as distributors of disease-free germplasm. Farmers were also trained in best management practices. The team conducted focus groups on orange and purple sweet potato palatability and preferences with local schools and non-governmental organizations. They also established demonstration gardens at schools and NGO sites. Through a newly developed partnership with local 4-H, the group is also working to promote the new varieties to youth. Researchers from SARI and Ghana’s University for Development Studies analyzed products already available in Ghana that use orange- or purple-fleshed sweet potatoes. The team has promoted the potatoes’ inclusion in traditional recipes, some of which have been served at SARI’s cafeteria. The team formulated a weaning food that incorporates the vitamin A-rich sweet potatoes, and have trained women entrepreneurs to process these colorful sweet potatoes into flour, purees and dehydrated chips. Local bakers are now using locally grown, orange sweet potato puree to make bread—and marketing it as more nutritious than other breads. 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Minnesota State Academies Health and Safety Plan for Students, Staff, and Visitors Updated as of September 1, 2023 Guiding Principles The Minnesota State Academies (MSA) are committed to providing safe and healthy campuses for our students, families, community, and employees. Decisions that were previously mandated by different government agencies are now made by MSA administrators, using best practices, guidance, and information available to us. Our health/safety plan will be reviewed periodically, and updates will continue to be implemented throughout the 2023-2024 school year in accordance with recommendations and/or guidelines from the Minnesota Department of Education (MDE), Minnesota Department of Health (MDH), and the Centers for Disease Control and Prevention (CDC) and as circumstances change on our campuses. While there are still some unknowns about the future of COVID-19 and its impact in Minnesota, our goal is to mitigate the potential for transmission of COVID-19 in our school and community and maintain the safety and health of everyone on our campuses. We have tried to address different concerns that parents/families and employees have shared with us through this plan. In it, you will find answers to the questions that have been asked, including what safety protocols are required around the campus. Changes and updates to this plan will be communicated with students, parents, family members, and employees promptly. At MSA, we have unique needs on our campus. Examples of our unique needs include: We serve students from all over the state. * We have a high percentage of students with health and/or other challenges. * About 40% of our students live on campus. * We also serve a wide range of age groups (12 months through age 22) on our campuses. * Many of our staff fall within high-risk categories. Due to those factors, our health/safety plan may have additional details and limitations beyond the usual mitigation strategies in neighboring school districts. We hope that you understand our unique situation and thank you for your continued support. Following these guidelines will require instruction, guidance, and support. We ask that you support your children's participation in school activities by: * teaching them to follow MSA health and safety guidelines, including possible restrictions of their social interactions with others. * helping them understand the importance of personal hygiene and handwashing. * helping them understand and practice social distancing and mask wearing, when required. * teaching and modeling proper coughing and sneezing practices. * as appropriate, getting vaccinated/boosted and encouraging others to do the same. * emphasizing the serious nature of this pandemic as well as other contagious illnesses and respecting the concerns of others in the community. * showing respect for those who may choose not to get vaccinated – there may be a variety of reasons for their decisions. Thank you for all your questions, patience, and continued support. Staying Up-to-Date with Vaccinations We continue to encourage all staff and students to stay up to date on routine vaccinations as this is essential to prevent illness from many different infections. Vaccines reduce the risk of infection by working with the body's natural defenses to help safely develop immunity to disease. For COVID-19, staying up to date with COVID-19 vaccinations is the leading public health strategy to prevent severe disease. Health Screening For any illness, including COVID-19, the most important aspect of self-screening is to Stay Home when Sick. People who have symptoms of illness, respiratory or gastrointestinal infections, such as cough, fever, sore throat, vomiting, or diarrhea, should stay home. Please stay home until 24 hours fever-free (without fever-reducing medication) and symptoms are significantly improved. Testing is recommended for people with symptoms of COVID-19. Staying home when sick can lower the risk of spreading infectious diseases, including COVID19, to other people. At-Home COVID-19 tests are available to staff and students (as long as supplies are available) from our health services department. Please call health services or speak with your supervisor if requesting an at-home test kit. Employees who stay home when sick should communicate with their supervisor following established call-in procedures. If they test positive for COVID-19, please also notify Human Resources. Upon arrival on campus or during the day, students who display symptoms of illness will be immediately referred to Health Services and our nurses will evaluate the students to determine if they can stay in school or must go home. Parents are responsible to have a plan to immediately pick up their child at any time that they might become sick throughout the year, including a back-up plan in case of severe weather and/or parent illnesses/conflicts. Students staying in our dorms will also be observed for symptoms by our residential educators. Students are encouraged to report symptoms and visit the health center for additional support as needed. In most cases, transportation companies will not be responsible for transporting students back home if the student displays a fever or additional symptoms. This underscores the importance of doing a health self-screening before sending students to school on district-provided transportation. We continue urge all families to practice healthy social distancing, hand hygiene, cough etiquette, and other mitigation measures at home and/or activities in the community, especially during interactions in large crowds, closed indoor spaces, and so forth so that exposure is minimized on our campuses. We have students from all over Minnesota and cross-contagion is something that we want to avoid as much as possible. Please continue to be aware of COVID19 contagion levels in your area. (CDC's COVID-19 by County) Other Safety Precautions We have established and will continue enhanced sanitation measures including frequent cleaning and disinfection of all classrooms, activity spaces, bathroom facilities, and residential spaces via an ionization process which involves spraying down each space with specially designed equipment which kills 99.9 percent of all viruses and bacteria. We have also installed specialized ionization systems to our HVAC system to provide an additional layer of sanitization to all our buildings. We will continue to encourage everyone to wash their hands frequently throughout the day. Updates to our Plan The MSA Instructional Leadership Team will continue to monitor health data and other factors and will send out communication to staff/families if there are changes in our health/safety protocols – as necessary, we may have to bring back restrictions and guidelines in previous versions of this health and safety plan to protect our students and staff. 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SEQ NO. 75 Presiding: Mr. President Senate of Maryland 2024 Regular Sessions QUORUM Corderman Voting Nay - 0 Not Voting - 1 McKay Excused from Voting - 0 Excused (Absent) - 0 Calendar Date: Jan 31, 2024 10:22 (AM) Legislative Date: Jan 31, 2024	<urn:uuid:bb7a4a6b-1e5a-44fa-8cae-f4043d92c096>	CC-MAIN-2024-33	https://www.mgaleg.maryland.gov/2024RS/votes/senate/0075.pdf	2024-08-16T05:12:01+00:00	crawl-data/CC-MAIN-2024-33/segments/1722641333615.45/warc/CC-MAIN-20240816030812-20240816060812-00444.warc.gz	662,136,979	91	eng_Latn	eng_Latn	0.715099	eng_Latn	0.715099	[ "eng_Latn" ]	false	docling	[ 255 ]	[ 0.287109375 ]	[ 0.6640625 ]	[ 1.8125 ]	[ 1.921875 ]	1	0	HuggingFaceFW/finepdfs
A Quiet Revolution Has Altered Financial Planning Goal-based planning is quietly changing the way Americans plan financially. While business coverage in the media focuses on hot stocks, corporate scandals, and movie box office numbers, this is a major story that can change your financial outlook. The difference between a goal-based financial plan and a traditional cash-flow-based plan is in the level of detail. Cash-flow plans are far more detailed and the details can get in the way. With a cash-flow plan, based on your current income, spending habits, savings rate, tax bracket, and portfolio, software is used to make projections about your financial future over the next 10, 20, or 30 years, or even longer. Each investment—every bond, every stock—is subject to a forecast breaking down the dividends, interest, and capital appreciation it is expected to provide over the period. Each expense must similarly be projected, year by year, from your mortgage to what you spend on food. Gathering all these numbers poses a problem. Many people simply never do it. Their financial plan ends before it ever begins. Apart from this human foible, a bigger problem with cash-flow based plans is that the projections rely on so many variables. Forecasting your rate of return on an individual security or what you will spend on gasoline during the next 30 years is too iffy. If your return forecast is off by a percentage point or two in either direction, your plan can be well off the mark. In other words, while intuitively you may believe that more data makes a financial plan more reliable, the opposite may actually be true. Limiting the variables may indeed provide a better view of the future. That’s the approach of goal-based planning. With a goal-based financial plan, you essentially admit that predicting your income and expenses with accuracy is too difficult. Instead of relying on projections of your income and expenses, goal-based plans focus on how much you are saving now and the return you expect to earn. In contrast to traditional financial planning, which calculates how much you could save, given your current income, expenses, and taxes, goal-based planning starts with how much you are saving. Instead of estimating your retirement income by requiring you to forecast returns on individual securities and accounts over the next 10, 20, or 30 years, a goal-based plan estimates how much of a nest egg you’ll accumulate by making a single assumption about the return on your total portfolio. Instead of requiring a budget forecast based on dozens of items, your expenses are estimated based on your major goals in life. The focus on your goals makes a plan more meaningful to most people. Bob Curtis, the founder of Pie (Continued on page 4) Rollercoaster Ride Anyone? No Thanks!! At times, this stock market will give even the biggest iron-stomached rider a run for their money. The ups and downs of the market may leave you a bit queasy. But, as this ride is for the most part, uncontrollable, you can’t afford to take a blind eye to planning your retirement, education, or just LIFE! You need to take control. This reminder came very close to home for us when Dave had his heart attack back in May. As he continues to recover, planning has allowed for him, his family, and us to sleep better knowing that our bases are covered. For you too, making sure that death or incapacitation does not put a financial burden on the ones around you will leave a legacy to be admired! Most of the articles included in this newsletter center around planning for uncertainty. Enjoy the article discussing goal-based planning, an easier way to plan for the future. Also discussed is what NOT to forget to include in your will when planning for the distribution of assets after you’re gone. Life insurance can be a real savior! Read about eight things to look for when purchasing (or if you already own) insurance. Have you ever wondered if you can put more money away—and furthermore, defer taxes on that money? An article on how using a Defined Benefit plan may be the answer. Lastly, how about a test? Put your thinking caps on and have fun with our Investment News Junkie quiz. Enjoy the rest of your summer! Jim Joseph, CFP® Client Relations Manager Are You An Investment News Junkie? It’s called market noise, and you know better than to let it distract you from your long-term financial plan. But it never hurts to stay informed, so you bookmark your favorite market news sites, never skip the paper’s money section, and tune in TV’s financial pundits. Use this quiz to gauge how well you paid attention last year. 1. Which currency did not gain ground against the dollar in 2006? a. yen b. euro c. pound d. Swiss franc 2. During 2006, the price of a barrel of light sweet crude oil peaked during what month: a. January b. May c. July d. November 3. In 2006, margin debt (funds borrowed against securities) reached $270.53 billion. When was the only other time margin debt exceeded $270 billion? a. 1987 b. 2000 c. 2003 d. None of the above 4. A radio network, a casino, and a supermarket chain were in the top 10 for 2006 in which category? a. initial public offerings b. stock market gainers c. private equity buyouts d. all of the above 5. Incidents involving CNBC star Maria Bartiromo spelled trouble for: a. former Citigroup executive Todd Thompson b. Federal Reserve chair Ben Bernanke c. both of the above d. neither of the above 6. True or false: In 2006, the housing boom faltered, with a decline in both the number and median price of existing home sales. 7. Commercial real estate in 2006 saw a decrease in vacancy rates and a rise in the average per square foot cost for: a. offices b. retail space c. industrial space d. all of the above 8. Drawn by the promise of big returns, investors poured a net $92 billion into hedge funds during the first nine months of 2006. For the year, the Credit Suisse/Tremont Hedge Fund Index outperformed: a. the Standard & Poor’s 500 Stock Index b. the Dow Jones World Index c. the Lehman Brothers U.S. Aggregate Bond Index d. all of the above 9. In 2006, measured in U.S. dollar terms, how did international market regions fare (from best to worst)? a. Latin America, Europe, Asia/Pacific b. Asia/Pacific, Europe, Latin America c. Europe, Asia/Pacific, Latin America d. Latin America, Asia/Pacific, Europe 10. Art prices soared in 2006 as new investors and collectors flooded into the market. Which artist’s work brought the highest price at auction? a. Pablo Picasso b. Willem de Kooning c. Andy Warhol d. Rembrandt 11. True or false: At year’s end, bond investors, apparently worried about the long-term health of the economy, were paying higher prices for 2-year U.S. Treasuries than for 10-year Treasuries. 12. The best and worst performing U.S. market sectors, respectively, in 2006 (as tracked by Dow Jones Indexes) were: a. telecommunications; retail b. oil and natural gas; construction materials c. media; chemicals d. food and beverage; travel and leisure. Answers: 1a; 2c; 3b; 4c; 5c; 6 true; 7d; 8c; 9a; 10b; 11 false; 12a. A Defined Benefit Plan Lets You Sock Away Large Amounts If Is your 401(k) not enough? With a Defined Benefit (DB) plan, you can sock away around $2 million for retirement over a relatively short period of time while deferring taxation. Plus, you can still contribute to a 401(k), SEP, or other personal retirement account. If you’ve gotten a late start on retirement saving, a DB plan could help you quickly catch up. But it won’t have much effect unless you can afford to fund it generously—for yourself and your employees. Unlike a Defined Contribution plan, such as a 401(k), which is built around what goes into it, a DB plan is based on what comes out during retirement. A fully funded plan could guarantee that you’ll receive as much as $2 million, either in a lump sum or as annuitized payments. To make sure you get there, actuarial calculations determine how much you must contribute each year. The size of that annual contribution is influenced by many factors, including the number of employees participating, their age and salary, and performance of the plan’s investments. In good years for the market, your contribution may be smaller, while a weak market could require you to write a larger check. A DB plan lets you receive an annual benefit equal to 100% of your company salary, up to $180,000 a year, until your benefit reaches the $2 million limit. With no limit on the annual contribution, a DB plan can be the ultimate catch-up tool for retirement for a small business owner with few employees and who is nearing retirement. Assuming you have the cash to make the maximum contributions allowed, you could accumulate $2 million in as little as a decade, depending on the return on plan investments. Meanwhile, you can continue to What Else Should Be In Your Will? When writing a will, most people focus on big assets—real estate, securities, and bank accounts. Often overlooked are smaller items, such as jewelry, paintings, and family heirlooms, as well as other instructions that have nothing to do with assets—whether you want to be buried or cremated, for example, or who should clean out your house after you’re gone. This begs the question: Exactly what, beyond the obvious, should be in your will? According to Mary Randolph, author of The Executor’s Guide: Settling a Loved One’s Estate or Trust (Nolo, 2006), “you can do pretty much whatever you want in your will.” The question is, will what you want benefit your descendants—or only add to the confusion? Many people writing wills indicate exactly who should receive specific big-ticket items—a car, a boat, the summer house—then stipulate that the rest of the estate be divided equally among all heirs. That’s nice and simple, says Randolph, but it could spark family disputes. “Even in families in which everyone gets along fine, in times of stress, disagreements can bubble up,” Randolph says. Your goal should be to leave specific instructions without getting too complicated. Attaching conditions to a gift, for example, can be problematic. Suppose you’d like to provide your daughter with a financial reward only if she attends college—but what does “going to college” really mean? Does she have to attend full time, or can she take night classes? Does she have to enroll in a four-year university, or is a community college or unaccredited online program acceptable? And is there a specific time frame? What if she attends college in 50 years—does the estate have to reserve enough money to pay her then? Randolph recommends you think about what material goods are particularly important to your family—your grandmother’s china, a favorite painting, an 18th century armoire—and make specific bequests of those items. But those instructions don’t necessarily have to be in your will. About half of U.S. states accept a “property memorandum”—a list, outside your will, of personal items you want to leave to certain people. If you choose this route, your will can simply indicate that you wish your personal effects to be divided according to the attached memorandum. This approach saves you the hassle of rewriting and re-notarizing your will if you acquire additional items you want to give away or change your mind about who gets what. For the remainder of your personal effects, try to come up with a way for heirs to divide things up among themselves. For example, you might let each descendant pick one item and then another, until everything is accounted for. Or, you might assign everyone a certain number of points, which can be used to bid on individual items. “That way, your children can decide what’s important to them,” Randolph says. “John may want to spend his 100 points on furniture, while Mary prefers to spend hers on a snow globe.” You can also make specific instructions in your will—for example, that your son gets the job of cleaning out your house, or that you want to be cremated, not buried. But here you may find yourself in tricky legal territory. First, you need to make such a request in language suggesting it is legally binding. “Saying, ‘I want my son to clean out my house,’ is not binding,” says Randolph. “But saying, ‘I appoint my son as executor and direct that he shall sort and divide my personal belongings as he sees fit’” is. Next, consider when your will is likely to be read. If you want to be cremated, it’s better to make that request in a final arrangements document or a similar form, because your will probably won’t be reviewed until after the funeral. Finally, realize that whether you make such requests in your will or another document, they may not have the weight of law. Most state laws don’t say anything about how to make final instructions legally binding. Those that do require a form that must be witnessed and notarized—and even then, the instructions have to be followed only if they’re reasonable. “You probably can’t say you want to be buried in a Cadillac,” says Randolph. “Your best bet is to write down what you want according to the laws of your state, and hope for the best.” --- You Can Overcome Some Obstacles fund your own Defined Contribution plan, deferring taxation on another $45,000 in income each year. The chief drawback to a DB plan is that if you have employees, you’ll have to fund their retirement benefit, too. That may not be a huge burden if your workers are mostly young and earning low salaries. But if you’re paying into the plan for well-paid employees nearing retirement age, the total contribution required could amount to a substantial drain. In general, any employee who is at least 21 and has worked for the company for a year or more must be covered by your plan. Of course, making contributions for employees won’t be an issue if yours is a one-person business. In fact, even those without a corporate structure may establish a DB plan. DB plans offer estate planning advantages. If your plan is set up to continue payments to a surviving spouse after your death, the ongoing income won’t be taxed as part of your estate, though your spouse will pay income tax on the payouts. In contrast, an inherited IRA or 401(k) could be subject to estate tax. Eight Ways To Save On Life Insurance The price you pay for life insurance largely depends on things you can’t or don’t want to change: your age, health, habits, and other lifestyle choices, such as smoking and skydiving. Still, there are ways to save when buying a policy. Buy the type of insurance you need. Though there are dozens of variations, life insurance basically comes in two flavors: term or permanent. With a term policy, you pay an annual premium and, assuming you die during the term of the policy, the insurer guarantees it will pay your beneficiaries the face amount of the policy upon your death. A permanent policy does the same thing, but premiums are higher, because you build up cash value that you can borrow against or withdraw if you cancel the policy. The right type of insurance for you depends on several factors, including your age, family situation, and financial goals. Often a term policy can save you money. Don’t be loyal to one company. You may receive free or discounted life insurance through a current or former employer. But you’ll probably need to supplement that coverage, and buying additional insurance from that insurer may not get you the best deal. Keep in mind, though, that you’ll likely have to qualify medically for a policy you buy on the open market, which may not be required if you buy through an employer. Negotiate. Smoke one cigar a month? You’ll probably be lumped into the same category as someone who smokes two packs of cigarettes a day. And a dangerous activity, such as skydiving, that you tried just once could also ratchet up your premium, even if you have no intention of doing it again. Your premium may be negotiable, if you write to the insurer explaining why you think you should qualify for a better rate. Find a specialist if you have health problems. Some insurers specialize in covering people with heart disease, cancer, or diabetes. These companies employ underwriters trained to differentiate, for example, between people with high blood pressure who take their medication regularly and those whose hypertension is uncontrolled. Buy in bulk. If you’re planning to buy $950,000 of coverage, a $1,000,000 policy may actually cost less. Insurance is priced in multiples of $250,000, and an insurer may charge disproportionately more for an in-between amount. Avoid hidden fees. Before you sign up for any convenience, find out how much it costs. For example, some insurers charge for deducting monthly payments automatically from your checking account. Choose riders carefully. An insurer may pad your policy with extras called riders. For example, the accidental-death rider, more commonly known as double indemnity, pays twice the normal death benefit if you perish in an accident. But the chance of that happening is quite small and may not be worth the extra cost. Be sure you understand what riders you are buying. Review. It’s wise to review your policies every two or three years, especially permanent policies, to see if they can be leveraged or exchanged into a new lower-cost policy. --- A Quiet Revolution (Continued from page 1) Technology, which makes goal-based planning software for financial professionals, cites the example of John and Ann, a couple who are both 59 years old and want to retire within four or five years. Whereas a traditional approach to planning might determine that the couple needs a retirement income of $124,000 a year to afford everything they want and that the couple’s savings can fund only about three-quarters of that amount, goal-based planning separates out John and Ann’s goals and lists them in order of importance. It determines, for example, that they need $72,000 a year to fund their basic living expenses. It estimates that they may be able to afford additional goals—$20,000 a year for travel until age 78; $10,000 annual gifts to their children for 10 years; a new $30,000 luxury car every four years; a $20,000 second car every six years; and additional outlays for dining, entertainment, and other niceties. Those goals aren’t all of equal importance to Ann and John. Obviously, meeting basic living expenses is a must; next, in order of importance, come the luxury car, travel, the second car, the children’s gifts, and extra living expenses. It turns out John and Ann can retire at age 63 and expect to fund almost all of their goals, though they’ll likely have to pinch pennies on entertainment. Approaching financial planning this way has several advantages. For one thing, it’s hopeful. Instead of simply saying you will fall short of your goals and run out of money during retirement, the goal-based approach tells you what you can afford. It allows you to choose which goals are most important to you and design strategies to improve your situation. For example, retiring two years later might allow you to fund all of your goals, and switching to a riskier portfolio could be worth considering as well. Creating a goal-based plan with fewer data inputs makes planning easier. Plans can easily be updated, making them more likely to be reviewed every year. Instead of the 75-page reports spawned by cash-flow-based plans, which often end up collecting dust, you receive a succinct report showing your progress toward meeting your goals annually. Our firm uses goal-based planning because we believe it serves you better. To find out more, please don’t hesitate to call us.	<urn:uuid:ea91aaae-5b9e-4f91-98ba-b389b7e7e64b>	CC-MAIN-2017-51	http://fsainvest.com/files/newsletters/36844158.pdf	2017-12-15T16:06:20Z	crawl-data/CC-MAIN-2017-51/segments/1512948575124.51/warc/CC-MAIN-20171215153355-20171215175355-00692.warc.gz	112,307,148	4,299	eng_Latn	eng_Latn	0.998307	eng_Latn	0.998902	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	rolmOCR	[ 4276, 9009, 14413, 19873 ]	[ 0.73828125 ]	[ 3.046875 ]	[ 3.484375 ]	[ 2.765625 ]	1	0	HuggingFaceFW/finepdfs
OXIDATION STUDIES II. Oxidation of Water and Tertiary Alcohols by Cobaltic Ions BY K. JIJEE AND M. SANTAPPA, F.A.Sc. (University Department of Physical Chemistry, Madras-25, India) Received October 27, 1965 ABSTRACT Studies on oxidation of water by cobaltic ions in perchloric, nitric and sulfuric acid media in the temperature range 20–30° C. at constant ionic strength of 2·2 M were carried out. An overall order of 3/2 for cobaltic ion concentration was observed in perchloric, nitric acid media and at low $[Co^{3+}] < 4 \times 10^{-3} \text{M}$ in sulfuric acid medium. At high $[Co^{3+}]$ in sulfuric acid medium an order 2 was observed. In all the three acid media an inverse dependence of the rates on $[H^+]$ was noticed. From the experimental results, an acid-independent reaction path was inferred in perchloric and nitric acid media. The effect of ionic strength, $HSO_4^-$ and initially added cobaltous ions as well as temperature was studied. Suitable reaction schemes were suggested to explain the experimental results and activation energy values for some of the rate parameters were evaluated. Kinetic studies on oxidation of tertiary amyl and tertiary butyl alcohols in sulfuric acid medium and that of the former in perchloric acid medium were carried out. The reaction rates were found to vary linearly with $[Co^{3+}]$ and [Alcohol]. From the effect of acidity and of $[HSO_4^-]$ in $H_2SO_4$ medium on the reaction rates it was concluded that in $HClO_4$ medium CoOH$^{2+}$ species were the active entities while in $H_2SO_4$ medium Co$^{3+}$ as well as CoOH$^{2+}$ species were the active entities. The influence of ionic strength, temperature, etc., on the reaction rates were studied and activation energy values for some rate constants were evaluated. INTRODUCTION Studies on oxidation of water by trivalent cobalt in nitric acid medium by Noyes and Deahl$^1$ did not lead to satisfactory explanation of the mechanism and effect of $[H^+]$ on the reaction rate was also not studied. Bawn and White$^2$ in their studies in $HClO_4$ and $H_2SO_4$ reported first as well as second order with reference to $[Co^{3+}]$ along with a variable order for $[H^+]$ (1 to 2) and their mechanism did not very well explain their results. On the other hand Baxendale and Wells$^3$ reported a 3/2 order for $[Co^{3+}]$ and an inverse square dependence of $[H^+]$ on the rate law for cobaltic ion disappearance. All the previous investigations were confined to low acidities ($<0.1\text{N}$) only. We present in this paper our results on oxidation of water by Co$^{3+}$ in perchloric, nitric and sulfuric acid media at $[H^+] = 0.4\text{M} - 2.0\text{M}$ at constant ionic strength of $2.2\text{M}$. Hoare and Waters$^4,5$ have reported results on oxidation of tertiary butyl alcohol in HClO$_4$ medium at $10^\circ\text{C}$. at $[H^+] = 0.325\text{M} - 3.25\text{M}$ and of other tertiary alcohols in methylcyanide-water mixture at $15^\circ\text{C}$. at $[\text{HClO}_4] = 1.57\text{M}$. The results on oxidation of tertiary butyl (T.B.A.) and amyl alcohols (T.A.A.) in sulphuric acid medium and tertiary amyl alcohol in HClO$_4$ medium are presented and discussed in this paper. EXPERIMENTAL Reagents.—The perchlorate$^6$ and sulfate$^2$ of Co$^{3+}$ were prepared by methods already described. Cobaltic nitrate was prepared along the same lines as for the perchlorate. Tertiary butyl alcohol (T.B.A.) and tertiary amyl alcohol (T.A.A.) (B.D.H.A.R. reagents) were distilled and the middle fractions used for all experiments. Other reagents, sodium or potassium bisulfate, sulfuric acid, perchloric acid, nitric acid, sodium nitrate, ceric ammonium nitrate, ferrous ammonium sulfate, etc., were of A.R. grade. Sodium perchlorate used for adjustment of ionic strength was prepared by neutralization of A.R. sodium carbonate with A.R. perchloric acid. Water doubly distilled over permanganate and passed through a column of “Bioderminrolit” mixed bed ion exchange resin was used for the preparation of all reagents. Estimations and rate measurements.—Methods of estimation of [Co$^{3+}$], total cobalt content, free acid, etc., in solution were as already described.$^6$ Experiments were conducted in long pyrex tubes fitted with B-24 joints. Solutions containing requisite amount of free acid and appropriate sodium salt of the free acid (and alcohol in the case of oxidation of alcohol experiments) were thermostated at the required temperature and deaerated with oxygen-free nitrogen. The cobaltic salt was added at the end of the deaeration period. The reaction was arrested by the addition of excess standard Fe$^{2+}$ and rates of cobaltic ion disappearance, $-R_{co}$, were computed as described.$^6$ RESULTS AND DISCUSSION A. Oxidation of Water Studies on oxidation of water were carried out in the temperature range 20–30°C. At the acidities ([H\(^+\]) = 0.4–2.0 M) employed in this work appreciable decomposition of water by Co$^{3+}$ was observed. Rates in sulfuric acid medium were usually greater than in perchloric or nitric acid media. (i) $HClO_4$ medium.—A 3/2 order with reference to [Co$^{3+}$] (Fig. 1, A, B) and an inverse dependence of [H$^+$] (Fig. 1, lines C–G) on $-R_{co}$ were observed. Plots of $-R_{co}$ vs. 1/[H$^+$] at various initial [Co$^{3+}$] were devoid of intercepts on the ordinates indicating that cobaltic ions (hydrated) as such were not important as the active species. Baxendale et al.$^3$ also found a 3/2 order for [Co$^{3+}$] but with an inverse square dependence of [H$^+$] on $-R_{co}$. They employed low acidity, [H$^+$] < 0·1 M. ![Graph](image) Fig. 1. Variation of $-R_{co}$ with [Co$^{3+}$] and [H$^+$] in $HClO_4$ medium. A and B: $-R_{co}$ vs. [Co$^{3+}$]$^{1.6}$ at Temp. 30°C. and 20°C. respectively and [H$^+$] = 1·2 M; $\mu$: 2·2 M. C, D, E, F, G: $-R_{co}$ vs. 1/[H$^+$]; C at [Co$^{3+}$]: 26·62×10$^{-9}$ M, Temp. 20°C. $\mu$: 2·2 M and D, E, F, G at [Co$^{3+}$]: 32·28×10$^{-9}$ M, 18·81×10$^{-9}$ M, 13·14×10$^{-9}$ M and 7·925×10$^{-9}$ M respectively all at $\mu$: 2·2 M, Temp. 30°C. (ii) $HNO_3$ medium.—In nitric acid medium results were similar to those in perchloric acid (Fig. 2, E, F). The plots of $-R_{co}$ vs. 1/[H$^+$] however left intercepts on the ordinates (Fig. 4, E) emphasizing the importance of the acid-independent reaction of Co$^{3+}$ (aq.) + water. The latter aspect was studied in detail along the following lines. At a series of different initial [Co$^{3+}$], [H$^+$] was varied at constant ionic strength. Plots of $-R_{co}$ vs. 1/[H$^+$] were linear (acid-dependent reaction) leaving different intercepts for different $[Co^{3+}]$. The slopes of these plots were proportional to $[Co^{3+}]^{3/2}$ (Fig. 2, C, D) while the intercepts to $[Co^{3+}]$ (Fig. 2, A, B). The acid-dependent rate was greater than the acid-independent rate by a factor of 5, the disparity increasing with increasing $[Co^{3+}]$ and hence giving an overall order of $3/2$ for $[Co^{3+}]$ in $-R_{co}$ vs. $[Co^{3+}]$ plots. ![Graph](image) Fig. 2. HNO$_3$ medium. A, B: Intercept vs. $[Co^{3+}]$ at 20° C. and 30° C. respectively at $\mu: 2.2 M$. C, D: Slope vs. $[Co^{3+}]^{1.6}$ at 20° C. and 30° C. respectively at $\mu: 2.2 M$; E, F: $-R_{co}$ vs. $[Co^{3+}]^{1.5}$ at $[H^+]: 1.2 M, \mu: 2.2 M$; E, at 20° C. F at 30° C. (iii) $H_2SO_4$ medium.—In sulfuric acid medium the order with reference to $[Co^{3+}]$ was found to depend on the initial $[Co^{3+}]$; at $[Co^{3+}] \leq 4 \times 10^{-3} M$, a 3/2 order (Fig. 3, C, D) and at $[Co^{3+}] > 4 \times 10^{-3} M$, an order of 2 for $[Co^{3+}]$ (Fig. 3, A, B) were observed. Plots of $-R_{co}$ vs. $1/[H^+]$ at various initial $[Co^{3+}] (> 4 \times 10^{-3} M)$ were linear (Fig. 4, F) with intercepts on the ordinates, the latter emphasizing the direct reaction between Co$^{3+}$ (aq.) and water. The plots of $-R_{co}$ vs. $1/[H^+]$ at low $[Co^{3+}]$ left no intercepts on the ordinate but at lower acidities the plots were flat and almost parallel to the abscissa (Fig. 3, E). A similar behaviour was observed with high $[Co^{3+}]$ also. Probably at low acidities inert ion pair sulfate complexes of the type suggested by Sutcliffe and Weber$^8$ are formed which may be slowly converted to inner sphere complexes. The formation of these inert complexes (ion pair as well as inner sphere) results in constancy of rates $-R_{co}$ with variation in $[H^+]$. For high $[Co^{3+}]$, intercepts varied as $[Co^{3+}]$ (Fig. 4, A, B) while the slopes varied as $[Co^{3+}]^2$ (Fig. 4, C, D). The magnitude of acid-independent ![Graph](image) Fig. 3. Variation of $-R_{co}$ with $[Co^{3+}]$ and $[H^+]$ in $H_2SO_4$ medium; all at $\mu: 2\cdot2 M$. A, B: $-R_{co}$ vs. $[Co^{3+}]^2$ at $[H^+]: 1\cdot0 M$ and Temp. 30° C. and 20° C. respectively. C and D: $-R_{co}$ vs. $[Co^{3+}]^{1.5}$ at $[H^+]: 1\cdot0 M$ and Temp. 30° C. and 20° C. respectively. E: $-R_{co}$ vs. $1/[H^+]$ at $[Co^{3+}]: 2\cdot324 \times 10^{-3} M$, Temp. 20° C. rate constant being less than the acid-dependent rate constant by a factor of 100, it was understandable that an overall order of two for $[Co^{3+}]$ was obtained from plots of $-R_{co}$ vs. $[Co^{3+}]$. From the foregoing experimental results the summary of the rate laws in various acid media is as follows: \[ HClO_4 \text{ medium: } -R_{co} = \frac{a_1 [Co^{3+}]^{3/2}}{[H^+]} \quad \text{at } \mu: 2\cdot2 M \] $(a_1 = 2\cdot242) \times 10^{-4} \text{ at } 20^\circ C.; 9\cdot084 \times 10^{-4} \text{ at } 30^\circ C.$ $E_{a1} = 24\cdot69 \text{ K. cals. mole}^{-1}$ HNO₃ medium: \[ -R_{co} = a [Co^{3+}] + \frac{b [Co^{3+}]^{3/2}}{[H^+]} \] at $ \mu: 2.2 \text{ M} $ \[ a = 8.8 \times 10^{-6} \text{ at } 20^\circ \text{C}; \quad 11.53 \times 10^{-6} \text{ at } 30^\circ \text{C}; \] \[ E_a = 4.773 \text{ K. cals. mole}^{-1}. \] \[ b = 2.05 \times 10^{-4} \text{ at } 20^\circ \text{C}; \quad 6.519 \times 10^{-4} \text{ at } 30^\circ \text{C}; \] \[ E_b = 20.44 \text{ K. cals. mole}^{-1}. \] H₂SO₄ medium: at \[ [Co^{3+}] < 4 \times 10^{-3} \text{ M} \] \[ -R_{co} = \frac{a_2 [Co^{3+}]^{3/2}}{[H^+]} \text{ at } \mu: 2.2 \text{ M}. \] \[ (a = 2.889 \times 10^{-3} \text{ at } 30^\circ \text{C}; \quad 1.131 \times 10^{-3} \text{ at } 20^\circ \text{C}; \] \[ E_a = 16.58 \text{ K. cals. mole}^{-1}) \] and at \[ [Co^{3+}] > 4 \times 10^{-3} \text{ M} \] \[ -R_{co} = a' [Co^{3+}] + \frac{b' [Co^{3+}]^2}{[H^+]} \text{ at } \mu: 2.2 \text{ M} \] \[ a' = 11.19 \times 10^{-5} \text{ at } 30^\circ \text{C}; \quad 2.083 \times 10^{-5} \text{ at } 20^\circ \text{C}; \] \[ E_{a'} = 29.7 \text{ K. cals. mole}^{-1}; \] \[ b' = 19.33 \times 10^{-3} \text{ at } 30^\circ \text{C}; \quad 6.183 \times 10^{-3} \text{ at } 20^\circ \text{C}; \] \[ E_{b'} = 20.15 \text{ K. cals. mole}^{-1}. \] Effect of ionic strength.—Increase of ionic strength in HClO₄ and HNO₃ ($ \mu = 0.4-4 \text{ M} $) increased the rate while in H₂SO₄ the opposite effect was observed (cf. Table I, a). This is probably due to the effect of $ \mu $ on the various equilibria involved in the different acid media in the presence of Co³⁺ ions. Initial addition of Co²⁺.—Initial addition of Co²⁺, $[Co^{2+}]/[Co^{3+}] = 0.5 - 20$ in HClO₄ and HNO₃ had no effect on the rates while in H₂SO₄ the rates were slightly retarded probably due to complexing of Co³⁺ (aq.) + SO₄⁻ (the latter from CoSO₄ added) which decreased the effective concentration of reactive cobaltic species, CoSO₄⁺ or Co³⁺ (aq.), etc. This was further supported by the fact that addition of Co(ClO₄)₂ in H₂SO₄ medium at constant ionic strength had no influence on the rates. These results further indicate that exchange reactions between Co$^{2+}$ (aq.) and Co$^{3+}$ (aq.)\textsuperscript{10,11} as well as the various species of Co$^{3+}$ (aq.) in the various acid media, are not of any mechanistic significance. Fig. 4. H$_2$SO$_4$ medium, all at $\mu$: 2·2 M. A, B: Intercept vs. [Co$^{3+}$] at Temp. 30° C. and 20° C. respectively; C and D: Slope vs. [Co$^{3+}$]$^2$ at Temp. 30° C. and 20° C. respectively; E and F: $-R_{Co}$ vs. 1/[H$^+$]; E: HNO$_3$ medium, [Co$^{3+}$]: 24·55×10$^{-3}$ M, Temp. 30° C. F: H$_2$SO$_4$ medium, [Co$^{3+}$]: 11·55×10$^{-3}$ M., Temp. 30° C. Mechanism.—Bawn and White\textsuperscript{2} as extension to studies of Oberer\textsuperscript{7} and Noyes and Deahl\textsuperscript{1} indicated the variable nature of the order of Co$^{3+}$, being unity at low [Co$^{3+}$] and 2 at high [Co$^{3+}$] and an inverse variable order for [H$^+$]. A mechanism based on the reactions (i) Co$^{3+}$ + OH$^-$ and (ii) CoOH$^{2+}$ + OH$^-$, both producing OH$^-$ which dimerised to H$_2$O$_2$ and the latter decomposing and liberating O$_2$ was suggested. The higher order 2 was explained on the basis of probable dimers like (Co–SO$_4$–Co)$^{+4}$ in H$_2$SO$_4$ and (Co–O–Co)$^{+4}$ in HClO$_4$ being the active species. On the other hand, studies by Baxendale and Wells\textsuperscript{3} have shown three halves order for [Co$^{3+}$] and an inverse second order for [H$^+$] and a suitable mechanism involving interaction of monomeric and dimeric species from the hydrolysis of Co$^{3+}$ (aq.) was suggested. It is to be noted however that Baxendale \textit{et al.} have used [H$^+$] < 0·1 N in HClO$_4$ and H$_2$SO$_4$ media in which region extensive hydrolysis of Co$^{3+}$ (aq.) and the formation of dimeric species was quite probable. In our studies, while the 3/2 order for $[Co^{3+}]$ in $HClO_4$, $HNO_3$ and $H_2SO_4$ at low $[Co^{3+}]$ is in agreement with the results of Baxendale et al., a strict $[H^+]$^{-1} dependence in contradistinction to $[H^+]$^{-2} dependence reported by the latter workers, was observed. Our results, however, may be explained on the basis of a mechanism slightly different (Step 4 below) from that proposed by Baxendale et al.: 1. $CoOH^{2+} + (HO - Co - O - Co)^{3+} \xrightarrow{k_1 \text{ slow}} 3Co^{2+} + OH^- + HO^o_2.$ 2. $HO^o_2 + CoOH^{2+} \xrightarrow{\text{fast}} Co^{2+} + H_2O + O_2.$ 3. $Co^{3+} + H_2O \xrightleftharpoons{K_1} CoOH^{2+} + H^+$ \[2CoOH^{2+} \xrightleftharpoons{K_2} [Co - O - Co]^{4+} + H_2O.\] The new equilibrium now assumed is 4. $[Co - O - Co]^{4+} + H_2O \xrightleftharpoons{K_3} (HO - Co - O - Co)^{3+} + H^+.$ On the basis of this mechanism the rate is given by \[-R_{co} = \frac{K_3k_1}{K_2^3} \frac{[(Co - O - Co)^{4+}]^{3/2}}{[H^+]} \approx \frac{K [Co^{3+}]^{3/2}}{[H^+]}. \] In $HNO_3$ medium it is assumed that the same type of equilibria are involved since addition of $NO_3^-$ in $HClO_4$ medium at constant $\mu$ had no effect on the rates which suggested that probably no nitrate ion pairs were formed. In $H_2SO_4$ medium however addition of $HSO_4^-$ at constant $\mu$ enhanced the rates with increasing $[HSO_4^-]$, but at higher $[HSO_4^-]$, a slight retardation was observed (ref. Table I, b) the latter phenomenon occurring probably due to formation of stable inert poly-sulfato complexes of $Co^{3+}$ (monomeric, dimeric, etc.). The initial increase in rates with increasing $[HSO_4^-]$ evidently indicates the involvement of sulfate ion pair (or inner sphere) complexes in the reaction sequence. Our results in $H_2SO_4$ medium at $[Co^{3+}] < 4 \times 10^{-3} M$ may be explained on the basis of a similar mechanism assuming $CoSO_4^+$ species instead of $CoOH^{2+}$ as the active species. Our results in $H_2SO_4$ medium at (a) Effect of ionic strength on the rates of oxidation of water by cobaltic ions HNO₃ medium: [H⁺] = 0·362 M; Temp. = 20° C., [Co³⁺] = 8·358 × 10⁻³ M \| μ, M (HNO₃ + NaNO₃) \| 0·4125 \| 0·8124 \| 1·346 \| 2·401 \| 2·945 \| 3·478 \| 4·011 \| \|----------------------\|--------\|--------\|-------\|-------\|-------\|-------\|-------\| \| − R_co × 10⁷ m/l/sec.\| 3·210 \| 3·505 \| 4·005 \| 4·406 \| 5·005 \| 5·805 \| 6·209 \| H₂SO₄ medium; [H⁺] = 0·5026 M; Temp. = 20° C.; (Co³⁺): 2·2 × 10⁻² M \| μ, M (H₂SO₄ + KHSO₄) \| 0·8 \| 1·4 \| 2·0 \| 2·6 \| 3·2 \| \|----------------------\|--------\|--------\|-------\|-------\|-------\| \| − R_co × 10⁶ m/l/sec.\| 5·937 \| 5·104 \| 4·583 \| 4·429 \| 4·271 \| (b) Effect of [HSO₄⁻] on the rates of water oxidation in H₂SO₄ medium by cobaltic ions [H⁺]: 0·3981 M, Temp. 20° C.; μ: 2·2 M; [Co³⁺]: 3·684 × 10⁻³ M (H₂SO₄ + NaHSO₄), M \| 0·398 \| 0·695 \| 0·945 \| 1·345 \| 1·745 \| 2·145 \| \|-------\|-------\|-------\|-------\|-------\|-------\| \| 4·783 \| 6·327 \| 7·360 \| 7·790 \| 7·582 \| 7·218 \| [H⁺]: 0·618 M; Temp. 20° C.; μ: 2·4 M; [Co³⁺]: 15·25 × 10⁻³ M (H₂SO₄ + NaHSO₄), M \| 0·618 \| 0·971 \| 1·271 \| 1·571 \| 1·871 \| 2·171 \| \|-------\|-------\|-------\|-------\|-------\|-------\| \| 3·591 \| 3·869 \| 3·994 \| 3·987 \| 3·885 \| 3·766 \| High [Co³⁺], second order for [Co³⁺] together with the 1/[H⁺] dependence can be satisfactorily explained as follows: \[ \text{Co}^{3+} + \text{HSO}_4^- \xrightleftharpoons{K_4} \text{CoSO}_4^+ + \text{H}^+ \] \[ \text{CoSO}_4^+ + \text{Co}^{3+} + \text{H}_2\text{O} \xrightleftharpoons{K_5} (\text{Co} - \text{O} - \text{CoSO}_4)^{2+} + 2\text{H}^+ \] \[ (\text{Co} - \text{O} - \text{CoSO}_4)^{2+} + \text{H}_2\text{O} \xrightarrow{k_2 \text{ slow}} 2\text{Co}^{2+} + \text{SO}_4^- + 2\text{OH}^\circ \] \[ 2\text{OH}^\circ \longrightarrow \text{H}_2\text{O} + \frac{1}{2}\text{O}_2 \] On the basis of this mechanism, the rate is given by \[ -R_c = k_2 (\text{Co} - \text{O} - \text{CoSO}_4)^{2+} \] \[ = k_2 K_5 \frac{[\text{CoSO}_4^+] [\text{Co}^{3+}]}{[\text{H}^+]^2} = \frac{K [\text{Co}^{3+}]^2}{[\text{HSO}_4^-] [\text{H}^+]} \] if \[ [\text{CoSO}_4^+] \approx [\text{Co}^{3+}]_{\text{Total}} \quad \text{and} \quad K = k_2K_5/K_4. \] For acid-independent reaction in HNO$_3$ and H$_2$SO$_4$ media \[ \text{Co}^{3+}(\text{aq.}) + 2\text{H}_2\text{O} \xrightarrow{k_3} \text{Co}^{2+}(\text{aq.}) + \text{O}_2 + 4\text{H}^+. \] The above reaction schemes fit in with our experimental observations very well. However, the question of formation of dimeric species leading to Co–O–Co bridging and that of the nature of active species being inner or outer sphere complexes, in our system, must be considered as unsettled. B. Oxidation of Alcohols Studies on oxidation of T.B.A. and T.A.A. in aqueous solution by Co$^{3+}$ in HClO$_4$ and H$_2$SO$_4$ in the temperature range 10–25°C. were carried out. It was found that oxygen had no effect on the reaction rate. In the range of cobaltic concentrations (10$^{-3} – 10^{-2}$ M) and acidities (0·5–2·0 M) used, a certain amount of decomposition of water was unavoidable but the overall rate, $–R_{co}$, was strictly proportional to the first power of [Co$^{3+}$]; log $a/a-x$ vs. Time plots were linear in both acids, with small constant intercepts corresponding to water oxidation rate. The pseudo first-order rate constants ($k$, sec.$^{-1}$) were strictly proportional to the first power of alcohol concentration (Fig. 5, A, B, C) for both alcohols. A linear variation of $k$, sec.$^{-1}$ with 1/[H$^+$] was observed (Fig. 5, D-I) with no intercepts on the ordinates in HClO$_4$ medium and with intercepts on the ordinates for H$_2$SO$_4$ medium (Fig. 5, F-I) for both alcohols. An oxidation route involving free cobaltic (aq.) ions also was evident in the latter case, while the hydrolysis product CoOH$^{2+}$ alone was probably the active species in HClO$_4$ medium. In their studies on oxidation of T.B.A. in HClO$_4$ medium (at [H$^+$] = 0·325, −3·25 M, Temp. = 10° C., $\mu$: 3·25 M) Hoare and Waters$^4$ reported that CoOH$^{2+}$ was the stronger oxidant. Our results with respect to T.B.A. are in accordance with those of Hoare and Waters. We find that for T.A.A. also, CoOH$^{2+}$ is the active species in HClO$_4$ medium. In H$_2$SO$_4$ medium, however, the inverse dependence of $k$, sec.$^{-1}$ on [H$^+$] may arise from CoOH$^{2+}$ and/or CoSO$_4^+$ being the active species. A direct variation of $k$, sec.$^{-1}$ with [HSO$_4^-$] would be noticed if CoSO$_4^+$ is the active species. Increase of total ionic strength using HSO$_4^-$, resulted only in less than 16% variation in the $k$, sec.$^{-1}$ values, the values actually decreasing at first with increasing [HSO$_4^-$] and then practically becoming constant (ref. Table II, a). This is probably due to the formation of stable inert sulfato complexes of Co$^{3+}$ (aq.) being formed and the consequent depletion of active Co$^{3+}$ species. The above results indicated that in H$_2$SO$_4$ medium CoSO$_4^{+}$ were not the active entities. Our results with reference to $k$, sec.$^{-1}$ with increase of $\mu$ in HClO$_4$ medium for both alcohols cannot be explained and the observed salt effect is therefore anomalous (\textit{cf.} Table II, \textit{a}). The inverse dependence of rate on [H$^+$] in H$_2$SO$_4$ medium may be satisfactorily explained on the basis of CoOH$^{2+}$ being the active species though present in smaller concentrations. Further support for this conclusion is adduced from the effect of [HSO$_4^-$] at constant $\mu$ (maintained with NaClO$_4$) when no direct variation of $k$, sec.$^{-1}$ with [HSO$_4^-$] was observed. On the contrary, ![Graph](image) Fig. 5. Variation of $k$, sec.$^{-1}$ with [A] and [H$^+$]. A, B: $k$, sec.$^{-1}$ vs. [T.A.A.] in H$_2$SO$_4$ and HClO$_4$ respectively. A: [H$^+$]: 1·0 M, Temp. 14° C., [Co$^{3+}$]: 2·138 \times 10^{-2} M. B: [H$^+$]: 2·0 M, Temp. 10° C., [Co$^{3+}$]: 1·335 \times 10^{-2} M. C: $k$, sec.$^{-1}$ vs. (T.B.A.) in H$_2$SO$_4$ at [H$^+$]: 1·0 M, $\mu$: 1·67 M, Temp. 14° C., [Co$^{3+}$]: 2·081 \times 10^{-2} M. D, E: $k$, sec.$^{-1}$ vs. [H$^+$]$^{-1}$ in HClO$_4$ medium. D: [T.B.A.]: 0·2554 M, Temp. 14° C., $\mu$: 2·1 M; [Co$^{3+}$]: 1·525 \times 10^{-2} M; E: [T.A.A.]: 8·001 \times 10^{-2} M; Temp. 10° C., $\mu$: 2·1 M, [Co$^{3+}$]: 1·572 \times 10^{-2} M; F-I: $k$, sec.$^{-1}$ vs. [H$^+$]$^{-1}$ in H$_2$SO$_4$ medium, initial [Co$^{3+}$]: 5–8 \times 10^{-8} M, $\mu$: 2·1 M; F: [T.B.A.]: 0·1 M, Temp. 15° C.; G: [T.B.A.]: 0·1 M, Temp. 25° C.; H: [T.A.A.]: 5·782 \times 10^{-2} M, Temp. 9° C.; I: [T.A.A.]: 5·782 \times 10^{-2} M, Temp. 14° C. the rate constants showed a decreasing trend (cf. Table II, b). This easily follows if it is assumed that CoOH$^{2+}$ alone is the active species. Table II (a) Effect of ionic strength on the oxidation of T.B.A. and T.A.A. by cobaltic ions \[ \text{[HClO}_4\text{]}: 1 \cdot 0 \text{ M; Temp: } 14^\circ \text{C., (T.B.A.)}: 0 \cdot 2554 \text{ M; [Co}^{3+}\text{]: } 1 \cdot 257 \times 10^{-2} \text{ M} \] \| $ \mu, \text{M (HClO}_4 + \text{NaClO}_4) $ \| 1 \cdot 00 \| 1 \cdot 42 \| 1 \cdot 92 \| 2 \cdot 42 \| \|------------------------------------------\|-----------\|-----------\|-----------\|-----------\| \| $ k \times 10^4 \text{ sec.}^{-1} $ \| 6 \cdot 2 \| 7 \cdot 041\| 8 \cdot 626\| 10 \cdot 44\| \[ \text{[HClO}_4\text{]}: 1 \cdot 028 \text{ M, Temp. } 10^\circ \text{C.; (T.A.A.)}=8 \cdot 001 \times 10^{-2} \text{ M; [Co}^{3+}\text{]: } 1 \cdot 572 \times 10^{-2} \text{ M} \] \| $ \mu, \text{M (HClO}_4 + \text{NaClO}_4) $ \| 1 \cdot 12 \| 1 \cdot 5 \| 2 \cdot 5 \| \|------------------------------------------\|-----------\|-----------\|-----------\| \| $ k \times 10^3 \text{ sec.}^{-1} $ \| 1 \cdot 919\| 2 \cdot 175\| 3 \cdot 358\| \[ \text{[H}_2\text{SO}_4\text{]}=1 \cdot 026 \text{ M; Temp. } 14^\circ \text{C.; (T.B.A.)}: 1 \cdot 054 \text{ M; [Co}^{3+}\text{]: } 2 \cdot 018 \times 10^{-2} \text{ M} \] \| $ \mu, \text{M (H}_2\text{SO}_4 + \text{NaHSO}_4) $ \| 1 \cdot 026 \| 1 \cdot 357 \| 1 \cdot 757 \| 2 \cdot 357 \| \|------------------------------------------\|-----------\|-----------\|-----------\|-----------\| \| $ k \times 10^4 \text{ sec.}^{-1} $ \| 5 \cdot 279\| 4 \cdot 484\| 4 \cdot 764\| 4 \cdot 918\| \[ \text{[H}_2\text{SO}_4\text{]}: 1 \cdot 0 \text{ M; Temp. } 14^\circ \text{C.; (T.A.A.)}=0 \cdot 1835 \text{ M; [Co}^{3+}\text{]: } 2 \cdot 01 \times 10^{-2} \text{ M} \] \| $ \mu, \text{M (H}_2\text{SO}_4 + \text{NaHSO}_4) $ \| 1 \cdot 056 \| 1 \cdot 485 \| 1 \cdot 913 \| 2 \cdot 341 \| \|------------------------------------------\|-----------\|-----------\|-----------\|-----------\| \| $ k \times 10^3 \text{ sec.}^{-1} $ \| 2 \cdot 618\| 2 \cdot 408\| 2 \cdot 550\| 2 \cdot 525\| (b) Effect of [HSO$_4^-$] on the oxidation of T.B.A. and T.A.A. in H$_2$SO$_4$ medium by Co$^{3+}$ \[ \text{[T.A.A.]}=5 \cdot 782 \times 10^{-2} \text{ M; Temp. } 14^\circ \text{C.; [Co}^{3+}\text{]: } 4 \cdot 908 \times 10^{-8} \text{ M; [H}^+\text{]: } 0 \cdot 5 \text{ M;} \] $ \mu: 2 \cdot 0 \text{ M} $ \| $ (\text{H}_2\text{SO}_4 + \text{NaHSO}_4), \text{M} $ \| 0 \cdot 426 \| 0 \cdot 926 \| 1 \cdot 426 \| 1 \cdot 926 \| \|------------------------------------------\|-----------\|-----------\|-----------\|-----------\| \| $ k \times 10^3 \text{ sec.}^{-1} $ \| 3 \cdot 434\| 1 \cdot 862\| 1 \cdot 382\| 1 \cdot 105\| \[ \text{[T.B.A.]: } 0 \cdot 12 \text{ M; Temp. } 22^\circ \text{C.; [Co}^{3+}\text{]: } 4 \cdot 586 \times 10^{-8} \text{ M; [H}^+\text{]: } 0 \cdot 3249 \text{ M;} \mu: 1 \cdot 8 \text{ M} \] \| $ (\text{H}_2\text{SO}_4 + \text{NaHSO}_4), \text{M} $ \| 0 \cdot 68 \| 1 \cdot 23 \| 1 \cdot 73 \| \|------------------------------------------\|-----------\|-----------\|-----------\| \| $ k \times 10^8 \text{ sec.}^{-1} $ \| 1 \cdot 326\| 1 \cdot 114\| 1 \cdot 028 \| If \[ k_{\text{obs.}} [\text{Co}^{3+}] \text{ Total } = k_a [\text{CoOH}^{2+}] \] and \[ [Co^{3+}] \text{ Total} = Co^{3+} + CoSO_4^+ + CoOH^{2+} \] \[ \frac{1}{k_{\text{obs.}}} = \frac{1}{k_a} + \frac{[H^+]}{k_aK_1} + \frac{K_2 [HSO_4^-]}{k_aK_1} \text{ if } K_1 \] is the hydrolytic equilibrium constant for $ Co^{3+} $ (aq.) and $ K_2 $ is the formation constant for $ CoSO_4^+ $. Further, the possibility of higher species, $ Co(SO_4)_2^- $, etc., being the active entities is eliminated, since if such were the case a direct dependence of $ k $, sec.$^{-1}$ on $[HSO_4^-]^2$ and $[Co^{3+}]^2$ and an inverse square dependence on $[H^+]$, should have been observed. From the foregoing results, the rate laws for both alcohols may be summarised as follows: HClO$_4$ medium: \[ -R_{v_o} = \frac{K [Co^{3+}] [A]}{[H^+]} = \frac{K_1 k_a [Co^{3+}] [A]}{[H^+]} \] where $[A] = \text{concentration of alcohol}; \ K_1 = \text{hydrolytic constant for } Co^{3+}; \ K_1 k_a = 1.245 \times 10^{-3} \text{ for T.B.A. at } 10^\circ C. \text{ and } \mu: 1.5 M.$ Hoare and Waters$^4$ have reported $1.82 \times 10^{-3}$ at $10^\circ C.; \mu: 3.25 M.$ For T.A.A. $ K_1 k_a = 3.53 \times 10^{-2} \text{ at } 10^\circ C. \text{ and } \mu: 2.3 M. $ Hoare and Waters$^5$ reported a value of $5.01 \times 10^{-2} \text{ at } 15^\circ C. \text{ for oxidation of T.A.A. in HClO}_4 \text{ medium, from extrapolation of their data in H}_2\text{O + Methylcyanide mixture.}$ H$_2$SO$_4$ medium: \[ -R_{co} = \left\{a_3 + \frac{b_3}{[H^+]} \right\} [Co^{3+}] [A] \] where $a_3$ and $b_3$ are constants corresponding to acid independent and dependent reactions respectively. Values of $a_3$ and $b_3$ at $\mu: 2.3 M$ are given below together with the E values. For T.A.A. in H$_2$SO$_4$. \[ a_3 = 3.078 \times 10^{-3} (9^\circ C.), 7.956 \times 10^{-3} (14^\circ C.); \] \[ E_{a3} = 30.59 \text{ K. cals. mole}^{-1} \] \[ b_3 = 1 \cdot 328 \times 10^{-3} (9^\circ C.) ; 4 \cdot 941 \times 10^{-3} (14^\circ C.) ; \] \[ E_{b_3} = 42 \cdot 33 \text{ K. cals. mole}^{-1}. \] For T.B.A. in $ H_2SO_4 $: \[ a_3 = 4 \cdot 6 \times 10^{-4} (25^\circ C.) ; 3 \cdot 2 \times 10^{-4} (15^\circ C.) ; \] \[ E_{a_3} = 6 \cdot 2 \text{ K. cals. mole}^{-1} \] \[ b_3 = 1 \cdot 875 \times 10^{-3} (25^\circ C.) ; 3 \cdot 886 \times 10^{-4} (15^\circ C.) ; \] \[ E_{b_3} = 26 \cdot 89 \text{ K. cals. mole}^{-1} \] The overall rate constant $ a_3 + b_3 / [H^+] $ evaluated from $ k, \text{sec}^{-1} $ vs. [A] plots are $ 5 \cdot 882 \times 10^{-4} $ (14° C.) for T.B.A. and $ 1 \cdot 369 \times 10^{-2} $ (14° C.) for T.A.A. under indentical conditions of $ \mu $ and $[H^+]: 1 \cdot 0 \text{ M}$. It is evident that there is good agreement between these values and sum of $(a_3 + b_3)$ values evaluated separately. Our results may be explained satisfactorily by the same mechanism as that proposed by Hoare and Waters$^5$ involving the fission of O–H bond leading to products. \[ R'CR_2OH + Co^{3+} \xrightarrow{\text{or}} R'CR_2O^\circ \xrightarrow{\text{CoOH}^{2+}} R^\circ' + R_2C = O \\ R^\circ' \text{ or } R^\circ \text{ on further reaction with } Co^{3+} \text{ will lead to alcohols which will be further oxidised to aldehydes, acids, etc.} \] ACKNOWLEDGEMENT One of us (K. J.) is grateful to the University Grants Commission for the award of Junior Research Fellowship and to Dr. V. Mahadevan for the assistance rendered in the early stages of this investigation. REFERENCES 1. Noyes and Deahl . . J. Amer. Chem., Soc., 1937, 59, 1337. 2. Bawn, C. E. H. and White, J. Chem. Soc., 1951, p. 331. A. G. 3. Baxendale, J. H. and Wells, Trans. Farad. Soc., 1957, 53, 800. C. F. 4. Hoare, D. G. and Waters, W. A., J. Chem. Soc., 1962, p. 965. 5. ———, Ibid., 1964, p. 2552. 6. "Vinyl polymerization, III. Polymerization of Acrylamide initiated by cobaltic ions in aqueous solution," Proc. Ind. Acad. Sci., 1966, 64 A, 128-40. 7. Oberer, Dissertaion, Zurich, 1903, from ref. 2 above. 8. Sutcliffe, L. H. and Weber, J. R., Trans. Farad. Soc., 1961, 57, 91. 9. Posey, F. A. and Taube, H., J. Amer. Chem. Soc., 1956, 78, 15. 10. Bonner, N. A. and Hunt, J. P., Ibid., 1952, 74, 1866; Ibid., 1960, 82, 3826. 11. Shankar, J. and Desouza, B. C., J. Inorg. and Nuclear Chem., 1962, 24, 187 and 693.	83688945-f64e-423f-a8b5-472b70f4389e	CC-MAIN-2020-40	http://repository.ias.ac.in/43381/1/90-Pub.pdf	2020-09-26T09:15:52+00:00	crawl-data/CC-MAIN-2020-40/segments/1600400238038.76/warc/CC-MAIN-20200926071311-20200926101311-00239.warc.gz	108,088,840	11,408	eng_Latn	eng_Latn	0.629104	eng_Latn	0.843528	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "nld_Latn", "eng_Latn", "eng_Latn", "azj_Latn", "eng_Latn", "eng_Latn", "zsm_Latn" ]	true	rolmOCR	[ 2400, 5016, 6658, 8420, 9784, 11887, 13619, 15714, 17789, 20591, 22529, 25820, 27707, 29504, 30138 ]	[ 0.78125, 0.61328125 ]	[ 4.46875, 4.59375 ]	[ 2.9375, 4.1875 ]	[ 2.640625, 2.203125 ]	1	0	HuggingFaceFW/finepdfs
Innovation Investment Award Application Evaluation Rubric I. REQUIRED ELEMENTS CHECKLIST TO BE REVIEWED BY IIA ADMINISTRATOR PRIOR TO COMMITTEE SCORING. APPLICATIONS WITH A TOTAL SCORE OF LESS THAN 7 ON REQUIRED ELEMENTS (or 0 on any criterion) WILL NOT BE FORWARDED TO THE COMMITTEE. If capacity allows, an incomplete application could be returned for updates by a determined deadline. (0 = not provided; 1 = partially provided; 2 = complete) \| Cover Page with applicant and project lead contact information \| \|---\| \| Letter of Organizational Support (from lead applicant’s president). Includes 1) A description of the capacity of the organization and its partners (if applicable) to carry out this project within grant project timelines (2) A stated understanding of required commitments to operationalize the project. (3) Agreement to meet with the project team leads at least monthly to discuss progress, assist with challenges on implementation and ensure support of institutional leadership. \| \| Executive Summary \| \| Project Narrative explains how labor market needs are addressed \| \| Evaluation metrics proposed \| \| Grant Budget within parameters, with minimum 10% matching funds \| \| Institutional Commitments checked in the afifrmative \| \| SUB TOTAL -- REQUIRED ELEMENTS (possible score 14) \| II. OVERALL EVALUATION CRITERIA SCORING DEFINITIONS i \| \| Score \| Defni ition \| \|---\|---\|---\| \| \| 0 \| Minimally Addressed or Does Not Meet Criteria - information not provided \| \| \| 2 \| Met Some but Not All Identifei d Criteria - requires additional clarifciation \| \| 4 \| 4 \| Addressed Criteria but Did Not Provide Thorough Detail - adequate response, but \| \| \| \| not thoroughly developed or high-quality response \| i a. Guiding Principles Using the scale above, to what degree does the proposal include the following key principles: b. Evidence-based Promising Practices Using the scale above, to what degree is the proposal grounded in evidence-based promising practices? Promising practices include: * Flexible scheduling and accelerated degree programs * Prior learning assessments and credit for prior learning * Competency-based education * Proactive and/or comprehensive advising support * Corequisite support and corequisite remediation * Work-based learning, apprenticeships, and corporate partnership programs * Career-aligned and guided pathways * Identify and eliminate barriers to transfer students * Systematic approach to basic needs support in which funds are directed toward the approach itself, not directly to students * Additional practices clearly outlined in the application, presenting evidence supporting the practice (For this score, it is not expected that applicants will incorporate ALL practices). \| \| The proposal outlines the incorporation of evidence-based promising practice(s) to \| \|---\|---\| \| \| specifically serve adult learners. \| \| \| The promising practice(s) chosen as the focus of the work suggest a high level of \| \| \| strategic and tactical thinking/planning, share an undergirding logic, and imply a \| \| \| strong theory of change and action that is explained in a compelling way in the \| \| \| proposal. \| \| SUB TOTAL – EVIDENCE-BASED PROMISING PRACTICES (TOTAL POSSIBLE 12) \| \| c. Institutional Outcomes Using the scale above, to what degree does the proposal outline Institutional Outcomes? d. Institutional Capacity and Sustainability Using the scale above, to what degree does the proposal address Institutional Capacity and Sustainability? e. Planning Process To plan for this proposed systems change, what kind of prior planning is outlined in the project narrative? Apply a score based on this range: \| 0-12 points \| MI-RAISE DESIGN LAB OR DETROIT DRIVES DEGREES D3C3 participation to develop this proposal demonstrated in narrative \| \|---\|---\| \| 0-6 points \| Other proposal planning process described in detail, score the information provided based on the 0-6 scoring defni ition used above. \| \| Score \| Criteria \| \|---\|---\| \| \| Thoughtful and collaborative planning process outlined for proposed system change. \| NOTE: APPLICATIONS MUST EARN A MINIMUM SCORE OF 6 IN THIS CRITERION TO BE FUNDED. TOTAL SCORE \| SUB TOTALS \| POSSIBLE RANGE \| \|---\|---\| \| \| 0-14 \| \| \| 0-18 \| \| \| 0-12 \| \| \| 0-12 \| \| \| 0-12 \| \| \| 0-12 \| I recommend this proposal: - Receive an Innovation Investment Award for the full requested amount. - Receive a partial Innovation Investment Award (detail the recommended amount): - Receive an Innovation Investment Award with the following conditions (details): - Not receive an Innovation Investment Award. REVIEWER COMMENTS (unresolved questions, suggestions for implementation, overall impression of proposal). 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2017 Chestnut Hill Architectural Hall of Fame 50th Anniversary Preservation Celebration Gala, featuring the Architectural Hall of Fame SATURDAY, NOVEMBER 4, 2017 The party of the year! This is the 50th Anniversary benefit for the Chestnut Hill Conservancy. The black-tie gala in a stunning private home (TBA) will honor Chestnut Hill’s legacy of extraordinary architecture and landscape by recognizing “Hall of Fame” places, as voted by the public during late summer and early fall. REGISTER — 215-247-9329 x202 OR CHCONSERVANCY.ORG Gala Sponsors as of May 2017 The Nottingham-Goodman Group Merrill Lynch JKJ pure love your insurance Dennis F. Meyer Inc. Old Village Master Painters, Ltd. 215-540-0196 Wescott Financial Advisory Group LLC Matthew Millan Architects, Inc. Bowman Properties 50TH ANNIVERSARY GALA SPONSORSHIP 4 OPPORTUNITIES - EACH MORE THAN 75% TAX-DEDUCTIBLE! THE PRESERVATION CELEBRATION GALA FEATURING THE ARCHITECTURAL HALL OF FAME \| NOVEMBER 4, 2017 — The party of the year! This is the 50th Anniversary benefit for the Chestnut Hill Conservancy. The black-tie gala in a stunning private home (TBA) will honor Chestnut Hill’s legacy of extraordinary architecture and landscape by recognizing “Hall of Fame” places, as voted by the public during late summer and early fall. The gala and the preceding public programming support the Chestnut Hill Conservancy’s mission to preserve the architectural, historical, and environmental resources that define the Chestnut Hill area. 50th Anniversary Gala Sponsorship \| $5,000 level Industry exclusivity. Naming of the event on all promotional material and press as “2017 Presenter.” Opportunity to briefly address the crowd. Bring up to 6 people to the event, including early champagne reception. All other $2,500-level benefits (below), with most prominent placement. 50th Anniversary Gala Sponsorship \| $2,500 level Bring marketing material and up to 4 people to the event, including early champagne reception. Logo on 1,000 invitations, event signage, and tent signage at the Chestnut Hill “Fall for the Arts” Festival attracting 30,000 passersby. Full-page glossy color ad in the Program Booklet seen by 300+ guests. That ad on a looping video played throughout event. Verbal recognition at the event. Hyperlinked logo on e-communications and event webpage. Opportunity to run a featured testimonial (yours alone) in e-newsletter to 2,500 subscribers. Hyperlinked logo on CH Conservancy Business Sponsorship webpage and promoted through e-newsletter 2+ times annually. Ability to market goods- and service-discounts in CH Conservancy communications. Special Package Sponsorship: 50th Anniversary Gala + Nights of Light \| $2,250 All 50th Anniversary Gala $1,500-level benefits (below) PLUS these Nights of Light benefits. (Offered individually at $1,500 Gala + $1,000 Nights of Light.) NIGHTS OF LIGHT \| FIRST WEEKEND OF OCTOBER 2017 (OPENING PARTY OCT. 6) — Exciting public art inspired by the Chestnut Hill Archives, this very special program will project moving and still images onto buildings and other structures along the Germantown Avenue commercial corridor during the evenings of October 6, 7, and 8. Will be seen by thousands. In collaboration with the Chestnut Hill Business District, Norwood-Fontbonne Academy, the Pennsylvania Academy of the Fine Arts, and the Woodmere Art Museum, so you’ll reach ALL of their audiences too! Logo projected alongside the imagery as part of the exhibition. Logo on program communications including mailed postcards, posters around town, and signage up during the wildly popular Chestnut Hill Harry Potter Festival. Hyperlinked logo on CH Conservancy e-communications and program webpage, as well as communications from all above partner organizations, reaching tens of thousands. Recognition in Chestnut Hill Local feature on this special event. 50th Anniversary Gala Sponsorship \| $1,500 level Bring 2 people to the event. Logo on 1,000 invitations, event signage, and tent signage at the Chestnut Hill “Fall for the Arts” Festival attracting 30,000 passersby. Half-page glossy color ad in the Program Booklet seen by 300+ guests. Hyperlinked logo on e-communications and event webpage. Hyperlinked logo on CH Conservancy Business Sponsorship webpage and promoted through e-newsletter 2+ times annually. WE ARE THRIVING There is no better time than now to sponsor! As we celebrate our 50th Anniversary in 2017, we are growing like never before. In six months alone, our email list has increased 35% and our social media audience has swelled 7 times over. Recent rebranding is generating buzz, and the work that we are doing for the community, supported in part by a major grant from the William Penn Foundation, is attracting media coverage and new supporters. OUR AUDIENCE = YOUR CLIENTS! Align your company with the only organization in Chestnut Hill ensuring that both the architectural heritage and the natural environment of this extraordinary urban village are maintained into the future. Our audience is comprised of dedicated local-business supporters, property owners who invest in old-house and landscape care, the environmentally conscious, and many engaged community members. Put your business in front of our audience and reap benefits. CHESTNUT HILL IS GROWING Chestnut Hill is growing, which is wonderful, but development pressure is rapidly rising. There is a dire need for an approach to growth that balances new development with protection of the historic architecture and ample open space that make Chestnut Hill so desirable in the first place. The Chestnut Hill Conservancy is leading the efforts for smart growth and the protection of the Wissahickon watershed. As a leading business owner, your show of support is both powerful and vital. SPONSOR NAME (as it will be listed) ____________________________________________________________ MAIN CONTACT PERSON _________________________________________________________________ ADDRESS ___________________________________________________________________________ CITY ___________________________________________________________ STATE ______ ZIP __________ PHONE __________________ EMAIL ______________________ CONFIRM AMOUNT $________________ PAYMENT PREFERENCE: ○ Single payment in full ○ Monthly until complete* ○ Quarterly until complete* PAYMENT SELECTION ○ Check ○ Stock transfer: contact me with instructions ○ Visa ○ MasterCard ○ AmEx CREDIT CARD # __________________________________________________________ SECURITY CODE ______ EXP DATE _____________ SIGNATURE (Required for credit card) ____________________________________________________________________________________________ RETURN TO – CHESTNUT HILL CONSERVANCY, 8708 GERMANTOWN AVENUE, PHILADELPHIA, PA 19118 The Chestnut Hill Conservancy is a 501(c)(3) nonprofit historic preservation and conservation organization. A copy of our registration and financial information may be obtained from the PA Dept. of State by calling 800-732-0999. Registration does not imply endorsement. *within one year of the CH Conservancy’s receipt of this form CONTACT DEVELOPMENT DIRECTOR KRISTIN SOUTHALL WITH QUESTIONS – firstname.lastname@example.org \| 215-247-9329 x 207	<urn:uuid:0383e6af-0022-49f9-92f1-20e4c710c977>	CC-MAIN-2017-26	http://chconservancy.org/wp-content/uploads/2015/07/CH-Conservancy-50th-Anniversary-Gala-Sponsorship.pdf	2017-06-27T01:42:50Z	crawl-data/CC-MAIN-2017-26/segments/1498128320887.15/warc/CC-MAIN-20170627013832-20170627033832-00683.warc.gz	73,559,190	1,550	eng_Latn	eng_Latn	0.95977	eng_Latn	0.994932	[ "eng_Latn", "eng_Latn" ]	true	rolmOCR	[ 794, 7224 ]	[ 0.76171875 ]	[ 1.109375 ]	[ 1.046875 ]	[ 2.625 ]	1	0	HuggingFaceFW/finepdfs
January Newsletter Happy New Year! I hope everyone was able to enjoy the holidays with family and friends. Sometimes it just doesn’t seem long enough! Please be patient with me as I start this new position (if you aren’t wearing a name badge, I will have a hard time remembering new names and faces). I am the world’s worst at remembering names. There are lots of fun programs and events planned for this year. There are so many opportunities to get involved with the Guild – either one-time commitments or recurring activities. Come prepared in January to find your place to volunteer and get involved. In honor of our Patriotic shower, please think about wearing red, white or blue! See you on January 21, 2025! Gisele January 21, 2025 Program Patriotic Shower for Operation Quilted Comfort “Great things in the McKinney Quilters Guild are never done by one person. They are done by a team of people.” This is a shower to help get the New Year started to refurbish our patriotic, red, white, and blue fabrics and batting. Monetary gifts are welcome for Color Catchers and labels should you not have any fabric stash. All are welcome to a Kit Cutting on Tuesday, January 28 at Sharon Wilhelm’s house, 1809 Midcrest Dr, Plano Tx 75075 from 10:00am—2:00am. RSVP 972–743-3575. Bring a snack or lunch. If you have any Patriotic Quilts, please bring them to the January meeting for Show and Tell. Sharon Wilhelm and Malinda Krzyzanowski, Co-Chairpersons 2024 Quilts 2024 Pillowcases & Laundry Bags MCKINNEY QUILTER’S GUILD MEETING MINUTES December 17, 2024 Suzan Crocker - Meeting called to order at 1:00, Welcome all members and any guests. There were no changes or corrections needed for the November meeting minutes or the Treasurer’s report, both will be filed for audit. Roxy Gross – There are 52 members present (no noted visitors). As of the meeting this month, the Guild recorded 13948 Community Service hours. Please let Roxy know if you have any unrecorded hours to try to reach 15,000 hours! Betsy Whiteman – Sunshine and Shadows: Kathy Chambliss is dealing with a fractured disc in her lower back and awaiting treatment plans. Margaret Neyman will be having surgery on her one good eye, prayers for success. Malinda K.’s husband Greg will be undergoing a heart procedure. Sara Lindsay’s husband is undergoing local chemo and PT for his arm. Betsy Whiteman’s grandson has graduated from UNT and has a job offer. Candy Koharchik – UFO - Joann Sams was the final winner. Other participants were Gisele Oakes, Mary Marrone, Sandy Griego, Deb Merrill, and Donna Mikesch. Candy will not be chairing the UFO challenge next year if anyone else is interested in taking over. Gisele Oakes – we raised almost $1600 with the donated charity raffle quilt; another big thank you to Sandy Griego for the beautiful quilt. Janie Squire was the winner of the quilt. The money will be divided between the Community Garden Kitchen, Samaritan Inn and the North Texas Food Bank. There are no plans for a charity quilt for 2025 unless someone wants to step up to chair, plan and organize the process and be responsible for completion and tickets sales. The 2025 Board Members were again introduced: Gisele Oakes, President Beth Smietana, VP Programs Julie Cadenhead, Treasurer Lorraine Brown, Secretary Jeannie Neckar, Education Roxy Gross, Membership Sharon Wilhelm, Information officer A big thank you to the Holiday Luncheon committee: Cynthia Kullberg, Mary Marrone and Diane Taylor for the beautiful organization and execution of all the plans for a delightful luncheon. Show and Tell and Door Prizes NEXT MEETING: PATRIOTIC SHOWER TO REPLENISH VETERAN QUILT SUPPLIES January 21, 2025 Minutes submitted by Gisele Oakes TREASURER’S REPORT December 2024 \| Description \| Amount \| \|----------------------\|----------\| \| Beginning Balance \| $18,507.53 \| \| Deposits \| $131.00 \| \| Distributions \| -$850.00 \| \| Ending Balance \| $17,788.73 \| $525.63 will be donated to each of the following charities: Community Garden Kitchen North Texas Food Bank Samaritan Inn This is the money collected from the sale of our 2024 Raffle Quilt. Report submitted by Carol Surrells, Treasurer Sunshine and Shadows Prayers needed. Sara L’s husband needs prayers after sinus surgery. Candy K and husband both have Covid. February 18th Program Trunk Show—Jill Isakson Jill has been making quilts for 30+ years. She will be presenting a trunk show of her colorful pieced quilts and sharing her thoughts on color and design. Ryan’s CASE for SMILES 2024 was a banner year for Ryan’s CasesforSmiles! Total pillowcases turned in by McKinney Quilters were 559! This bypasses last year's 472 that were completed. This past year we found a summer camp for kids living with cancer and were able to donate 140 pillowcases. New outlets for pillowcases are being explored so let's keep up the good work! Carolyn Kerr December Door Prizes We Appreciate Your Generosity! Thanks to the Quilt Shops for their generous gifts to our guild. Thank you Missouri Star and our Guild Members for their donations! And especially to Deb and Malinda for the gathering! Box Car Quilts—Aubrey, Tx Downtown Dry Goods—McKinney, Tx Fabric Fanatics—Plano, Tx Linda’s Electric Quilters—McKinney Prairie Quilt, Hennessey, Ok Quilt Country—Lewisville, Tx Quilt Mercantile—Celeste, Tx Missouri Star—Hamilton, Mo Urban Spools—Dallas, Tx Deb Merrill & Malinda Krzyzanowski Please remember to send a Thank You to our donors. If you do not have any thank notes, please see me or Malinda. We have some! Quilt Hangers Quilt Hangers & Accessories Div. 1809 Midcrest Drive Plano, Texas 75075 Phone 972-424-7791 Email: email@example.com Websites: www.quiltideas.com By Quilt Ideas Loren & Sharon Wilhelm McKinney Quilters Guild Mini Quilt Auction And Other Items For Sale Tuesday, May 20th 1:00 - 3:00 It’s not too early to start making a mini or two for the Mini Quilt Auction. If each one of us made just one, we would have 120 to hand in to our new Chairperson. AND if you made more than one we could SHOCK her. Here are the instructions... 1. Do your best quality of work as this auction is a fund raiser for the operation of the guild, pays for speakers and programs for the year. 2. Quilted by hand or machine—not tied 3. Best selling themes are holidays; ie. Christmas & Halloween. OR scrappy, seasonal, vintage etc. 4. Size for mini 24” per side. Anything larger should be a buy now price. 5. Invite your friends and family. A hand out invitation will be provided at the sign in table. Chairperson Needed for this committee. Contact Julie Cadenhead 214-641-7613 to volunteer. Newsletter Submissions Deadline: 1st Thursday. Please submit or contact your newsletter editor. 2025 Committees and Chairpersons Block of the Month-Bonnie Landon Christmas Luncheon– Open Door Prizes– Deb Merrill Education – Jeannie Neckar Facilities - Guild Members Friendship Blocks - Mary Ann Baltzer Meals on Wheels – Open Thanksgiving Boxes- Santa Bags - Membership - Roxy Gross Name Tags - Roxy Gross Newsletter, Publicity - Sharon Wilhelm Operation Quilted Comfort/Veterans- Sharon Wilhelm & Malinda K Photographer - Donna Mikesch & Betsy Whiteman Programs, & Facilities Beth Smietana - Chairperson - Workshops– MJ Fielek Project Linus - Elaine Henry Retreat/Spring - Red Boot Retreat- Hillsboro, Tx Carol Surrells & Lisa Terry Retreat/Fall - Stitchin’ Heaven, Quitman, Tx - Cynthia Weisz - Chairperson - Paula Washler Retreat/ Day - Open Ryan’s CaseforSmiles - Carolyn Kerr, Chairperson Sunshine and Shadows - Betsy Whiteman Ways and Means - Officers May Mini Madness Auction– Open May Mini Special Quilt-Open Scrap Sale—Jean Ann Clarke, Chair Deb Merrill, Melissa Hoffman and Jeannie Neckar Website-Bonnie Landon Yearbooks/Directory - Sharon Wilhelm 2025 Officers Committee Chairperson will be published after each officer gets her committees filled. McKinney Quilter’s Guild: 2025 Officers \| Position \| Name \| Email \| Phone Number \| \|-------------------\|--------------------\|------------------------------\|--------------------\| \| President \| Gisele Oakes \| firstname.lastname@example.org \| C/817-966-8445 \| \| Vice President \| Beth Smietana \| email@example.com \| C/703-434-2984 \| \| Secretary \| Lorraine Brown \| firstname.lastname@example.org \| C/703-403-2094 \| \| Treasurer \| Julie Cadenhead \| email@example.com \| C/214-641-7613 \| \| Membership \| Roxy Gross \| firstname.lastname@example.org \| C/805-857-8788 \| \| Education \| Jeannie Neckar \| email@example.com \| C/719-510-2424 \| \| Information Officer/Newsletter \| Sharon Wilhelm \| firstname.lastname@example.org \| 972-424-7791 C/972-743-3575 \| \| Webmaster \| Bonnie Landon \| email@example.com \| C/214-707-6745 \| For Sale Babylock Flourish II New MSRP $3,499 Sale price $1,999 6.25 x 10.25" Embroidery Field 18 built-in embroidery stitches 13 built-in embroidery fonts Two-way USB connectivity Cuts jump stitches Advanced Needle Threader Color LCD Touchscreen On-screen embroidery editing Push-button features Quick-set, top-loading bobbin 181 Built-in Embroidery Designs Contact: Jamie Engle, 469.693.6073 Happy New Year Quilters! Project Linus, Collin, Cooke, Grayson & Rockwall Counties, Texas blanket delivery total since 2004 is 108,580. We delivered 8,019 blankets in 2024; 1,284 of those in the month of December. We meet every Wednesday from 9:00-2:00 to make blankets. All are welcome to join in the fun and fellowship. Bring your lunch. In addition, Project Linus meets every 3rd Saturday from 9:00-2:00 at 1985 FM-1138, Royse City while the West McKinney Project Linus group meets every 2nd Tuesday (January 14 & February 11) at 1:00pm in the Heard-Craig Carriage House, 205 W Hunt St, McKinney. Donations are welcome, financial, fleece, yarn, fabric, batting, your valuable time and expertise. Talk to Elaine Henry for more information or contact Regina Forthman, via our Facebook page, Project Linus Collin Cooke Grayson Rockwall Counties Texas. Elaine Henry Join or Renew Your Membership It’s time to renew your McKinney Quilters Guild Membership! Bring it to the January meeting! Scrap Fabric Sale October 2025 Thinking of cleaning out your sewing room? Doing a little organizing and realizing that you need to get rid of some of your fabric? Set your calendars for October 15th! We will have our annual scrap fabric sale at our regular meeting. Your donated fabric can be sold to be one of our money makers for the guild that helps to pay for the speakers. (And you and your quilting friends can buy material at a dollar a yard.) What you need to get rid of could be just what someone else needs. More information is to come in the February newsletter! Jean Ann Clarke - Chairperson Shop in store for: - Creative Grids Rulers - Huge selection of ByAnnie’s hardware and stabilizers - Quilter’s Dream Batting - Large selection of wide-back fabric - Minky Cuddle Fabric - Binding by the Yard - Grunge, Solids, Thatched, and more fabric blenders 972-661-0044 - Quilting Classes - Custom Quilting - Edge-to-Edge Quilting - Hundreds of quilting designs - Choice of variegated or solid thread colors 17811 Davenport Road, Ste 38 \| Dallas, TX 75252 \| firstname.lastname@example.org \| www.sewletsquiltit.com Newsletter Submissions Deadline: 1st Thursday. Please submit or contact your newsletter editor. McKinney Quilters Guild 2025 Block-of-the-Month Happy New Year! The Block of the Month for 2025 has been designed in two color ways—a patriotic red, white and blue palette and a Christmas palette. You are free to choose your own color palette if you prefer. A coloring page will be posted on our website at https://www.mckinneyquiltersguild.net under the Block of the Month tab under “Guild Activities.” As we’ve done in years past, you can make a quilt top in the patriotic color way to donate to Operation Quilted Comfort, and make another in the Christmas color way to keep for yourself or give to someone as a Christmas gift. The finished quilt will measure 54” x 54”. The total fabric needed is listed below. In February we will release the instructions for the first block. Details to follow . . . Fabric Requirements: Background 1-3/8 yards Blue (or green) 5/8 yard Yellow 7/8 yard Dark Red 5/8 yard Light red 1/4 yard Backing 3 yards Binding 1/2 yard Happy Quilting! Bonnie McKinney Quilters Guild 2024 Raffle Quilt “The Queen & Her Court II” By Wing and a Prayer design 96” x 108” The sales of the tickets and this money will be distributed to 3 community service organizations in McKinney: Community Garden Kitchen North Texas Food Bank Samaritan Inn. Winner Janie Squier. Spring Retreat Information Red Boot, April 30 – May 4, 2025 19 HCR 1309, Hillsboro, TX 76645 Join us for 4 nights at the Red Boot retreat in Hillsboro! We’ve made arrangements for 26 of our members to have a wonderful and fun getaway. The retreat will begin at 11:00pm on Wednesday, April 30th, and will end on Sunday, May 4th at 12:00pm. The cost of $405 per person includes the 4 nights stay and 11 meals beginning with dinner on Wednesday. There is a continental breakfast each morning as well as lunch and dinner served on Thursday, Friday and Saturday, and Brunch at 9am on Sunday. Registration forms will be available at the January 21st meeting. A $50 deposit will hold your place, and the remaining amount is due by March 15th. Please complete the registration form and mail with your deposit (checks made payable to McKinney Quilters Guild) to the attention of Carol Surrells. Mailing address is on the registration form. If you have any questions, please contact Lisa Terry at 469-733-6394 or Carol Surrells at 214-697-5318. What To Bring • Join or renew your membership. • Remember to bring back the quilts you took to finish for the Veterans, Project Linus Quilts and Ryan’s Case for Smiles Pillowcases. • Wear your nametags so we can get a name and face together especially all our new members. (New Members get your picture made.) • Don’t forget when you sign in with Roxy to post your volunteer hours each month. As a 501(c)3 organization, our goal this year is 14,705 hours. You can count any volunteer hours you do for other organizations also. • Greeter: Jeannie Neckar, Cindy Quinn January Birthdays 1 Paula Rzomp 6 Sharla Brockway 17 Linda Samsury 22 Kathy Bradbury 22 Paula Smith 29 Roxanne Garrett Please bring a snack. February Birthdays 2 Judy Losey 9 Nadine Darby 10 Ronnie Stone 12 Roz Constant 17 Kathy Chambliss 18 Carol Anne Johnson 21 Robin Fisk 22 Candy Koharchik 25 Cynthia Weisz 26 Bertie Ferrell 26 Mary Ann Baltzer 27 Lillian Hughes Please Bring a snack. Advertising Rates Business Card (3 1/2" x 2") $6.00/month or $12.00/quarter (3 consecutive mos.) Quarter Page (4 1/4" x 5 1/2") $10.00/month or $24.00/quarter (3 consecutive mos.) Half Page (5 1/2" x 8 1/2") $15.00/month or $36.00/quarter (3 consecutive mos) Format: Microsoft Publisher or Word, PDF or JPEG. 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McClean St Leo Drive Barclay St Blake Pl Bangalow St Parkinson St Normandie St Matron Porter Dr H ROUTES 740 / 741 Milton – Narrawallee – Mollymook Ulladulla – Burrill Lake – Tabourie Lake Termeil – Bawley Point – Kioloa	<urn:uuid:5a0a6fec-15cf-45ea-ae34-cd0147209915>	CC-MAIN-2018-47	http://ulladullabus.com.au/pdf/route_map.pdf	2018-11-17T08:54:46Z	crawl-data/CC-MAIN-2018-47/segments/1542039743351.61/warc/CC-MAIN-20181117082141-20181117104141-00224.warc.gz	371,583,866	84	eng_Latn	eng_Latn	0.453462	eng_Latn	0.468424	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 117, 242 ]	[ 0.48828125 ]	[ 0.75 ]	[ 1.046875 ]	[ 1.1875 ]	1	2	HuggingFaceFW/finepdfs
Medical Science To Cite: Almoneef MI, Hawsawi AI, Alsamaan BA, Abdulrahim TKA. Unstable pelvic trauma patient: Emergency department presentations, physical examination, and imaging: Systematic review. Medical Science 2024; 28: e104ms3319 doi: https://doi.org/10.54905/disssi.v28i150.e104ms3319 Authors' Affiliation: 1Emergency Medicine Consultant, Emergency Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia 2Saudi Board Emergency Medicine Resident, Emergency Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia 3Medical Intern, College of Medicine, Bisha University, Bisha, Saudi Arabia Peer-Review History Received: 15 January 2024 Reviewed & Revised: 19/January/2024 to 25/March/2024 Accepted: 28 March 2024 Published: 16 August 2024 Peer-review Method External peer-review was done through double-blind method. Medical Science pISSN 2321–7359; eISSN 2321–7367 © The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution License 4.0 (CC BY 4.0)., which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. DISCOVERY SCIENTIFIC SOCIETY Unstable pelvic trauma patient: Emergency department presentations, physical examination, and imaging: Systematic review Moneef Ibrahim Almoneef 1 , Amjaad Ibraheem Hawsawi 2 , Bayan Abdulkarim Alsamaan 2 , Tamim Khalid Abdullah Abdulrahim 3 ABSTRACT Background: Patients with forceful trauma frequently have pelvic fractures, prompt and precise diagnosis can enhance patient outcomes. Whether physical examination are enough in this situation is still up for debate. The purpose of this study is to conduct a comprehensive evaluation of research on the diagnostic efficacy of physical examinations for pelvic fractures in individuals who have suffered severe trauma. Method: we followed Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA), in this study. We searched MEDLINE, Cochrane, and PubMed for pertinent studies published between 2009 and 2023. We included 6 studies in our systematic review. Results: Data from 40667 people were included in the research. Four articles were prospective, and two were retrospective. The majority of the study was carried out at the trauma centre or emergency department of a university hospital. Emergency physicians performed physical exams at an emergency department or trauma unit. CT or xray were used as reference standards. Results from the CT scan, X-ray, and symptoms criteria showed no significant difference in the absence of a distracting injury. To reduce the danger of significant pelvic bleeding, it is helpful to apply a pelvic binder as soon as feasible, depending on the trauma cause or clinical outcomes. Conclusion: Regardless of the results of a physical examination or the patient's state of consciousness, imaging tests have to be conducted on all trauma patients. Keywords: Emergency department, pelvic trauma, physical examination 1. INTRODUCTION The early diagnosis and treatment of pelvic fractures is crucial for individuals with multiple trauma injuries. All of the information currently available points to the fact that a comprehensive clinical examination can effectively identify a significant and unstable pelvic fracture and that undetected fractures are typically small or stable and don't need to be treated urgently (Den-Boer et al., 2011). The iliac crest is manually compressed to determine the stability of the pelvic ring (Yong et al., 2016). Manual distraction of the pelvis involves pressing the iliac crest outward with both hands if instability is not detected (Den-Boer et al., 2011). When a patient complains of discomfort upon compression or there is movement of the pelvic ring, instability is suspected. It has been demonstrated that evaluating pelvic stability in polytraumatized patients can be challenging, particularly when the patient is unconscious. One potentially hazardous consequence of pelvic manipulation is the possibility of dislodging formed clots, which might lead to more bleeding (VanStigt et al., 2009). A dependable external fixation of the pelvic ring in unstable fractures was made possible by the invention of pelvic binders and their simple application (Bonner et al., 2011). Clinical research revealed that pelvic binders greatly enhance cardiovascular health, lower the incidence of pulmonary problems, and minimize the need for blood transfusions (Spanjersberg et al., 2009). For the first assessment and treatment of pelvic ring fractures, the clinical examination of pelvic stability and pelvic palpation are recommended, although their validity is questioned because of their sensitivity, which ranges from 26.5 to 59%, and their specificity, which ranges from 71 to 99.9% (Shlamovitz et al., 2009). According to a poll conducted among trauma surgeons, 91% of them concur with this suggestion (Wohlrath et al., 2016). According to current standards, screening techniques for individuals with severe blunt trauma injuries include regular pelvic X-rays (ATLS, 2013). Additionally, a pelvic radiograph is not necessary for conscious, awake individuals who do not have pelvic discomfort or tenderness. However, pelvic X-rays are often performed as part of a protocol-driven assessment in all patients who have had blunt trauma, with little regard to the severity of the injuries. As a result, there may be an overuse of radiographic exams, particularly in patients who do not appear to be injured or who have experienced a single trauma, such as conscious, hemodynamically and respiratory stable patients who do not exhibit symptoms of a pelvic fracture (Van-Trigt et al., 2018). It is vital to take into account the clinical utility and diagnostic potential of physical examination in order to comprehend its clinical significance in this situation. To estimate these parameters while following methodological criteria, however, only a few systematic reviews have been carried out (McInnes et al., 2018). In order to evaluate the clinical value and diagnostic accuracy of physical examination for pelvic fracture in patients with blunt trauma, this study was conducted. 2. METHOD Comprehensive review and meta-analysis of research on the reliability of physical examinations in diagnosing pelvic injuries. We reported our findings using the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA). Patients with blunt trauma who may have suffered a pelvic injury were the intended participants. Physical examination for pelvic fractures was the relevant index concern Van-Leent et al., (2019) and it is defined as follows: When applying manual internal and external rotational stress, as well as anteroposterior and superior-inferior stress, palpation may reveal pelvic bone discomfort or hip dislocation, soreness, ecchymosis, hematoma and laceration, over the pelvic ring. Along with the parameters established by the lead study authors, the goal condition was regarded as a pelvic fracture resulting from blunt trauma that was identified by emergency physician based on CT scan or x-ray. All research on the diagnostic yield of physical exams in the treatment of patients with blunt trauma in emergency rooms or trauma centres for the detection of pelvic fractures was included. Retrospective, prospective, and observational studies were among the research designs that qualified. Diagnostic case-control studies and case studies with incomplete physical examination accuracy data were omitted. Each study was individually examined by all authors to ensure eligibility before data extraction. Conflicts amongst reviewers were settled through dialogue. Figure 1 indicated the reasons full text publications were excluded. We looked through MEDLINE, Cochrane, and PubMed to find all relevant studies published in the period from 2009 to 2023. We yielded 540 articles from the selected databases and after duplication removal 428 articles remained which undergone screening for title and abstract, and 355 were remove, leaving 73 full text articles which read by all authors to exclude ineligible studies. Finally, 6 REVIEW \| OPEN ACCESS studies were included in our review. Search was conducted without any limitations on language. We manually scanned the references of all qualified research to find further papers that could be relevant. The features of the study (year of publication, author, design, nation, clinical settings, sample size), the patient, and the factors pertaining to diagnostic accuracy were retrieved. All contributors gathered and organized data into Google Sheets and Google Documents. 3. RESULTS The analysis comprised data from 40667 individuals. Two articles Lustenberger et al., (2016), Shlamovitz et al., (2009) were retrospective, while four Moosa et al., (2019), Van-Leent et al., (2019), Schweigkofler et al., (2018), Majidinejad et al., (2018) were prospective (Table 1). The majority of research were conducted at a university hospital's emergency room or trauma center. Patients with Glasgow Coma Scale (GCS) scores of ≥13 or lower were included in one study Moosa et al., (2019); patients with GCS scores of ≤13 were included in other studies. Inquiries regarding pelvic discomfort, pelvic inspection and palpation, pelvic stability evaluation, and other procedures were part of the physical examination. In an emergency department or trauma centre, physical examinations were conducted by emergency physicians. The reference standards were CT or x-ray Shlamovitz et al., (2009), Majidinejad et al., (2018), Schweigkofler et al., (2018), uncertain Lustenberger et al., (2016) x-ray (Moosa et al., 2019). A radiologist Shlamovitz et al., (2009), Moosa et al., (2019) or an undisclosed expert Van-Leent et al., (2019), Lustenberger et al., (2016), Majidinejad et al., (2018), Schweigkofler et al., (2018) interpreted the results. Research on unstable pelvic fractures was conducted (Schweigkofler et al., 2018). According to Majidinejad et al., (2018), the absence of a pelvic fracture was detected with a 39.7% sensitivity and a 100% specificity in the clinical signs and symptoms. There was a significant difference in the other criteria, but there was no significant difference in the lack of a distracting injury, according to the results of the CT scan, X-ray, and symptoms criterion. The ability to activate Straight Leg Raise and the lack of pelvic soreness or tenderness had a substantial influence on the prediction of not having pelvic pain. Any distracting illness can be eliminated from the criteria without compromising specificity or raising sensitivity (Table 2). Table 1 Characteristics of included studies \| Citation \| Country \| Study setting \| Year of publication \| Number of participants \| Men percentage \| \|---\|---\|---\|---\|---\|---\| \| Moosa et al., 2019 \| Pakistan \| Emergency \| 2019 \| 133 \| 68% \| \| Van-Leent et al., 2019 \| Netherlands \| Trauma center \| 2019 \| 54 \| - \| \| Schweigkofler et al., 2018 \| Germany \| Trauma center \| 2017 \| 147 \| 66% \| \| Majidinejad et al., 2018 \| Iran \| Emergency department \| 2018 \| 3527 \| 76% \| \| Lustenberger et al., 2016 \| Germany \| Trauma registry \| 2016 \| 35490 \| 69% \| \| Shlamovitz et al., 2009 \| USA \| Trauma center \| 2009 \| 1316 \| 92% \| Table 2 Main results and conclusion of studies selected \| Citation \| Main results \| \|---\|---\| \| Moosa et al., 2019 \| Fifty-two of the 133 patients were men. The average age of the group was 37. Ten percent of the patients had a pelvic X- ray and clinical examination result in a true positive for a pelvic fracture, whereas the other ten percent had a false negative. Two patients who had X-ray evidence of a fracture were overlooked by the clinical assessment and were deemed false positives. Furthermore, no fracture was seen on the X-ray or clinical examination, making 77.4% of the patient’s genuine negatives. \| \| Van-Leent et al., 2019 \| Of the 56 patients in the research, 11 had a pelvic ring fracture. Just five of the 13 patients who received pelvic compression devices suffered a pelvic ring fracture. doctors who conducted clinical examinations had a 0.45 overall sensitivity and a 0.93 specificity. \| \| Schweigkofler et al., 2018 \| This research comprised 254 individuals from 12 different trauma centres who had suspected pelvic injuries. It was determined that 95 out of 254 cases—46 type B and 49 type C fractures—had unstable pelvic fractures. After 61% of the cases underwent mechanical stability testing, the results showed a sensitivity of 31.6% and a specificity of 92.2%. In fact, 11.5% of patients exhibited mechanical instability. Nevertheless, due to clinical judgment, noninvasive external stabilization was administered to 65.4% of patients before diagnostic imaging. In the ensuing CT scans, 72% had evidence of severe bleeding. 33 pelvic ring fractures were not stabilized before to hospitalization. \| \| Majidinejad et al., 2018 \| Clinical signs and symptoms had a 100% specificity and a 39.7% sensitivity to the absence of a pelvic fracture. The findings of the X-ray and CT scan, as well as the clinical signs and symptoms criterion, did not show a significant difference in the absence of a distracting injury; on the other hand, there was a significant difference in the other criteria. The prediction of not experiencing pelvic pain was significantly impacted by the absence of pelvic discomfort or tenderness as well as the capacity to activate SLR. It is possible to exclude any distracting ailment from the criteria while maintaining specificity and increasing sensitivity. \| Shlamovitz et al., 2009 pelvic fracture. Type B and C pelvic fractures were not suspected in the pre-hospital setting in 40.5% and 32.3% of cases, respectively. GCS < 8 and age more than 60 were independent risk factors for failing to detect a pelvic injury in the pre-hospital context. The likelihood of overlooking a pelvic injury was reduced in the cases of hypotension and a high injury severity. Unstable pelvic ring physical examination findings showed a sensitivity and specificity of 8% and 99%, respectively, for identifying any pelvic fracture and 26% and 99.9%, respectively, for identifying pelvic fractures that were mechanically unstable. For pelvic fractures diagnosis in patients with a GCS >13, the sensitivity and specificity of pelvic pain or tenderness were 74% and 97%, respectively, and 100% and 93%, respectively, for unstable pelvic fractures diagnosis. For any pelvic fracture diagnosis, the sensitivity and specificity of pelvic deformity existence were 30% and 98%, respectively, but for the detection of pelvic fractures that were mechanically unstable, they were 55% and 97%, respectively. Consequently, regardless of the results of the physical assessment, a mechanical pelvic stabilization in the pre-hospital setting should be taken into consideration for patients with severe blunt trauma injuries. In patients with blunt trauma, the appearance of unstable pelvic ring or a pelvic deformity during physical examination has a low sensitivity for identifying unstable pelvic fractures. According to this research, individuals who have had severe trauma and have a GCS of >13, as well as no pelvic pain or tenderness, are less likely to experience unstable pelvic fracture. 4. DISCUSSION According to this comprehensive research, the range of pelvic fractures for which a physical examination is sensitive is 0.761–0.952. Additionally, compared to patients with decreased consciousness, trauma patients with GCS ≥ 13 had a sensitivity range of 0.847 to 0.998. The evidence quality was low overall, but increased when studies including individuals with reduced consciousness were eliminated. Regardless of the physical examination results, all trauma patients should have imaging tests done. Meanwhile, physical examination is a valuable screening tool, according to our review study. In general, the frequency of pelvic fractures and the patients' level of consciousness determine the clinical value of physical examinations. Whether a patient is conscious or not, imaging tests should always be ordered for trauma patients receiving care at a trauma centre or tertiary care centre. The clinical utility of a test is typically determined by its prevalence of the target condition, diagnostic accuracy, physician policy regarding associated risks, and patient and physician preference. According to the findings of Van-Leent et al., (2019) study, patients who have had high-impact blunt trauma and have a strong suspicion of a pelvic ring fracture may find it challenging to rule out a pelvic fracture at the accident scene based solely on physical examination. Unlike the meta-analysis carried out by Sauerland et al., (2004) this investigation was carried out on the spot with patients who had hemodynamic or neurologic impairments. Surprisingly, study by Van-Leent et al., (2019) revealed that patients with neurologic impairment (GCS ≤ 13) had a higher manual compression test (MCT) sensitivity. Due to concurrent brain injuries or distracting injuries, collecting a patient's history might be challenging in polytraumatized individuals. Van-Leent et al., (2019) findings suggest that patients with neurologic deficits have more clouded pelvic ring clinical examinations, whereas patients with hemodynamic deficits had less obscured pelvic ring examinations. Van-Leent et al., (2019) came to the conclusion that a pelvic fracture is not ruled out by a negative MCT. This supports the conclusion, which is consistent with the work of Yong et al., (2016) that pelvic binders ought to be the standard of therapy following high-energy blunt trauma regardless of MCT. The pelvic binder should be utilized with a low threshold, as verified by the MCT's limited accuracy and possible hazards (Van-Stigt et al., 2009). Most trials had an overall sensitivity of nearly 100% for identifying a pelvic fracture that was clinically significant and needed special care. Only 7 out of 97 pelvic fractures were missed on clinical examination in the study by Gonzalez et al., (2002) which evaluated a total of 2176 consecutive blunt trauma patients presenting with a GCS C 14; none of the missed fractures required surgical intervention (sensitivity, 0.93). REVIEW \| OPEN ACCESS The overall sensitivity and specificity of a meta-analysis that evaluated the clinical examination's dependability in identifying pelvic fractures, pooling data from 12 trials with more than 5 thousand patients, were found to be 0.9, translating to a 10% false positive and false negative rate, respectively (Sauerland et al., 2004). In contrast to these results, a small number of other studies Grant, (1990), Shlamovitz et al., (2009) found lower sensitivities, ranging from 27 to 59%, for clinically identifying pelvic instability. Regarding the validity of the pre-hospital physical evaluation of the pelvis, our results support these findings. 5. CONCLUSION The results of this review showed that, irrespective of the results of physical examinations or the patients' states of consciousness, imaging studies should be carried out for all patients with trauma. Clinicians should, however, take the prevalence of the target ailment into account when evaluating the value of a physical examination. Ethical approval Not applicable Funding This study has not received any external funding. Conflict of interest The authors declare that there is no conflict of interests. Data and materials availability All data sets collected during this study are available upon reasonable request from the corresponding author. REFERENCES 1. ATLS Subcommittee; American College of Surgeons' Committee on Trauma; International ATLS working group. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg 2013; 74(5):1363-6. doi: 10.1097/TA.0 b013e31828b82f5 2. Bonner TJ, Eardley WG, Newell N, Masouros S, Matthews JJ, Gibb I, Clasper JC. Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring. J Bone Joint Surg Br 2011; 93(11):1524-8. doi: 10.1302/0301-620X .93B11.27023 3. Den-Boer TA, Geurts M, Van-Hulsteijn LT, Mubarak A, Slingerland J, Zwart B, Van-der-Heijden GJ, Blokhuis TJ. The value of clinical examination in diagnosing pelvic fractures in blunt trauma patients: a brief review. Eur J Trauma Emerg Surg 2011; 37(4):373-7. doi: 10.1007/s00068-011-0076-7 4. Gonzalez RP, Fried PQ, Bukhalo M. The utility of clinical examination in screening for pelvic fractures in blunt trauma. J Am Coll Surg 2002; 194(2):121-5. doi: 10.1016/s1072-7515(01) 01153-x 5. Grant PT. The diagnosis of pelvic fractures by 'springing'. Arch Emerg Med 1990; 7(3):178-82. doi: 10.1136/emj.7.3.178 6. Lustenberger T, Walcher F, Lefering R, Schweigkofler U, Wyen H, Marzi I, Wutzler S; TraumaRegister DGU. The Reliability of the Pre-hospital Physical Examination of the Pelvis: A Retrospective, Multicenter Study. World J Surg 2016; 40(12):3073-3079. doi: 10.1007/s00268-016-3647-2 7. Majidinejad S, Heidari F, Kafi Kang H, Golshani K. Determination of Clinical Signs and Symptoms Predicting No Pelvic Fracture in Patients with Multiple Trauma. Adv Biomed Res 2018; 7:112. doi: 10.4103/abr.abr_127_17 8. McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM; and the PRISMA-DTA Group; Clifford T, Cohen JF, Deeks JJ, Gatsonis C, Hooft L, Hunt HA, Hyde CJ, Korevaar DA, Leeflang MMG, Macaskill P, Reitsma JB, Rodin R, Rutjes AWS, Salameh JP, Stevens A, Takwoingi Y, Tonelli M, Weeks L, Whiting P, Willis BH. Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement. JAMA 2018; 319(4):388-396. doi: 10.1001/jama.2017.19163 9. Moosa MA, Gill RC, Jangda I, Sayyed RH, Zafar H. Is pelvis xray essential in stable trauma patients? Step towards lowering the treatment cost. J Pak Med Assoc 2019; 69 (Suppl 1) (1):S33S36. 10. Sauerland S, Bouillon B, Rixen D, Raum MR, Koy T, Neugebauer EA. The reliability of clinical examination in detecting pelvic fractures in blunt trauma patients: a metaanalysis. Arch Orthop Trauma Surg 2004; 124(2):123-8. doi: 10. 1007/s00402-003-0631-8 11. Schweigkofler U, Wohlrath B, Trentsch H, Greipel J, Tamimi N, Hoffmann R, Wincheringer D. Diagnostics and early treatment in prehospital and emergency-room phase in suspicious pelvic ring fractures. Eur J Trauma Emerg Surg 2018; 44(5):747-752. doi: 10.1007/s00068-017-0860-0 12. Shlamovitz GZ, Mower WR, Bergman J, Chuang KR, Crisp J, Hardy D, Sargent M, Shroff SD, Snyder E, Morgan MT. How (un) useful is the pelvic ring stability examination in diagnosing mechanically unstable pelvic fractures in blunt trauma patients? J Trauma 2009; 66(3):815-20. doi: 10.1097/TA .0b013e31817c96e1 13. Spanjersberg WR, Knops SP, Schep NW, Van-Lieshout EM, Patka P, Schipper IB. Effectiveness and complications of pelvic circumferential compression devices in patients with unstable pelvic fractures: a systematic review of literature. Injury 2009; 40(10):1031-5. doi: 10.1016/j.injury.2009.06.164 14. Van-Leent EAP, Van-Wageningen B, Sir Ö, Hermans E, Biert J. Clinical Examination of the Pelvic Ring in the Prehospital Phase. Air Med J 2019; 38(4):294-297. doi: 10.1016/j.amj.2019.0 4.004 15. Van-Stigt SF, Tan EC, Van-Vugt AB. Acute behandling van bekkenfracturen. Ned Tijdschr Geneeskd 2009; 153:A500. 16. Van-Trigt J, Schep NWL, Peters RW, Goslings JC, Schepers T, Halm JA. Routine pelvic X-rays in asymptomatic hemodynamically stable blunt trauma patients: A metaanalysis. Injury 2018; 49(11):2024-2031. doi: 10.1016/j.injury.20 18.09.009 17. Wohlrath B, Trentzsch H, Hoffmann R, Kremer M, SchmidtHorlohè K, Schweigkofler U. Präklinische und klinische Versorgung der instabilen Beckenverletzung: Ergebnisse einer Online-Umfrage [Preclinical and clinical treatment of instable pelvic injuries: Results of an online survey]. Unfallchirurg 2016; 119(9):755-62. German. doi: 10.1007/s00113-014-2679-z 18. Yong E, Vasireddy A, Pavitt A, Davies GE, Lockey DJ. Prehospital pelvic girdle injury: Improving diagnostic accuracy in a physician-led trauma service. 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"A level Sociology is one of the few subjects where you get the chance to think." Is it fair that wealthy parents can buy the best education for their children? What causes groups like ISIS to emerge? Why do girls perform better than boys in education? Do couples today have equal relationships? Who do we count as 'family'? What is green crime? Is religion in long-term decline? How do sociologists do their research? Can those with power avoid punishment for their crimes? "If you like observing people and understanding why they behave like they do – you will love A level Sociology!" Why study Sociology? Sociology is about society, people and behaviour. It helps us understand life, ourselves and how we interact with others. Sociology teaches you how to... Investigate facts and use deduction Put over your point of view fluently Support your arguments with hard evidence Sociology gives you an inquisitive mind and a valuable insight into people and the world we live in. These skills are highly valued by universities and employers – and will benefit you for the rest of your life. Sociology is great for... University A level Sociology combines well with other subjects and is accepted by universities as an excellent foundation for a range of degree courses. Our Sociology students have gone on to study Sociology, Law, Medicine, Teaching, Criminology, Social policy, Media, English Literature, History and Politics. Careers A level Sociology gives you an excellent set of transferable skills. This makes it great for many occupations, from marketing to social work, teaching to criminal justice. Whatever career you are interested in, Sociology gives you a head start. What will I study? You will study four topics over two years and sit three examinations at the end of Year 2. 1. Education How do personal relationships, class, gender and ethnicity affect how we learn? 2. Families and Households How has the population, the family and our roles within it changed over recent years? 3. Beliefs in Society What part does ideology, science and religion play in shaping our lives? 4. Crime and Deviance Why is there crime and what is the role of the criminal justice system? For a full list of what is studied, please email firstname.lastname@example.org or email@example.com	<urn:uuid:2671bd29-7468-4f96-98de-1ef57e1a382b>	CC-MAIN-2024-42	https://www.huntingtonschool.co.uk/attachments/download.asp?file=275&type=pdf	2024-10-12T22:10:27+00:00	crawl-data/CC-MAIN-2024-42/segments/1727944254995.79/warc/CC-MAIN-20241012205209-20241012235209-00808.warc.gz	687,202,486	512	eng_Latn	eng_Latn	0.998095	eng_Latn	0.998392	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 1109, 2334 ]	[ 1.921875 ]	[ 3.28125 ]	[ 3.09375 ]	[ 2.453125 ]	1	1	HuggingFaceFW/finepdfs
LEAP FLOOR 1 EVACUATION PLAN Copper pipe mapping SHOP ROOM 5 ROOM 6 HALLWAY KITCHEN STOCKROOM ROOM 4 H/L CONF OFFICE ROOM 3 ROOM 2 HALLWAY ENTRY REC AREA HALLWAY ROOM 1 PORCH BACK ENTRY Legend O - WH = water heater O - F = inline water filter @ - Sink # - Toilet ← - cold water line ↑ - hot water line ↓ - all copper → - Water fountain - not used LC201 - Staff bathroom (sink 1) LC202 - North student bathroom (sink 2) LC203 - South student bathroom (sink 3) LC204 - Kitchen sink LC205 - Utility sink (sink #5)	<urn:uuid:7e4a51b6-2fd4-4fc9-ba11-19ea5c5ee18b>	CC-MAIN-2021-49	http://edocpub.epa.ohio.gov/publicportal/ViewDocument.aspx?docid=1625690	2021-12-06T23:20:13+00:00	crawl-data/CC-MAIN-2021-49/segments/1637964363327.64/warc/CC-MAIN-20211206224536-20211207014536-00301.warc.gz	25,581,635	182	eng_Latn	eng_Latn	0.555714	eng_Latn	0.555714	[ "eng_Latn" ]	false	rolmOCR	[ 514 ]	[ 0.98828125 ]	[ 1.375 ]	[ 1.046875 ]	[ 1.2890625 ]	1	0	HuggingFaceFW/finepdfs
Easy Scavenger Hunt Activity Key Questions: 1. Which animal would you expect to like the cold, but actually prefers the warm weather of Peru and Chile? (Humboldt Penguin) 2. Which animal can only be found on the Galapagos Islands? (Galapagos Tortoises) 3. As cubs, these two were orphaned in the wild but now have a home at the Akron Zoo. (Grizzly Bears) 4. How much does a snowy owl weigh? (3-6 lbs) 5. These animals love to play with zoo visitors. Slide through their exhibit! (River Otters ) 6. This animal can't roar. It has the softest voice of any of our big cats. (Snow Leopard) 7. Garden eels look like plants swaying in the water when they are doing what? (Hunting for plankton) 8. How much do you weigh in Grizzly Bear food? 9. How many Volts can an electric eel release in one burst? (600) 10. This bird is a great sniffer. In fact, it has such large nostrils, you can see right through them! (Andean Condor) 11. Why does the Green Tree Python have white spots? (To help it camouflage)	<urn:uuid:adbf52b8-3172-4f66-9910-5ac567dfd228>	CC-MAIN-2021-49	https://www.akronzoo.org/Data/Sites/1/Attachments/easy-scavenger-hunt-answers.pdf	2021-12-04T02:13:14+00:00	crawl-data/CC-MAIN-2021-49/segments/1637964362923.11/warc/CC-MAIN-20211204003045-20211204033045-00139.warc.gz	679,111,456	263	eng_Latn	eng_Latn	0.998102	eng_Latn	0.998102	[ "eng_Latn" ]	false	docling	[ 1000 ]	[ 2.75 ]	[ 2.484375 ]	[ 3.4375 ]	[ 1.7265625 ]	1	0	HuggingFaceFW/finepdfs
The New York City Council Legislation Details File #: Version: * LU 0748- 2012 Name: Planning, 502 W 151st St & 526/8 W 151st St, Manhattan (20135202 HAM) Status: Type: Land Use Application Adopted In control: Subcommittee on Planning, Dispositions and Concessions On agenda: 12/18/2012 Enactment date: Enactment #: Title: Application No. 20135202 HAM submitted by New York City Department of Housing Preservation and Development (“HPD”) for a modification of an exemption of real property taxes for the property located at 502 West 151st Street, Tax Block 2082, Lot 36, and 526/8 West 151st Street (Tax Block 2082, Lot 52), Borough of Manhattan, Community Board 9, Council District 7. This matter is subject to Council review and action at the request of HPD and pursuant to Sections 123(4), 125 and 577 of the Private Housing Finance Law. Sponsors: Leroy G. Comrie, Jr. Indexes: Attachments: 1. Land Use Calendar - December 17, 2012, 2. Land Use Calendar - Week of December 17, 2012 - December 21, 2012, 3. Committee Report, 4. Resolution, 5. Hearing Transcript - Planning 12/17/12, 6. Hearing Transcript - Land Use 12/17/12, 7. Hearing Transcript - Stated Meeting 12-18-12	<urn:uuid:466af8bb-ed6e-44be-9e47-def09cfd3ef0>	CC-MAIN-2023-40	https://legistar.council.nyc.gov/ViewReport.ashx?M=R&N=Master&GID=61&ID=1255454&GUID=DCDD229F-03A0-4293-BDCC-C96756D2EB6D&Title=Legislation+Details	2023-09-26T09:29:57+00:00	crawl-data/CC-MAIN-2023-40/segments/1695233510179.22/warc/CC-MAIN-20230926075508-20230926105508-00024.warc.gz	394,301,835	347	eng_Latn	eng_Latn	0.557363	eng_Latn	0.557363	[ "eng_Latn" ]	false	docling	[ 1200 ]	[ 0.388671875 ]	[ 1.15625 ]	[ 1.5546875 ]	[ 2.65625 ]	1	0	HuggingFaceFW/finepdfs
They do not look down at the path below but look up toward the destination and the goal. Thus the Pope writes: Faith is born of an encounter with the living God who calls us and reveals his love, a love which precedes us and upon which we can lean for security and for building our lives. Transformed by this love, we find fresh vision, new eyes to see; we realize that it contains a great promise of fulfilment, and that a vision of the future opens up before us (LF §4). Because of sin, human beings have a tendency to be self-absorbed. Looking only to ourselves, we become isolated from God and isolated from one another. But precisely because faith is attached to hope in God’s promises and love for him and his people, ‘faith is also a light…opening before us vast horizons which guide us beyond our isolated selves towards the breadth of communion’ (LF §4). At one point, speaking about the way that faith contributes to human society here and now, Pope Francis writes that ‘without a love which is trustworthy’, upon which faith can build, ‘nothing could truly keep men and women united’ (LF §51). Society would be built upon a ‘calculus of conflicting interests or on fear’ rather than true community. On the other hand: Faith is truly a good for everyone; it is a common good, its light does not simply illuminate the horizon of the Church, and does not serve solely to construct an eternal city in the hereafter; it helps us build our societies in such a way that they can journey towards a future of hope (LF §51). THE GOAL OF THE JOURNEY OF FAITH So we have identified that the beginning of the journey of faith is the encounter with the living God in Jesus. We know that ‘caught up in and guided by his love’ (LF §53) Christians travel forward in community on the path of faith in ‘a firm hope’. This leads us to ask the next important question about Lumen Fidei: what is the horizon towards which the journey of faith strives? What is ‘the goal and thus the meaning of our common path’ (LF §25)? The Pope answers this question with another, rhetorical, question: ‘What other reward can God give to those who seek him, if not to let himself be found?’ (LF §35). There are many who pride themselves in being seekers, but are reluctant to embrace the certainty of objective truth even when they find it. But what is the purpose of seeking God if not finding God? Because faith has taught us that God is faithful, it also teaches that God will fulfil his promises. The Pope quotes St Augustine: ‘Man is faithful when he believes in God and his promises; God is faithful when he grants to man what he has promised’ (LF §10). On several occasions, the word ‘fulfilment’ appears in the Encyclical. Reflecting on the Eucharist, Pope Francis writes: ‘we also find the bread and wine, which leads from the visible world to the invisible. In the Eucharist we learn about the heights and depths of reality. The bread and wine are changed into the body and blood of Christ, who becomes present in his passover to the Father: this movement draws us, body and soul, into the movement of all creation towards its fulfilment in God’ (LF §44). The journey of faith, like the Eucharist, has two dimensions. It looks back to the life, death and resurrection of Jesus and all God’s promises in him. But it looks forward to ‘the ultimate fulfilment’ (LF §44) of eternal communion with God. ‘Thus wonderfully interwoven,’ writes Pope Francis, ‘faith, hope and charity are the driving force of the Christian life as it advances towards full communion with God’ (LF §7). CONCLUSION – A ROAD MAP FOR THE ENCYCICAL I have not tried to summarise the Encyclical Lumen Fidei. Rather, I have attempted to provide the reader of Pope Francis’ first encyclical with a road map and a compass to enter into his meditation and teaching. The overall idea behind the Encyclical is very simple: from our first encounter with God’s love in Christ, we embark upon the journey of faith, travelling towards a new horizon, the hope of ultimate fulfilment in communion with God. This is, of course, only an outline to orientate the reader. It cannot replace reading the Encyclical itself, just as reading a map cannot replace the journey. Nor is reading the Encyclical a pilgrimage to be undertaken by modern means of transportation; to get the most out of it, it must be done on foot, taking time with each paragraph, savouring each sentence, and, above all, reflecting on the whole of Lumen Fidei in prayer. QUESTIONS: 1. In LF §33, Pope Francis writes that ‘the decisive moment in Lumen Fidei’s journey of faith…[was] in an experience of hearing. In the garden, he heard a voice telling him: “Take and read”’. What was your ‘decisive moment’ for your faith? How was it an ‘encounter with Christ? How do you continue to ‘encounter Christ’ today? 2. Do you find ‘the journey of faith’ difficult? In Chapter Three of Lumen Fidei, Pope Francis tells us that ‘those who believe are never alone’. What kinds of assistance does God give us in the community of the Church for the journey? Do we make use of them? 3. What do you normally think of as the goal or end point of our journey of faith? Pope Francis writes that ‘whole of life is drawn into a journey towards full communion with the living God’ (LF §45)? How does this goal relate to our life of faith in this world here and now? David Schütz is the Executive Officer of the Ecumenical & Interfaith Commission of the Archdiocese of Melbourne. A former Lutheran pastor, he entered the Catholic Church in 2001 after a ‘year of grace’ and soul-searching. --- INFORM Lumen Fidei - The Light of Faith (First Encyclical Letter) Pope Francis --- In this article, David Schütz provides us with a ‘Road Map’ for understanding Pope Francis’ first Encyclical Letter, Lumen Fidei (On Faith). INTRODUCTION - A PAPAL ENCYCICAL Thanks to the 24/7 media cycle, we are quickly becoming familiar with our new Supreme Pontiff Francis – or at least we think we are. The media has created its own narrative by which to understand Pope Francis. Focusing upon his ‘humility’, his unpredictable actions such as the Maundy Thursday foot washing, and his simple way of addressing the crowds, this narrative depends in large part on a ‘hermeneutic of rupture’ between Pope Francis and his predecessor, Pope Emeritus Benedict XVI. However, the Encyclical Letter Lumen Fidei (trans. ‘Light of Faith’, henceforth LF) released on 5 July 2013, is a clear reminder that Pope Francis is exercising his magisterium in complete continuity with Benedict and Blessed John Paul II. Furthermore, the Encyclical reminds us that we still have a lot to learn about the new Pontiff, and even more to learn from him. Pope Francis himself has told us that this is an encyclical written by ‘four hands’ – his and Benedict’s (although actually Benedict writes with a pen in one hand rather than two on a word processor!). Having written major encyclicals on Love (Deus Caritas Est) and Hope (Spe Salvi), Pope Emeritus Benedict had always planned to issue an encyclical on the subject of the third ‘theological virtue’, Faith. After his renunciation of the papal office, Benedict passed on to his successor a draft which was ‘almost complete’. Francis tells us that, ‘as [Benedict’s] brother in Christ, I have taken up his fine work and added a few contributions of my own’ (LF §7). There was some speculation that it might have been issued in the name of both popes, but of course, this would have been impossible. As Pope Emeritus, Benedict no longer has the authority of the papal office. Only Pope Francis has the authority to issue a papal teaching. Nevertheless, we can think God’s plan for this encyclical: that the best of gifts of both pontiffs have been brought to the service of the Church’s magisterium. The fact that the Encyclical on Love, Deus Caritas Est, had itself been begun by Blessed John Paul II and completed by Benedict means that the entire trilogy is a fine example of the continuity of the papal magisterium. Readers must therefore overcome the temptation to apply ‘source criticism’ to the Encyclical, trying to work out which bits were written by Benedict and which bits by Francis. There is no point to this exercise; nor does Francis allow us the luxury of it. No matter who the pope is, ‘the Successor of Peter, yesterday, today and tomorrow, is always called to strengthen his brothers and sisters in the priceless treasure of that faith which God has given as a light for humanity’s path’ (LF §7). ‘This Encyclical, like any encyclical, is the work of the Supreme Pontiff of the Catholic Church. The ‘priceless treasure’ that the Pope hands on to us is always the same, even though the person who holds the office of Pope may change. Thus, the Encyclical Lumen Fidei was signed by Pope Francis on 29 June 2013 (the Feast of St Peter and St Paul), and addressed to ‘the bishops, priests and deacons, consecrated persons and the lay faithful’ of the Church. THE JOURNEY OF FAITH Although it is quite possible to read a papal encyclical in a single sitting, those who attempt to comprehend such a document as a whole will often struggle. Encyclicals are not like books or essays which are written to develop a particular idea in a single line of argument. Rather, they are teaching documents which approach a particular subject from as many different angles as the pope judges necessary and relevant to the Church’s contemporary needs. In this sense, they are also research documents, including bishops and theologians and other members of the Church with foundations and direction for a further working out of the subject with which it deals. This can make attempting to ‘summarise’ an encyclical like Lumen Fidei very difficult; it is, in a sense, already a summary of the Church’s teaching on the subject of faith. So let us ask instead what Lumen Fidei is actually about: is it possible to locate a central idea? Although the Latin title is translated ‘the Light of Faith’, this is not its ‘theme’. The title comes from the opening words of the Encyclical in Latin. Lumen Fidei has much to say on the subject of faith as ‘light’, particularly in the way that faith relates to the sense of ‘sight’, but faith also relates to the sense of ‘hearing’ and even ‘feeling’. The most important word of the Encyclical lies in a word that is used 36 times in the English translation: ‘journey’. Connected with this are other words: ‘path’ (27 times) and ‘way’ (15 times), as well as ‘road’, ‘pilgrimage’, ‘destination’ and ‘goal’. These words translate various words in the Latin original (the translation is not always consistent), principally via (36 times) and iter (51 times). Those who have been watching Pope Francis’ homilies on the internet or reading reports of them will know that he often describes the Christian life as a camino, that is, a journey or a pilgrimage. If you pay attention to the way that Pope Francis talks about ‘journeying’, ‘walking’, ‘moving’, ‘going forward’ and so on, you will understand a lot about how he views the Church as an evangelising, charitable, missional Church, which is never stationary or static, but always ‘going places’ (as we might say). In his very first homily he began by saying: > In these three readings, I see that there is something in common: movement. In the first reading, movement is the journey [itself]; in the second reading, movement is in the up-building of the Church. In the third, in the Gospel, the movement is in [the act of] profession [of faith]: walking, building, professing (Sistine Chapel, 14th March, 2013, emphasis in italics added). Each of these three themes is prominent in Lumen Fidei. Professing the faith is what the whole document is about. The theme of journeying, as we have seen, is constant. The theme of faith as an act of building is introduced as a minor secondary theme in §50 where, in commenting on the Letter to the Hebrews, Pope writes, ‘faith is not only presented as a journey, but also as a process of building, the preparing of a place in which human beings can dwell together with one another’ (emphasis added). If, while reading the Encyclical, you take note of the constant recurrence of the idea of ‘journeying’, then there is one passage which will jump out at you as soon as you come across it. It is this: > Faith, as we have said, takes the form of a journey, a path to be followed, which begins with an encounter with the living God (LF §46). Although it comes rather late in Lumen Fidei, nevertheless, this one sentence encapsulates the central idea of the document as a whole. With this in mind, everything else falls into place. A PERSONAL ENCOUNTER This sentence also shows the beautiful way in which Pope Francis’ first encyclical resonates with the first encyclical of Benedict XVI, Deus Caritas Est (On ‘Christian Love’, henceforth DCE). There is a sentence in the first paragraph of the latter which may well be one of the most memorable and significant sayings in the whole of Benedict’s magisterium: > Being Christian is not the result of an ethical choice or a lofty idea, but the encounter with an event, a person, which gives life a new horizon and a decisive direction (DCE §1). Reading these two sentences together, as I believe Pope Francis wishes us to do, we learn that the journey of the Christian life (the life of faith) begins with the personal encounter with Jesus Christ (in whom ‘the living God’ is most fully revealed). It is precisely this encounter which compels the Christian to embark upon the journey. We may be familiar with the way in which our Protestant brothers and sisters talk about ‘a personal relationship with Jesus’. Pope Francis and Benedict want the Catholic Faithful also to be aware of the crucial importance of this personal encounter for Christian faith. There are, however, differences. For a start, according to the Catholic Faith, the personal encounter with the living God takes place sacramentally, beginning with baptism: > While the sacraments are indeed sacraments of faith, it can also be said that faith itself possesses a sacramental structure. The awakening of faith is linked to the dawning of a new sacramental sense in our lives as human beings and as Christians, in which visible and material realities are seen to point beyond themselves to the mystery of the eternal (LF §40, emphasis added). A second difference is that the personal encounter of each believer with Jesus – indeed the whole journey of faith – is not the encounter /journey of an isolated individual, but of the whole community of faith, the Church. Throughout Lumen Fidei, Francis is at pains to stress the objectivity of faith. If: > [f]aith is more than a personal effort, a leap in the dark, to be taken in the absence of light, driven by blind hope, it is also a shared, objective light, capable perhaps of warming the heart and bringing personal consolation, but not something which could be proposed to others as an objective and shared light which points the way (LF §3) then it would only be ‘true for you but not for me’, as many say these days. Precisely because the Truth in which we place our faith has an objective reality, it is a faith that can be shared by an entire community of ‘faithful’ people. We not only say ‘I believe’ but we believe’ (LF §39). The journey of faith therefore is not a solo journey, but ‘enables us to become part of the Church’s great pilgrimage through history until the end of the world’ (LF §22, emphasis added). NEW HORIZONS Another word that appears regularly in Lumen Fidei is the word ‘horizon’ – often accompanied by the description ‘immense’ (§1) or ‘vast’ (§4). In one striking passage, Pope Francis brings together all three theological virtues as he expands upon Benedict’s line from DCE: > Encountering Christ [ie. beginning the journey of faith], letting themselves be caught up in and guided by his love, enlarges the horizons of existence, gives it a firm hope which will not disappoint (LF §33). As we have seen, Benedict taught that the personal encounter with Christ ‘gives life a new horizon’, a new goal and destination (DCE §1). The journey of faith is not like that of a sight-seeing tourist, travelling on ‘roads which take us in endless circles, going nowhere’ (LF §3). Rather, the journey of faith has a ‘decisive direction’ and a particular goal. In this sense it is precisely like a pilgrimage, in which the meaning of the journey is completely determined by the destination. The person who embarks upon the journey of faith has their head and eyes lifted up toward the horizon – the farthest point that the eye can see.	<urn:uuid:206ec522-6591-41d2-a23a-aaaf4a770464>	CC-MAIN-2019-09	http://holyinnocentscroydon.org.au/files/Inform/Inform_145_The_Light_of_Faith_-_First_Encyclical_Letter_Lumen_Fidei.pdf	2019-02-18T07:48:17Z	crawl-data/CC-MAIN-2019-09/segments/1550247484772.43/warc/CC-MAIN-20190218074121-20190218100121-00195.warc.gz	126,293,531	3,835	eng_Latn	eng_Latn	0.99706	eng_Latn	0.997348	[ "eng_Latn", "eng_Latn" ]	true	rolmOCR	[ 5853, 16799 ]	[ 1.1484375 ]	[ 4.78125 ]	[ 4.75 ]	[ 2.640625 ]	1	0	HuggingFaceFW/finepdfs
Enzyme immobilized as biosensor in monitoring of the carbamate pesticides Ionela Daniela Popescu\textsuperscript{1}, I. Nicolae\textsuperscript{2}, C. Tanase\textsuperscript{1}, E. Raducan\textsuperscript{1} and E. Codorean\textsuperscript{1} \textsuperscript{1} "Victor Babes" National Institute, , Spl. Independentei, 99-101 76201, Bucharest, Romania Phone/Fax: +004 021 411 51 95; e-mail: email@example.com \textsuperscript{2} University of Bucharest, Faculty of Chemistry Carbamates are potent biological agents used extensively in applications ranging from agriculture to medicine and industry. The source of the insecticidal action of the methyl- and dimethylcarbamates is their ability to directly inhibit cholinesterase (ChE) in both insect and mammals. Additionally to their neurotoxicity, the carbamates exhibit biochemical, immunotoxicological and pharmacological effects widely investigated experimental in our research group. A high acute toxicity of these compounds creates a need for fast responding detection system in order to protect human health during manufacturing and application processes and subsequently sensitive systems for reliable control of food products and environment pollution. Enzyme (ChE) sensors based on the inhibitory property of the carbamates have been found to be simple and inexpensive tools in their monitoring in water and soil. The mode of action of these pesticides is based on irreversible inhibition of acetylcholinesterase and the same principle is utilized for analysis. The activity and stability of cholinesterases, as well as their sensitivity towards a given inhibitor, depend on the type and the source of cholinesterase. Acetyl- or butyryl-cholinesterases have been purified and are now commercially available. An amperometric biosensor for the detection and determination of carbamate pesticides, based on a ferophthalocyanine-modified carbon electrodes coupled with acetylcholinesterase was used in evaluation of the carbamates levels in area with expected or determined pollution; the results represent the start point in monitoring environmental carbamates and other pesticides using enzyme biosensors. Introduction Inhibition of immobilized enzymes in biosensors Some new problems arise in the use of immobilized enzymes instead of soluble enzymes to detect inhibitors. First of all, the immobilization of an enzyme generally induces conformational modifications that may affect its activity and its sensitivity towards inhibition. Moreover, many reports point out that immobilization induces a decrease in the sensitivity of enzymes towards inhibitors. When using biosensors, the inhibition process is influenced by various new parameters such as microenvironment effects, diffusion limitation and possible interactions between the substrate and/or the inhibitor and the membrane (9, 5). Unlike biosensors devoted to the determination of substrates, the detection of inhibitors requires the use of low enzyme loading in order to detect very low inhibitor concentrations. Consequently, enzyme electrodes used in such assay must work under kinetic control. This concept is not usual in the design of biosensors for substrate determination where high enzyme loading are used, so that the responses are governed by diffusion constraints. The mode of action of these pesticides is based on irreversible inhibition of acetylcholinesterase and the same principle is utilized for analysis. The use of cholinesterase as a sensing element does not allow for the selective detection of a particular pesticide, but rather provides an estimation of the total anticholinesterase activity of a sample. Enzyme (ChE) sensors based on the inhibitory property of the carbamates have been found to be simple and inexpensive tools in their monitoring in water and soil. The mode of action of these pesticides is based on irreversible inhibition of acetylcholinesterase and the same principle is utilized for analysis. The activity and stability of cholinesterases, as well as their sensitivity towards a given inhibitor, depend on the type and the source of cholinesterase (1, 2, 6). An amperometric biosensor for the detection and determination of carbamate pesticides, based on a ferophthalocyanine-modified carbon electrodes coupled with acetylcholinesterase was used in evaluation of the carbamates levels in area with expected or determined pollution; the results represent the start point in monitoring environmental carbamates and other pesticides using enzyme biosensors. Material and methods An amperometric biosensor for the detection and determination of carbamate pesticides, based on a ferrophthalocyanine-modified carbon electrodes coupled with AChE (immobilized enzyme biosensors) was used in evaluation of the carbamates levels (2, 3, 8). Two methods were used: kinetic and incubation method. The immobilized enzymes biosensor was used to determination of carbofuran concentration (N-methyl carbamate): The mode of action is based on irreversible inhibition of acetylcholinesterase by carbamates and the same principle is utilized for analysis. The inhibition process is influenced by various parameters such as time and substrate concentration, their optim values must to be established before the each pesticide determination. Preliminary results Optim reaction time for the carbofuran determination is presented in Figure 1. Positive linear response induced by AChO concentration up to 0.9mM. Saturation of the enzyme substrate between 1mM – 1,5 mM AChO. An appreciable enzyme inhibition by substrate begins after 1,6 mM AChO expressed by remission of the intensity. The pattern suggests the optim substrate concentration between 0,9 mM – 1,6 mM AChO. Figure 1 Correlation of the AChE inhibition with the carbofuran concentration (kinetic method) is presented in Figure 2. The pattern indicates: - A short time / intensity positive dependence with maximum value at 5 min. - Longer incubation times induced the return to lower values of the reaction. - The optimal reaction time for carbofuran was established 5 min. ![Figure 2](image) AChE inhibition induced by various carbofuran concentration (incubation method) is presented in Figure 3. - The lowest detectable concentration of carbofuran was limited 0,1 ppb. - Carbofuran concentration between 0,1 – 1,2 ppb induced a good positive correlation with % AChE inhibition. - Kinetic method allowed optimal work determination of carbofuran concentration was limited between 0,1 – 1,2 ppb ![Figure 3](image) Preliminary data about influence of the substrate concentration on the intensity of biosensors response is presented in Figure 4. - Detectable limit concentration of carbofuran beginning about 0,05 ppb (lower than those obtained by kinetic method). - The carbofuran concentration in range 0,1 – 1,2 ppb induced a positive correlation with the AchE inhibition. • Incubation method allowed optim work determination of carbofuran concentration between 0,05 ppb – 1,2 ppb. ![Graph showing the relationship between conc. AChO (mM) and I (nA)](image) Figure 4 Conclusions - Enzyme sensors based on the inhibitory property of the pesticides on acetylcholinesterase (AChE) have been found to be simple and inexpensive tools for the detection of pesticides. - Kinetic method allowed determination of carbofuran in concentration on range limited between 0,1 – 1,2 ppb. - Incubation method allowed determination of carbofuran concentration in range limited between 0,05 ppb – 1,2 ppb. - Optim work time for carbofuran determination was established at 5 min; - The pattern of substrate concentration indicated the optim values between 0,9 mM – 1,6 mM AchO. - Incubation method - allowing to detect lower concentration (about 0,05 ppb) of carbofuran - was more sensitively compared to kinetic method (0,1 ppb). - The results represent the start point in monitoring environmental carbamates and other pesticides using enzyme biosensors. References 1. Banki L., Bioassay of pesticides in the laboratory, Akademiai Kiado, Budapest 1978 2. Ciucu A., Biosensors for environmental monitoring, Niculescu Publishing House, Bucharest 2000 3. Eto M., Organophosphorus pesticides: organic and biological chemistry, CRC Press 1974 4. Lifshitz M, Shahak E, Bolotin A, Sofer S., Carbamate poisoning in early childhood and in adults, J Toxicol Clin Toxicol;35(1):25-7, Toxicology Unit, Soroka Medical Center, Beer-Sheva, Israel 1997 5. Marty J. L., Biosensors for the detection of pesticides, Niculescu Publishing House, Bucharest 2000 6. Padeu S., Antolini F., Adami M., Nicolini C., Enzymatic biosensors for the detection of pesticides based on silicon technology, The Third World Congress of Biosensors, New Orleans, 1994 7. Sherma J., Analytical methods for pesticides and plant growth regulators, Academic Press, New York, vol. 17, 1989 8. Van Emon J.M., Seiber J.N., Hammock, Immunoassay techniques for pesticides anaalysis., Academic Press, New York, vol. 17, 1989 9. Wilson I. B., Acetylcholinesterase, The Enzymes, Boyer P. D., Lardy H., Myrback K., Academic Press, London 1960	<urn:uuid:9b7d3518-f527-4751-9cc9-e5bf5e4d8a61>	CC-MAIN-2018-43	http://prague2003.fsu.edu/content/pdf/469.pdf	2018-10-21T16:50:28Z	crawl-data/CC-MAIN-2018-43/segments/1539583514162.67/warc/CC-MAIN-20181021161035-20181021182535-00549.warc.gz	301,206,281	2,081	eng_Latn	eng_Latn	0.789282	eng_Latn	0.914863	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	rolmOCR	[ 4530, 5743, 6907, 9141 ]	[ 0.94140625 ]	[ 4.15625 ]	[ 3.078125 ]	[ 1.9609375 ]	1	0	HuggingFaceFW/finepdfs
Extreme Earth – Year 6 Important Images Key Dates, Events and Facts Vocabulary ShelterBox is an international charity that was established in Cornwall in 2000. They provide emergency shelter and aid to families around the world who have lost their homes to disaster or conflict. Deadly Natural Disasters: - 1931 China Floods killed between 1 and 4 million people. - 2010 Haiti Earthquake (12th January) killed around 316,000 people. - 2004 Indian Ocean Earthquake (26th December) killed around 280,000 people. 13 countries lie along the equator. The Pacific Ring of Fire is a horseshoeshaped line on a map which is home to around 75% of the world's volcanoes and 90% of the world's earthquakes. Climate – a regions weather patterns over a period of time. Equator – an imaginary line exactly in the middle of the Earth dividing the Northern Hemisphere and the Southern Hemisphere. Precipitation – water that falls back to the ground. Evaporation – turning liquid into vapour. Condensation – turning vapour into liquid. Drought – temporary water shortage. Lightning – occurs when parts of clouds become charged. Tropical Storm – typhoons, hurricanes and cyclones that develop in tropical areas of the ocean. Typhoon – tropical storms in the Pacific Ocean. Hurricane – tropical storms in the Atlantic Ocean. Cyclone – tropical storms in the Indian Ocean. Tornado – a spiralling funnel of air which descends from a storm cloud. Tectonic plates – the Earth's crust is made up of these, like a jigsaw. Earthquake – when the Earth's crust (tectonic plates) pull and push against themselves. Richter Scale – used to measure the strength of an earthquake. Tsunami – a large ocean wave. The name comes from the Japanese 'tsu' meaning harbour and 'nami' meaning wave. Volcano - an opening in the Earth's crust that allows magma, hot ash and gases to escape. Question Extreme Earth – Year 6 Quiz A B C \| 1. \| When did the 2004 Indian Ocean Earthquake happen? \| Christmas Day \| Boxing Day \| \| New Years Day \| \|---\|---\|---\|---\|---\|---\| \| 2. \| What is the equator? \| An area of land \| A planet in space \| \| The two plates beneath the Earth’s surface \| \| 3. \| How many countries lie along the equator? \| 13 \| 20 \| \| 11 \| \| 4. \| What percentage of the world’s volcanoes and earthquakes lie on the Pacific Ring of Fire? \| 50% of volcanoes and 65% of earthquakes \| 70% of volcanoes and 10% of earthquakes \| \| 75% of volcanoes and 90% of earthquakes \| \| 5. \| The three tropical storms are… \| Typhoons, hurricanes and tornadoes \| Blizzards, hailstorms and floods \| \| Doris, Derek and Dorian \| \| 6. \| Earthquakes occur when… \| It gets too hot \| \| When the Earth’s \| Before a really heavy storm \| \| \| \| \| \| crust (tectonic \| \| \| \| \| \| \| plates) pulls and \| \| \| \| \| \| \| pushes against \| \| \| \| \| \| \| themselves \| \| \| 7. \| What escapes from a volcano? \| Boiling hot water \| Magma, hot ash and gases \| Magma, hot ash \| Ice and rocks \| \| \| \| \| \| and gases \| \| \| 8. \| Earthquakes are measured using… \| Data loggers \| The Hydro Scale \| \| The Electron Recorder \| \| 9. \| What is a tsunami? \| Another type of earthquake \| A famous mountain in Peru \| \| A large ocean wave \| \| 10. \| What is condensation? \| Water that falls back to the ground \| Turning liquid into vapour \| \| Turning vapour into liquid \| D	<urn:uuid:6adc6161-ad0d-45d7-a852-120af5c5b189>	CC-MAIN-2020-40	https://www.thorndownprimaryschool.co.uk/wp-content/uploads/Year-6-Spring-Knowledge-Organiser-Extreme-Earth.pdf	2020-09-27T13:32:27+00:00	crawl-data/CC-MAIN-2020-40/segments/1600400279782.77/warc/CC-MAIN-20200927121105-20200927151105-00282.warc.gz	1,044,341,876	886	eng_Latn	eng_Latn	0.99723	eng_Latn	0.996963	[ "eng_Latn", "unknown" ]	false	docling	[ 1871, 3337 ]	[ 4.1875 ]	[ 3.328125 ]	[ 3.84375 ]	[ 1.5234375 ]	1	0	HuggingFaceFW/finepdfs
Multinodular goiter with retrosternal extension causing airway obstruction: Management in intensive care unit and operating room Sir, Airway compromise and difficult intubation may be anticipated in huge thyroid with gross tracheal deviation. Retrosternal extension can present with compression of structures below it and may mimic a medical condition or as emergency respiratory obstruction. Benign goiters affect 5% of the general population in nonendemic areas and 15% in endemic areas, and of these 1-15% of all patients undergoing thyroidectomy have a retrosternal goiter.\textsuperscript{[1,2]} A 58-year-old female, with thyroid swelling presented with sudden onset of dyspnea, noisy breathing, and cough with expectoration for 5 days. She was provisionally diagnosed and treated for chronic obstructive pulmonary diseases. She had expiratory wheeze with respiratory distress, bilateral crepitations, rhonchi, with saturation of 85 with oxygen by the mask of 5 L/min, pulse rate of 150 beats/min. She required immediate intubation and respiratory support, Intubated with injection propofol and injection suxamethonium without difficulty. The lobes of the thyroid gland were diffusely palpable and nodular. Lower pole of thyroid swelling was not palpable. Investigations showed hematocrit 27; white blood cells of 17.700/mm\textsuperscript{3}, thyroid function tests-free T3 0.59 ng/ml, free T4 2.13 mcg/ml, thyroid stimulating hormone 1.25 IU/ml. Lateral view of neck X-ray showed compression of the trachea [Figure 1] and anteroposterior view showed deviation of the trachea to left. Fiberoptic flexible bronchoscope passed through the endotracheal tube (ETT) showed edema and congestion of luminal wall, side-to-side narrowing and intraluminal bulge at the level of thyroid. On computed tomography scan severely narrowed trachea from C6 to D2 with narrowest part at D2 measuring 6 mm and extension of left thyroid gland retrosternally just above the arch of aorta [Figure 2]. She was planned for elective thyroid surgery, after obtaining informed consent, injection glycopyrrolate as premedication, induced with propofol, maintained with fentanyl, oxygen, nitrous oxide, isoflurane. ETT was changed to reinforced tube threaded over bougie, during this process patient was breathing spontaneously and had inspiratory stridor as we were exchanging the tube. Intra operative period was uneventful and thyroid gland extending up to arch of aorta. Muscle relaxation maintained with vecuronium and vitals monitored. Post procedure she returned to intensive care for observation for 5 days, flexible intubating fiberoptic scope was introduced into the trachea through ETT, tracheal rings were inspected after withdrawal of ETT up to cricoids cartilage. The integrity \textbf{Figure 1:} Lateral view X-ray showing compression of trachea \textbf{Figure 2:} Computed tomography showing thyroid gland just above on the arch of aorta of the cartilages checked by mechanical compression of tracheal rings by the surgeon and observing through the fiber optic scope for the recoil to the original shape. Extubation done confirming there was no collapse of lumen, no stridor or respiratory distress. Upper airway obstruction due to thyroid gland has been reported up to 31% and difficulty in intubation has been reported 11%. Central airway obstruction produces symptoms of dyspnea, stridor, or obstructive pneumonia and is often misdiagnosed as asthma. Meticulous planning for managing difficult airway and perioperative care in planned extubation after confirming the absence of airway compromise is of prime importance. Difficult airway algorithms and experience of the anesthesiologist plays a major role in management and outcome of the procedure. The early identification of all probable outcomes and prompt mobilization of resources allowed a favorable outcome in this case. Acknowledgment We acknowledge our colleague and ENT-ONCO surgeon Prof. S. M. Azeem Mohiyuddin for his dedication and patient care throughout the management of this case. Ravi Madhusudhana, B. R. Krishna Kumar, N. Suresh Kumar, R. B. Rakesh, K. R. Archana, B. G. Harish Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India Correspondence: Dr. N. Suresh Kumar, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India. E-mail: firstname.lastname@example.org References 1. Abraham D, Singh N, Lang B, Chan WF, Lo CY. Benign nodular goitre presenting as acute airway obstruction. ANZ J Surg 2007;77:364-7. 2. Cohen JP. Substernal goiters and sternotomy. Laryngoscope 2009;119:683-8. 3. Hedayati N, McHenry CR. The clinical presentation and operative management of nodular and diffuse substernal thyroid disease. Am Surg 2002;68:245-51. 4. Amathieu R, Small N, Catineau J, Poloujadoff MP, Samii K, Adnet F. Difficult intubation in thyroid surgery: Myth or reality? Anesth Analg 2006;103:965-8.	0c186d9c-6df0-4935-b3ae-7b57a5efd763	CC-MAIN-2024-33	https://www.ijccm.org/doi/IJCCM/pdf/10.4103/0972-5229.138163	2024-08-10T20:19:26+00:00	crawl-data/CC-MAIN-2024-33/segments/1722640822309.61/warc/CC-MAIN-20240810190707-20240810220707-00578.warc.gz	634,233,932	1,193	eng_Latn	eng_Latn	0.976151	eng_Latn	0.987076	[ "eng_Latn", "eng_Latn" ]	true	rolmOCR	[ 2937, 4966 ]	[ 0.73828125 ]	[ 4.09375 ]	[ 3.25 ]	[ 1.9453125 ]	1	0	HuggingFaceFW/finepdfs
MSE 528: Microhardness Hardness Measurements Objectives: (1) To understand what hardness is, and how it can be used to determine material properties. (2) To conduct typical engineering hardness tests and be able to recognize commonly used hardness scales and numbers. (3) To be able to understand the correlation between hardness numbers and the properties of materials (4) To learn the advantages and limitations of the common hardness test methods Materials: Aluminum welded sample and steel case hardened sample Instrument: Microhardness tester For Memo Report: (1) Provide table with measured hardness and distance for the 2 microhardness samples (2) Graph in Excel, hardness versus distance for the 2 samples to define the case depth. (3) Briefly discuss objective topics. Introduction: It is a common practice to test materials before they are accepted for processing and put into service to determine whether or not they meet the specifications required. One of these tests is hardness. The Rockwell, Brinell and durometer machines are those most commonly used for this purpose. 1. What is Hardness? The Metals Handbook defines hardness as "Resistance of metal to plastic deformation, usually by indentation. However, the term may also refer to stiffness or temper, or to resistance to scratching, abrasion, or cutting. It is the property of a metal that gives the ability to resist being permanently deformed (bent, broken, or have its shape changed), when a load is applied. The greater the hardness of the metal, the greater resistance it has to deformation. In metallurgy, hardness is defined as the ability of a material to resist plastic deformation. The dictionary of Metallurgy defines the hardness as the resistance of a material to indentation. This is the usual type of hardness test where a pointed or rounded indenter is pressed into a surface under a substantially static load. 2. Hardness Measurements: Hardness measurement can be defined as macro-, micro- or nano- scale according to the forces applied and displacements obtained [1]. Measurement of macro-hardness is a quick and simple method to obtain mechanical property data for the bulk material from a small sample. It is also widely used for the quality control of surface treatments processes. However, when concerned with coatings and surface properties (important to friction and wear processes), the macro-indentation depth would be too large relative to the surfacescale features. Where materials have a fine microstructure, are multi-phase, non-homogeneous or prone to cracking, macro-hardness measurements will be highly variable and will not identify individual surface features. It is here that micro-hardness measurements are appropriate. Microhardness is the hardness of a material as determined by forcing an indenter such as a Vickers or Knoop indenter into the surface of the material under 15 to 1000 gf load; usually, the indentations are so small that they must be measured with a microscope. Capable of determining hardness of different microconstituents within a structure, or measuring steep hardness gradients such as those encountered in case hardening. Conversions from microhardness values to tensile strength and other hardness scales (e.g. Rockwell) are available for many metals and alloys [2]. Micro-indenters work by pressing a tip into a sample and continuously measuring: applied load, penetration depth and cycle time. Nano-indentation tests [3] measure hardness by indenting with a very small, on the order of 1 nano-Newton, indentation force and measuring the depth of the indention that was made. These tests are based on new technology that allows precise measurement and control of the indenting forces and precise measurement of the indentation depths. By measuring the depth of the indentation, progressive levels of force are measurable on the same piece. This allows the tester to determine the maximum indentation load that is possible before the hardness is compromised and the film is no longer within the testing ranges; providing a check (verification) to be made to determine if the hardness remains constant even after an indentation has been made. There are various mechanisms and methods that have been designed to complete nanoindentation hardness tests. One method of force application is using a coil and magnet assembly on a loading column to drive the indenter downward. This method uses a capacitance displacement gauge. Such gages detect displacements of 0.2 to 0.3 nm (nanometer) at the time of force application. The loading column is suspended by springs, which damps external motion and allows the load to be released slightly to recover the elastic portion of deformation before measuring the indentation depth. This type of nanoindentation machine can be seen in Figure 1. Another method of nano-indentation uses a long-range piezo driver and an elastic element as shown in Figure 1b. When the indenter is moved downward by the piezo driver, the elastic element resists the movement and establishes a force. This force is measurable by knowing the distance that the indenter moved downward after touching the film surface. An LVDT (linear variable differential transform) records the position of the shaft, thereby measuring the indentation depth and the spring force applied at one time. 3. Hardness Measurement Methods There are three types of tests used with accuracy by the metals industry; they are the Rockwell hardness test, the Brinell hardness test, and the Vickers hardness test. Since the definitions of metallurgic ultimate strength and hardness are fairly similar, it can generally be assumed that a strong metal is also a hard metal. The way the three of these hardness tests measure a metal's hardness is to determine the metal's resistance to the penetration of a non-deformable ball or cone. The tests determine the depth the ball or cone will sink into the metal, under a given load, within a specific period of time. The following are the most common hardness test methods used in today`s technology: 1. Rockwell Hardness test 2. Brinell Hardness 3. Vickers Hardness 4. Knoop Hardness 3.1: Rockwell Hardness Test The Rockwell Hardness test is a hardness measurement based on the net increase in depth of impression as a load is applied. Hardness numbers have no units and are commonly given in the R, L, M, E and K scales. The higher the number in each of the scales means the harder the material. Hardness has been variously defined as resistance to local penetration, scratching, machining, wear or abrasion, and yielding. The multiplicity of definitions, and corresponding multiplicity of hardness measuring instruments, together with the lack of a fundamental definition, indicates that hardness may not be a fundamental property of a material, but rather a composite one including yield strength, work hardening, true tensile strength, modulus of elasticity, and others. In the Rockwell method of hardness testing, the depth of penetration of an indenter under certain arbitrary test conditions is determined. The indenter may either be a steel ball of some specified diameter or a spherical diamond-tipped cone of 120 angle and 0.2 mm tip radius, called Brale. The type of indenter and the test load determine the hardness scale (A, B, C, etc) [4]. A minor load of 10 kg is first applied, which causes an initial penetration and holds the indenter in place. Then, the dial is set to zero and the major load is applied. Upon removal of the major load, the depth reading is taken while the minor load is still on. The hardness number may then be read directly from the scale. The hardness of ceramic substrates can be determined by the Rockwell hardness test, according to the specifications of ASTM E-18. This test measures the difference in depth caused by two different forces, using a dial gauge. Using standard hardness conversion tables, the Rockwell hardness value is determined for the load applied, the diameter of the indenter, and the indentation depth. The hardness testing of plastics is most commonly measured by the Rockwell hardness test or Shore (Durometer D) hardness test. Both methods measure the resistance of the plastic toward indentation. Both scales provide an empirical hardness value that doesn't correlate to other properties or fundamental characteristics. Rockwell hardness is generally chosen for 'harder' plastics such as nylon, polycarbonate, polystyrene, and acetal where the resiliency or creep of the polymer is less likely to affect the results. The results obtained from this test are a useful measure of relative resistance to indentation of various grades of plastics. However, the Rockwell hardness test does not serve well as a predictor of other properties such as strength or resistance to scratches, abrasion, or wear, and should not be used alone for product design specifications. The Rockwell hardness tester to measure the hardness of metal measures resistance to penetration like the Brinell test, but in the Rockwell case, the depth of the impression is measured rather than the diametric area. With the Rockwell tester, the hardness is indicated directly on the scale attached to the machine. This dial like scale is really a depth gauge, graduated in special units. The Rockwell hardness test is the most used and versatile of the hardness tests. For soft materials such as copper alloys, soft steel, and aluminum alloys a 1/16" diameter steel ball is used with a 100-kilogram load and the hardness is read on the "B" scale. In testing harder materials, hard cast iron and many steel alloys, a 120 degrees diamond cone is used with up to a 150 kilogram load and the hardness is read on the "C" scale. The Rockwell test uses two loads, one applied directly after the other. The first load, known as the "minor", load of 10 kilograms is applied to the specimen to help seat the indenter and remove the effects, in the test, of any surface irregularities. In essence, the minor load creates a uniformly shaped surface for the major load to be applied to. The difference in the depth of the indentation between the minor and major loads provides the Rockwell hardness number. There are several Rockwell scales other than the "B" & "C" scales, (which are called the common scales). The other scales also use a letter for the scale symbol prefix, and many use a different sized steel ball indenter. A properly used Rockwell designation will have the hardness number followed by "HR" (Hardness Rockwell), which will be followed by another letter which indicates the specific Rockwell scale. An example is 60 HRB, which indicates that the specimen has a hardness reading of 60 on the B scale. There is a second Rockwell tester referred to as the "Rockwell Superficial Hardness Tester". This machine works the same as the standard Rockwell tester, but is used to test thin strip, or lightly carburized surfaces, small parts or parts that might collapse under the conditions of the regular test. The Superficial tester uses a reduced minor load, just 3 kilograms, and has the major load reduced to either 15 or 45 kilograms depending on the indenter, which are the same ones used for the common scales. Using the 1/16" diameter, steel ball indenter, a "T" is added (meaning thin sheet testing) to the superficial hardness designation. An example of a superficial Rockwell hardness is 15T-22, which indicates the superficial hardness as 22, with a load of 15 kilograms using the steel ball. If the 120 degree diamond cone were used instead, the "T" would be replaced with "N". The ASTM (American Society for Testing & Materials) has standardized a set of scales (ranges) for Rockwell hardness testing. Each scale is designated by a letter. SCALE: Typical Applications A Cemented carbides, thin steel and shallow case hardened steel B Copper alloys, soft steels, aluminum alloys, malleable iron, etc. C Steel, hard cast irons, pearlitic malleable iron, titanium, deep case hardened steel and other materials harder than B 100 D Thin steel and medium case hardened steel and pearlitic malleable iron E Cast iron, aluminum and magnesium alloys, bearing metals F Annealed copper alloys, thin soft sheet metals G Phosphor bronze, beryllium copper, malleable irons H Aluminum, zinc, lead K, L, M, P, R, S, V Bearing metals and other very soft or thin materials, including plastics. Standards: ASTM E18 Metals, ISO 6508 Metals, ASTM D785 Plastics Procedure for Rockwell Test 1. The indenter moves down into position on the part surface 2. A minor load is applied and a zero reference position is established 3. The major load is applied for a specified time period (dwell time) beyond zero 4. The major load is released leaving the minor load applied The resulting Rockwell number represents the difference in depth from the zero reference position as a result of the application of the major load (Figure 2). HR = E - e F0 = preliminary minor load in kgf, F1 = additional major load in kgf, F = total load in kgf, e = permanent increase in depth of penetration due to major load F1 measured in units of 0.002 mm, E = a constant depending on form of indenter: 100 units for diamond indenter, 130 units for steel ball indenter, HR = Rockwell hardness number, D = diameter of steel ball. 3.2. Brinell Hardness Test Brinell hardness is determined by forcing a hard steel or carbide sphere of a specified diameter under a specified load into the surface of a material and measuring the diameter of the indentation left after the test. The Brinell hardness number, or simply the Brinell number, is obtained by dividing the load used, in kilograms, by the actual surface area of the indentation, in square millimeters. The result is a pressure measurement, but the units are rarely stated [5]. See link on course website for more information. Advantages: 1. One scale covers the entire hardness range, although comparable results can only be obtained if the ball size and test force relationship is the same. 2. A wide range of test forces and ball sizes to suit every application. 3. Nondestructive, sample can normally be reused. Disadvantages: 1. The main drawback of the Brinell test is the need to optically measure the indent size. This requires that the test point be finished well enough to make an accurate measurement. 2. Slow. Testing can take 30 seconds not counting the sample preparation time. 3.3. Vickers Hardness Test It is the standard method for measuring the hardness of metals, particularly those with extremely hard surfaces: the surface is subjected to a standard pressure for a standard length of time by means of a pyramid-shaped diamond. The diagonal of the resulting indention is measured under a microscope and the Vickers Hardness value read from a conversion table [9]. See link on course website for more information. Procedure: To perform the Vickers test, the specimen is placed on an anvil that has a screw threaded base. 1. The indenter is pressed into the sample by an accurately controlled test force. 2. The force is maintained for a specific dwell time, normally 10 -15 seconds. 3. After the dwell time is complete, the indenter is removed leaving an indent in the sample that appears square shaped on the surface. 4. The size of the indent is determined optically by measuring the two diagonals of the square indent. 5. The Vickers hardness number is a function of the test force divided by the surface area of the indent. The average of the two diagonals is used in the following formula to calculate the Vickers hardness. The operation of applying and removing the load is controlled automatically. Several loadings give practically identical hardness numbers on uniform material, which is much better than the arbitrary changing of scale with the other hardness machines. A microscope is placed over the specimen to measure the square indentation to a tolerance of plus or minus 1/1000 of a millimeter. Measurements taken across the diagonals to determine the area are averaged. The correct Vickers designation is the number followed "HV" (Hardness Vickers). Strengths 1) One scale covers the entire hardness range. 2) A wide range of test forces to suit every application. 3) Nondestructive, sample can normally be used. 4) The advantages of the Vickers hardness test are that extremely accurate readings can be taken. 5) It is very precise for testing the softest and hardest of materials, under varying loads Weaknesses (1) The main drawback of the Vickers test is the need to optically measure the indent size. This requires that the test point be highly finished to be able to see the indent well enough to make an accurate measurement. (2) Slow. Testing can take 30 seconds not counting the sample preparation time. (3) Vickers machine is a floor standing unit that is rather more expensive than the Brinell or Rockwell machines [11]. 4. Relationship of Hardness to Other Material Properties Hardness covers several properties: resistance to deformation, resistance to friction and abrasion. The well known correlation links hardness with tensile strength (Figure 3), while resistance to deformation is dependent on modulus of elasticity. The frictional resistance may be divided in two equally important parts: the chemical affinity of materials in contact, and the hardness itself. So it is easy to understand that surface treatments modify frictional coefficients and behavior of the parts in contact. The abrasion resistance is partially related to hardness (between 2 metallic parts in frictional contact, the less hard one will be the more rapidly worn), but experiments show that the correlation resistance against wear/ hardness presents some inversions [28] . A correlation may be established between hardness and some other material property such as tensile strength. Then the other property (such as strength) may be estimated based on hardness test results, which are much simpler to obtain. This correlation depends upon specific test data and cannot be extrapolated to include other materials not tested. The yield strength in tension is about 1/3 of the hardness [29] . To find the ball park figure for the yield strength convert the hardness number to MPa (or psi) and divide by 3. For example take the Vickers number, which has the dimension kg/mm 2 , and multiply by 10 to (approximately) convert it to /mm 2 (=MPa) then divide by three. For example: HV 300 corresponds to a Sigma-y of approximately 1000 MPa. An approximate relationship between the hardness and the tensile strength (of steel) is, Where HB is the Brinell Hardness of the material, as measured with a standard indenter and a 3000 kgf load. Wear is generally affected by several factors, among them materials selection, friction, surface load, sliding distance, surface hardness, surface finish, and lubrication. Controlling these factors can contribute to a successful application by helping to prevent wear and premature product failure. Wear can be defined as both material loss and deformation at contact surfaces. Wear results in particle generation and surface degradation Properties are high wear resistance; high strength, hardness and fracture toughness; low porosity; high creep and corrosion resistance; The hardness of a metal limits the ease with which it can be machined, since toughness decreases as hardness increases Toughness is a combination of high strength and medium ductility. It is the ability of a material or metal to resist fracture, plus the ability to resist failure after the damage has begun. A tough metal, such as cold chisel, is one that can withstand considerable stress, slowly or suddenly applied, and which will deform before failure. Toughness is the ability of a material to resist the start of permanent distortion plus the ability to resist shock or absorb energy [31]. Additional Tables and References: The summary table for different hardness testing methods [26] Hardness units conversion table [27] [1] http://www.plint.co.uk/at2/leaflet/te76.htm [2] http://www.mee-inc.com/microhar.html [3] http://www.ccm.ecn.purdue.edu/tfd/testing_methods/nanoindentation.htm [4] http:www.calce.umd.edu/general/Facilities/Hardness_ad_.htm [6] http://www.bikepro.com/products/metals/hardness.html [7] http://www.wargamer.org/GvA/background/hardness1.html http://www.bartleby.com/65/ha/hardness.html [9] http://www.steelmill.com/DICTIONARY/dom_desc_576_594.html [10] http://www.britannica.com/bcom/eb/article/2/0,5716,212+1,00.html [11] http://www.bikepro.com/products/metals/hardness.html [14] http://www.britannica.com/bcom/eb/article/8/0,5716,40048+1,00.html [15] http://isl-garnet.uah.edu/Composites/s.html#Shore hardness [17] http://www.airproducts.com/chemicals/17600/castp.html [18] http://www.minerals.net/resource/property/hardness.htm [19] http://www.britannica.com/bcom/eb/article/4/0,5716,54534+1+53205,00.html [20] http://www.users.skynet.be/gentec/thrmsel.htm(companies provide different hardness values for their different type of die attach products. [21] http://www.engmatsys.com/die.htm(companies provide different hardness values for their different type of die attach products) [22] http://www.dowcorning.com(companies provide different hardness values for their different type of die attach products) [23] http://www.matweb.com [25] http://www.dowcorning.com a: Ref. By Pecht Handbook of Electronic Package Design, 1991 [26] http://www.hardnesstesters.com/hardness_train3.htm [27] http://www.wargamer.org/GvA/background/hardness4.htm l [28] http://www.kimwin.com.my/inj_89.htm [29] http://www.efunda.com/forum/show_message.cfm?start=1&thread=4261&id=4358 [30] http://www.engineering.usu.edu/mae/faculty/thfronk/mae2060/chap6/sld033 [31] http://www.adtdl.army.mil/cgi-bin/atdl.dll/tc/9-237/Ch7.htm#tab7_1	<urn:uuid:d4eef7be-dbbb-454d-af84-02d0583d01c0>	CC-MAIN-2021-49	http://www.csun.edu/~bavarian/Courses/MSE%20528/MicroHardnessLab.pdf	2021-12-04T04:53:23+00:00	crawl-data/CC-MAIN-2021-49/segments/1637964362930.53/warc/CC-MAIN-20211204033320-20211204063320-00115.warc.gz	105,513,141	4,742	eng_Latn	eng_Latn	0.930177	eng_Latn	0.995137	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "unknown", "eng_Latn" ]	false	docling	[ 2478, 5349, 7340, 10441, 12948, 14891, 18619, 19900, 19998, 20036, 21849 ]	[ 1.6328125, 1.140625 ]	[ 3.765625, 3.46875 ]	[ 4.28125, 4.46875 ]	[ 2.234375, 0.9140625 ]	1	0	HuggingFaceFW/finepdfs
Weekly Summary of COVID-19 in Schools Report posted Friday, February 12, 2021 The table below provides a list of Idaho K-12 schools with COVID-19 cases known to the Idaho Department of Health and Welfare. Case counts are sourced from local public health, media, and school reporting, and are limited to available information. Notes: * To prevent patient identification, data are excluded for schools with less than 50 students enrolled or without available enrollment information* * Data sourced from reports that do not include an actual case count, but reference multiple cases, are denoted with a (+) symbol. A school with 2+ cases has at least 2 known cases. * Data are excluded for online and virtual schools** * Cases reported to or identified by IDHW more than one week after case identification will be included in the cumulative case count. * Cumulative case counts include cases known to the department before the week of Sept. 25 Boise Senior High - 1 - 2 46 Canyon Ridge High - - 1 - 28+ Fairview Elementary 3 - 1 - 14+ Gem Prep: Nampa - - - - 1 Horseshoe Bend K-12 - - - - 2 Lincoln Elementary (Rexburg) - - - - 6 Mountain View High - - 4 2 94 Oneida High* - - - - - Rose Hill Montessori - - - - - St. Maries Community Education Alt* - - - - -	<urn:uuid:e7a9ac60-3042-4fb4-ad34-1fde27b0f33f>	CC-MAIN-2021-17	https://coronavirus.idaho.gov/wp-content/uploads/2021/02/School-Report-2.12.21.pdf	2021-04-13T21:45:01+00:00	crawl-data/CC-MAIN-2021-17/segments/1618038075074.29/warc/CC-MAIN-20210413213655-20210414003655-00145.warc.gz	300,292,823	330	eng_Latn	eng_Latn	0.999786	eng_Latn	0.998448	[ "eng_Latn", "unknown", "unknown", "unknown", "unknown", "unknown", "unknown", "unknown", "unknown", "unknown", "unknown" ]	false	docling	[ 944, 979, 1015, 1053, 1085, 1121, 1166, 1202, 1231, 1268, 1320 ]	[ 0.88671875 ]	[ 1.5078125 ]	[ 1.171875 ]	[ 0.859375 ]	1	0	HuggingFaceFW/finepdfs
Digging the Lake: PSMHS Heritage Trunk History Geography Underwater Archaeology We are pleased to offer our second heritage kit for classroom use: "Digging the Lake" introduces students to the varied themes that make up the history and geography of an urban lake, using the Lake Union Underwater Archaeology Project as a focus. Photos, videos, maps, suggested activities, and resource materials allow elementary and middle school students to learn about methods of historical research, including the use of primary and secondary sources and the role of underwater archaeology. The kit also includes diving equipment that children may try on. Both this and our first Maritime History Kit are available to rent through the Museum of History and Industry's Education Department for $30.00 for a two-week period. To arrange to rent the kit, go to MOHAI's Portable Museum Request Form on their website. For more information, contact PSMHS at email@example.com. Digging the Lake: PSMHS Heritage Trunk INVENTORY SHEET Objects * Diver’s mask and snorkel * Diver’s vest * Diver’s gloves * Diver’s slates (3) and “erasers” (2); extra pencils * Diver’s flippers Binder CD-ROM (2 - in front of binder) 13 laminated photos Book: Legends of the Lake (2 copies) Brochure: Lake Union & Portage Bay – History in the Heart of Seattle (2 copies) Package of activity sheets for copying Inventory sheets (in front of binder)	<urn:uuid:a2240fde-a0a1-466b-b64e-bdd5d0e291ce>	CC-MAIN-2021-43	https://mohai.org/wp-content/uploads/2021/09/Education_PortableMuseum_DigTheLake_Overview_2021.pdf	2021-10-24T08:43:09+00:00	crawl-data/CC-MAIN-2021-43/segments/1634323585916.29/warc/CC-MAIN-20211024081003-20211024111003-00513.warc.gz	533,834,118	324	eng_Latn	eng_Latn	0.891335	eng_Latn	0.985882	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 967, 1429 ]	[ 2.359375 ]	[ 2.46875 ]	[ 1.5625 ]	[ 1.921875 ]	1	0	HuggingFaceFW/finepdfs
Teen Volunteer Requirements * Must be between 13-18 with positive attitude * Liability release signed by parent/guardian on file with contact information. * Must maintain good grades (A's and B's). o Parent/Guardian over 18 must sign in/out teen daily * Clothing Required: Long pants, closed toed shoes, shirt with sleeves (t-shirt is ok) and volunteer button (provided). All clothing must be family-friendly. You will get dirty so don't wear your Sunday best. o If something happens and we cannot contact a parent/ guardian, teen will not be permitted to volunteer any longer. * Clothing Recommended: hat, gloves, sunscreen * No cell phones or texting or headphones * Water is provided but bring a snack/lunch if you wish. * * If you need paperwork for school, clubs, court, etc, you need to bring two paper copies with you each time you volunteer. We do not provide paperwork, letters, webpage completion, emails, etc. If you have any questions/concerns, please contact us at 702-982-8000 or in person. Hope to see you soon.	<urn:uuid:2c2cfad5-f754-41e4-a016-f337a0dd6be6>	CC-MAIN-2024-42	https://thelasvegasfarm.com/wp-content/uploads/2024/09/Teen-festival-volunteer-information-sheet.pdf	2024-10-08T20:51:58+00:00	crawl-data/CC-MAIN-2024-42/segments/1727944253563.54/warc/CC-MAIN-20241008202049-20241008232049-00572.warc.gz	499,080,245	239	eng_Latn	eng_Latn	0.996041	eng_Latn	0.996041	[ "eng_Latn" ]	false	docling	[ 1034 ]	[ 0.84375 ]	[ 1.5078125 ]	[ 2.984375 ]	[ 2.1875 ]	1	0	HuggingFaceFW/finepdfs
Compatibility of Grass Seeding and Coniferous Regeneration of Clearcuts in the South Central Interior of British Columbia by M.B. Clark and A. McLean Province of British Columbia Ministry of Forests COMPATIBILITY OF GRASS SEEDING AND CONIFEROUS REGENERATION OF CLEARCUTS IN THE SOUTH CENTRAL INTERIOR OF BRITISH COLUMBIA by M.B. Clark and A. McLean$^1$ E.P. 590.3 Research Note #83 Forest Service Research Division Ministry of Forests Province of British Columbia Legislative Buildings Victoria, B.C. V8V 1X5 $^1$M.B. Clark - Forester, Research Division, Ministry of Forests, Kamloops, B.C. A. McLean - Ecologist, Agriculture Canada, Kamloops, B.C. Clark, Murray Bruce, 1923- Compatibility of grass seeding and coniferous regeneration of clearcuts in the south central interior of British Columbia. (Research note - British Columbia Forest Service ; #83 ISSN 0384-2002) "E.P. 590.3." Bibliography: p. ISBN 0-7719-8034-5 1. Forest reproduction - British Columbia 2. Grazing - British Columbia. 3. Cut-over lands - British Columbia. I. McLean, Alastair, 1921-, joint author. II. British Columbia. Forest Service. Research Division. III. Title. IV. Series: British Columbia. Forest Service Research note ; no. 83. SD409.C5 634.956'097114 # TABLE OF CONTENTS \| Section \| Page \| \|----------------------------------------------\|------\| \| ABSTRACT \| ii \| \| LIST OF TABLES \| iii \| \| LIST OF PLATES \| iv \| \| INTRODUCTION \| 1 \| \| Study Areas \| 1 \| \| RESULTS AND DISCUSSIONS \| 3 \| \| AREA 1 \| 3 \| \| A. Conifer Production \| 3 \| \| B. Forage Production \| 4 \| \| C. Beef Production \| 4 \| \| AREA 2 \| 8 \| \| AREA 3 \| 8 \| \| A. Conifer Production \| 12 \| \| B. Forage Production \| 12 \| \| AREA 4 \| 12 \| \| AREA 5 \| 14 \| \| A. Conifer Production \| 14 \| \| B. Forage Production \| 16 \| \| AREA 6 \| 16 \| \| AREA 7 \| 18 \| \| A. Conifer Production \| 18 \| \| B. Forage Production \| 18 \| \| AREA 8 \| 18 \| \| A. Conifer Production \| 20 \| \| B. Forage Production \| 20 \| \| SUMMARY AND CONCLUSIONS \| 22 \| \| RECOMMENDATIONS \| 22 \| \| ACKNOWLEDGEMENTS \| 24 \| \| REFERENCES \| 25 \| The effects of sowing non-rhizomatous species of domestic grasses on clearcuts and the subsequent grazing of these on the establishment, survival and growth of coniferous tree species, primarily lodgepole pine (Pinus contorta var. latifolia Engelm.), was investigated. Generally, there is compatibility between trees and grass provided that cooperation exists between managers and users of the resources. The degree of forage utilization and period of time when, and over which, the forage is utilized is the most critical factor in the overall question of tree-grass compatibility. Exceptions to many situations can and do occur, therefore guidelines applicable to specific situations are unreliable and it is necessary to take an holistic approach to the subject of tree-grass compatibility. One can only assume that certain interactions will occur if specific recommendations are followed. \| Table \| Description \| Page \| \|-------\|-----------------------------------------------------------------------------\|------\| \| 1 \| Descriptions of Study Areas \| 2 \| \| 2 \| Tree Seedling Survival, Damage and Height Growth on Grass-Seeded and Unseeded Areas - Area 1 \| 5 \| \| 3 \| Herbage Yields (kg/ha oven-dry weight) from Seeded and Unseeded Areas for a Four-Year Period \| 6 \| \| 4 \| Average Daily Gain by Weigh Periods for Cows and Calves and Stocking Rates on Area 1, 1973 to 1976 \| 6 \| \| 5 \| Percent Stocking, Number of Seedlings, Mortality and Height Growth of Tree Seedlings on Seeded and Unseeded, and Fenced and Unfenced Areas - Area 3 \| 11 \| \| 6 \| Herbage Yields (kg/ha, oven-dry weight) from Seeded and Unseeded Areas for a Three-Year Period - Area 3 \| 11 \| \| 7 \| Percent Stocking, Number of Seedlings and Damage to Tree Seedlings on Grass-Seeded and Unseeded Areas - Area 4 \| 13 \| \| 8 \| Percent Stocking, Number of Seedlings, Height Growth, Mortality and Damage to Tree Seedlings on Grass-Seeded, Unseeded, and Fenced and Unfenced Areas - Area 5 \| 15 \| \| 9 \| Percent Stocking, Number of Seedlings and Density of Vegetation on Grass-Seeded and Unseeded Areas - Area 6 \| 17 \| \| 10 \| Survival, Damage and Height Growth of Tree Seedlings on Fenced and Unfenced Areas with Two Densities of Grass Cover over a Three-Year Period - Area 7 \| 19 \| \| 11 \| Herbage Yields (kg/ha, oven-dry weight) from Seeded and Unseeded Areas for a Four-Year Period - Area 7 \| 19 \| \| 12 \| Natural Regeneration, Percent Survival and Height of Planted Seedlings on Fenced and Unfenced Areas with Two Densities of Grass Cover \| 21 \| \| Plate \| Area \| Description \| Page \| \|-------\|------\|-----------------------------------------------------------------------------\|------\| \| 1 \| One \| One year following grass seeding and two years after planting of pine. Light utilization of forage, with trees obscured by grass. \| 7 \| \| 2 \| One \| Four years following grass seeding and five years after planting of pine. Successful plantation and good utilization of forage. Complete compatibility. \| 7 \| \| 3 \| Three\| One year following grass seeding and two years after site-preparation for natural regeneration of pine. Area fenced. \| 9 \| \| 4 \| Three\| Five years following grass seeding and six years after site-preparation for natural regeneration of pine. Grass has not inhibited establishment of pine on ungrazed area. \| 9 \| \| 5 \| Three\| Five years following grass seeding. Grass and grazing compatible with establishment and growth of pine seedlings. \| 10 \| INTRODUCTION The work described herein was initiated to study the effect of sowing non-rhizomatous species of domestic grasses, and the effect of subsequent grazing of these, on the establishment, survival and growth of coniferous tree species, primarily lodgepole pine (Pinus contorta var. latifolia Engelm.). Secondary objectives were to determine the forage production and utilization, and to determine cattle weight gains under controlled rotational grazing of areas sown with domestic grasses. The need for such studies became evident following extensive grass sowing on logged and/or burned lands prior to the early 1970's. Conflicting opinions arose concerning the objectives of these seedings and their effects on the regeneration of tree species. The competitive effect of grass seeding upon regeneration, if any, had not been defined, nor had direct damage by grazing cattle been assessed. Differences of opinion among researchers elsewhere were not helpful in resolving the problem. The project, as described herein, was a cooperative study involving the Research Division and the Range Administration of the British Columbia Ministry of Forests, and the Agriculture Canada Research Station at Kamloops, British Columbia. Study Areas Between 1971 and 1974, 32 clearcuts of various sizes were selected for study and aerially sown with grasses at the rate of 4.5 kg per ha. Portions of each clearcut, or similar adjacent clearcut blocks, were left unseeded as controls. Twenty-one of the areas were eventually deleted because of poor grass germination or distribution, later severe disturbance by fire, or because of plantation failures. Two areas were added at a later date as supplemental data. Data on grass productivity and forage utilization were collected on five of the study areas whereas data on cattle weight gains were collected on only one. Preliminary results of the study covering the first two years were published in British Columbia Forest Service Research Note No. 63 in 1974. Results of an interrelated study were published in British Columbia Forest Service Research Note No. 70 in 1975. A myriad of interactions between grass, trees and cattle may occur between or within areas between years due to variations in either soils, elevation, topography, precipitation, temperature, or cattle numbers and management. Therefore, each area of study has been presented as an entity since each has characteristics different from the other. Descriptions of study areas are presented in Table 1. \| Area \| Size (ha) \| Biogeoclimatic zone \| Elev. (m) \| Post-logging treatment \| Area of grass treatment (ha) \| Type of regeneration \| Temp. May-Oct. (°C) \| Average precip. May-Oct. (mm) \| \|------\|-----------\|---------------------\|-----------\|-----------------------\|-----------------------------\|----------------------\|---------------------\|-------------------------------\| \| 1 \| 130 \| ESSF \| 1340 \| Broadcast-Burned \| 110 \| Planting \| 30 \| -10 \| \| 2 \| 50 \| ESSF \| 1280 \| Broadcast-Burned \| 40 \| Planting \| 30 \| -10 \| \| 3 \| 12 \| IDF \| 1220 \| Windrowed-Burned \| 12 \| Natural \| 31 \| -12 \| \| 4 \| 5 \| IDFa \| 1220 \| Windrowed-Burned \| 5 \| Natural \| \| \| \| 5 \| 20 \| ESSF \| 1435 \| Bunched-Burned \| 20 \| Natural \| 29 \| -9 \| \| 6 \| 10 \| ESSF \| 1435 \| Scarified \| 10 \| Natural \| \| \| \| 7 \| 16 \| ESSF \| 1400 \| Broadcast-Burned \| 16 \| Natural \| \| \| \| 8 \| 8 \| ESSF \| 1370 \| Bunched-Burned \| 8 \| Natural \| \| \| \| 9 \| 16 \| ESSF \| 1415 \| Bunched-Burned \| 16 \| Natural \| \| \| \| 10 \| 36 \| IDF \| 1370 \| Drag-Scarified \| 36 \| Natural \| 30 \| -10 \| \| 11 \| 34 \| IDFa \| 1370 \| Drag-Scarified \| 34 \| Natural \| \| \| \| 12 \| 44 \| IDFb \| 1190 \| Windrowed-Burned \| 36 \| Natural \| 28 \| -4 \| \| 13 \| \| \| \| \| \| Direct Seeding \| \| \| ESSF - Engelmann spruce-subalpine fir; IDF - Interior Douglas fir; IDFa - Interior Douglas fir, moist RESULTS AND DISCUSSION Germination and growth of grass, and germination and survival of naturally regenerated tree seedlings, were directly affected by climatic conditions prevalent during the term of the study. For example, 1973 was one of the driest years on record for the Kamloops Forest District and this contributed to lower than normal herbage production and to higher than average damage by cattle to both conifer and grass seedlings. Mid-May temperatures during 1974 reached an all-time record low for most of the study areas and this, combined with the generally cool and moist spring season, adversely affected grass germination. Frost occurred almost every month during most years of the study at medium to high elevations of the study areas and probably had some adverse effect on grass growth and conifer seedling establishment. Increases in yield of forage can be expected from seeded clearcuts over unseeded ones. Doubling of yields or better were demonstrated along with a higher proportion of palatable and more nutritious forage. The average percent increases ranged from about 40 to 200%. Considerable year-to-year variation occurred on both seeded and unseeded areas. On all sites, there was some natural seeding taking place so it seems likely that continued improvement in yields can be expected. However, the average yields of seeded species were between about 590 kg and 1540 kg with a maximum close to 2270 kg on one area in 1975. AREA 1. This area of 130 ha was planted with lodgepole pine and Engelmann spruce during spring 1971. The whole area, with the exception of a 20 ha control strip, was sown with the B.C. Forest Service grass-legume mix during late 1971. The complete area was fenced in 1972 and divided into three fenced fields of similar size. Objectives of fencing were two-fold: (1) to control numbers of cattle within the study area, and (2) to conduct rotational grazing and determine the amount of damage to a plantation under different degrees of forage utilization. A. Conifer Production Sampling consisted of survival, damage assessments, and height measurements on 25 seedlings (natural or planted) in each of eight plots within each of the grass seeded and unseeded portions of each field. Clipping of forage for productivity was carried out on plots within and outside exclosures constructed during 1973 in the west and centre fields. \| Species \| % by Weight \| No. seeds/kg \| \|-----------------------\|-------------\|--------------\| \| Timothy \| 25 \| 557,000 \| \| Orchardgrass \| 25 \| 296,000 \| \| Bromegrass \| 20 \| 62,000 \| \| Crested wheatgrass \| 20 \| 79,000 \| \| Alsike clover \| 10 \| 317,000 \| * The grass-legume mix contained the following species: There was no significant difference in cattle-caused mortality between grass seeded and unseeded areas, nor was there a significant relationship between cattle-related mortality and annual percentage utilization of forage (Table 2). Although a fair proportion of seedling mortality was attributable to cattle, the absolute losses were insignificant. Differences in seedling height growth between fields were significant but these were due to site quality and seedling interactions (species, and natural versus planted) rather than to grass competition or grazing. Evidence during the past two years indicates that lodgepole pine height growth has been restricted by grass competition where no grazing occurs. The average height of lodgepole pine seedlings with grass competition and no grazing was 1.39 m as compared with 1.62 m for seedlings with no grass competition and no grazing. This indicates that grass may be restricting seedling height growth. However, the average height of 1.27 m for seedlings with grass competition and grazing was better than the 1.18 m average height for seedlings with grazing and no grass competition, showing that the effect of grass competition may not be as indicated. More specific and reliable data on lodgepole pine seedling growth as affected by grass competition will be available from studies concluding in 1978. B. Forage Production The relative production of herbage on grass-seeded and unseeded areas was determined from clipped plots over four years. The average yield for seeded areas in the West field was 913 kg/ha (oven-dry weight) and 538 kg/ha for unseeded areas (Table 3). The increase represented a 70% increase in weight of herbage produced by domestic grasses. C. Beef Production The fields were stocked with cows and calves at an average rate of 0.7 ha/animal-unit-month* (AUM) over four years (Table 3). At this rate, the degree of utilization varied between 65 and 85%. The rate was considered heavy and was designed to reveal any damage to trees by livestock. Even at these rates the amount of damage to the coniferous reproduction was negligible. There was, however, browsing on the shrubs, although aspen reproduction was not seriously repressed. Since stock were seldom on any field for more than a month at a time. An animal-unit is considered to be a 453 kg cow or equivalent grazing on an area for 1 month. \| Field \| Grass cover \| Survival (%) 1972 \| Survival (%) 1976 \| Mortality caused by cattle (%) 1972 to 1976 \| Average total height growth (cm) 1972 to 1976 \| \|-------\|-------------\|-------------------\|-------------------\|---------------------------------------------\|---------------------------------------------\| \| West \| Seeded \| 100 \| 93.5 \| 31 \| 87 \| \| \| Unseeded \| 100 \| 95.0 \| 22 \| 80 \| \| Center\| Seeded \| 100 \| 93.0 \| 38 \| 48 \| \| \| Unseeded \| 100 \| 99.0 \| 50 \| 47 \| \| East \| Seeded \| 100 \| 95.0 \| 11 \| 47 \| \| \| Unseeded \| 100 \| 97.5 \| 20 \| 47 \| a Majority of seedlings sampled were lodgepole pine. b Majority of seedlings sampled were Engelmann spruce. TABLE 3. HERBAGE YIELDS (KG/HA OVEN-DRY WEIGHT) FROM SEeded AND UNSEeded AREAS FOR A 4-YEAR PERIOD \| Treatment \| 1973 \| 1974 \| 1975 \| 1977 \| Average \| \|-----------\|------\|------\|------\|------\|---------\| \| Seeded \| 907 \| 709 \| 1105 \| 930 \| 913 \| \| Unseeded \| 475 \| 673 \| 493 \| 511 \| 538 \| TABLE 4. AVERAGE DAILY GAIN BY WEIGH PERIODS FOR COWS AND CALVES AND STOCKING RATES ON AREA 1, 1973 TO 1976. \| Weigh Periods \| 1973 \| 1974 \| 1975 \| 1976 \| Average \| \|------------------------\|------\|------\|------\|------\|---------\| \| Cows (kg) \| \| \| \| \| \| \| July to mid-August \| .65 \| .27 \| .59 \| .48 \| .49 \| \| Mid-August to Sept. 30 \| -.06 \| .05 \| -.11 \| .29 \| .04 \| \| Sept. 30 to late October \| -.64 \| -.54 \| -.57 \| -.48 \| .56 \| \| Season \| .03 \| .07 \| .17 \| .25 \| .13 \| \| Calves (kg) \| \| \| \| \| \| \| July to mid-August \| .84 \| .83 \| .79 \| .82 \| .82 \| \| Mid-August to Sept. 30 \| .61 \| .68 \| .58 \| .64 \| .63 \| \| Sept. 30 to late October \| .31 \| .27 \| .16 \| .44 \| .29 \| \| Season \| .61 \| .68 \| .60 \| .68 \| .64 \| \| Stocking rate (ha/AUM) \| \| \| \| \| \| \| July to mid-August \| 1.09 \| .85 \| 1.19 \| 1.64 \| 1.19 \| \| Mid-August to Sept. 30 \| .66 \| .67 \| .76 \| .57 \| .66 \| \| Sept. 30 to late October \| .72 \| .49 \| 1.58 \| .89 \| .92 \| \| Season \| .69 \| .57 \| .87 \| .85 \| .73 \| PLATE 1. One year following grass seeding and two years after planting of pine. Light utilization of forage, with trees obscured by grass. PLATE 2. Four years following grass seeding and five years after planting of pine. Successful plantation and good utilization of forage. Complete compatibility. and damage to the trees was minimal, even with the heavy stocking rate, we suggest that where severe damage occurs to trees, it is a result of repeated trampling and heavy grazing over a long period of time rather than browsing, and that severe trampling does not normally occur over short grazing periods. Grazing trials began in July of 1973. Cattle for the experiment were supplied by a nearby ranch and consisted mainly of young cows and their calves. The fields were grazed in rotation from early July to mid-October. Length of season varied from year to year but the four-year average was 104 days. Although some year-to-year variation occurred in animal gains over the season, the trends and total gains were comparable (Table 4). The four-year average daily gains were .64 kg for calves and .15 kg for their dams (Table 4). Using the average weight gains and stocking rates, the pastures produced 59.8 kg of beef per hectare per year. AREA 2. This area of 50 ha was sown by fixed-wing aircraft with grasses in late 1971 and planted with spruce seedlings during Autumn 1972. Turbulent air conditions during the time of grass sowing caused drift of seed onto the control strip, negating comparative studies of seeded versus unseeded effects. Nevertheless, plots were established during 1973 to study effects of grazing cattle on the planted spruce seedlings. Cattle grazing was continuous over a four-month period during the first summer following planting and plot establishment. Forage utilization reached 86 and 58% on seeded and unseeded portions respectively. This resulted in severe plot disturbance by cattle and made further data collection impossible. During the first year, 11% of the seedlings died as a direct result of cattle damage and an additional 31% of living seedlings were severely damaged through trampling. Forage productivity was not measured on this area. AREA 3. This study area consisted of two blocks windrowed and burned in late 1970. One block of 12 ha was sown by hand with grass in late 1971 and one block of 5 ha was left unseeded as a control. Two exclosures, each approximately 0.2 ha, were constructed during 1972 in each block. Data on natural establishment and survival of conifer seedlings, cattle damage, and seedling height growth were collected on 25 20 m² plots within exclosures and within adjacent unfenced plots in each of the grass seeded and unseeded areas. PLATE 3. One year following grass seeding and two years after site-preparation for natural regeneration of pine. Area fenced. PLATE 4. Five years following grass seeding and six years after site-preparation for natural regeneration of pine. Grass has not inhibited establishment of pine on ungrazed area. PLATE 5. Five years following grass seeding. Grass and grazing compatible with establishment and growth of pine seedlings. Area Three ### Table 5. Percent Stocking, Number of Seedlings, Mortality and Height Growth of Tree Seedlings on Seeded and Unseeded, and Fenced and Unfenced Areas - Area A 3 \| Treatment \| Tree stocking (%) \| Number of seedlings/ha \| Mortality of seedlings/ha \| Mortality due to animals (%) \| \|-----------\|-------------------\|------------------------\|--------------------------\|-----------------------------\| \| \| 1972 \| 1976 \| 1972 \| 1976 \| 1972 to 1976 \| \| Seeded \| \| \| \| \| \| \| Fenced \| 3 \| 30 \| 914 \| 1458 \| 395 \| 0 \| 28 \| \| Unfenced \| 26 \| 51 \| 5510 \| 3880 \| 3361 \| 46 \| 31 \| \| Unseeded \| \| \| \| \| \| \| \| \| Fenced \| 21 \| 48 \| 4065 \| 4757 \| 1285 \| 20b \| 36 \| \| Unfenced \| 10 \| 31 \| 1804 \| 1705 \| 1062 \| 29a \| 35 \| a Mortality caused by cattle. b Mortality caused by rodents. ### Table 6. Herbage Yields (kg/ha, oven-dry weight) from Seeded and Unseeded Areas for a 3-Year Period - Area 3. \| Treatment \| 1973 \| 1974 \| 1975 \| Average \| \|-----------\|------\|------\|------\|---------\| \| Seeded \| 1354 \| 1159 \| 464 \| 986 \| \| Unseeded \| 519 \| 590 \| 471 \| 527 \| A. Conifer Production Comparisons of changes in number of seedlings over the term of the study for seeded-fenced versus unseeded-unfenced and for seeded-unfenced versus unseeded-unfenced confirmed the significant effect of cattle on seedling survival (Table 5). Nevertheless, the mortality occurring as a direct result of cattle damage was less than that resulting from natural causes (climate, site, intraspecific competition) and rodents. Of specific importance was that regardless of amount or cause of mortality, all areas (fenced or unfenced, seeded or unseeded) had a sufficient number of surviving and established seedlings per hectare for adequate stocking of the areas. Distribution of seedlings was poor in localized areas but this was no more a result of cattle damage than of natural causes. Differences in seedling heights (Table 5) between seeded and unseeded areas with no grazing indicated possible limitations on height growth by grass competition. However, there were no significant differences in seedling height between ungrazed and grazed areas that had been seeded nor between seeded and unseeded areas that had been grazed. Such differences could be expected if grass had actually limited height growth of the lodgepole pine seedlings. B. Forage Production The grass seeded area produced an average of 986 kg/ha clipped herbage over three years and 527 kg/ha on the unseeded areas (Table 6). This represented an increase in herbage yield of 87% from domestic grasses. The summer of 1973 was dry and this was reflected in the low yield of domestic grass that year. Utilization of forage on the grass-sown area was high each year, averaging 83% over three years, as compared with 44% utilization on the unseeded area. The heavy use of forage by cattle on the grass-sown area was reflected in the high mortality of tree seedlings due to cattle. AREA 4. This study area consisted of five clearcut blocks of 20, 10, 16, 8, and 16 ha. A cut block of 20 ha bunched and burned, a cut block of 16 ha broadcast burned, and a cut block of 16 ha bunched and burned were sown by fixed-wing aircraft with grasses in late 1971. A cut block of 10 ha scarified during logging, and a cut block of 8 ha bunched and burned were left unseeded as control areas. Data on seedling establishment, survival, and cattle damage were collected on each 5 m² sub-plot of 100 20 m² plots within each of the grass-seeded and unseeded blocks. \| Treatment \| Tree stocking (%) \| Number of seedlings/ha \| Mortality of seedlings/ha \| Mortality due to animals (%) \| \|-----------\|-------------------\|------------------------\|--------------------------\|-----------------------------\| \| \| 1972 \| 1974 \| 1972 \| 1974 \| \| Seeded \| 12 \| 28 \| 2234 \| 1892 \| 1607 \| 32 \| \| Unseeded \| 25 \| 47 \| 6326 \| 6110 \| 2702 \| 20 \| Accumulative increases (additional germination) and decreases (mortality) in number of seedlings were significantly higher on unseeded blocks than on grass-seeded blocks (Table 7). The greater increase on unseeded blocks as compared with grass-seeded blocks indicates that grass inhibited conifer seedling establishment and survival. If this were true, one could also expect a greater decrease in number of seedlings on grass-seeded blocks than on unseeded blocks but this did not occur, even though cattle damage was higher on the grass-seeded blocks. The real effects of interspecific competition were confounded by differences in site preparation between cut blocks, hence seed availability. Grazing was very intensive during 1973 and 1974 and, coupled with a very dry 1973, extensive cattle damage occurred to both forage plants and lodgepole pine seedlings. However, mortality through natural causes was also very high and mortality as a direct result of cattle damage was less than a third of all mortality. On the average, cattle damage did not have any significant effect on percentage of area stocked with regeneration. Forage productivity was not measured on this area. AREA 5. This study area consisted of two clearcut blocks of 36 and 34 ha drag-scarified during 1971. The 36 ha block was sown by fixed-wing aircraft with grasses in late 1971 and the 34 ha block was left unseeded as a control. A. Conifer Production Two exclosures, each approximately 0.2 ha, were constructed within each block in 1972. Data on lodgepole pine establishment, survival, and animal damage were collected on each 5 m$^2$ area of 25 20 m$^2$ plots within fenced and adjacent unfenced plots within each treatment block. The survival of lodgepole pine seedlings was not affected by grass competition although grass, apparently, did limit the absolute number of seedlings (Table 8). This limitation was a minor consequence since grass-seeded areas became adequately stocked with seedlings. Similarly, the intraspecific competition within ungrazed and unseeded treatments had an effect on number of seedlings surviving but not on actual amount of area stocked with lodgepole pine. Cattle damage was heavy and contributed to approximately half of the total mortality, but this did not materially affect the over-all degree of stocking. The higher mortality due to cattle damage on the unseeded area should not be entirely unexpected since greater cattle foraging is required where forage production is low. \| Treatment \| Tree stocking (%) \| Number of seedlings/ha \| Mortality of seedlings/ha \| Mortality due to animals (%) \| Average total height growth (cm) \| \|-----------\|------------------\|------------------------\|--------------------------\|-----------------------------\|---------------------------------\| \| \| 1972 \| 1976 \| 1972 \| 1976 \| 1972 to 1976 \| \| Seeded \| \| \| \| \| \| \| Fenced \| 11 \| 43 \| 2273 \| 2916 \| 927 \| 0 \| 20 \| \| Unfenceda \| 24 \| 35 \| 4559 \| 3052 \| 5319 \| 49 \| \| \| Unseeded \| \| \| \| \| \| \| \| \| Fenced \| 30 \| 65 \| 7500 \| 8167 \| 1878 \| 0 \| 21 \| \| Unfenced \| 18 \| 51 \| 5819 \| 5609 \| 1730 \| 56 \| 20 \| a Unfenced plots within the grass-seeded block were destroyed by powerline right-of-way construction during 1975; therefore, data for the seeded-unfenced treatment were not collected beyond 1974 and figures presented are 1974 rather than 1976. Grass did not have any significant effect on lodgepole pine height growth as indicated by seedling heights in the grass seeded-fenced treatment (average height 20 cm) as compared with seedlings in the unseeded-fenced treatments (average height 21 cm). B. Forage Production The grass-seeded area yielded an average of 1027 kg/ha of clipped herbage over two years and 491 kg/ha on the unseeded areas. This represented an increase in herbage yield of 110% from domestic grasses. The herbage yields (kg/ha) on the grass-seeded and unseeded areas for the two years were: \| Treatment \| 1973 \| 1974 \| Average \| \|-----------\|------\|------\|---------\| \| Seeded \| 837 \| 1216 \| 1027 \| \| Unseeded \| 442 \| 540 \| 491 \| AREA 6. This study area, of approximately 44 ha, was windrowed and burned in 1973. Thirty-six hectares were sown by fixed-wing aircraft with grasses during early 1974 and 8 ha were left unseeded as a control. Three treatment blocks, each approximately 2 ha, were established so as to overlap equally the grass-seeded and unseeded treatments. The 1 ha sub-plot in each of grass seeded and unseeded treatments was split into 0.5 ha plots for lodgepole pine seeded and unseeded treatments. Treatment sub-sub-plots were randomized for lodgepole pine seeding in both the grass seeded and unseeded halves of each main plot. Lodgepole pine (untreated seed) was sown at the rate of 0.6 kg/ha during the spring of 1974. Data on lodgepole pine germination, survival, and damage by animals were collected on each 5 m² area of 10 20 m² sample plots in each treatment sub-sub-plot. Revegetation of the area with native species masked effects, if any, of sown grasses (Table 9). Also, cattle use of the area was very light from 1974 through 1976 with no damage to seedlings occurring. Number of seedlings establishing were related more to distance of plots from perimeter seed source than to any other factor. Forage productivity was not measured on this area. \| Grass pine treatment \| Lodgepole pine treatment \| Tree stocking (%) \| No. seedlings/ha all species \| Density of vegetation (% of area covered) \| \|----------------------\|--------------------------\|-------------------\|-----------------------------\|------------------------------------------\| \| \| \| 1974 \| 1976 \| 1974 \| 1976 \| \| Seeded \| \| P1 \| All sp. \| P1 \| All sp. \| \| Seeded \| \| 5 \| 5 \| 44 \| 67 \| \| Unseeded \| \| 1 \| 1 \| 2 \| 46 \| \| Unseeded \| \| 0 \| 0 \| 0 \| 20 \| * P1 - Lodgepole pine AREA 7. This study area was a portion of an area of a few hundred hectares in size which supported a dense stand of willow (Salix spp.). The area was windrowed in 1971 and sown by hand with grasses at the rate of 6 kg plus per hectare to provide grazing pastures. A combination of a good seedbed for spruce provided by windrowing, scattered spruce trees with a good seed-crop in 1971 and favourable conditions for germination produced a large number of spruce seedlings at the same time as grass establishment. A. Conifer Production Prior to commencement of grazing in 1973, two exclosures, each approximately 0.2 ha, were constructed in an area of heavy grass cover and in an area of light grass cover; i.e. almost missed during seeding. Data on seedling survival, growth and cattle damage were collected on 200 seedlings within each exclosure and within unfenced plots adjacent to the exclosures. Mortality of spruce seedlings averaged 46% on unprotected plots, with 78% of this as a direct result of cattle damage. Mortality and damage were significantly higher in heavy grass cover than in light grass cover but the effect of grass competition was negligible in comparison with effect of cattle (Table 10). Growth of spruce seedlings was not affected by density of grass cover. B. Forage Production The grass-seeded area yielded an average of 1469 kg/ha of clipped herbage over a four-year period and 640 kg/ha on the unseeded areas (Table 11). This represented an increase in herbage yield of 130% from domestic grass. Forage utilization by cattle averaged about 70% over three years but varied from a low of 40% in 1974 to a high of 90% in 1973. AREA 8. The study area was a small portion of a large 1973 wildfire. Grasses were sown by fixed-wing aircraft on the burned area in late 1973 at the rate of 13.5 kg/ha for erosion control and aesthetics. Utilization of forage was a secondary objective. Distribution of grass seed was poor over portions of the burn. Some strips received TABLE 10. SURVIVAL, DAMAGE AND HEIGHT GROWTH OF TREE SEEDLINGS ON FENCED AND UNFENCED AREAS WITH TWO DENSITIES OF GRASS COVER OVER A 3-YEAR PERIOD - AREA 7. \| Treatment \| Mortality No. seedlings $^a$ \| Mortality due to cattle (%) \| Average total height growth (cm) \| \|---------------\|---------------------------------\|-----------------------------\|----------------------------------\| \| Heavy grass \| \| \| \| \| Fenced \| 55 \| 0 \| 15 \| \| Unfenced \| 127 \| 112 \| b \| \| Light grass \| \| \| \| \| Fenced \| 21 \| 0 \| 16 \| \| Unfenced \| 80 \| 30 \| b \| $ ^a $ Based on 200 seedlings per treatment plot. $ ^b $ Insufficient healthy seedlings for growth measure. TABLE 11. HERBAGE YIELDS (KG/HA, OVEN-DRY WEIGHT) FROM SEeded AND Unseeded Areas For A 4-Year Period - Area 7 \| Treatment \| 1973 \| 1974 \| 1975 \| 1977 \| Average \| \|-----------\|------\|------\|------\|------\|---------\| \| Seeded \| 760 \| 1623 \| 2253 \| 1239 \| 1469 \| \| Unseeded \| 595 \| 705 \| 514 \| 745 \| 640 \| more than 13.5 kg/ha and others received less than the usual 4.5 kg/ha. The area of the study was planted with two-year-old Douglas fir seedlings in spring of 1974. Data on survival and growth of the seedlings were collected on 50 seedlings in each of two plots in each of heavy and light grass cover. One set of contiguous plots containing Douglas fir seedlings in light grass cover and heavy grass cover was fenced to exclude cattle. Data on germination and survival of lodgepole pine natural regeneration were collected on 5 m$^2$ plots surrounding each planted seedling. No grazing was permitted during 1974 and only minor grazing occurred during 1975. A. Conifer Production Survival of planted stock was affected by a combination of grass density, site quality and quality of planting stock. Although establishment of natural regeneration appeared to be affected by the density of grass, it was related more to available seed and quality of seedbed. However, there was an apparent relationship between density of grass and survival of natural regeneration (Table 12). This should not be interpreted that grass cover inhibits survival of natural regenerating lodgepole pine since rate of grass sowing was exceptionally high on this area. B. Forage Production The heavily grass-seeded area yielded an average of 1031 kg/ha of clipped herbage over two years and 347 kg/ha on the lightly-seeded areas. This represented an increase in herbage yield of 197% for domestic grass. The herbage yields (kg/ha) on the heavily and lightly-seeded areas for the two years were: \| Treatment \| 1974 \| 1975 \| Average \| \|-----------------\|------\|------\|---------\| \| Heavily seeded \| 856 \| 1207 \| 1031 \| \| Lightly seeded \| 288 \| 406 \| 347 \| \| Treatment \| No. natural seedlings/ha \| Survival (%) planted stock \| Average height of planted stock (cm) \| \|--------------\|--------------------------\|----------------------------\|-------------------------------------\| \| \| 1974 \| 1975 \| 1975 \| 1974 \| 1975 \| \| Heavy grass \| \| \| \| \| \| \| Fenced \| 2,422 \| 642 \| 42.0 \| 24.9 \| 31.1 \| \| Unfenced \| 791 \| 99 \| 16.0 \| 28.0 \| 30.2 \| \| Light grass \| \| \| \| \| \| \| Fenced \| 11,120 \| 10,131 \| 92.0 \| 26.6 \| 38.7 \| \| Unfenced \| 5,041 \| 5,930 \| 84.0 \| 27.7 \| 34.9 \| SUMMARY AND CONCLUSIONS The Interior Douglas fir and Engelmann spruce-subalpine fir biogeoclimatic zones have a potential for producing both trees for the forest industry and grass for the ranching industry. This is not to say that, for example, all clearcut areas in either zone are suitable or compatible for trees and grass. Each area must be rated according to soil capability, erosion hazards, regeneration objectives, and cattle management problems. Generally, there is compatibility between trees and grass provided that cooperation exists between managers and users of the resource. The degree of forage utilization and period of time when, and over which, the forage is utilized, are the most critical factors in the over-all question of tree-grass compatibility. The question of livestock control is a serious problem that has not yet been resolved. Experience on seeded wildfires suggests that considerably greater production can be expected to continue for up to 20 years following seeding before the tree canopy closes in. Similar longevity of grass stands can be expected on clearcut areas. It is impossible for the scientist to unequivocally state answers to the myriad interactions which may occur. The variations in soils, elevation, topography, logging method and post-logging site treatment between areas, or the climatic conditions between years, may significantly alter the relationship between grass and trees at any given time. Exceptions to many situations can and do occur; therefore guidelines applicable to specific situations, for example, site preparation treatments, are unreliable. It is therefore necessary to take an holistic approach to the question of tree-grass compatibility. One can only assume that certain interactions will occur if specific recommendations are followed. The forest and range managers must coordinate planning so as to ensure that specific critical areas will receive the required attention. In this way conflicts can be kept to a minimum. RECOMMENDATIONS Where damage to lodgepole pine and spruce occurs, it is a result of repeated trampling rather than browsing. Therefore, clearcuts should be intensively grazed for short periods of time only, particularly during the first year of tree establishment. Because domestic grasses such as Timothy and orchardgrass develop faster in spring than does pinegrass, clearcuts seeded to these species should be grazed early in the season. Since orchardgrass produced good regrowth in fall it is often possible to graze areas containing this species again in late summer. If there is a group of clearcuts in an area, grazing should be on a rotational basis, if possible. Forage yields can be significantly increased on clearcuts by seeding domestic grasses. Overstocking by lodgepole pine on some sites may be reduced by temporarily grazing heavily. More legumes should be included in grass mixes for seeding on clearcuts to increase levels of nitrogen in the soil. Since most stands will thicken in during the first three years following seeding, lighter seeding rates should be used to reduce early competition with tree seedlings. Although cognizant of the need to sow grass at the time when the seedbed is new and fresh, we recommend that grass not be sown more than one year prior to restocking of a clearcut by artificial reforestation methods unless there exists a critical need for forage on the specific area concerned. ACKNOWLEDGEMENTS The assistance, and interest displayed in the project, of Mr. F. Devick, Rancher, and Mr. T. Jeanes, Balco Industries Limited, is gratefully acknowledged. Advice and assistance on statistical analysis and programming were obtained from Mr. M. Kovats of Research Division. REFERENCES Clark, M.B. and McLean, A. 1974. Compatibility of grass seeding and coniferous regeneration on clearcuts in the south central interior of British Columbia. B.C. Forest Service Res. Note 63. Clark, M.B. and McLean, A. 1975. Growth of lodgepole pine seedlings in competition with different densities of grass. B.C. Forest Service Res. 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Fear for safety MEXICOMaría Estela García Ramírez (f), aged 24, and her family María Estela García Ramírez has been forced to flee her home in Oaxaca State in the face of recent threatening incidents linked to the murder of her husband, allegedly by members of the police. She fears that her family or her husband's family may become the target of reprisals in her absence. On 20 August 1997, while attending a meeting of indigenous women in Altimirano, Guerrero State, an unidentified man approached María Estela García Ramírez. He began to interrogate her about a formal complaint she had made before the Attorney General of Oaxaca State against members of the judicial police concerning the murder of her husband, Severino Jiménez Almaraz (see below). When she left, she was followed by the same man in a car that did not bear any numberplates. Previously, on 14 August 1997 a number of heavily armed men had gone to her mother's house asking in a threatening manner where María Estela García Ramírez was, stating that they wanted to talk to her about the same complaint. María Estela García Ramírez has since fled to Mexico City in fear for her safety. BACKGROUND INFORMATION On 23 April 1997 more than 60 agents of the state judicial police arrived at the house of Severino Jiménez Almaraz, a local peasant activist. Severino was brutally beaten and shot in the back of his leg. Although seriously injured, he managed to escape from the house but was closely followed by the police. On 25 April María Estela filed a complaint before the state Attorney General who informed her that her husband had died in an armed confrontation with the police. The same day, an unidentified group of heavily armed men visited the community where the family of María Estela lives, asking where she was. Amnesty International has documented an alarming number of human rights abuses committed by members of the security forces in the Loxicha region of Oaxaca State (see UA 265/97, AMR 41/74/97, 11 August 1997 and follow-up AMR 41/81/97, 29 August, for the most recent case). Zapotec indigenous activists have been targeted for their presumed involvement with the Ejército Popular Revolucionario (EPR), Popular Revolutionary Army, an armed opposition group operating in the area. Since June 1996 at least 130 people have been arbitrarily detained, principally in the penitentiary of Santa María de Ixcotel, Oaxaca State. Amnesty International fears that they are all at serious risk of torture and has called for the unconditional release of those who have been accused on unfounded charges of having links to the EPR. RECOMMENDED ACTION: Please send telegrams/telexes/faxes/express/airmail letters in Spanish or your own language: - urging that immediate measures be taken to ensure the physical safety of María Estela García Ramírez, of her family and of members of the family of Severino Jiménez Almaraz; - calling for a prompt and thorough investigation into the apparent extrajudicial execution of Severino Jiménez Almaraz and for those responsible to be brought to justice; - expressing concern at these killings and at the continuing human rights violations in the region of San Agustín Loxicha, Oaxaca State; if possible, also: - calling for the unconditional release of all those who have been detained on unfounded charges of having links with the EPR. APPEALS TO: 1) Minister of Interior Lic. Emilio Chuayffet Chemor Secretario de Gobernación Secretaría de Gobernación Bucarelli 99, 1er piso, Col Juarez, 06699 México DF, MEXICO Telegrams: Secretario de Gobernación, México DF, México Faxes: + 52 5 546 5350; + 525 535 9952 Salutation: Sr. Secretario / Dear Minister 2) Governor of the state of Oaxaca Lic. Diódoro Carrasco Altamirano Gobernador del Estado de Oaxaca Palacio de Gobierno Oaxaca, Oaxaca, MEXICO Telegrams: Gobernador Carrasco, Oaxaca, Mexico Faxes: + 52 951 637 37 (If voice, ask "me puede dar tono de fax, por favor) Salutation: Sr. Gobernador / Dear Governor COPIES TO: Human Rights Organisation Acción de los Cristianos para la Abolición de la Tortura (ACAT) Interior Zona Comercial C.U. Apdo 70-634, Adm 70, CP 04511 México D.F. MEXICO Faxes: + 525 264 7332 Daily newspaper Sr. Editor La Jornada Balderas 68 06050 México D.F., MEXICO Faxes: +525 521 2763 / 510 1901 and to diplomatic representatives of MEXICO accredited to your country. PLEASE SEND APPEALS IMMEDIATELY. Check with the International Secretariat, or your section office, if sending appeals after 23 October 1997.	<urn:uuid:545410e4-c87f-404e-9452-2db2ee0c5251>	CC-MAIN-2021-04	https://www.amnesty.org/download/Documents/160000/amr410831997en.pdf	2021-01-25T10:44:16+00:00	crawl-data/CC-MAIN-2021-04/segments/1610703565541.79/warc/CC-MAIN-20210125092143-20210125122143-00530.warc.gz	654,166,519	1,139	eng_Latn	eng_Latn	0.722197	eng_Latn	0.981399	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 2913, 4548 ]	[ 0.85546875 ]	[ 3.09375 ]	[ 2.015625 ]	[ 2.328125 ]	1	0	HuggingFaceFW/finepdfs
inWebo and LS International Team Up to Offer the Most Agile & Secure MFA Solution to Swiss Market Partnership enables LS International to expand the wide offer with protection for all your B2B and B2C applications with inWebo MFA. CHIASSO, Switzerland – July 14th, 2021 – LS International is pleased to announce inWebo, a key international player in the cybersecurity industry, as the latest partner to join its growing ecosystem. inWebo's multifactor authentication (MFA) SaaS solution is used by 500 customers around the world to verify identities of employees, partners and customers before granting access to IT services or cloud accounts. Multifactor authentication (MFA) is primarily known to secure data and IT resources against identity theft, credential stuffing and phishing. It is also an excellent tool to promote employees' mobility and productivity, a key asset in the current context of digital transformation and workplace shift from office to remote. Furthermore, with significant compliance issues in data management and protection, MFA can be essential to comply with regulatory requirements in some industries and/or jurisdictions, like the financial or the health sector. LS International selects inWebo MFA for its UX & Security by Design approach powered by state of the art technology and advanced unique features. [x] The most secured SaaS MFA solution: unique combination of random dynamic key technology and HSM for maximum security [x] 100% compatible with all apps & tech architectures: effortless integration thanks to hundreds of connectors, API & SDK [x] Deviceless, Passwordless, Effortless: exclusive passwordless browser token for a seamless user experience inWebo's full SaaS MFA helps worldwide companies address their digital challenges: increasingly sophisticated cyber-attacks, employee mobility, telecommuting, BYOD and digitalization of the workstation. With this partnership, LS International is committed to supporting and assisting its customers in building a safer, simpler and more productive digital environment. "Our target is always being able to offer to our customer the most innovative and updated technologies available in terms of cybersecurity, answering in advance the changing market demand. With inWebo we expand our security offering portfolio with an extremely effective solution that is also easy to implement in order to increase the protection to the access of our customers' resources." said Davide Bortolotto, CEO at LS International. "inWebo's growth strategy is based on two pillars: partnerships and international development. That's why we are excited to initiate this relationship with LS International in Switzerland. Together we will offer Swiss companies the best cybersecurity expertise and the most advanced MFA solution available on the market." said Olivier Perroquin, CEO at inWebo Find out more about inWebo's MFA solution: https://www.inwebo.com/en About inWebo Founded in 2008, inWebo is a key international player in the cybersecurity industry thanks to its full SaaS multifactor authentication solution, one of the most secure and agile on the market. inWebo MFA protects transactions, B2B applications, VPN, SSO, PAM, IAM and sensitive consumer applications (online banking, ehealth, etc.) against identity theft, phishing and credential stuffing. Its patented technology, based on random dynamic keys, combines two key elements: a very high security and an improved user login experience thanks to its exclusive deviceless and passwordless token. Certified by the French national cybersecurity agency (ANSSI), inWebo's solution secures the access of more than 5 million users across 500 worldwide companies. https://www.inwebo.com/en About LS International LS International SA is a Swiss company with an international vision: it is part of Lantech Longwave, the Italian leading system integrator, and part of the Zucchetti Group, the first software house in Europe. Its main focus is creating simple and efficient ways to collaborate between people and companies through innovative IT networking technologies with a special attention for Cybersecurity. To learn more, visit www.lsinternational.ch and follow us on LinkedIn, For more information, please contact: INWEBO Guillaume Absi firstname.lastname@example.org LS INTERNATIONAL Marta Brambilla email@example.com	<urn:uuid:655c01b3-d81b-4e42-ad52-198b1d34e05a>	CC-MAIN-2021-43	https://www.lsinternational.ch/gallery/prls-international-inwebo-partner-release140721.pdf	2021-10-20T02:53:05+00:00	crawl-data/CC-MAIN-2021-43/segments/1634323585302.56/warc/CC-MAIN-20211020024111-20211020054111-00012.warc.gz	1,053,528,277	870	eng_Latn	eng_Latn	0.990602	eng_Latn	0.993371	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 2938, 4378 ]	[ 0.466796875 ]	[ 1.78125 ]	[ 1.75 ]	[ 2.703125 ]	1	1	HuggingFaceFW/finepdfs
Geophysical Research Abstracts Vol. 20, EGU2018-12028-1, 2018 EGU General Assembly 2018 © Author(s) 2018. CC Attribution 4.0 license. Historic Tsunami Risk Scenarios – A reassessment of the largest mega-tsunamis in human history under today's conditions Andreas Schaefer, James Daniell, and Friedemann Wenzel Karlsruhe Institute of Technology, Geophysical Institute, Karlsruhe, Germany (firstname.lastname@example.org) Tsunamis are a rare, but devastating natural disaster type. Many places in the world already experienced mega tsunamis as in 2004 in the Indian Ocean or 2011 in Japan. However, there are many more, much older events of comparable intensity which took places centuries ago which have been in part forgotten. A potential reoccurrence of similar successor events may severely affect the local and far-ﬁeld coast lines. Thus, it is necessary to reassess the potential impact of those in regards of the inundation and wave propagation pattern but also their expected social and economic losses. For that purpose some of the most disastrous historic events for which sufﬁcient historic evidence was found are remodeled and losses are computed on the basis of today's exposure and infrastructure. Potential variability in regards of magnitude, location and slip distribution are considered to provide a probability range for various loss metrics. These events include the tsunamis of Cascadia, 1700, Lima 1746, Mexico1787, Crete 365 and many more. This collection of historic risk scenarios helps to identify potential worst-case scenarios within the historic context of a region.	<urn:uuid:d92651f1-3882-4de2-861c-18ee8801db44>	CC-MAIN-2022-40	https://meetingorganizer.copernicus.org/EGU2018/EGU2018-12028-1.pdf	2022-10-04T04:38:15+00:00	crawl-data/CC-MAIN-2022-40/segments/1664030337473.26/warc/CC-MAIN-20221004023206-20221004053206-00023.warc.gz	426,949,473	351	eng_Latn	eng_Latn	0.988881	eng_Latn	0.988881	[ "eng_Latn" ]	false	docling	[ 1591 ]	[ 1.21875 ]	[ 3.453125 ]	[ 2.875 ]	[ 2.265625 ]	1	0	HuggingFaceFW/finepdfs
产品说明书 Product Specification 产品名称 Product Name Mouse anti-human C-reactive protein monoclonal antibody 货号 Catalog Number CSB-DA402GmN① 产品形态 Formation Liquid 保存缓冲 Storage buffer 100mM NaCl, 15mM NaN3, pH 7.2 宿主 Host Mouse 亚型 Isotype IgG 存储条件 Storage Aliquot and store at ≤-20 ℃. Avoid repeated freeze / thaw cycles 有效期 Valid Period -20 ℃ for two years 相对纯度 Purity 90%±5% by SDS-PAGE 运用 Application LETIA	<urn:uuid:cb4da62a-c49d-4e64-8e90-144acfa1bf0b>	CC-MAIN-2023-40	https://www.cusag.cn/uploadfile/2022/0928/20220928020001855.pdf	2023-10-01T01:35:36+00:00	crawl-data/CC-MAIN-2023-40/segments/1695233510734.55/warc/CC-MAIN-20231001005750-20231001035750-00381.warc.gz	798,465,991	156	eng_Latn	eng_Latn	0.447082	eng_Latn	0.447082	[ "eng_Latn" ]	false	docling	[ 432 ]	[ 0.58984375 ]	[ 1.625 ]	[ 1.140625 ]	[ 2.453125 ]	1	0	HuggingFaceFW/finepdfs
STATE OF FLORIDA COUNTY OF ST LUCIE KNOW ALL MEN BY THESE PRESENTS, that STUART DEVELOPMENT CORPORATION, LOUIS A WEHLE and his wife, ELIZABETH R WEHLE, and GEORGE C SLATON, Trustee, the owners of the tract of land lying and being in Section 24, Township 37 South, Range 40 East, St Lucie County, Florida, shown herein as PLAT NO I, "BEAU RIVAGE", and more particularly described as follows, to wit: Beginning at the southern corner of said Section 24; thence North along the east line of said Section 24, a distance of 2064.73 feet (the conventional north line of said Section 24 is assumed to be North-South, and all other lines shown hereon are relative thereto); thence West, a distance of 180 feet; thence N56°20'00" W, a distance of 72.09 feet; thence West, a distance of 504.00 feet; thence S25°00'00" E, a distance of 100 feet; thence North, a distance of 793.64 feet; thence N50°00'00" E, a distance of 554.00 feet, more or less, to a point in a line parallel to, and 399.97 feet westerly from, measured at right angles to, the east line of said Section 24; thence South along said parallel line, a distance of 310 feet, more or less, to a point in the south line of said Section 24; thence N80°14'40" E, along said south line, a distance of 400 feet to the point of beginning. All Block Corners are rounded with a 25 ft radius unless otherwise noted. Exemptions for Public Utilities unless otherwise shown. Building Setback Lines shall be as required by St Lucie County Zoning Regulations or Deed Restrictions. STATE OF NEW YORK COUNTY OF MONROE I HEREBY CERTIFY, that on this day personally appeared before me, an officer duly authorized to administer oaths and take acknowledgments, LOUIS A WEHLE and his wife, ELIZABETH R WEHLE, to me well known and known to me to be the individuals described in and who executed the foregoing dedication, and that they did so before me that they executed the same freely and voluntarily for the purposes therein expressed. AND I FURTHER CERTIFY, that the said ELIZABETH R WEHLE, known to me to be the wife of the said LOUIS A WEHLE, on a separate and private examination formerly made by me before the execution of the foregoing, her said husband did acknowledge that she made herself a party to said dedication for the purpose of renouncing, relinquishing and conveying all her right, title and interest, whether legal, beneficial or of separate property, statutory or equitable, in and to the Street described therein, and that she executed the said dedication freely and voluntarily and without any compulsion, constraint, apprehension or fear of or from her said husband. WITNESS my hand and official seal of Rochester, County of Monroe, and State of New York, the 1st day of August, A.D. 1958. Notary Public My Commission expires: August 7, 1961 STATE OF FLORIDA COUNTY OF PALM BEACH I HEREBY CERTIFY, that on this day personally appeared before me, an officer duly authorized to administer oaths and take acknowledgments, A.J. COSMETTI and DOYLE ROGERS, President and Secretary, respectively, of STUART DEVELOPMENT CORPORATION, a Florida Corporation, to me well known and known to me to be the individuals described in and who executed the foregoing dedication, and that they did so before me that they executed the same as such officers of said Corporation by and with the authority of the Board of Directors of said Corporation for the purposes therein expressed, and that their act and deed was the act and deed of said Corporation, and the said Trustees and Directors, respectively, he executed the foregoing dedication freely and voluntarily for the purposes therein expressed. WITNESS my hand and official seal of West Palm Beach, County of Palm Beach, and State of Florida, this 5th day of August, A.D. 1958. Notary Public My Commission expires: July 29, 1960 STATE OF FLORIDA COUNTY OF PALM BEACH I HEREBY CERTIFY, that on this day personally appeared before me, an officer duly authorized to administer oaths and take acknowledgments, A.J. COSMETTI and DOYLE ROGERS, President and Secretary, respectively, of STUART DEVELOPMENT CORPORATION, a Florida Corporation, to me well known and known to me to be the individuals described in and who executed the foregoing dedication, and that they did so before me that they executed the same as such officers of said Corporation by and with the authority of the Board of Directors of said Corporation for the purposes therein expressed, and that their act and deed was the act and deed of said Corporation, and the said Trustees and Directors, respectively, he executed the foregoing dedication freely and voluntarily for the purposes therein expressed. WITNESS my hand and official seal of West Palm Beach, County of Palm Beach, and State of Florida, this 5th day of August, A.D. 1958. Notary Public My Commission expires: March 30, 1959 Approved: August 12, 1958 Board of County Commissioners By: Larry J. Kirkham Chairman By: County Engineer BROCKWAY, WEBER & BROCKWAY ENGINEERS WEST PALM BEACH, FLORIDA PLAT NO I "BEAU RIVAGE" FIELD OFFICE: WEST OR. BY: M.G.S. SCALE: 1" = 100' DATE: MAY 1958 Dwg. No.: 57-1156 Approved: August 12, 1958 Board of County Commissioners By: Larry J. Kirkham Chairman By: County Engineer Approved: August 12, 1958 Board of County Commissioners By: Larry J. Kirkham Chairman By: County Engineer	<urn:uuid:4ac5b679-0651-4d7c-8f6a-378befdfcf91>	CC-MAIN-2024-42	https://plat.martinclerk.com/Files/Fmr_StLucieCounty/BK%2011%20PG%20024-001.pdf	2024-10-12T16:44:39+00:00	crawl-data/CC-MAIN-2024-42/segments/1727944254157.41/warc/CC-MAIN-20241012143722-20241012173722-00512.warc.gz	395,709,599	1,331	eng_Latn	eng_Latn	0.99304	eng_Latn	0.99304	[ "eng_Latn" ]	false	rolmOCR	[ 5362 ]	[ 0.5078125 ]	[ 1.6171875 ]	[ 1.765625 ]	[ 2.421875 ]	1	0	HuggingFaceFW/finepdfs
Parallel Implementation of Gabor Wavelet Processing in PyTorch Team: Huiran Duan, Zelin Wu Supervisor: Prof. Dr. Manuel G¨unther, Roger Bavibidila April 27, 2023 1 Introduction Image processing is the extraction of information from image data and has a long history in research. One particular traditional approach of image processing is the application of Gabor ﬁlters [Daugman, 1985], which have been used for the task of face recognition and other face-related tasks [Wiskott et al., 1997, Zhang et al., 2005, G¨unther, 2012, G¨unther et al., 2012, Schneider et al., 2011]. Gabor wavelets are ﬁlters that are applied to images, and they model the ﬁrst levels of the human visual system. Even when training deep networks, it has been shown that the learned ﬁlters have large similarities with Gabor wavelets [Krizhevsky et al., 2012]. Early approaches of incorporating Gabor wavelets directly into deep learning systems, however, only model parts of the whole processing chain [Luan et al., 2018]. There exists and open-source package 1 that implements the whole chain of Gabor wavelet processing for images in C++ with Python bindings. This package has been implemented by Manuel G¨unther some years ago as part of Bob [Anjos et al., 2012, Anjos et al., 2017], but it has been deactivated in the last version due to a restructuring and removal of all C++ implementations. 2 The goal of this Master project is to rewrite this package using PyTorch, so that it can be reactivated. The documentation 3 of the package shows some use cases. First, a family of (typically 40) Gabor wavelets is deﬁned that includes Gabor wavelets in various scales and orientations. Second, a given image is ﬁltered with these 40 Gabor wavelets to produce 40 complex-valued ﬁlter responses. Third, Gabor jets [Wiskott et al., 1997, G¨unther, 2012] are extracted at certain locations in the image. Finally, these Gabor jets can be compared with dedicated similarity functions to achieve various goals such as landmark detection [Wiskott et al., 1997], disparity estimation [G¨unther et al., 2012] or classiﬁcation [Schneider et al., 2011, G¨unther, 2012]. As an example, Gabor jets extracted in a grid graph structure can be used for face recognition [G¨unther et al., 2012], an example implementation is also available. 4 The problem with the existing implementation is that it is done in C++ and without parallelization. Furthermore, the available implementation does not allow the incorporation of the Gabor ﬁltering into modern deep learning methods. Since PyTorch allows parallelization on the GPU and includes everything required to perform image ﬁltering, the task is to implement the Gabor wavelet processing in PyTorch. This includes to deﬁne the (complex-valued) ﬁlters as PyTorch Module, the extraction of Gabor jets, and the parallel implementation of their similarity computations. Additionally, the existing documentation needs to be updated, and it is required that all tests deﬁned in the current package will pass with the new implementation. Preliminary implementations of the Module are available and can be used, including Gabor wavelets in spatial and frequency domain, as well as ﬁrst implementations of the Gabor wavelet transform. 2 Assignment Before starting, we ﬁrst need to set up the working environment. Since we will use and extend functionality in Bob [Anjos et al., 2012], documentation on the package development in Bob is available online 5 and should be followed. The ﬁrst task is to implement Gabor wavelet processing in PyTorch. This can be done in spatial domain by deﬁning convolution ﬁlters similar to (or deriving from) 2D convolutions. Additionally, an implementation 1 https://gitlab.idiap.ch/bob/bob.ip.gabor 3 https://www.idiap.ch/software/bob/docs/bob/bob.ip.gabor/master/index.html 2 https://gitlab.idiap.ch/bob/bob.ip.gabor/-/issues/6 4 https://www.idiap.ch/software/bob/docs/bob/bob.example.faceverify/master/index.html 5 https://www.idiap.ch/software/bob/docs/bob/bob.extension/stable/index.html in frequency domain shall be provided that speeds up processing when ﬁlters are large. This frequency domain implementation requires deﬁning Gabor wavelets in frequency domain, transforming images using fast Fourier transform (FFT), multiplying images and ﬁlters in frequency domain, and perform an inverse FFT to the results. The second task is to transform the complex-valued responses of the Gabor ﬁlters into Euler representations, i.e., magnitude and phase, which should also be implemented as a PyTorch Module and can serve as an activation function on the previous results. Third, Gabor jets should be deﬁned by extracting the 40 responses at certain (or all) locations in the image. If time allows, grid graphs of Gabor jets should be implemented, including the I/O functionality, preferably using HDF5. Fourth, diﬀerent similarity functions should be implemented in PyTorch. Ideally, comparisons should be implemented in parallel, for example, for comparing a Gabor jet from a speciﬁc location to Gabor jets of all other locations in the image. If possible, such an implementation should be parallelized onto the GPU, but the multiprocessing module can also be utilized. Implementing disparity estimation is part of this task. Finally, the available documentation of the package needs to be adapted such that it reﬂects the new implementation. Available test cases should not be touched unless they do not make sense in the new PyTorch environment. It should be made sure that the tests pass with the new implementation. Additionally, Jupyter notebooks can be created to showcase the usage of the package. Possibly, the package is re-integrated into the Bob ecosystem at the Idiap Research Institute. 3 Schedule Assuming 30 hours of work per week and a total of 15 ECTS with an average of 30 hours per ECTS, we arrive at a total workload of 15 weeks full-time. These should be distributed as follows. Week 1-3 Setting up the work environment, installing all required tools, building a joint software design and interface. Week 4-5 Implementing the Gabor wavelet family as an extension of the PyTorch Conv2d layer. Implementing the activation function to turn complex-valued responses into Euler representations. Week 6-7 Implementing the Gabor wavelet processing in frequency domain using torch.fft for the FFT. ⇒ Milestone 1: An image can be ﬁltered with a family of Gabor wavelets, and the result of the spatial domain transform and the frequency domain transform produce similar results. Week 8-9 Implementing Gabor jets, including I/O functionality. Possibly implement them as Module in PyTorch. ⇒ Milestone 2: Gabor jets can be extracted from images, saved and loaded from HDF5 ﬁles. Week 10-12 Implementing similarity functions of Gabor jets and Gabor graphs in parallel. ⇒ Milestone 3: Gabor jet disparities and other similarity functions are implemented. Week 13-15 Updating the documentation of the package and improving the test cases. ⇒ Milestone 4: The documentation is up-to-date and all test cases pass. If time allows Implement the Gabor wavelet processing with learnable wavelets that can be updated by gradient descent. Design a small end-to-end network and learning example that shows a proof of concept. Optionally Implement grid graphs of Gabor jets as image representation. Update the face veriﬁcation example to work with the new package. Optionally Integrate the new package into the Idiap ecosystem including the continuous integration system. The project is designed for three students, given our current progress in the implementation of the Gabor wavelets. I recommend to ﬁrst design the API interface, which makes it easier to combine other tasks and work on them in parallel. Afterward, the spatial and frequency-domain implementation of Gabor wavelets can be done in parallel by two students, while the third is working on Gabor jets and their similarities. Subsequently, the documentation and the test cases shall be updated, before going to the optional steps. It is recommended to update the test cases while implementing the functionality. Writing the project report is part of the Master project. As a template, the L A TEX thesis template from my webpage 6 should be used. I would recommend to start writing early and keep note of what was done when, and by whom. At the end of the project, there will be a joint presentation of the results in my research group. 6 https://www.ifi.uzh.ch/en/aiml/theses.html 4 References [Anjos et al., 2012] Anjos, A., El-Shafey, L., Wallace, R., G¨unther, M., McCool, C., and Marcel, S. (2012). Bob: a free signal processing and machine learning toolbox for researchers. In ACM International Conference on Multimedia (ACMMM), pages 1449–1452. [Anjos et al., 2017] Anjos, A., G¨unther, M., de Freitas Pereira, T., Korshunov, P., Mohammadi, A., and Marcel, S. (2017). Continuously reproducing toolchains in pattern recognition and machine learning experiments. In International Conference on Machine Learning (ICML). [Daugman, 1985] Daugman, J. G. (1985). Uncertainty relation for resolution in space, spatial frequency, and orientation optimized by two-dimensional visual cortical ﬁlters. Journal of the Optical Society of America Part A. [G¨unther, 2012] G¨unther, M. (2012). Statistical Gabor graph based techniques for the detection, recognition, classiﬁcation, and visualization of human faces. PhD thesis, Technical University of Ilmenau. [G¨unther et al., 2012] G¨unther, M., Haufe, D., and W¨urtz, R. P. (2012). Face recognition with disparity corrected Gabor phase diﬀerences. In International Conference on Artiﬁcial Neural Networks (ICANN), pages 411–418. Springer. [Krizhevsky et al., 2012] Krizhevsky, A., Sutskever, I., and Hinton, G. E. (2012). ImageNet classiﬁcation with deep convolutional neural networks. In Advances in Neural Information Processing Systems (NIPS). [Luan et al., 2018] Luan, S., Chen, C., Zhang, B., Han, J., and Liu, J. (2018). Gabor convolutional networks. IEEE Transactions on Image Processing. [Schneider et al., 2011] Schneider, H. J., Kosilek, R. P., G¨unther, M., Roemmler, J., Stalla, G. K., Sievers, C., Reincke, M., Schopohl, J., and W¨urtz, R. P. (2011). A novel approach to the detection of acromegaly: accuracy of diagnosis by automatic face classiﬁcation. The Journal of Clinical Endocrinology & Metabolism, 96(7):2074–2080. [Wiskott et al., 1997] Wiskott, L., Fellous, J.-M., Kr¨uger, N., and von der Malsburg, C. (1997). Face recognition by elastic bunch graph matching. Transactions on Pattern Analysis and Machine Intelligence, 19:775–779. [Zhang et al., 2005] Zhang, W., Shan, S., Gao, W., Chen, X., and Zhang, H. (2005). Local Gabor binary pattern histogram sequence (LGBPHS): A novel non-statistical model for face representation and recognition. In International Conference on Computer Vision (ICCV). 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2024/2025 Vademecum for new 3rd Faculty of Medicine students Emergency Card for Our Students This card helps you in case of need to obtain any assistance or help with interpretation. You can pick up this emergency card at the study division. Keep it always with you, please! The phone number is available 24/7 Držitel/ka této karty je studentem/kou 3. lékařské fakulty Univerzity Karlovy, Ruská 87, Praha 10. Pokud se vyskytnou problémy - zejména kvůli jazykové bariéře - kontaktujte prosím pohořovostní číslo níže. +420 724 292 312 Should any problems arise especially in communicating with Czech Police, contact the Faculty Emergency Phone number above. Everyone who does not speak the official (Czech) language has a right to interpretation and to an interpreter, who will translate all questions asked and answered. Important Phone Numbers Emergency NON-STOP service of the Vice-Dean for Undergraduate Education...........................................+420 724 292 312 Assistant to the Vice-Dean for Undergraduate Education..................................................+420 267 102 177 Emergency Medical Service.................................................................................................................155 Police Emergency..............................................................................................................................158 Fire Brigade .....................................................................................................................................150 Foreign Police ...............................................................................................................................+420 974 820 680 Dear students and colleagues, I would like to welcome you to the academic community of the Third Faculty of Medicine of Charles University. From the moment when you make the Matriculation Oath in the Great Hall of the Carolinum, you have the same rights and responsibilities as other members of the academic community. You can find further information on the status of the members of the academic community in Article 5 of the Constitution of CU. I admire that you chose a vocation here where you will help the ill. I also appreciate that you chose our faculty for your studies. Let me introduce the faculty to you. The Faculty of Medicine in Prague was founded in 1348 with Charles University. In 1953, the faculty was divided into three separate faculties – one of them was the Medical Faculty of Hygiene in the medical compound in Vinohrady. After 1990, the faculty moved to the new (current) building. Both the contents of its instruction and the name of the faculty were transformed. In 2019, the faculty gained the older neighboring building, currently called building B. The Third Faculty of Medicine educates future doctors in a wide range of medical sciences (the Master’s programme of General Medicine) but also other medical experts in relevant Bachelor programmes. Research is also an important feature of our faculty and many of our students participate on it. The Doctor study programmes are formative for future scientists and academicians. The Third Faculty of Medicine is one of eight faculties of medicine in the Czech Republic. It is a medium-sized faculty but we are one of the most successful when it comes to scientific production and independent evaluations of success of our graduates. This is due to our focus on practical education. We call our education system “problem-oriented”, which means that we teach our students to understand primarily interconnections, to approach patients as ill individuals with a particular symptom, to analyze this symptom, and propose further steps. You can see the difference clearly when you compare the names of examinations at our faculty to other (traditionally-oriented) faculties of medicine – especially in the initial years of study. A very valuable feature of the faculty are our open and friendly relations between students and teachers. You all passed very difficult entry examinations and we are proud that our system of entrance process leads to accepting self-confident and intelligent students who grow into true personalities during their studies. The faculty supports student activities – especially if they are focused on members of the academic community of the faculty (their scientific, sport, cultural or other activities, etc.) or charity work. I am looking forward to meeting you during your studies and to your initiatives to improve the quality of our education. I believe that you all will be successful in the difficult studies ahead of you and that we will meet at your graduation ceremony. I will finish my message with the traditional academic “Quod bonum, felix, faustum, fortunatumque sit”. Prague, Czech Republic August 1, 2024 prof. MUDr. Petr Widimský, DrSc. The Dean of the Third Faculty of Medicine of Charles University Welcome We wish you a warm welcome to Charles University and hope that you will have an enjoyable and enriching experience as a student here. We hope that coming to study at our university will be an exciting experience with opportunities to broaden your academic, social, and cultural horizons. All international flights arrive at Václav Havel Prague Airport, approximately 20 km to the Northwest of the city centre. You can get into town either by catching a city trolleybus (No. 59) or by taking a taxi. There are three ways you can get from the airport to the dormitory: 1) You can take a taxi or UBER – this is undoubtedly the most comfortable way to travel, but also the most expensive. Prices for a taxi journey from the airport into town range from CZK 500 to 1,200 depending on your precise destination. There is an Uber Airport service in the arrival hall, use the electronic kiosks to plan and pay for your journey in advance. If you do decide to use a taxi, make sure you get a written estimate for the cost of your journey from the company in the airport lounge before you set out, since this reduces the chance of the driver trying to overcharge you (ask a taxi driver for the price before). If on TAXI, pay only the prices set on the meter and ask for a printed receipt! 2) Take city trolleybus No. 59 to "Nádraží Veleslavín" Metro Station, line A. Then, after you get to Nádraží Veleslavín, take a subway or a taxi (if you don't want to/can not use the subway). This reduces the length of the taxi journey. 3) Take city bus No. 100 — a special fast and frequent service from the airport to the Zličín metro station (underground line B) from where you can get to central Prague by metro. To take the city bus you will need to buy a ticket for CZK 30 (valid for 30 minutes) or CZK 40 (valid for 90 minutes) in the airport lounge or at the bus stop from a machine, where you can use your credit cards, and you should remember to validate the ticket by date-stamping it when you get on the bus. There is also the possibility to get “SMS ticket”, but this is possible only for those who have a Czech phone number. For general information on Václav Havel Airport Prague, see the [website](#), which includes full details of transport to the airport by city bus, minibus and taxi (in English). ### Some useful websites - Václav Havel Prague Airport: [www.prg.aero/en](http://www.prg.aero/en) - Prague Public Transport: [www.dpp.cz/en](http://www.dpp.cz/en) - Prague City Tourism: [www.prague.eu/en](http://www.prague.eu/en) The Third Faculty of Medicine is located on Ruská 87, Prague 10. The closest metro stop is Želivského on line A (green). Students from non-EU or non-EFTA countries who wish to stay in the Czech Republic for more than 90 days have to apply for a visa. An application for the visa should be submitted to the Czech Embassy or Consulate in the student’s country of origin in good time before arrival. Please be aware that the administration process can easily take 8 weeks. The price of the visa fee depends on the country you come from. Even when you have the visa you are legally obliged to register with the Police Foreign Department within 3 days of your arrival. The residency visa for more than 90 days is valid for 1 year and allows the foreign citizen to travel repeatedly into and out of Czech territory. The residence of foreign nationals in the Czech Republic is governed by the Act on the Residence of Aliens in the Territory of the Czech Republic (law no. 326/99, as amended). Under the terms of this law, it is not possible for first-time visa applicants to apply for a student visa on the territory of the Czech Republic, or even to pick up a visa they have previously applied for. Students therefore must apply for (and obtain) a visa before their departure to the Czech Republic. If you are a citizen of an EU or EFTA state you do not need to apply for a visa. Within 30 days of your arrival to the Czech Republic, however, you must apply for a Residence Permit at the Police Foreign Department Due to the Czech Republic's membership of the EU, citizens of European Union (EU) countries (Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden), citizens of European Economic Area (EEA) countries (Iceland, Liechtenstein and Norway), and citizens of Switzerland do not require any visa for any type of visit or stay in the Czech Republic. At the point of entry to the Czech Republic, an EU citizen needs to present only a travel document at the request of the police. EU citizens entering the territory of the Czech Republic will be allowed to use national ID cards besides standard travel documents (e.g. ordinary passport, diplomatic passport, service passport). The currently operative EU regulations provide for a necessary minimum period of validity of travel documents or ID cards, neither do they stipulate that ID cards, used instead of travel documents, must have a machine-readable zone. To permit entry to its territory, the Czech Republic will accept all kinds of identity cards included in a handbook currently prepared by the EU that will contain specimens of the indicated national documents of all EU member states. Foreign nationals from outside the EU continue to need a visa. If you need help with your visa, you can contact Integration Centre Prague. Temporary Residence Permit If an EU citizen intends to stay in the territory of the Czech Republic for a period exceeding three months, he/she will be entitled (but not obliged) to apply to the police for a special residence permit (temporary residence permit). The issue of the said permit is not a condition for the stay of EU citizens in the territory of the Czech Republic, irrespective of the purpose of the stay. On the other hand, it has benefits for a foreign resident in situations, where proof of a Czech address is required, e.g. for some rental and purchase agreements. If the application is handled affirmatively, the police issue the EU citizen with a permit card. Citizens of Switzerland, Norway, Liechtenstein, Iceland and their family members who are not EU citizens will be issued by the police residence permit cards Průkaz o povolení k pobytu (cover in green colour). Rights and Duties of Foreign Nationals in Czech Republic Every foreigner as well as any other person residing in the Czech Republic must observe the laws and legal regulations which apply to them (i.e. criminal code, tax laws, etc.). Nevertheless, there are certain (additional) duties, which must be fulfilled by foreigners in particular. This manual provides a basic overview of the rights and duties of foreign nationals when in contact with the police. Nevertheless, the Czech law may occasionally differentiate between the EU citizens including citizens of Iceland, Norway, Lichtenstein, or Switzerland (hereinafter collectively referred to as “EU citizens”) and the non-EU citizens. Duties Every foreign national must be able to prove his or her identity, if requested by the police. - EU citizens can prove their identity with a passport or an ID card. - Non-EU citizens prove their identity with a passport and/or a residence permit. After arrival – EU citizens - If the length of the intended stay is longer than 30 days, EU citizens are obliged to report their presence to the appropriate Foreign Police Department in the location of their stay. EU citizens can temporarily stay in the Czech Republic without any special permit, solely on the basis of a travel document or an identity card. However, if they plan to stay longer than 3 months, they can request a certificate of temporary residence or a permanent residence permit. - EU citizens are also bound to report any changes to surname, marital status, and changes of data contained in the residence card within 15 days to the appropriate authority, which issued the residence card. - EU citizens are required to report a change in the place of residence within 30 working days of this change occurring, if the change is expected to last longer than 180 days (for further information visit this page). After arrival - non-EU citizens - After arrival, non-EU citizens are obliged to report their presence to the appropriate Foreign Police Department in the location of the place of their stay within 3 working days as well as report a change of address within 30 days of the change. - To stay in the Czech Republic for longer than 3 months, non-EU citizens require a long-term visa, or a long-term or permanent residence permit. For further information visit [this page](#). Non-EU citizens must report any changes to surname, marital status, or changes to data in passport or another travel document to the appropriate authority, which issued their residence permit within 3 days. Every foreign national must prevent documents issued under the Czech law against loss, theft, damage or misuse and ensure that the contained data are true. Every foreign national must report loss, damage, destruction, or theft of a document issued under the Czech law within 3 days. Every foreign national must immediately report loss or theft of passport or other travel document. Sanctions In the case of a breach of the above-mentioned duties a financial penalty (fine) of up to 3,000 CZK can be imposed. Rights Everyone has a right to equal treatment and non-discrimination. Everyone has a right to be informed about the nature and cause of the charges laid against him or her, and about the legal basis for such charges. All provided information must be comprehensible and complete. Everyone has a right to respond to charges laid against him or her. Everyone who does not speak the official (Czech) language in case of official processes (Police, court of law) has a right to interpretation and to an interpreter, who will translate all questions asked and answered. Should any problems arise especially in communicating with Czech Police, please contact the NONSTOP Emergency Phone number +420 724 292 312 Costs of Living The cost of living in the Czech Republic is on average comparable to that of other Central and East European countries. A single student is advised to have available approximately CZK 15,000 (app. EUR 700) per month to cover food, basic transport and accommodation. \| Category \| Cost Range \| \|-------------------\|--------------\| \| Rent \| CZK 5,000–15,000 \| \| Food \| CZK 4,000–5,000 \| \| Transport \| CZK 130–400 \| \| Leisure time \| CZK 2,000–3,000 \| Total CZK 11,130–23,400 Be aware that the level of rent varies depending on which city you live in, whether you use the University dormitory or private place and if you share the flat or not. The final cost of living depends on your personal spending habits, of course. Money and Banking Money The currency is the Czech crown (Koruna česká – Kč), divided into 100 hellers. Hellers are only used for accounting – in reality all payments are in whole crowns. The following denominations are in circulation: Notes: 100; 200; 500; 1000; 2000 and 5000 Kč; Coins: 1, 2, 5, 10, 20 and 50 Kč Most of the shops and service providers in Prague and big cities accept major credit cards (usually except for American Express). Many services (public transport, food delivery) can be paid online too. In rural areas of the country however it is still what is considered a “cash economy”, which simply means that most transactions are made in person, in cash. At present some of the older banknotes (100, 200, 500, 1000) are being exchanged for newer types, the basic difference if that the aluminum foil stripe is wider in the new banknotes. If a banknote would be refused in a shop/restaurant based on the fact it is “old”, do not worry, these notes will be exchanged at any bank branch. Banks There are branches of all the main Czech as well se international banks such as: - Air Bank - Česká spořitelna (ČS) - Československá obchodní banka (ČSOB) - Komerční banka (KB) and other smaller branches where you can open an account. Bank opening hours are generally 8 am to 5 pm Monday to Friday and some banks are open on Saturday morning. Nearly all banks have 24-hour AMT cash machines and a foreign exchange desk where you can exchange your currency and traveler’s cheques. Lost Credit Cards - American Express – information at: +420 222 800 333, +420 222 800 111 - Visa – information at: +420 800 142 121, +1410 581 9994 - MasterCard/Eurocard – information at: +420 800 142 494, +1 636 722 7111 - Diners Club Czech – hot line: +420 222 316 675, +420 267 197 450, (at weekend +420 221 779 924) - Commerzbank – information at: +420 272 771 111 Mobile Operators In the Czech Republic you have a choice of three mobile phone networks: Vodafone, T-Mobile and O2. In the cities of the Czech Republic all networks provide excellent coverage. Unfortunately, there is very little difference in price between their tariffs. For example, all three networks offer their unlimited calling plan for on average CZK 500 monthly with data ranging between 3–20 GB. Be careful with the contract lengths on mobile phone tariffs as the standard here is 24 months. Vodafone offers a student tariff for CZK 487 monthly which includes unlimited calling, SMS and data (speed 4 Mb/s) within the European Union. Keep in mind that, to get the student discount you must have a student card (ISIC card) that you will be able to obtain after you fully register at the university. Thus, we advise you to get the student mobile plan after you get your ISIC card. (See page 18 for more info on the ISIC card) Alternatively, if you are a light mobile phone user you may wish to consider getting a pre-paid card. All of the mobile networks offer them. The webpages of 3 main mobile operators are: www.t-mobile.cz, www.o2.cz, www.vodafone.cz. Accommodation in Prague (dormitory) Living in university accommodation is a great way to get to know people when you first come to the Czech Republic. Students are usually housed in double occupancy rooms with shared kitchen and bathroom facilities. Single rooms are available in a limited amount. There are two types of rooms: 1) Unit system consisting usually of two double rooms sharing a small kitchenette (hot plate and small fridge) and bathroom facilities. 2) Double rooms with communal showers and kitchens at the end of each hall. All dormitories provide bedding (pillow, duvet and sheets, changed regularly). Most also have laundry facilities. The accommodation is provided either for the whole school or academic year, i.e. from October to June, or from October to September of the next year. If you would like to be accommodated in student’s dormitory, first check the webpage: www.kam.cuni.cz. The study division helps with accommodation for the first-year students. Private Accommodation It is not difficult to find private accommodation in our university cities. For a three-room flat (two rooms and kitchen) situated in the centre of Prague you can pay about CZK 30,000. You can visit these sites for example: - www.movetoprague.com - www.sreality.cz - www.spolubydlo.cz/hledam/pokoj/praha/ - www.bydleni.cz/reality/ - www.annonce.cz/byty-k-pronajmu.html - www.facebook.com/groups/1930109730542350/ All contracts you sign should be written in English or in a language you understand. In doubts, contact the Study Division - DO NOT sign anything you do not understand! Emergency Medical Service In the case of urgent emergency call 155! Emergency medical treatment is free of charge for all visitors to the Czech Republic EU/EFTA (i.e. European Union, Norway and Switzerland) citizens. Any other medical, dental or hospital care and all care provided to NON EU/EFTA citizens will be charged in full, unless otherwise specified in the governmental agreement between the Czech Republic and the student’s home country. Special arrangements exist for EU/EFTA citizens – see lower. (It is essential that all other students arrive with adequate health insurance for the entire duration of their stay, arranged in advance of their departure from home). In the Czech Republic, nonprescription drugs and medicines are sold only in pharmacies. They are not available at supermarkets. Pharmacies may be recognized by the prominent green cross-displayed over the shop-front. Many have staff, who can speak English, Russian or German, and are used to offering medication advice to tourists (esp. in the city centers). In Prague, you can find pharmacies open 7 days/week in shopping centres and also some nonstop pharmacies – e.g. Belgická 37 – very close to náměstí Miru Metro A station. Health Insurance EU nationals Students arriving from EU member states should ensure that they request a European health insurance card (EHIC) from their local health authorities before departure from their home countries. Nationals of EU countries who are staying temporarily in the Czech Republic are entitled to receive URGENT necessary medical treatment free of charge. To obtain treatment under the provisions of the European regulation it is important to contact medical institution (doctor, dentist, hospital), which is covered by the contract with the public health insurance system (most of them do – details can be obtained from the health insurance funds). For more information, please visit [www.kancelarzp.cz/en](http://www.kancelarzp.cz/en). Your European health insurance card (EHIC), or Provisional certificate has to be submitted to attending physician. If none of the above-mentioned documents are presented, the physician can insist on cash payment. If non-acute treatment is needed, the physician will normally ask you to confirm your expected length of stay in the territory of the Czech Republic and will advise you to choose one of Czech contracting health insurance funds – for non-acute care. Prescriptions are issued by a doctor, and may be filled at a pharmacy. You may have to contribute to the cost of your drugs or medicines, and this cost is not refundable. In case of urgent medical transport or in case of treatment by doctor of emergency service it is also necessary to present your European health insurance card, or Provisional certificate. Please note that non-urgent or elective treatment which can reasonably be postponed until the persons return to his/her country are not covered, and for these eventualities we recommend you take out extra medical or commercial travel insurance with an insurance provider in your home country. EU students should ask their home insurance company to provide them so called S2 certificate – which is a guarantee that their non-urgent planned treatment will be reimbursed. In connection with the possibility of vaccination against COVID-19, but also due to free health care in the Czech Republic for EU citizens + Norway and Switzerland (holding European health insurance card) there is possibility to get an Auxiliary Insurance for Foreign students – at any of the public health insurance companies in the Czech Republic. This operation is free. We have excellent experience with insurance companies Všeobecná zdravotní pojišťovna (VZP – 111) and Zdravotní pojišťovna ministerstva vnitra (ZPMV – 211). When staying in the Czech Republic for a longer time it is possible to choose and contact one of the health insurance funds, where you can be registered. You will receive a registration document called “Certificate of Registration” which shall be submitted to the attending doctor / dentist / at the hospital before getting the treatment. We highly recommend making this connection with the Czech public health insurance. How to get it? It is easy. Come in person to a branch of any public health insurance company with a valid identity card and a European Health Insurance Card (EHIC). Within a few minutes, they will generate the number of the insured in the Czech Republic, including confirmation. VZP insurance company – Prague 1, Na Florenci 2116/15, firstname.lastname@example.org, phone: +420 952 222 222, office hours: Monday and Wednesday 8:00–17:00, Tuesday and Thursday 8:00–15:00, Friday 8:00–14:00. They will process your request on the ground floor of the building, they speak English at this branch. ZPMV insurance company – Prague 3, Vinohradská 2577/178, email@example.com, phone: +420 233 002 111, office hours: Monday 8:00–18:00, Tuesday and Thursday 8:00–15:30, Wednesday 8:00–17:00, Friday 8:00–12:00. They will process your request on the ground floor of the building, they speak English at this branch. Non-EU nationals Non-EU students should ensure that they have private medical insurance or they must expect to pay cash for all medical care. We strongly urge all non-EU international students to consult with their home medical insurance company prior to travelling abroad to confirm whether their policy applies to the Czech Republic and whether it will cover emergency expenses such as a medical evacuation. In case the home medical insurance company’s policy does not cover the Czech Republic, contract insurance with Pojišťovna VZP. It is the only currently approved medical insurance provider for foreigners, for more information see their website. Healthcare for Students Non-acute health care for foreign students of Third Faculty is provided by Dr. Rachel Elizabeth White and Dr. Veronika Valchová (firstname.lastname@example.org), who is positioned at the building I, ground floor, halfway left of the entrance, second or last door on the left – appropriately marked. Office hours for non-emergency cases are every Wednesday, 12:30–14:30, and every Monday, 7:30–11:00. It is not necessary to make an appointment. Urgent cases during daytime by phone appointment +420 267 162 690. Please bring with you, your insurance card, passport and ISIC. In the event of an acute illness, you can visit round the clock the Emergency unit at the Dept. of Paediatrics and Adolescent Medicine, building M of Vinohrady Hospital for nonsurgical emergencies, surgical emergencies are dealt with at the Dept. of Surgery (building H), injuries at the Dept. of Orthopaedic Surgery (building H), eye emergencies at the Dept. of Ophthalmology (building E), gynaecologic emergencies at the Dept. of Gynaecology and Obstetrics (building D). Acute dental care is provided by the Dept. of Dentistry (building N) but only Mo-Fri 7:00–15:00. If you have any difficulties with finding acute medical assistance, do not hesitate to call the NONSTOP EMERGENCY phone number +420 724 292 312. Other important phone numbers are at the front page of this booklet. Hepatitis B + Measles Vaccinations It is compulsory for students of medical faculties to be vaccinated against the hepatitis B virus (except for those who have demonstrably had the disease or have a sufficient amount of antibodies against HbsAg higher than 10 IU/l.). You are prohibited from taking part in tuition in a medical facility without being vaccinated (or proving you have the sufficient amount of antibodies). Your GP will give you this vaccination – please submit the confirmation of vaccination to the study division of the Dean’s Office. Where can I get the required vaccinations – Hepatitis B/Measles for study at the faculty? You can contact the Department of Occupational and Travel Health in the University Hospital, (Building I, ground floor). You can make an appointment and get further information at www.objednavky.fnkv.cz – but this system is in Czech only, so ask the Study Division for assistance. Always bring your vaccination records, or medical records which document your previous vaccinations. Students are also obliged to submit a certificate of measles vaccination or to submit a certificate of sufficient level of measles antibodies was established. Vaccination (2 doses of vaccination aged 0–15 years, or 1 dose aged 15+ years) the student proves either by a written confirmation of a doctor – usually a general practitioner for children and adolescents or a general practitioner on the form “Certificate of vaccination”, or a photocopy of vaccination card. In case of unavailability of information from a general practitioner or in case of other need, students of the 3rd Faculty of Medicine can be tested for measles antibodies or measles vaccinations at FNKV workplaces for a reduced price – those interested in this procedure must contact study division officer. Where can I get a TB Skin Test, or get a TB booster shot? Our hospital does not provide TB skin testing or TB booster shots. You can obtain a letter of reference from MUDr. Jana Malinová (phone no.: +420 267 162 682). Then, you will go with the letter to the Calmetisation centre in Prague 10 – Pulmonary department – Calmetisation, Plaňanská street 573/1, Prague 10 – Malešice; where you can get a TB skin test or TB booster shot. (+420 281 019 243) I need laboratory tests (e.g. MRSA, or other) before taking part in hospital training. Can I come to Dr. White’s Clinic on Thursday? It is not necessary to come to the clinic; you can only e-mail to inform them (in case of the office holidays, or unexpected situations). Then, you can come directly to the clinic for the swab test on Tuesday or Thursday, at 7:30 in the morning. Remember: you should not brush your teeth before taking the MRSA swab test! The results will be available in 3 days; you can be informed in person or via e-mail. Dental Care Dental clinic offers our students basic dental care. Applicants may come personally to consulting room no. 3 (+420 267 163 343) or to consulting room no. 5 (+420 267 163 289). If you are afraid, they can use ENTONOX (N₂O+O₂) to calm you down. They also offer dental hygiene in consulting room no. 7 – best after the visit of above mentioned or after consulting with another dentist. For making the appointment (Dental hygiene), call 267 163 268. More information on the reception and above-mentioned numbers. Address: Faculty Hospital Královské Vinohrady, Department of Stomatology, Šrobárova 50, 100 34 Prague 10, building N Counselling If you encounter any study or personal problems during the course of your studies, you can contact your group tutor/co-tutor or the Vice-Dean or one of his staff, who may either help you directly or arrange for the provision of the necessary assistance at a specialized facility. Liability Insurance All students and staff of the Third Faculty of Medicine at Charles University are covered by an insurance policy concluded with Česká podnikatelská pojišťovna, a.s., Vienna Insurance Group, in respect of "third-party liability for damage arising in connection with the activities performed in accordance with the unabridged version of the Statutes of Charles University". The amount of the indemnity limit is CZK 20,000,000 and this policy is valid throughout the Czech Republic. The excess for each insured party is CZK 1,000 per insurance claim. This insurance does not cover the risk of contracting an infectious disease. UNIVERZITA KARLOVA V PRAZE 3. LÉKAŘSKÁ FAKULTA 3rd Faculty of Medicine Board of 3rd Faculty of Medicine prof. MUDr. Petr Widimský, Ph.D. Dean of the Third Faculty of Medicine prof. MUDr. Monika Arenbergerová, Ph.D. Vice-Dean for Public and International Relations doc. MUDr. Pavel Dlouhý, Ph.D. Vice-Dean for Specialized Education and Public Health Promotion prof. MUDr. František Duška, Ph.D. Vice-Dean for Support and Evaluation of Research prof. MUDr. Valér Džupa, CSc. Vice-Dean for Academic Career Development prof. MUDr. Hana Malíková, Ph.D. Vice-Dean for Accreditation and for Career and Social Affairs MUDr. David Marx, Ph.D. Vice-Dean for Undergraduate Education and Student Affairs prof. MUDr. Romana Šlamberová, Ph.D. Vice-Dean for Postgraduate Studies and Student Research Activities doc. MUDr. Jan Trnka, Ph.D. Vice-Dean for Development JUDr. Zdeňka Mužíková Bursar The highest legislative body of a university or a faculty in the Czech Republic is the Academic Senate. The Academic Senate of Charles University (AS CU) consists of representatives of both the academic staff and the students of all the university’s faculties. The Academic Senate of the Third Faculty of Medicine (the “AS of the Third Faculty of Medicine of CU”) has a total of 32 members. The representation of academic staff and students is at parity (16 representatives each). The Senate’s student chamber consists of representatives of all programmes taught at the faculty, including at least two students in the English language programme. Senators are elected by members of the faculty’s academic community for a three-year term. A presidium is elected to coordinate the AS, comprising the Senate Chair, the Vice-Chairman elected from the ranks of the academic staff, and the Vice-Chair elected from among students. Please, do take part in these elections, vote for candidates or stand for election. Every one of us is responsible for the state of our academic community and this is a prime way to influence its further development. Among other things the Academic Senate: - decides on the establishment of new departments, - approves the faculty’s internal regulations, the conditions for admission to the faculty as well as the faculty’s long-term educational, scientific and research plans, - passes resolutions on the appointment of the Dean of the faculty, provides an opinion on the proposed study programmes The Senate meets once a month and its meetings are open to the public. The minutes of senate meetings are posted on the faculty’s website. Board doc. MUDr. Jan Gojda, Ph.D. Chair of the AS of 3rd FoM CU Department of Internal Medicine 3rd FoM CU and UHKV e-mail: email@example.com prof. MUDr. Spyridon Gkalpakiotis, Ph.D., MBA Vice-Chair – Members of Teaching Staff Department of Dermatovenerology 3rd FoM CU and UHKV e-mail: firstname.lastname@example.org MUDr. Viktor Šebo Vice-Chair – Members of Students student, doctoral study – Human Physiology and Pathophysiology e-mail: email@example.com Czech National Holidays in Academic Year 2024/2025 Schools are closed, no business performed, some holidays all large shops are closed too \| Holiday \| Date \| \|----------------------------------------------\|---------------\| \| St. Wenceslas Day – Day of Czech Statehood \| 28. 9. 2024 \| \| Foundation of the Czechoslovak State (1918) \| 28. 10. 2024 \| \| Victory of Freedom and Democracy (fall of Communism) \| 17. 11. 2024 \| \| Christmas Day – First Christmas Holiday \| 25. 12. 2024 \| \| St. Stephen’s Day – Second Christmas Holiday \| 26. 12. 2024 \| \| Restoration Day of the Independent Czech State \| 1. 1. 2025 \| \| Good Friday \| 18. 4. 2025 \| \| Easter Monday \| 21. 4. 2025 \| \| Labor Day \| 1. 5. 2025 \| \| Victory Day \| 8. 5. 2025 \| \| Day of Saints Cyril and Methodius \| 5. 7. 2025 \| \| Jan Hus Day \| 6. 7. 2025 \| Academic Year 2024/2025 \| Event \| Date \| \|--------------------------------------------\|---------------\| \| Start of the winter semester \| 30. 9. 2024 \| \| Christmas vacation \| 21. 12. 2024–5. 1. 2025 \| \| Exam period \| 27. 1. 2025–21. 2. 2025 \| \| Start of the summer semester \| 24. 2. 2025 \| \| Exam period \| 9. 6. 2025–30. 6. 2025 / 1. 9. 2025–30. 9. 2025 \| \| Summer vacation \| 1. 7. 2025–31. 8. 2025 \| \| End of the academic year \| 30. 9. 2025 \| Student Cards You only need your valid passport with you – there are 2 types of Student Cards. A simple one, that is issued for free and serves for several purposes concerning your studies (Library, University Information System, etc) or a card, that also serves as International Student Identity Card (ISIC) – this can be also used to gain discounts at several cultural and other sites (see www.isic.cz). The issue centre at Information and Advisory Centre of Charles University is the only university centre, where you can buy an International Student Identity Card (ISIC). The price is CZK 230. ISIC cards can also be bought at branches of GTS International. In order to have access to libraries, computer rooms, cafeterias, reading rooms and so on you need the Charles University Student Card, which can be issued to you in one of the following centres. Card Service Centres - CU Point, Celetná 13, 110 00 Praha 1, tel. 224 491 610 (Monday–Thursday 9:00–12:00, 12:30–18:00; Friday 9:00–12:00, 12:30–16:00) - Faculty of Law of CU, nám. Curieových 7, Praha 1, ground floor, door number 6, tel. 221 005 487 (Monday–Thursday 9:00–12:30, 13:00–16:30; Friday 9:00–13:00) - Faculty of Mathematics and Physics of CU, Ke Karlovu 3, Praha 2, second basement floor, room M 266, tel. 221 911 468, (Monday–Thursday 8:00–12:00, 12:30–16:00; Friday 9:00–12:00, 12:30–15:00) Tutor system The commencement of higher education studies can be accompanied by a relatively high level of stress – a new environment, new people, a great deal of information that must be absorbed often in very short time frames. You will undoubtedly successfully handle most of these factors on your own. However, you may find yourself in a situation when you will appreciate the service provided by the faculty’s tutors. Your study group will be assigned a tutor – one of the senior teachers of the faculty. This tutor will contact you during the first weeks of your studies and meet the group. The main duties of Tutors are: - To assist students, particularly during the first year, in adapting to the university setting and to the manner of tuition within the framework of the integrated programme. - To arrange contact, if need be, between students and the responsible Vice-Dean or another official of the Third Faculty of Medicine. If need be, tutors shall also make sure, that students find their bearings in the array of medical, social and psychological services provided by the pertinent organizations. - To arrange or provide for counselling and guidance for students, namely as regards problems related to the course or organization of studies or in the event of a difficult social situation. - To keep students abreast of opportunities for student research activities and optional student courses. - In short – the Tutors serve to resolve, in a fast and flexible way, student’s problems in areas directly relating to their studies, to organizational and social matters, to the area of students’ participation in science research activities and to their future employment prospects. Tutors are available to students upon prior appointment (preferably by e-mail). Should the need arise, the discussion of an urgent matter can be arranged by contacting MUDr. David Marx, Ph.D., the Vice-Dean for Undergraduate Education and Student Affairs, by the faculty NONSTOP SOS helpline: +420 724 292 312. Stressful situations may arise at the commencement of studies, particularly during the first year, caused by the process of adapting to greater study demands, finding the ideal way of preparing for tuition, as well as the different environment in which the students find themselves. Consulting any of these problems with tutors is always welcome. Tutors can also assist students in certain social problems, can help to find a doctor or a psychologist. The tutors of the Third Faculty of Medicine are prepared to communicate personally or in writing with any student. Students have a tendency, particularly at the start of their studies, to postpone the resolution of their problems, which results in an accumulation of stress and further complicates the problem – do not hesitate taking advantage of the support provided by the faculty’s tutors whenever you believe it is appropriate. Student Mental Health Contact Point The contact point serves for all our students who have any issues concerning mental health – either with regards to study burden (anxiety, sleep problems, inadequate procrastination, problems with concentration) or caused by anything else (adaptation problems, partnership problems etc.). The contact point provides initial psychotherapeutic interview and (if needed) continuing care by a clinical psychologist or psychiatrist. The service is elective – for urgent, acute situations please contact Emergency Intervention Centers – Crisis Intervention Centre RIAPS. In acute situations you can also contact the faculty emergency hotline (nonstop +420 724 292 312). Contact point is situated in room B111 (ground floor building B, left entrance) – you can easily make an appointment at tkp.lf3.cuni.cz All information shared with the psychologist/psychiatrist is strictly confidential and without your consent must not be shared with anybody. Services of the contact point are provided free of charge. Students Counselling Centre at the Department of Hygiene, 3rd FoM CU – building C/10, NIPH Provided services - Counselling on personal development and stress management – assistance in adaptation to new study and living conditions; assistance in a difficult personal situation; stress management and support of a healthy lifestyle - Study counselling – assistance in solving study issues; assistance in identifying an effective learning style - Counselling on quitting smoking - Reference to specialized services – crisis intervention; psychiatric consultation; psychotherapy; pharmacological support of quitting smoking, etc. Contact Person Doc. MUDr. Dagmar Schneidrová, CSc. E-mail: firstname.lastname@example.org Phone: +420 267 102 340 Consultations: Wednesday 10:00–12:00, 13:00–16:00 upon previous agreement via email or phone At the 3rd Faculty of Medicine of Charles University, we pride ourselves on a friendly and open environment. In order to maintain and cultivate such an environment, let us introduce the areas that the contact person for the CU Ombudswoman is working on and could help you with. These include especially complaints related to: - inappropriate behaviour in the workplace or a study group showing signs of psychological pressure, bullying, discrimination, or sexual harassment - unequal treatment, conflict of interest or inappropriate behaviour between persons in unequal positions of power - unjustified delays and cases where the competent authority appears not to act - situations where communication is ineffective, and the issue needs to be dealt with impartially The main role of the contact person for the CU Ombudswoman is therefore: - to provide assistance to all students and staff who contact her, or refer them to other faculty authorities, or recommend another solution where appropriate - to seek, through mediation in defined areas, solutions to disputes that are acceptable to both parties involved - to ensure communication between the CU Ombudswoman and the management of the 3rd Faculty of Medicine and provide assistance to the CU Ombudswoman The contact person for the CU Ombudswoman does not deal with complaints: - without proper written processing - belonging to the agenda of other faculty bodies or departments Study Division The Study division deals with study-related matters of all undergraduate students. Any student can contact the Study division in order to obtain a confirmation of student status which may be required by various authorities or institutions. This division has pre-printed forms, where the student merely fills in his/her personal details. Students must always show proof of his/her student status (Student ID Card). The study division also issues official transcripts of records (grades) on request. If a student encounters problems related to his or her studies and wishes to request for changes to be made in his/her study plan, he/she must always submit a written request to the Study division, where he/she shall be advised of the possible ways of resolving the problem at hand. He/she shall receive a form from the [website](http://www.lf3.cuni.cz/en) on which to write the request. The student shall send the request to the study division (depending on the nature of the problem), who shall then consider the request and decide on the manner of its settlement. It is very important for students to monitor [www.lf3.cuni.cz/en](http://www.lf3.cuni.cz/en), where they can find all the current information. Students submit their e-mail addresses to the study division so that they can receive information and various notifications also by email. Vice-Dean and Associate Deans MUDr. David Marx, Ph.D. Vice-Dean for Undergraduate Education and Student Affairs Students wishing to contact the Vice-Dean for Undergraduate Education and Student Affairs may make appointment: Lucie Millerová Secretary of the Vice-Dean Building B, 3rd FoM CU, room 213, left entrance phone: +420 267 102 177 e-mail: email@example.com or firstname.lastname@example.org It is possible to contact the Vice-Dean for Undergraduate Education and Student Affairs or a member of his team at any time, 24/7, by calling +420 724 292 312 in the event of an emergency (acute matters pertaining to health care, social support, acute legal advice, etc.). Deputies of Vice-Dean For Undergraduate Education and Student Affairs doc. MUDr. Miloslav Franěk, Ph.D. e-mail: email@example.com phone: +420 224 902 714 doc. MUDr. Jan Novák, Ph.D. e-mail: firstname.lastname@example.org doc. MUDr. Jan Gojda, Ph.D. e-mail: email@example.com phone: +420 267 163 031 PhDr. Hana Svobodová, Ph.D. e-mail: firstname.lastname@example.org tel.: +420 267 102 942 Daniela Lvová Head of Study Division Building B, 3rd FoM CU Room 209b phone: +420 267 102 205, mobile: +420 725 812 057 e-mail: email@example.com Staff in Charge of English Curriculum Students Marie Ghasemi Officer for admission, 1st and 2nd study year of Master programme General Medicine in English Building B, 3rd FoM CU, room 205 phone: 267 102 189 e-mail: firstname.lastname@example.org Karolína Rosická Officer for 3rd–6th study year of Master programme General Medicine in English Building B, 3rd FoM CU, room 205 phone: 267 102 140 e-mail: email@example.com Ing. Tereza Svobodná coordinator of events of the Study Division Building B, 3rd FoM CU, room 205 phone: 267 102 190 e-mail: firstname.lastname@example.org Office Hours \| Day \| Time \| \|-----------\|---------------\| \| Monday \| 7:30–12:00 \| \| Tuesday \| 13:00–15:30 \| \| Wednesday \| 7:30–12:00 \| \| \| 13:00–18:00 \| \| Thursday \| 7:30–12:00 \| \| Friday \| 7:30–12:00 \| Students are expected to visit the division during office hours. In the first instance students should contact the officer of the study division assigned to their programme/year, but all the division’s staff are generally able to handle any types of problems. If a student needs advice, he/she can also turn to the head of the study division, and to the Vice-Dean for Undergraduate Education and Student Affairs or his deputy should he/she need advice on serious problems. How to Address Teachers and Staff Teachers at institutions of higher learning in the Czech Republic have titles corresponding to their hierarchical classification – the highest title is that of a professor ("profesor"), the medium level title being that of an associate professor ("docent") and the lowest level title being that of an assistant professor ("odborný asistent"). In the course of routine interaction, it is sufficient to use the title "doctor" or "professor". In the Czech Republic it is not customary to use first names when addressing faculty teachers or its staff – in the case of a faculty's staff, it is customary to use the titles "Mr/Mrs/Miss". About the Curriculum The medical curriculum at the Third Faculty of Medicine aims at teaching medicine in a modern way with an emphasis on integrating related fields for better understanding and retention. Students also meet patients already in the first year and can therefore see medicine in a clinical context from the very start of their studies. The whole six-year programme is divided into three cycles, which are further subdivided into modules and courses. The first cycle is built around basic medical sciences and focuses on understanding the inner workings of the human body and mind. The second cycle deals with pre-clinical subjects and the third cycle is clinical work. The first cycle includes two large modules and several courses. Module Cellular Basis of Medicine will teach you about cells and tissues, their components, metabolic pathways and the various ways these are related to health and disease. This module is examined at the end of the first year and this is the first major exam you will encounter. Several other courses in the first year will introduce you to communication skills, basic nursing skills and medical ethics and you will meet your first patients face to face. Biophysics will give you the necessary background in medical Physics, introduce you to the physical basis of radiology and nuclear medicine and other diagnostic and therapeutic methods plus a primer in information technologies. Medical Terminology will teach you how to talk like a doctor with some Latin and Greek. Module Structure and Function of the Human Body, in the second year, builds on the basis created by the "cellular" module. It deals with tissues and organs, their shapes, spatial relationships and functions. This module is examined at the end of the second year. In order to complete a course or module you will have to attend classes, hand in required written work, sit for test and at the end, successfully pass an exam. The specific requirements for individual courses differ but all can be found in the Student Information System (SIS, see below). It is highly advisable to check the requirements of all your courses at the start of the academic year to plan efficiently your time and avoid any unpleasant surprises. Credit Point System Each course is assigned a certain number of credit points detailed in the study plan of the relevant degree programme expressing the ratio between the amount of work that a student must do to complete a given course to the total amount of work that must be undertaken to complete all the course set by the study plan for the given semester. Study plans prescribe which courses are compulsory or compulsory elective for the given degree programme; other courses taught at the University are deemed to be optional for the given study programme. Subjects taught at other institutions are also deemed optional. One of the conditions for registration into the next stage of a specific degree programme (year) entails acquiring a certain number of credit points. At the annual registration every student records into his/her student report book ("index") all the compulsory and compulsory elective courses which are prescribed for a given stage of the degree programme. Once a student completes all these subjects he/she receives a number of credit points. It is recommended that at least 3 credit points should be obtained during every year of study for optional courses, because for example, the conditions for receiving a merit award include having collected at least 60 credit points for the given stage of the degree programme (year). Minimum number of credit points for registration into the second year of the degree Programme General Medicine The minimum number of credit points required for registration into the second year of the General Medicine programme is 45. \| Minimum number of credit points \| OF THIS: Number of credit points for optional subjects included as part of the minimum number of credit points for registration \| OF THIS: Minimum number of credit points for compulsory subjects \| \|---------------------------------\|-----------------------------------------------------------------------------------------------------------------\|---------------------------------------------------------------\| \| 45 \| 9** \| 36* \| \| \| OR \| \| \| 45 \| 8 \| 37 \| \| 45 \| 7 \| 38 \| \| 45 \| 6 \| 39 \| \| 45 \| 5 \| 40 \| \| 45 \| 4 \| 41 \| \| 45 \| 3 \| 42 \| \| 45 \| 2 \| 43 \| \| 45 \| 1 \| 44 \| \| 45 \| 0 \| 45 \| * Minimum number of credit points for compulsory subjects when receiving the maximum possible number of credit points for optional subjects Maximum number of credit points for optional subjects included in the minimum number of credit points for registration Example:** A student received 42 credit points for compulsory subjects. In order to advance to the second stage of the studies, the student must have a minimum of 45 credit points, i.e. he/she must obtain at least another 3 points for optional subjects. The share of optional subjects that may be included as part of the minimum number of credit points for registration to a higher stage (year) is at most 15% of the normal number of credits, i.e. a maximum of 9 credits. Example: If a student collects 15 credit points for optional subjects, he/she can only use 9 points for the purposes of advancing to the higher stage of studies, and is therefore required to receive the remaining points, i.e. 36, for compulsory subjects. Electronic Recording of Attendance The attendance of students at lectures, seminars, laboratories and workshops is recorded electronically. An electronic student ID card reader will be placed at the entrance to each classroom in Buildings A, B, FNKV/X and the practical teaching classrooms. When entering the classroom, each student will prove his/her presence by attaching his/her student ID card to the marked area of the electronic reader. The reader will register the attached ID and confirm the action by beeping and displaying the student's name on the reader's display. Attendance records for a given class can only be taken within a maximum of 10 minutes before the start of the term and a maximum of 10 minutes after the start of the class. Checking the proof of attendance and the complete history of student ID card retrieval on the electronic attendance readers can be viewed in the "Attendance" section of the Electronic Timetable application of the 3rd Faculty of Medicine. Cellular Basis of Medicine – Cell In the first year, you will have the subject Cellular Basis of Medicine – Cell. It is the greatest and the most important subject in both, winter and summer semesters. Every detailed information about the subject you can find updated in SIS at the beginning of the winter semester. The Cell consists of four courses, the first two will take place in the winter semester, the remaining two in the summer semester. There are 5 disciplines (subjects) involved in the Cellular basis of medicine (biochemistry, molecular biology, genetics, histology and immunology), which you will encounter differently in individual courses - depending on the topic of the course. Each course starts with the theoretical foundations of the theme, the second part of course is devoted to the specific applications. In the first course (Cell Structure and Heredity) you will review and deepen your knowledge from the secondary school. This tutorial is a good basis for the upcoming parts of the Cell. The application of knowledge about the structure of the cell is genetics and various hereditary disorders in this course. The second course (Metabolism and Cell Specialization) will increase your knowledge of metabolic pathways and their coherence with the structures and functions of the cell. The application of this knowledge is the structure and functioning of muscle and connective tissue in this course. In the third course (Cell Signaling and Immunity) you will get acquainted with various signaling molecules and ways of transmitting signals between cells and inside cells. The application of this knowledge are details of the structure and functioning of nervous tissue in the second part of the course, as well as the structure and functioning of the immune system. The fourth course (Cell Cycle and Development) will bring you closer to the mysteries of cell growth and embryo development, you will also learn the basics of oncology, where genetic mutations play the great part. The application of this knowledge in the second part of the course is the influence of the environment and foreign substances on cells, so you will end the whole course not only with the topic of ecology itself, but also with the topic of human evolution. The structure of the subject is divided into lectures, seminars and practice. Lectures are optional, but we recommend attending them, as you will learn a lot of useful things here. At the seminars, you learn more details, various examples mentioned in lectures are discussed here, and your essays are also presented here. But the most important thing is that you can use the seminars to get answers to your questions. Do not hesitate to ask your teachers at the moment about everything you do not understand. It is best when you look at the materials from the lectures before the seminar, so you can find out what you need to ask. All exercises (practice) are mandatory, without their completion you won’t get the credit and you won’t be admitted to the exam. This practice includes histology exercises where you learn to recognize individual tissues under a microscope. These exercises are completed in each semester with histological examination of the recognition of histological preparations. Other practice is molecular biology where you will try PCR or electrophoresis in laboratories and also practice in biochemistry and genetics. Another mandatory part of the Cell course are Clinical Detective Stories (CDS), which are case reports where you try to solve a certain problem that is concerned to the medical topic you had learned. To get the credit, you also need to solve all the tasks that you will have online in the Moodle. It is necessary to obtain a credit from the subject Cellular Basis of Medicine in winter and summer semester, too. Without these two credits, you cannot register for the exam. In the summer semester this subject is completed with the exam. Credit You will receive the credit after you fulfill all the requirements from each subject (detailed in SIS). A list of all these requirements, including whether you have already fulfilled the requirement or not, can be found in the [Vyuka application](#) (see the button on the bar with the name of the course Cellular Basics of Medicine). These include, for example, the completion of practical exercises, various tests (e.g. course or combined, etc.), clinical detective stories, essays, moodle tasks, histological examination, etc. In order to be admitted to the exam, you have to obtain all credits. Course tests All courses are completed by a written course test which is written at the faculty personally, on the faculty’s iPads in the Moodle program – the same program in which the Moodle tasks are. So the tasks in Moodle also serve you to try out the types of questions that you await in the tests. The questions in the test always consist of all subjects that are taught in the given course. Course tests are written when the individual course finishes during each semester (i.e. 2 in the winter semester and 2 in the summer semester). The maximum score from the course test is 60 points; the number of points you achieve in the test is then converted into the following points (0–5) which are added to your exam result from the Cellular Basis of Medicine (in each term). \| % \| below 50% \| 50–60% \| 61–70% \| 71–80% \| 81–90% \| 91–100% \| \|-----\|-----------\|--------\|--------\|--------\|--------\|---------\| \| points \| 0 \| 1 \| 2 \| 3 \| 4 \| 5 \| It is necessary to obtain at least 6 out of 10 points in each semester together. The total summary of the points reached from the course tests are added to the exam result. Combined tests If you do not reach adequately number of points in the course tests you will have to write the combined test from both courses of the semester at once (i.e. winter combined test and/or summer combined test). The test is written in the examination period, the points from the combined tests are NOT added to your exam results. The combined test consists of questions for a total of 80 points, it is written on the faculty’s iPads, at the faculty in person, in the Moodle program. The combined test contains the topics of both 2 courses of the semester, to pass the test it is necessary to obtain at least 60% of the points from the test (48 points). Exam The final exam will take place in the summer examination period (June–September) in the form of a written test from all five subjects (biochemistry, histology, molecular biology, genetics and immunology). In order to pass the exam you have to obtain at least 60% of points from questions of each subject and at the same time to obtain at least 70% of the total number of points from the test. The points you gain during the year in course tests will be added to your total score and they can help you to pass the test or improve your mark. However, these points are not added to the 60% requirement from each subject, you must reach this mark regardless of your work during the year. The exam test can be taken three times at maximum, only in the summer examination period. Exam dates are announced in SIS – you can sign up for the exam only if you’ve received both semester credits (winter and summer). You MUST sign up for the chosen date of the exam in SIS: you will not be able to take the test without it. Once you register for an exam you have to attend – if you fail to attend without a prior apology you will lose the attempt, i.e. out of three total attempts you will only have two (or one if you fail to attend again without a prior apology). The first exam date is only for students with both credits fulfilled on schedule, i.e. those who do not need to take a summer combined test (more details in Requirements for credit). The test includes questions from all the subjects of the module, the summary of points from each subject is the same. The topics of the test questions are the same as the topics of lectures of the whole module (see syllabus). The total number of points from the test: 40 points for each subject, i.e. $40 \times 5$ subjects = 200 points altogether (= 100%). To pass the exam you have to: a) reach at least 60% of points from each of the five subjects (i.e. 24 points / subject) and at the same time b) reach at least 70% of points from the whole test (140 points) The points gained from the course tests (see below) during the year are added to the total number of points from the exam test (in each term): 4 courses x 5 points = maximum 20 points. Therefore, it is very good to have the best possible results from the course tests. These points are not added to the point counts from individual subjects but to the total number of points from the whole test. Viewing the results of written examinations After correcting each test, the results are published under the student’s number in the Výuka application. At the same time it opens a preview on their tests. Students can see their answers and the correct answers and evaluation of the question. If the student disagrees with the evaluation (result) of the question, he/she may request for a revision of marking of the test question his/her objections to the evaluation according to the Dean’s Directive No. 9/2011. This is done by filling in the form Request for a revision of marking of the test question (the form is available for download in the vyuka application) and sending this completed form to the email email@example.com. The student submits this written request within 5 business days of the day the examination results are announced. Later requests will be not accepted. The student’s request will be answered within 5 business days at the latest and will be sent by email to the student. Finally about the subject Cell During the year, all the teachers who teach in the Cell subject are at your disposal. You can contact them at any time (by a specific email or personally) and arrange a consultation with them at any time of the year and ask about the lessons. If you have any questions about general information about the subject Cell, please email firstname.lastname@example.org. The questions about the specific lectures, seminars, practices and other credit obligations send directly to your teachers – you can find their names for each lecture unit in the Výuka application and in your schedule. Attending all seminars and lectures and completing all the tasks and duties in the course on time increases the possibility of successfully passing the final exam. Student Study Evaluation All teachers at the faculty naturally strive to give the best possible education and one of the tools of its continual improvement is to have feedback from the other side – from you students. Student evaluation of courses is a very important part of faculty life and we wish for you to participate on it as actively as possible. You do not need to worry as your evaluation is anonymous so that it is not possible to track your answers. There is also the Committee for Study Evaluation that participates in the organization and assessment of the feedback from evaluations where you are represented by your student representatives from all study programmes at the faculty. The feedback is discussed at the Faculty Academic Senate, which also includes parity representation of students. You can evaluate your courses directly at the web application Timetable. It is possible to evaluate individual lectures (including tests) by clicking on stars in the detail of a teaching unit, you can also choose the teacher for classes that are taught by more people (such as seminars or practical lectures for individual study groups). The evaluation is a number between 0 and 7, 0 being the worst and 7 the best, you can also add or specify your evaluation with a comment. The comments are what gives us the best feedback so we will be glad if you use this option often. You evaluate individual lectures anonymously. As stated above, the evaluation is not possible to be tracked back to you. Of course, the application also allows you to evaluate whole courses, subjects or teachers within the semestral evaluation, which is divided into winter and summer parts. There is the numerical scoring and the voluntary comment too, the evaluation is always anonymous. The semestral study evaluation also allows you to fill out a questionnaire with more focused questions. The semestral study evaluation can be accessed from the Výuka application by clicking on the relevant button at the upper part of the screen. For your own comfort, you can start the semestral evaluation during the semester, save the concept and edit it later and then send it to us at the end of the semester. You can of course also evaluate courses after they ended (during the examination period) but once you send an evaluation, you will not be able to change it. The annual results of the evaluation led to many important changes in the general curriculum of individual study programmes and to minor adjustments in the organisation of subjects and individual study units. Some changes can be implemented very quickly, others require certain time and conceptual transformations (there might be even several years between the evaluation and the implementation). Nonetheless, it changes nothing on the fact that evaluations are one of the key features for the faculty administration to ensure and improve the quality of education and the results of the evaluations are thus a major focus of our attention. Please, take study evaluations very seriously and dedicate the necessary time to it (both during the year and during the examination periods) and thus become an active part of the improvement of the education at our faculty! Awards for Students Two types of awards, as specified in Sections 9 and 17 of Act No. 111/1998 Coll., on institutions of higher learning, and in the Award Regulations of Charles University are applicable to undergraduate students: Special purpose awards - awards granted to a student for extraordinary results in research, sports, art, or other significant creative results; the Dean decides on granting this scholarship and its amount; • financial aid in case of a dire social situation; the conditions governing the granting of this aid (always for a certain time period) are announced by the Dean, after the Academic Senate of Charles University gives its opinion – these conditions are uniform for all of the university’s students; • awards to support studies abroad or internships in the Czech Republic or abroad; the Dean sets the conditions for granting this scholarship and its amount; • in cases worthy of special consideration, such as participation in teaching, in the development of information technologies or international co-operation, charitable work or other significant extracurricular activities contributing to the society; the Dean sets the conditions for granting this scholarship and its amount in accordance with the faculty’s Scholarship Regulations. Applications for special-purpose awards are submitted to the Dean of the faculty via the Study division. Each application is assessed individually, based on an opinion of the Dean’s Board, whose meeting is attended by a member of the student’s chamber of the faculty’s Academic Senate. Award for exceptional study results (Merit Award) • This award may be granted subject to the Rules for the Granting of Awards at the Third Faculty of Medicine of Charles University, which is based on the University’s Award Regulations. Students enrolled in the first year are not eligible to this type of award. This award is granted to the top 10% of the students in the master’s as well as bachelor’s programs studying their second or higher year if they received at least 60 credit points in their preceding year of study. • The specific amount of the Merit Award in a given academic year is set by the Dean, based on a recommendation from the faculty’s Academic Senate. Unlike special-purpose awards, the award for exceptional study results requires no application – the candidates’ results (grade averages and credit points) are submitted by the Study division to the Dean and the Academic Senate. No student has a legal entitlement to the payment of any award. The awards fund providing finances for the Merit Award is filled by the fees charged for duration of study in excess of the standard period of study – i.e. for a master’s degree over seven years and for a bachelor’s degree over four years. Catering Students may take their meals: a) at the faculty canteen located on the ground floor of faculty main building (A) b) at the canteen of the University Hospital Královské Vinohrady (FNKV) – the canteen operates on a self-service basis Students interested in buying meals there pay the full price of the meals. Student Canteens of Charles University \| Name \| Location \| Address \| \|---------------\|----------------\|--------------------------\| \| Albertov \| Praha 2 \| Albertov 7 \| \| Arnošta z Pardubic \| Praha 1 \| Vorašilská 1 \| \| Budeš \| Praha 2 \| Wenzigova 20 \| \| Jednota \| Praha 1 \| Opletalova 38 \| \| Kajetánka \| Praha 6 \| Radimova 12 \| \| Právnická \| Praha 1 \| Nám. Curieových 7 \| \| Sport \| Praha 6 \| J. Martiho 31 \| Research Activities It is impossible to imagine modern medicine without the latest scientific findings, which is the reason why research activities are a priority for Charles University. As students of the Third Faculty of Medicine at Charles University you can participate in research at any time during the course of your studies; in the third and fourth years, "student research activity" is included as a compulsory elective course. Participation in any of the many research projects conducted at the faculty will enable you not only to discover the often-exciting background of the dry scientific facts described in textbooks and lectured about by teachers and to learn many practical skills, but also to expand your horizons and to break through into new, more profound ways of thinking about the world around us. The annual Student Scientific Conference gives you the opportunity to present your results to researchers from other fields as well as to other students and, among other things, to practice your communication skills, which are so important for every doctor. In addition, research activities are a big advantage should you intend to enroll in postgraduate studies at Czech or, in particular, foreign universities, and the contacts you make during your research activities can also help you when looking for employment. The simplest way of becoming involved in medical research is to directly contact the person researching the topic that interests you, to request more detailed information and to offer your services as a member of the team. Of course, it will not always be possible to satisfy your interests in research on account of capacity, technical or other reasons, but the Third Faculty of Medicine greatly supports scientific activities of its students, and the leaders and members of research teams will be glad to welcome you among them. Library – Centre of Scientific Information Information about the Centre of Scientific Information of the Third Faculty of Medicine (CSI), library operations, services and other activities can be found on the CSI website. The CSI closely cooperates with the Central Library of the Charles University, which provides a selected part of the professional agenda and services centrally for the entire Charles University (CU). In addition to the library of the 3rd FoM, students can also use libraries at other faculties of the Charles University. To use the services of the CU libraries, to access information systems and e-resources, a personalized CU ID card and a valid Central Autentification System (CAS) password are required. Electronic registration (login) is required before visiting any CU library for the first time: [library.cuni.cz/e-application](http://library.cuni.cz/e-application) You will find the book lending library and the study room with a free access to shelves on the ground floor of the 3rd Faculty of Medicine’s Dean’s Office building A in the left wing (near the canteen). Through the front door you enter the lending protocol, where documents are borrowed and returned via a computer system. A turnstile takes you through to the free-access storage areas and the free-choice study room, where you can choose your own books to take home or study. Books can also be returned during library closure times via the so-called Biblioboxes (some converted lockers in the library corridor). In the library of 3rd FoM you can borrow basic and recommended literature for study, which is purchased according to the requirements of the teachers at the 3rd FoM. As the library space is limited, the range of books available for loan is also limited. Additional alternatives are purchased access to e-resources, selectively, e.g. (BOOKPORT – Czech medical books, Thieme MedOne Education – foreign, EBSCO eBooks – Czech and foreign, Merck Manuals – foreign, AMBOSS – for students of higher years). Access to electronic resources and databases at Charles University is available from every computer at the faculty and by remote access from any computer, i.e. from home or dormitory. It is forbidden to enter the library and study room with backpacks, food and drink and a switched on mobile phone. Lockers are available in the hallway outside the library or in the faculty lobby to store your belongings. Contact Library: Oldřiška Cidlinská, Lenka Peroutková phone: 267 102 103 (library), 267 102 181 (library office) e-mail: email@example.com Head of the CSI: PhDr. Martina Hábová phone: 267 102 547 e-mail: firstname.lastname@example.org Opening Hours – until September 29, 2024 \| July 8th–September 20th \| September 23th–September 27th \| \|-------------------------\|-------------------------------\| \| Only wednesdays \| Monday 9:00–12:00 13:00–16:00 \| \| \| Tuesday 9:00–12:00 13:00–16:00 \| \| \| Wednesday 9:00–12:00 13:00–16:00 \| \| \| Thursday 9:00–12:00 13:00–16:00 \| \| \| Friday 9:00–14:00 \| Opening Hours – from October 2024 \| September 30th 2024–June 30th 2025 \| \|------------------------------------\| \| Monday 9:00–12:00 13:00–16:00 \| \| Tuesday 9:00–12:00 13:00–17:00 \| \| Wednesday 9:00–12:00 13:00–16:00 \| \| Thursday 9:00–12:00 13:00–17:00 \| \| Friday 9:00–14:00 \| Selected Links - E-application to CU libraries – library.cuni.cz/e-application/ - UKAŽ – Central discovery service – catalog CU libraries – ukaz.cuni.cz/en - PEZ – portal electronic resources CU – eresources.cuni.cz Hi, dobrý den! Welcome to the next chapter of your life. A new city, a new university, and a brand-new life are ahead of you for the next 6 years. Very soon you will notice that at the Third Faculty of Medicine, we are a close-knit family. Within a short period of time, you’re going to walk the faculty halls feeling like a god because everyone will say hello as you pass by. Upper years will welcome you with open arms and treat you like a younger sibling. If you can’t find your way through the confusing hospital buildings, we’ve got your back :). Statistically, we may not be very abundant, but we definitely host a handful of the best and coolest parties. From Dobronice, to Freshers Week, to Deans Day, and the list goes on; you will meet some of your closest friends and the most fun people. Don’t worry, you will never feel too lonely or too bored. Dobronice marks the beginning of your journey; you’ll be crazy if you miss it. There you will be assigned a “Coach” – an upper year student who will devote their time to introduce you to the faculty and its programs. Your coach will be your knight and shining armor now and all year round, take good care of them. After that comes Fresher’s Week, a series of events you cannot dare and miss either. We promise that you will have the time of your life by partying like no tomorrow. You can read more about Freshers Week later in this book. Medicine is not a piece of cake, but that doesn’t mean you can’t live your life either. Don’t let the huge workload stop you from taking a breather here and there. After all we are all human, so a little fun will definitely not stop you from achieving your goals. If you have made it this far you are a true queen (or king). Stay strong our little Freshers, and good luck (you’ll need it). Yours truly, Your colleagues from LF3 Let’s Go by Steps The following section was all written by students; in the next pages we’ll introduce you to the faculty and try to tell you everything you need to know about this new journey that has just begun. So, let’s start from the beginning and where everything starts… Dobronice – Welcoming Camp Dobronice is a village in the South Bohemian Region of the Czech Republic that gives the name to our welcoming camp. Long story short, it’s 4 days of camping, we mean fancy camping – no tents or sleeping bags, everybody gets a hut and a bed – where you’ll get to meet your classmates, students from the upper years and some professors. The programme is full of activities and we assure you that there will be no time to kill! If we were to divide the schedule, we could put it in this way: - Day Programme: during the day you’ll have some seminars about the faculty and how everything works; You’ll also hear about all the associations and on-going projects that you can join; - Night Programme: When the sun goes down and the moon arises in the sky, the music goes up and you’ll begin to fly! Cheesy rhymes aside, the night programme is memorable. This is the student’s favourite part of the day and when you get to chill with everyone and just enjoy the evening and the fun surprises, we have prepared. There is so much we could tell you about Dobronice, yet none of it would be enough to describe it. This is one of the moments of your life that you’ll remember for a long time. Dobronice is known for creating friendships and memories. Make sure you do not miss it! Even if your leg is broken! If it has a cast, then there’s no excuse to stay at home (and if you need it, we can even change it for you there, think about it)! After Dobronice your first weeks in Prague should not be left in blank. The faculty offers you the possibility of taking the following courses. Usually they each last between 2 to 4 hours, every day for two weeks at the end of September. Czech Language Intensive Course The faculty offers an intensive course of Czech that you should consider attending - Why that? Because in the beginning of the year that will be the only moment in the next six years, when you’ll actually have the time to focus on Czech – and this is a great thing, because if you get a good start, Czech language will not be a problem for you during first year and you should be able to pass it easily. Learning Czech is not the easiest thing, so you should definitely take advantage of this course. Also, while studying and living here, speaking Czech is something that you won’t be able to avoid for long – you’ll need it in your everyday life, either when going to the supermarket, or at the hospital interviewing patients. And if so far, this was not enough to convince you, then know that the course is counted as an optional subject and will give you 3 credits for your diploma. Biochemistry Intensive Course Yes, we know that you’re probably thinking that this is starting to be a little too much of intensive courses, but trust us on this one: you will not want to skip this either! Just like Czech, but 10 times worse, biochemistry is something that will hunt you down for the rest of your life as a doctor, and especially in med school. Coming from many different places, our students sometimes show different knowledge. This course is exactly to put an end on that and put everybody on the same level and get them ready to start the year. We highly recommend that you take this course, because it will give you all the basis that you need to face biochemistry in first year (believe us, it’s not that easy) and also counts as an optional subject so, 3 more credits. Moving to a new country far away from home is not the easiest decision. But if you thought that you are going to be alone for the first couple of weeks, then you thought wrong. Our mission in this university is to make sure you are always surrounded by people who make your time worth-while. Freshers Week is the time and event for it. The week before school starts, you will be bombarded by a series of events and parties guaranteed to fill your agenda. For a full 7 days you have the chance to be occupied by the biggest social events Prague has ever seen! The question is will you take that chance? Day 1 – 23/09: Oktoberfest – Pubcrawl What’s a better way to kick off the week if not by competing for a special prize while visiting pubs, and doing it all Munich style! Day 2 – 24/09: Movie Awards – Sunset & Chill Imagine: Sunset, some food, some drinks, chill evening with your friends and it also feels like you’re attending Oscars? Sounds just about perfect, doesn’t it? Day 3 – 25/09: Roaring 20s Masquerade – Boat Party Dancing on a boat sailing Vltava among ladies and gentlemen all dressed in 1920s fashion! Day 4 – 26/09: Olympic Games – Day Trip and Paddle Boats Olympic Games leading to the great finale of enjoying Paddle Boat rides! Day 5 – 27/09: Rio Carnival – Interfaculty Party Is Brazil too far? No worries, we brought the most colorful event of the world to Prague! Join us and meet students from other faculties! Day 6 – 28/09: Food Festival – Foods & Drinks Come and gain more strength to finish the week with delicious street food prepared just for you! Day 7 – 29/09: St. Patricks Day – Orientation Day & Beanies Do not miss the perfect opportunity to get to know our faculty better! You will learn everything about the subjects you’ll have and how to take part in extracurricular activities – all that during the Orientation day! Information directly from the teachers, guarantors of the subjects, older students will show you around the faculty and hospital, so you don’t get lost on the first day of school, and we will tell you how to become a member of our student organizations and last but not least – you will have an opportunity to buy a faculty coat, T shirt or a hoodie. What can be better, after first half of the day full of useful information from Orientation Day, than partying with a Leprechaun on Beanies! We know we know… all this hype and no information about tickets? Head on to our Instagram page @fw2024_3lf and find out all the necessary details! The price of a week full of adventures and happy memories is only 850 CZK! First Thing First Moving abroad is not only about the Instagram pictures and the typical “Currently: 🇨🇿 Prague 🇨🇿” on your profile – you’ll need to handle some grown-up businesses, so let’s first address those: Visas and Residence Permits If you’re from a country member of the European Union, European Economic Area (Iceland, Lichtenstein and Norway) and Switzerland, you won’t need a Visa to live the Czech Republic. All you need are documents to show where you’re from and who you are (national photo ID is sufficient). But if you are from any other foreign country, you will need a visa and should check your requirements at the web site of the Ministry of Foreign Affairs of the Czech Republic. There you can find a list with the contact information of your foreign embassies and details on goods that you can bring into the country. Note that you cannot apply for a student visa from within the Czech Republic. All non-EU citizens planning stay here for longer than three months, e.g. like us for the purpose of studying, must register at the local Foreign Police (Koněvova 188/32; Prague 3). But be careful! Just because it is the foreign police, that does not mean that the officers speak a foreign language! You can sometimes get by with English and German but the reality is that rarely you will not need a person to translate for you. The easiest way is to bring a friend with you, who speaks Czech or get an agency to put all the paperwork together. There are law firms which can help, especially if you for example are holding two citizenships or your family does not reside in their country of origin. EU citizens, staying here for longer than three months, may also apply for a temporary residence permit within the time frame of 3 months. You receive a so called “Rodné číslo” (Birth Number). This registration will help you when renting or buying apartments or even applying for minor things such as internet connection. Accommodation in Prague When first coming to Prague, some people opt for the dormitories provided by the University, at least for the first months of their stay. It’s an easy to make friends and to create a support system, since they try to match people by their schools onto the same floors or rooms. All dorms provide sheets, pillows and blankets for you. They are exchanged on a regular basis and there are facilities for washing your laundry. The prices can vary between 5,000 and 7,000 Kč (CZK) per month. Usually, the dormitories also have cafeterias that serve cooked meals and sell snacks in-house. The other option, and what eventually most people that start at the dorms, ends up doing, is to move into apartments together with friends and to a closer place to the city center. For a two-bedroom apartment in the area Strašnice, Vršovice, Vinohrady and Žižkov, which surround our school and are usually no longer than a 20-minute tram ride away, a nice flat should be in between 20,000 to 26,000 Kč per month. Surprisingly, in the Czech Republic the tenant pays the commission (usually one month of rent) to the real estate agent. Finding apartments nowadays is not an easy task, as Prague is more and more loaded, but if you’re on the search for something, try www.sreality.cz or www.foreigners.cz In addition to these websites, you might want to check out some Facebook groups, usually people moving out of apartments, post some offers there – like this one: https://www.facebook.com/groups/132234910740385/ Or our faculty’s flatshare group: https://www.facebook.com/groups/397093482043018/ Life Cost and “Normal Expenses” To estimate your living expenses here is hard. People are very different. Food and drinks are quite cheap, while renting an apartment can be pricy depending on where you live. However, here are some values you can use to guide you in the first month: - Food: 4,500 Kč, - transportation about 300 Kč, - spare time activities 3 500 Kč. Be aware this is just an estimate. It all will depend on your own habits, the times you eat out, go drinking or where you live. Health Insurance and 24h Pharmacies If you’re an European citizen, make sure to have your European Health Card, you can read more about it [here](#). If not, you will need to get an insurance. For that, there are several companies in Prague, just google some and go with the one that offers the best conditions for you. 24h Pharmacies you can find at: - Na Františku 8, Praha 1; - Belgická 37, Praha 2; - Videňská 800, Praha 4; - Motol Hospital – V Úvalu 84, Praha 5; - Vítězné náměstí 997/13, Praha 6; - Františka Křižíka 22, Praha 7; - Plaňanská 573/1, Praha 10. Your Schedule One characteristic of LF3 is that your schedule changes every day. This is good because it helps when studying for exams, because on one week you might need a free Wednesday and on the other, a free Tuesday, and also it never gets boring. You can access the schedule on rozvrh.lf3.cuni.cz We recommend to sync your personal schedule to your iOS or Google Calendar. Your coach will help you how to make it. Basic Concepts Before we go further, let’s first clear up some things and get you acquainted with some basic terms... Types of Classes Lecture – A lesson taught to all the study groups at once. You can find the material of lectures on Vyuka, along with their statements. Lectures are not mandatory. Seminar – A class made up of your study group only. Depending on the subject, a seminar can either be mandatory or not – usually they’re not and mandatory seminars will be shown as seminars with Controlled Attendance in Vyuka. Seminars aim to deepen the material taught in the lecture, this is an excellent opportunity for students to ask questions, discuss and go through things that weren’t clear. Practice – Depending on the subject, a practice can be a lab (Histology, Biochemistry, or Molecular Biology) or a lesson (Medical Terminology, Czech, Medical Czech, Biophysics, or ICM). Most of the time, practices are mandatory. Individual Study – A time to meet with your group members in order to tackle and solve a Clinical Detective Story task. Consultation – A private lesson between you and your chosen professor to ask whatever your heart desires. You can book a consultation by emailing your professor of choice. The lesson is free of charge. Clinical Detective Story – A task that includes questions about a mysterious medical case. You solve this task with your group members and then present your findings in a mandatory seminar a week later. Evaluation Methods Course Test – An exam that tests you on all the lectures, seminars, and practices you have studied. Combined Test – In case you have not collected enough points to pass the semester, the combined test is your second chance for doing so. It combines two courses and is comprised of statements only. You need 70% in order to pass. Slide Test – A histology exam the consists of two parts: a written and oral part. The written part consists of slide recognition by writing them on a piece of paper. If you pass the written part, you will be forwarded on the oral part where you answer questions regarding a specific slide. Since the exam is oral, your examiner decides if you pass or fail. Module B – The final exam that tests you on all the courses you studied from the beginning of the year onwards. The Informatic System of the Faculty Výuka – “Education” in Czech Available on vyuka.lf3.cuni.cz This is the faculty’s platform where you’ll find all lectures, seminars, practical exercises and study materials for them. The website allows you to ask questions to teachers and evaluate subjects and teachers as well. This is where you’ll find one of the most important practice exercises in first year: statements – Yes or No questions based mostly on the material taught in the lecture, available in Vyuka for you to test your knowledge. Example of Teaching Unit in Výuka SIS – Study Information System Available on is.cuni.cz/studium Here you apply for optional courses, check exam dates and sign up for them, and monitor your results. Wifi/Eduroam Here you can change and set your password for the wifi. Remember that Eduroam is an international network, so you can have access to it with your account anywhere. Different Way of Teaching As you know, LF3 is one of the few faculties in Europe teaching medicine with a different programme. The majority of faculties starts by teaching anatomy and the structures of the body all at once – being anatomy a single subject. Later on, in second year, students usually learn more about biochemistry and the metabolism of the body, etc. Here, at LF3, things work a little different. 1st Year: The Cell – Module B “How everything should work – Microscopically” Take a look in the mirror – you see a body, right? That body works due to several organs working together, and in turn, those organs are a mesh of tissues, all organized and structured. But if you look closer, you’ll see that those tissues are made of cells – and that’s your starting point – the cell. In first year, you’ll get to learn what makes up a cell; what types of cells do we have in the body and how do they work together; How do they obtain energy and spend it and how they communicate; Final Exam: Module B – a written exam. Main Subjects: Biochemistry; Histology; Molecular Biology; Genetics; Immunology; Embryology; 2nd Year: The Structure and Function of The Human Body – Module A “How everything should work – Macroscopically” In second year, you learn about all the organs and structures in the body: how they work, what their functions are, how they developed, etc. Final Exam: Module A – an oral exam. Main subjects: Anatomy; Physiology; Histology; Embryology; Biochemistry; 3rd Year: Pathology and Pathophysiology “How everything can go wrong and what happens when it does” Third year is a crazy ride, but a clinical one already. During the winter semester you’ll learn the general basis of pathology and pathophysiology (how things can go wrong – the so called: problems/diseases) Then in the summer semester, you’ll learn more about bacterial, viral, fungal and parasitic infections; as well as cancer, haematology disorders and some basic principles of internal medicine. First Year – What to Expect As explained before, LF3 has a unique way of teaching medicine. However, the order of the topics is not the only difference in our faculty. The teaching here follows an integrated system. All subjects mentioned above for first year are, in reality, grouped together in one single subject called Cellular Basis of Medicine or, as we like to call it, The Cell – this is the most important and challenging subject you’ll face in first year. It’s composed of several smaller subjects like Biochemistry; Histology; Molecular Biology; Genetics; Immunology and Embryology. The Cell is divided in 4 courses/modules – these are basically 4 big topics that you’ll study within this subject, and these are: - Cell structure and Heredity (WS) - Cell metabolism and Specialization (WS) - Cell signalling and Immunity (SS) - Cell cycle and Development (SS) But how does it work? The principle behind this strategy is that the topic is in the middle and it’s the object of study, and the subjects are like lenses that you’ll use to look at the topic from different perspectives. If you don’t get enough points to pass the semester, you can always take a combined test. Further information about the points system will be given to you during the first week of classes. Keep in mind that some of the smaller subjects within the cell, might have their own smaller tests as well, or practices where you need to write reports, or other type of evaluation. To find out exactly what requirements you have to fulfil in order to complete the semesters, head to vyuka, press on Cellular Basis of Medicine and then press the box with the following symbol If you pass both semesters, you get to sit the Module B Exam – which is a written exam with 4 parts, one for each course. Passing the subject “The Cell” is mandatory in order to proceed to second year. So, in the first course, “Cell structure and Heredity”, you’ll learn all the basics about cells and genetics from the point of view of several subjects/sciences. In Histology you’ll learn how cells come together to form tissues, and what type of tissues they can form; In Molecular biology, you’ll learn about all the organelles that make up a cell; In Biochemistry, you’ll see what molecules build up all those structures and so on. In the end of each course, you’ll be tested on the topic with a written test combining some of the subjects you studied (for example, there could be one part of biochemistry, one of histology and two of molecular biology). If you don’t get enough points to pass the semester, you can always take a combined test. Further information about the points system will be given to you during the first week of classes. Keep in mind that some of the smaller subjects within the cell, might have their own smaller tests as well, or practices where you need to write reports, or other type of evaluation. If you pass both semesters, you get to sit the Module B Exam – which is a written exam with 4 parts, one for each course. Passing the subject “The Cell” is mandatory in order to proceed to second year. Other Subjects Apart from the Cell, you’ll have other subjects that you shouldn’t underestimate. Some of them will only last a semester, and some will last for both. Czech Language – Speaking Czech is something that some try to avoid, but you really shouldn’t underestimate this subject. Besides the fact that you’ll be living in the Czech Republic for the next 6 years, you’ll definitely need it when visiting the hospital. Medical Terminology – This subject will give you the basis in the two main languages used in medicine, either to name anatomical structures or diseases – and these are Latin and Greek – the relevance of it is to facilitate understanding the nomenclature of diseases and learning anatomy. Introduction to Clinical Medicine I – This will be your most clinical subject this year. In ICM I, you’ll learn how to communicate with patients; the basis of hospital life and clinical procedures, such as bandaging; injections; etc. The subject holds seminars, practices (mandatory) and an internship of 80 hours (also mandatory). Biophysics – Consists of several lectures, accompanied by practices and ends with a written exam. Here you will learn about several techniques and treatments used in hospitals like X-Rays, CT scans and radiotherapy – and all the physics behind them. Ethics – You’ll discuss several ethical conflicts that doctors and medicine face nowadays and study how different philosophies would approach and try to answer these problems. Public Health – You will learn how healthcare systems work, focusing on the Czech one and understanding the patient’s rights based First Aid – This is the star-subject of our faculty, and one of student’s favourites. First aid is taught in a unique way at LF3 – based on practice and real situations; Throughout the year you’ll have several lectures and practices to learn some techniques and the basics of first aid. Once you’re done with all the first steps, LF3 will take you into field and make you learn like little birds learn how to fly: pushing you off the nest straight into reality! That’s right, around May everyone will pay a second visit to Dobronice. There you’ll have an intensive course of First Aid, where you’ll learn based on real simulations. The course consists of 3 days, 2 nights, more than 8 different simulations and 20 realistic cases; Students will be divided into groups and go through all simulations. Sometimes you’ll play a victim, sometimes you’ll be a rescuer, but whatever happens, you won’t stop! With you there will be a big team of professors, upper year students, several doctors and medical staff to teach you and debrief you on each simulation. Once back in Prague, your knowledge will be tested with a practical exam - you go inside a room and have a simulation prepared that you have to solve. The course is amazing and the amount of information you actually learn from doing things is incredible. This is one of the things that you should definitely not miss, even if you have a certificate in First Aid, take the opportunity to update your knowledge. The Space of the Faculty LF3 is nowhere near “Château de Versailles”; it’s more of a tiny little cocoon that you will walk blindfolded very soon. Here is a list of the most prominently used spaces that you should take advantage of: Cafeteria – If we’re being honest, the cafeteria is definitely going to be your ride-or-die. There you can find snacks, drinks and sandwiches. We also offer a lunch menu everyday between 11 AM and 2 PM (including vegetarian options). Lecture Halls – We have three Lecture halls: Jonáš Hall, Burian Hall, and Syllaba Hall. Just keep walking forward from the entrance till you get to the green double doors – you can’t miss them. Printing and Computer Space – A small space that lies between Syllaba Hall and Burian Hall. Recharge your ISIC cards in room 547 and feel free to print whatever your heart desires using the computers. Note that the printers print in black-and-white only. The Silent Room (aka room 222) – You can probably hear a pin fall to the ground in this room. You can access it using your ISIC cards. Put your phones on silent, your voices on mute, and hit the books. Notice that during exam period it might get full fast, so make sure you arrive early. The 6th Floor – It is a large space on the last floor dedicated for chilling and studying (but mostly studying). You can host study groups, heat your lunch in the microwave, and even take a little nap there. Security – You can find the security room right as you enter the faculty on your left. There you can ask for a locker or a key for a room – yes, after 15h and all day on the weekends, you can ask for a classroom and use it to study. It also doubles as a Lost-and-Found. A little tip, the guard only speaks Czech so get ready to pull out your knowledge from that intensive course. Malý Eden – A café that lies in the street facing the faculty. You can go there for a quick cup of coffee or a beer. We also host events there; don’t miss out! Library – The faculty opens its door for 7-days a week. You are welcome to study there even on the weekends. Most of the time, the guard will ask you to leave around midnight. Make use of this opportunity if you like studying with people around. Professors – Writing an Email Most people you’ll come across with in LF3 own one or more academic titles and in general, you should use them. When addressing your teachers here are some letters you might want to consider putting in front of their names before reaching out to them: Titles can be scientific, pedagogical or academic. Pedagogical and Academic titles usually come before the name. Pedagogical Titles (from lowest to highest) – as. (assistant); doc. (associate professor); prof. (professor) Academic Titles – MUDr. (doctor of medicine); Ing. (engineer); Mgr. (Master – has a master’s degree) After the name you usually find… Scientific Degrees – Ph.D. (doctor, not of medicine tho); CSc. (Candidate of Sciences); DrSc. (Doctor of Sciences) As said before, when communicating with teachers you should try to use these titles, especially with written communication; When at the faculty, and if you’re not sure what title the person holds, you can go with “Doctor” – that usually doesn’t arise any problems. When to email a teacher? To arrange a consultation; To clarify something or ask for information – There are several situations when you can email them, one when you SHOULD: if you’re going to miss a practice. Doesn’t matter if you’re sick or if you’re simply out of the country, if you have a practice, you should let your teacher know. Student Mental Health Support Centre The contact point serves for all our students who have any issues concerning mental health – either with regards to study burden (anxiety, sleep problems, inadequate procrastination, problems with concentration) or caused by anything else (adaptation problems, partnership problems etc.). The contact point provides initial psychotherapeutic interview and (if needed) continuing care by a clinical psychologist or psychiatrist. The service is elective – for urgent, acute situations please contact Emergency Intervention Centers – [Crisis Intervention Centre RIAPS](#). In acute situations you can also contact the faculty emergency hotline (nonstop +420 724 292 312). Contact point is situated in room B 111 (ground floor building B, left entrance) – you can easily make an appointment at [tkp.lf3.cuni.cz](#). All information shared with the psychologist/psychiatrist is strictly confidential and without your consent must not be shared with anybody. Services of the contact point are provided free of charge. Study Tips Looking back at pre COVID and during COVID studying, we have gathered the best studying tips to guide you on how to stay sane and productive during your academic life. - Use space repetition tools (Quizlet, Anki) - Split your studying time in smaller portions with frequent small breaks to maximize efficiency (Pomodoro method) - Leave any unnecessary electronic devices away from you, that could be in a different room or use apps such as “Forest” that has the dual function of counting your study time as well as being able to block the use of some apps on your device all whilst accumulating points that can be used to plant a real tree! - Study in groups! Talking out loud and with other people allows you to look at topics from a different perspective plus practicing with other people can ease your nerves once you see that everyone is on the same boat! Achieving the study & social life balance Studying hard and consistently are two very important factors when talking about how to have a successful academic year, but maintaining a healthy state of mind is what ties all your hard work together. How to achieve that? - Take breaks and be a university student. Studying is important but enjoying yourself as you study is more important. Try to organize your weeks schedule in a way that will allow you to see other people, go on road trips, explore Prague! - Exercise! This is super especially in case another lockdown comes our way since keeping a healthy body promotes a healthy mind. If the gym, running, or any other type of sport is not your cup of tea try to at least incorporate a nice walk to unwind at the end of your day. - Talk to someone! It important to surround yourself with people that will help you and support you when you need them. And if you feel like you are in a dark place don’t think twice about it and reach out for help! The faculty provides us with psychological help so don’t be afraid to use it. - Take part in university activities and join different clubs! All university clubs can be found in the pages below so don’t hesitate to contact email@example.com or firstname.lastname@example.org to ask more about them and how to get involved! Now that you’ve heard about the faculty and we’ve pretty much covered all the main, serious topics; it is finally time for you to meet the amazing community around you. Our faculty is known for a great environment and friendly people. Most of us participate in the majority of events and take part in the organization of some – and you can as well! Everything in life is a matter of balance – studying is important but having breaks is as well. Most of our work and the events we do are the result of a tremendous union of efforts and motivation and there’s plenty of things happening at the faculty, in fact, most of us have a hard time keeping up with all the activities. Take Home Message: Whatever you like to do or whatever you feel like doing – there’s a place for you to join! Find out everything about our students and what they’re doing in the next pages. Trimed is the student association of the Third Faculty of Medicine in Prague. Founded in 1997, Trimed hasn’t changed its values since then. Our role at the faculty is simple: to bring the community together and provide students with opportunities to expand their horizons in several ways. Our work is split into three big fronts: Cultural Department Is in charge of organizing some of the chilliest hangouts to the fanciest events of this faculty. Annual Spring Ball – One of the most awaited events of the whole year, the traditional Spring Ball sells out year after year the National House of Namesti Miru. Allow yourself to unwind in a royal atmosphere and experience one of the fanciest parties ever – for sure one not to be missed. Charity Music Festival – Have you heard that song about Histology? Then you should definitely come! On the stage we’ll have all bands at LF3 performing their greatest hits and some covers. All revenue goes to a different Charity Institution every year. Christmas Celebration – A small event at the sixth floor, where we invite all the faculty to grab a cup of hot wine and sing along some of the old Christmas classics --- Study Department This is the department opening doors and expanding horizons. They’re responsible for some of the best science fairs and conferences you’ll ever see. Students Conference – This is one of the biggest science fairs at LF3 where all students interested in doing some research project get to participate and present their work. So, even if lab work and research isn’t your thing, you should definitely stop by to see the work of your colleagues. Trimed Job – Trimed Job is the answer to all your questions about the future. This fair brings old graduates from our faculty to talk with students about their lives and careers. Recently Trimed Job has also started to bring companies interested in hiring doctors to come closer and get to know our students. There’s no better place to rethink your future! Orientation Day – As a fresher, this is an event you should definitely not miss. This is an event where you’ll get to know the faculty and the campus around, and have several lectures on how to pass the year. But don’t get mistaken! The Orientation day might end but the program for our freshers doesn’t. Together with all teachers and the faculty staff, we will have a fun journey to PM club to join Beanie a.k.a. traditional Medical Christening where we’ll celebrate the beginning of a new semester! Old doctors from our faculty say that the tradition used to be to go from the club, directly to classes, but we don’t really do that anymore, or do we…? --- Social Department Takes care of events that bring the whole community together. They’re in charge of keeping things in a cool level and organizing the best parties! Parník/Steam Boat Party – As soon as the sun shines, we turn on the boat and dive in one of the craziest parties ever. Parník is a boat, themed party where everyone dresses up and gets on a cruise with a drink in their hand a lot of good music. Saint Nikolas Party – Before you pack your things and go home for the winter break, we will not let you leave without first saying good bye! Vinohradská Trojka – This is one of the biggest and coolest events of Summer Semester. V3 is a race, around the faculty and hospital of Vinohrady. This is a charity event happening every year to support a hospital manages by our faculty in Kenya. But if running isn’t your thing, you can always just join us for the huge barbecue outside and grab a drink with us. But if you think that this was it, you couldn’t be more mistaken. Above are only mentioned some of the events happening throughout the year. Our calendar is way fuller than this and there will be plenty of other activities happening that you do not want to miss. To make sure you’re on top of everything, follow us on facebook and Instagram! Besides these three big departments, Trimed is operating through other several branches working more independently and discovering some other areas. International Department Is a branch of Trimed operating for the English Curriculum. Our tasks vary according to the season but mostly we’re here to handle everything that goes by in English. We work closely with all the other branches and departments of Trimed, and are involved in the organization of several events – some of them created by us and implemented at the faculty as a result of the collision of several cultures. Dean’s Day – Hard to believe, but Dean’s Day is basically a holiday at LF3, when the Dean gives all students the day off, for them to get together and socialize. What do we do? Depends on the mood. Sometimes we play football against teachers, sometimes we do other stuff. Last year we got a huge bouncy castle and set up a barbecue in front of the study division. International Food Day – This is an old tradition from the international curriculum and an event you will not want to miss. IFD comes from the best thing in EC – differences. It’s the celebration of several cultures through food, music and performances. All in all, it’s a great evening where you get to eat crazy things from all over the world, and all cooked by students. Trimed Visuals Do you see all the pictures in this book illustrating events and organizations? Most likely, someone from Trimed Visuals took them! This is the branch of Trimed in charge or covering everything with a camera. Any event, any occasion, they’re going to be there. Also, one of their most important projects is lectures recording. These guys are responsible for the videos you find online of that lecture you missed when you were “sick” – because of them, you can learn biochemistry on your pyjamas while enjoying a bowl of cereals. ACTER Acter is a group of people devoted to emergency medicine and simulation medicine. They’re the ones doing most of the organization of the First Aid Camp, and taking care of anything involving fake blood – either at the open doors’ day or any other event. Sports Department Look at you, starting medicine and thinking about quitting the healthy life – well, we have good news: none of that is needed. At the moment, Trimed has its own teams in different sports. All of them are led by students and having regular practices during the year. Some of them even compete in some leagues or against other faculties. Do you want to get to know them? Here they are! Trimed Vipers – Basketball Got established in March 2019. Although it has been created recently, the team has shown the quality of its players already starting off their journey with a series of wins and remain undefeated. The group consists of an international mix of players with varying levels of experience, some played in higher leagues around the globe, and some never played competitive before. We aim to bring everyone together who loves to play basketball, is ambitious to improve their skills and keen to meet new people at the same time! Our long-term goal is to become part of a regular league and attend the European University Championship. Practice takes place once a week during the regular semester weeks 1 to 15 in a facility close to the faculty and is prepared by a dedicated coach each time. Everyone is welcomed to join the team for a workout after talking to one of the organizers! To keep track of the team’s activities you can follow us on Facebook (facebook.com/trimedvipers) and Instagram (instagram.com/trimed_vipers). We are looking forward to see you on the court playing or supporting us off the court! Contact us via our Facebook page. HC Trimed – Hockey HC Trimed Prague is the faculty’s Hockey team consisting mainly of students from the 3rd Faculty of Medicine, both Czech and English curriculum. Apart from students the team gets its power from the strength of wise teachers and doctors from the University Hospital Královské Vinohrady. Playing good and professionally, HC Trimed has brought several victories home. These soldiers slide on ice, like butter slides on a toast. Their trainings happen during the semester with flexible schedules. They’re playing the amateur Prague Ice Hockey League once a week. Too keep up with them and know where the skates will slide next, follow them on Facebook (facebook.com/HCTrimedPraha) and Instagram. LF3 F.C. – Football LF3 F.C. is the official football team of our faculty. It is composed of players from both English and Czech curriculum. We play matches 11v11 both against other faculties of our university and against other universities and even friendly games against proper football clubs. We haven’t lost a single match last two years - mostly thanks to training sessions, which are held 1-2x a week (on a small pitch 5v5) near Riegrovy Sady. If you are motivated, are missing competitive football and consider to join us please contact Borna Bazargani or Murat Nevzat Aslan! Trimed Volley Broskis – Volleyball If you are interested in playing volleyball, join our team! We provide weekly practice and playing opportunities for all volleyball enthusiasts. Don’t be shy because this team is all about sharing the passion for the sport, practicing together and mainly having fun playing. We also aim to develop long-lasting relationships between the members whilst honing and practicing the team’s volleyball skills. We play every week at the sport center at Náměstí Jiřího z Lobkovic, Prague 3, just 10 min walk from the faculty. Time and Date tba, changes and news will be posted on our facebook group Tridance Do you dance? or do you feel like dancing? Because if you have the desire, we have the space! Tridance is a dance group that every year participates in the traditional annual ball of the Third faculty, which takes place in early March at the National House in Vinohrady, and a team of cheerleaders, which was formed two years ago to support our hockey and basketball teams. Whether you want to dance for a crowd of fancy people dressed up in suits and dresses, or you’d rather be on ice cheering for our players, Tridance is the group for you! Contacts for individual sport leaders can be found on the website www.trimed.cz "Clavicula" and "A Patella" are the faculty's choirs, two acapella groups. Many years ago, Morten Hagir and Simen Aleksander founded a Norwegian men's choir (now: A Patella) which developed into a long tradition of singing without background music or instruments. New choir members started joining from different countries and soon a female acapella group with the name "Clavicula" was founded as well, which makes us now a mixed choir from multiple nations. As the former conductors Stefan Lindal Theofilakis and Yngve Leirfall graduated in 2019, the choirs recently acquired a new leader, Helene. Stefan and Yngve built an amazing tradition over the past years – singing at the annual spring ball and at the Norwegian Christmas party as well as the Norwegian Constitutional Day. Every year, in the beginning of May, they have a choir trip to a Czech village called Lechovice over a whole weekend, ending with a little concert in church. Recently they've also started volunteering for an organisation called the Tyler Robinson Foundation (TRF) that financially supports families that have a child fighting cancer. Through street music and a benefit concert they already collected money to help TRF and are looking forward to keep doing that within the next years. Here at the choir, we sing songs in different genres and languages, whether that be an English Pop song or a Norwegian Christmas song – the most important thing is to always have fun and to come together every week to share our passion for music! If you are interested in joining our choir, you are very welcome to come to our rehearsals every Thursday at 7 PM on the 6th floor of our faculty. Don't be shy to join, you don't need to audition for us; if you have fun singing, think you pitch well and you are free to come to rehearsals once to twice every week, you already have what it needs to be a new member. We are looking forward to welcoming you! Reach us on Facebook! For the male choir contact: Tomáš Mandula, for the female choir contact: Adéla Čepelková. Cesta ven – “The Way Out” Cesta ven is a small and relatively young students’ organization with big dreams! One that we’ve recently accomplished is Malý Eden, our own cafe that we opened right in front of the faculty. Literally translated, Malý Eden stands for Little Heaven. The café is a place for you to get away and just have a cold beer with friends after an exam or savour a cup of coffee while planning your strategy for Module B – honestly, it’s ideal for any situation or mood. Besides drinks, we also sell cakes, sandwiches, and soon, hopefully, hot meals. We are open every day from 9 to 9, except on Fridays, we close at 3 p.m. Malý Eden is a place managed by students and for students so, if you wish to join the team and fulfil your life-long desire of becoming a barista at a student’s café, you can get a job here. Our cafe is also a community center, we do pub quizzes, international cultural nights, lectures and discussions on popular topics, both medical and non-medical ones. We also help organize charity events and work together with our friends from Trimed, IFMSA and the faculty. Apart from that, we like to welcome new initiatives, so feel free to contact us if you’d like to organize any event with us. Last but not least, there’s Dudlík Fest This is our annual charity music festival and this will be our 5th year running. All of our festival’s proceeds go to help children’s charities. This year we want to help kids with disorders within the spectrum of autism – for that, we need your help. Last year we gave over 80,000 CZK to help children in need of palliative care so, help us make this year’s festival event greater, and don’t miss out on our festival on October 17! For more details, follow us on Facebook or Instagram, or you can send Ali an email at email@example.com. The name already suggests that being with IFMSA means gaining a collective of friends and acquaintances across Czech and international medical faculties. When we write Czech, we mean all Czech medical faculties, when we write world, we mean the 129 countries where IFMSA branches are located and there are opportunities to travel for internships. And that is a very big IFMSA family. But how is all this possible? I don't think it would be possible without targets. Ours is: to unite all students of general medicine in the Czech Republic in a common effort to help others, to improve public health, and at the same time to achieve the highest quality education that will enable them to practice the medical profession competently with a humane approach to patients and in accordance with ethical values. Ideally, you should get involved right from your freshman year, you will gain valuable experience - whether it's on an internship or on projects, you will make new friends at the faculty or even around the world and you will have the opportunity to get the most out of yourself. The IFMSA section and the whole society feels like a big colossus, but at the faculty level you soon get to know everyone and can get involved wherever you want. If you have an idea, definitely don't hesitate to come up with it, maybe it will lead to a new project that we don't have here at the faculty yet. And if an existing project appeals to you, you can become a project officer - you'll be in charge of it, and you'll work with others to move the section forward. The fact that the whole IFMSA 3rd Faculty is connected means that you don't have to worry about being on your own, there is a person in every year group who is "involved" in IFMSA and can advise you. Even in the first year, you will find passionate students who have become projectionists while studying for the cell. There were sections mentioned that IFMSA is divided into - there are 6 in total and you can look into all of them, they have plenty of projects: - SCOPH – Standing Committee for Public Health - SCORA – Standing Committee for Sexual and Reproductive Health and Rights including HIV and AIDS - SCOME – Standing Committee for Medical Education - SCORP – Standing Committee for Human Rights & Peace - SCOPE – Standing Committee for Professional Exchanges - SCORE – Standing Committee for Research Exchanges These standing committees are represented by coordinators at local, national and international level. The committees coordinate various programs and preventive or humanitarian projects. IFMSA also organizes monthly internships with over 13,000 medical students from around the world. More information about IFMSA and its activities can be found at: www.ifmsa.org IFMSA in the Czech Republic is represented by the member organization IFMSA CZ, founded in 1993. Any student of medical faculties in the Czech Republic who applies for the membership can become an IFMSA member. Membership is voluntary and free of charge, allowing you to participate in clinical and research internships abroad and help with the organization of different projects. IFMSA CZ aims to unite and connect all medical students in the Czech Republic in an effort to help others, improve public health and at the same time to achieve the highest quality education. IFMSA CZ operates at all 8 faculties in the Czech Republic. Throughout projects we try to positively influence our environment and disseminate knowledge about health issues to the general public. Through lectures, courses, workshops and internships abroad, we aspire to create opportunities of personal development, for our members. IFMSA LF3 is the local branch of IFMSA CZ at our faculty. Besides participating in all national projects, IFMSA LF3 has its own projects developed and coordinated at the faculty by students. The most important projects currently taking place at all faculties in the Czech Republic include; awareness-raising events for the general public related to the World Diabetes, Health or AIDS Days. Many other projects, which we will mention below, also take place at different IFMSA CZ branches. We, as students from the 3rd Faculty of Medicine, are involved in all national projects and at the same time we organize a large number of events locally at our faculty whilst also cooperating with other student associations. We organize projects aimed for the general public, even for the youngest children, through the Teddy Bear Hospital project, where we playfully try to relieve mainly, preschool children of the fear of white coats, but also older children. Another, very useful project we run is the Interactive first aid course providing both practical and theoretical knowledge and training for children and working individuals. The real challenge is Advanced Sex Education. In a fun way we talk to children about relationships, sex and the prevention of transmission of venereal diseases. An introductory meeting and trainings for new lecturers are held starting from October! Among the social events we should mention Láskopárty (the Love Party), traditionally held at the turn of November and December as part of the World AIDS Day. Before Christmas you can look forward for Vánoční cukrování (Christmas Candies). A group of musically gifted students is preparing a music performance and charity collection with a fair and a tasting of candies with a Christmas well-spiced punch on the premises of the Faculty. When it comes to personal development, there is a series of lectures called Know Your Specialists about the professional life of a doctor in a particular field, followed by a discussion where you can find out what interests you most. This can help you choose your dream specialization. In the Surgical Sewing and Biological Material Collection workshops, you will learn basic suturing techniques on a pig’s foot or the basics of blood collection techniques at the Blood Collection Centre. As a part of the science-popularizing cycle Medicafé, you have the opportunity to meet experts of particular subjects in the pleasant environment of Prague cafes. During the Talk with Hands workshops you will learn how to communicate with deaf patients and break down the communication barrier. The Bridge project, which mainly organizes the National Cultural Days, is aimed to build connections between two curricula (Czech and English). Representatives of different nationalities represented at our faculty organize dinners full of traditional dishes, pastries, drinks, music and dance, which are worth experiencing. You can learn about many other projects and opportunities at the informational meeting or at face-to-face meetings with IFMSA CZ any time of the year. Internships In cooperation with other IFMSA member organizations we organize two types of professional internships abroad around the world. - Research internships: you will participate in the selected research project. You can take part in such kind of an exchange starting from the 2nd year. - Clinical internships: the clerkship takes place in a selected hospital department and you can take part in it starting from the 3rd year. The list of the internships offered, and the detailed information can be found on our website (see below). National and International Events Every year, twice a year, IFMSA CZ General Meetings organized by the Czech IFMSA branches, as well as International IFMSA General Meetings organized worldwide, promise an unforgettable experience, enjoyment and countless new friendships. Another opportunity to meet friends from other Czech faculties is Open Weekend, an intensive teambuilding weekend with soft-skills development workshops traditionally organized on the third weekend in October. You can also meet friends from abroad at other international events, such as the IFMSA Euregme European Meeting. How to become a member? If you want to join IFMSA, just fill in the [form](#). Membership doesn’t commit you to anything, doesn’t cost anything, and is valid for the duration of your studies, where you can earn points towards an internship. We would love it if you and your circle mates could come along to the recruitment event the first week of term – IFMSA Wants You! – Here you will learn more details and meet a lot of new people you can turn to, whether for school issues, IFMSA issues, or even extra-curricular issues. If you have any further questions, feel free to email firstname.lastname@example.org and we will answer everything. Good luck not only in your studies! IFMSA team ANSA – Association of Norwegian Students Abroad ANSA (Association of Norwegian Students Abroad) is, as the name tells, a Norwegian organization for students abroad. ANSA works organizationally and politically for international students. The main focus is to maintain social, cultural, economical and professional interests of their students. Taking care off students rights and make their opinions heard. ANSA has students all around the world, both on national and local level. There is a national board and two local boards in the Czech Republic. The local boards are located in Prague and in Brno. In addition, ANSA arranges plenty of events throughout the year. Even though it is organized by Norwegian students, the events are for other students as well, regardless of their nationality. Some of the events arranged throughout the year are fresher’s week (in cooperation with TriMed), sport tournaments, the famous Christmas Table, skiing trips, pub quiz and Norway’s Constitution Day on May 17. This is the main event of the year. The day is celebrated with parade across Charles bridge, barbeque, cakes and games in the park. The school choir usually sings for us. In the evening the event continues with cakes and snacks, band and DJs. May 17 has a special place in our hearts and we want to share the day with all students from all nationalities. Norwegians are really proud of their culture and as you can see, we LOVE to share it with other students. We are very happy when all of our international friends join our events. Happy fresher’s week and we are looking forward meet you! CHARLIE – Charles University LGBT+ Club Charlie - the queer society of Charles University - offers students and academic staff of Charles University and other universities, as well as their friends and supporters, a platform for self-realization, meeting, fun and solving common problems. It focuses primarily on developing the social life of LGBTQ+ people. It seeks to bring different people together and change the often stereotypical view of queer people, creating a more diverse academic and non-academic life for all those who throw away any prejudices and are willing to enjoy other new opportunities for enjoyment not only on campus. Charlie hosts a number of regular and special events. These include regular Tuesday meetings, A Charlie’s Queer Meet Up, topical lectures, film nights, trips, board games and panel discussions. We cooperate with a number of other clubs and organizations, including Prague Pride and the Student Council of the Faculty of Arts of Charles University. We are members of PROUD and internationally also The International Lesbian, Gay, Bisexual, Transgender & Queer Youth & Student Organisation (IGLYO). Contacts E-mail: email@example.com Instagram: instagram.com/spolekcharlie Facebook: facebook.com/spolekcharlie Web: spolekcharlie.cz/en/ Most Frequently Asked Questions What is the difference between a seminar and a lecture? A lecture combines all students from all the study groups to explain one of the topics essential for the exam. While studying, you will notice that most lectures include a set of statements. Your attendance is not mandatory for any lecture. On the other hand, a seminar combines the students from your study group only. A lot of the times, your seminars further explain lectures and give you more insight on the topic being tackled. Most seminars are not mandatory, but some can be. How do I borrow books from the library? Simple, simple: head to the library, ask to register in the system and that’s it. Feel free to take any book home (except the ones you can’t :p). Where do I find PDFs of books instead of buying them? Most upper year students have the PDF version of books, so don’t be too shy to ask. Where can I buy a white lab coat? During orientation day, the university will be selling white lab coats essential for your practices. How do I use the printers? You can add money on your ISIC cards in room 547. After that, log into a computer on the first floor using your Student ID number and set password. Now you can open any document you would like to print. (Note that the printers only print in black and white) How can I borrow a room to study? On weekdays (Mon-Friday), you can ask the security for a key to a room you would like to study in after 5:00 PM. On weekends (Sat-Sun), you can borrow a room any time of day. The security guard will keep your ISIC card until you return the keys. How do I sign up for Histology “individual study” or “slide test”? You can sign up for an individual study or slide test date using the following link: prihlasovani.if3.cuni.cz What is the individual study room 106? You will find room 106 on your schedule as the room for individual studying. You cannot access this room. During your “individual study” time, meet up with your group mates at a set location and distribute the roles for your task. How can I join any of the associations mentioned before (like Trimed, IFMSA, Cesta Ven)? The best way to get started is by attending the events. Get to know our work and you’ll get to know us. After that, all you need is enough motivation and will to work. \| Czech \| English \| \|-------------------------------------------\|----------------------------------------------\| \| Dobrý den, ráno, večer \| Good day, morning, evening \| \| Na shledanou \| Goodbye \| \| Ahoj, čau \| Hello \| \| Děkuji \| Thank you \| \| Prosím \| Please \| \| Ano x Ne \| Yes x No \| \| Jak se máš? Já se mám dobře. \| How are you? I am fine. \| \| Jak se jmenuje? \| What’s your name? \| \| Jmenuji se Rachel. \| My name is Rachel. \| \| Můžete mi pomoci? \| Can you help me? \| \| Nemluvím česky. \| I don’t speak Czech. \| \| Mluvite anglicky? \| Do you speak English? \| \| Nevíte, kde je Strmá ulice? \| Do you know where Strma street is? \| \| Nevíte, kde jsou nejbližší toalety (WC)? \| Do you know where are the nearest toilets (WC)? \| \| Potřebuje se dostat do Strmé ulice. \| I need to get to Strma street. \| \| Kolik je hodin? \| What time is it? \| \| Kde je nejbližší policejní stanice? \| Where is the nearest police station? \| \| Kdy máte otevřeno? \| When are you open? \| \| Studuji medicínu. \| I study medicine. \| \| 3. lékařská fakulta \| Third Faculty of Medicine \| \| Univerzita Karlova \| Charles University \| \| Odjezd / příjezd \| Departure / Arrival \| \| Východ / vchod \| Exit / Entry \| \| Zastávka \| Public transport station / Stop \| \| Autobus, tramvaj, metro, taxi \| Bus, Tram, Subway / Underground, Taxi \| \| Centrum města \| City center \| \| Policie / První pomoc / Hasiči \| Police / First Aid / Fire Brigade \| \| Lékárna \| Pharmacy \| \| Pekárna \| Bakery \| \| Potraviny – pečivo (housky, rohlíky) \| Food – Pastry (Rolls, Buns) \| \| Chleba, sendvič \| Bread, Sandwich \| \| Ovoce, zelenina \| Fruit, Vegetables \| \| Mléko, máslo, sýr, maso \| Milk, Butter, Cheese, Meat \| 3. lékařská fakulta Univerzity Karlovy 2024 Určeno pro studenty samoplátce prvních ročníků magisterského studia General Medicine. Zpracovalo studijní oddělení na základě dodaných podkladů ke dni 1. 8. 2024. Neprodejné. Náklad 120 kusů. Obsah dokumentu je chráněn autorskými právy. 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In order for us to best assist you with transitioning your medical care, please complete the information below. List the names of any specialty providers or the names of any specialist’s clinics you have visited within the last two years. This information may be used to obtain medical records for your provider for treatment, payment, and health care operations as described in the Notice of Privacy Practices. \| Provider Name/Practice Name \| Address/Phone Number \| Office Use Requested? \| \|---------------------------------------------\|----------------------\|-----------------------\| \| Previous Primary Care Physician: \| \| Yes \| \| Allergist: \| \| No \| \| Cardiology/Pulmonology: \| \| Yes \| \| Dermatology: \| \| No \| \| Ear, Nose & Throat (ENT): \| \| Yes \| \| Endocrinology: \| \| No \| \| Gastroenterology: \| \| Yes \| \| Nephrology: \| \| No \| \| Neurology: \| \| Yes \| \| Oncology/Hematology: \| \| No \| \| Ophthalmology: \| \| Yes \| \| Pain Management: \| \| No \| \| Podiatry/Orthopedic: \| \| Yes \| \| Rheumatology: \| \| No \| \| Urology: \| \| Yes \| Vascular: Other: Have you had a recent ER visits or hospitalizations? Please provide the reason, hospital and dates of admission: ☐ I do not currently see any specialists. Signature of Patient Date Signature of Parent/Guardian/Personal Representative* Date Printed Name of Parent/Guardian/Personal Representative* Date *If you are signing as a personal representative of an individual, describe your authority to act for this individual and provide any corresponding documentation (healthcare power of attorney, healthcare surrogate, guardian, etc.): For Office Use Only: Sign and date this form after checking “Yes” or “No” to whether the records were requested. Signature of Office Personnel Date Printed Name of Office Personnel Date	<urn:uuid:841e9eb5-fd84-41e1-9832-b4c928add22e>	CC-MAIN-2024-22	https://www.centerwellprimarycare.com/content/dam/care-delivery/primary-care-org-sites/senior-primary-care-site/web-assets/pdf/new-patient-paperwork/2024-new-patient-paperwork/Provider%20History%20Form.pdf	2024-05-26T15:00:58+00:00	crawl-data/CC-MAIN-2024-22/segments/1715971058956.26/warc/CC-MAIN-20240526135546-20240526165546-00722.warc.gz	593,104,953	452	eng_Latn	eng_Latn	0.985916	eng_Latn	0.989237	[ "eng_Latn", "eng_Latn" ]	false	rolmOCR	[ 2028, 2784 ]	[ 0.275390625 ]	[ 0.427734375 ]	[ 1.09375 ]	[ 2.90625 ]	1	0	HuggingFaceFW/finepdfs
SAME Space Coast Post Small Business Expo & Networking Event Thursday, February 21, 2019 11:00am – 3:30pm Courtyard by Marriott – Cocoa Beach 3435 N Atlantic Ave, Cocoa Beach, FL 32931 Take advantage of this opportunity to meet with small business representatives from the 45 th Space Wing, USACE JAX, USACE Mobile, NASA/KSC, NAVFAC SE, NPS, GSA, Canaveral Port Authority as well as several large and small business partners. Individual Registration: ________ Active Military/Government Personnel - $15 ________ SAME Member - $25 ________ Non-Member - $75 Vendor Table (Limited Number Available): ________ SAME Space Coast Post Member: Vendor Table (2.5'x6') includes registration for 1 attendee - $100 ________ Other Post/Non-SAME Member: Vendor Table (2.5'x6') includes registration for 1 attendee - $150 Please Note: - Large display set ups cannot be accommodated in a single vendor table space. - Registration is required, and payment is due at time of registration. - Payment is non-refundable. Participants who cancel within 24 hours of the event may use their registration fee towards a 2019 Space Coast Post Meeting. - Pay by credit card (on-line at http://samespacecoast.org/). - For more information, please contact: Michelle Shoultz – mshoultz@ fraziereng.com. Company Name: __________________________________________________________________________________ Attendee Name: ___________________________________________________________________________________ Email: _______________________________________________________________________________________________ Phone: ______________________________________________________________________________________________	<urn:uuid:1bb5e990-ad1a-42b2-bbee-a717af46f569>	CC-MAIN-2019-18	https://www.patrick.af.mil/Portals/14/documents/SAME_Small_Business_Expo_2019_Registration.pdf?ver=2018-12-12-111537-750	2019-04-21T13:00:52Z	crawl-data/CC-MAIN-2019-18/segments/1555578531462.21/warc/CC-MAIN-20190421120136-20190421142136-00265.warc.gz	769,636,420	349	eng_Latn	eng_Latn	0.977839	eng_Latn	0.977839	[ "eng_Latn" ]	false	docling	[ 1704 ]	[ 0.23828125 ]	[ 0.2294921875 ]	[ 1.0390625 ]	[ 2.53125 ]	1	1	HuggingFaceFW/finepdfs
Lexmark X792 Family Business productivity with robust color performance * Duplex not available on C792e model. Color Solutions Duplex printing* Up to 50 ppm Network Copy Scan Fax Security Eco-friendly This is an FCC Class A device. Not intended for use in residential or domestic environments. Robust color printing Designed for busy color printing environments, the Lexmark X792 Family delivers vibrant, professional quality output that is consistent from the first page to the last. - Lexmark Extra High Yield Print Cartridge available, offering yields of up to 20,000* pages - Print and copy in duplex at speeds as fast as 50 ppm in both black and color - Match brand sensitive corporate colors on marketing collateral and within Microsoft Office with Lexmark Named Color Replacement and PANTONE calibration - Lexmark Color Care Technology to manage color usage and control costs - Instant warm-up fuser to help reduce energy consumption and improve time to first page Business productivity The Lexmark X792 Family combines exceptional multifunction performance with time-saving applications designed to make you more productive. These MFPs can deliver the performance of much larger copiers, but with a smaller footprint and a more affordable price. - Duplex scanning to scan both sides of your documents in one pass - Advanced copy functions let you interrupt long print runs to make a quick copy, and proof the first copy set before completing your copy job - Scan to multiple destinations, including scan to email, scan to FTP, scan to fax, scan to network, and more - Preloaded applications to drive greater efficiency, and Lexmark Embedded Solutions Framework to further extend the capabilities of the device Flexibility Select from a number of expandability options and finishing features you would expect from more expensive products. - Ultra-reliable paper feeding to support diverse media, including card stock, labels, UV-resistant outdoor media, banner media and more - Robust output options, including a five-bin assignable mailbox, an offset stacker, a staple finisher, and a staple with hole punch finisher - Input capacity expandable up to 2,650 sheets with a high-capacity feeder or extra drawers - Connectivity and application solution cards allow integration into most IT environments Easy and intuitive The Lexmark X792 Family is designed for easy operation and maintenance. - Extra large, easy to navigate 10-inch class color touch screen provides audible and tactile feedback to make completing tasks intuitive - Print and scan preview features help you select documents or specific pages within a document - Directional lights on the device provide visual cues to guide you through tasks and maintenance operations - Eco-friendly settings such as the Sleep button and Hibernate Mode - Available device fleet management software Make a lasting impression with award-winning color The documents you print define an important image—yours. That’s why Lexmark’s color MFPs help businesses be more productive and stand out with vibrant color. With the ability to print professional quality color in-house, you can add instant impact and save costs by virtually eliminating the need to outsource print jobs. Lexmark also offers a host of color-access and control tools to manage costs. The right touch The Lexmark e-Task color touch screen is a key access point to your printer. The extra large customizable 10-inch class interface gives you the ability to preview thumbnails of documents prior to printing, as well as change print jobs at the device. You can even view, select and print specific pages within a document directly from the touch screen. New interactive sensory features provide both tactile and audible feedback, helping to guide you through each operation, confirming a touch has registered and indicating an action is transpiring. Protecting your information From the data traveling through your network to the pages being printed, Lexmark’s innovative security controls give you peace of mind that your valuable corporate data is protected at every stage. ▶ Cutting-edge user authentication and authorization controls, including LDAP, help protect your device and data ▶ Card reader option to add an extra layer of security ▶ Hard disk encryption protects sensitive data on the disk drive ▶ Automatic, scheduled or manual disk wiping ▶ IPSec, SNMPv3 and 802.1x network security supported ▶ Security-audit logging to help track and identify security risks True image always Lexmark is dedicated to designing and manufacturing products that deliver exceptional quality and reliable performance. Maximize the return on your investment, extend the service life of your Lexmark printing equipment and make a lasting impression by always insisting on Lexmark Genuine Supplies, Service and Parts. Lexmark X792 Family color laser printers are backed by a one-year limited warranty. For further protection against unexpected expenses or downtime, extended warranty offerings are available. Save time and money through solutions Reduce unnecessary printing and simplify work processes through Lexmark solutions. The X792 Family features the Lexmark Embedded Solutions Framework (eSF), our platform that enables you to add a wide range of software applications directly onto the device. Solutions are designed with your productivity in mind, helping you streamline—or even eliminate—paper intensive business processes. Preloaded solutions* on the X792 family: Forms and Favorites Eliminate waste and inefficiencies associated with preprinted forms. Store frequently printed forms, marketing materials or other documents online, then print them on demand. Scan to Network Scan a hardcopy document and route the image to one of 100 predefined personal or public shared network folders. Change Language** Easily switch the language displayed on the touch screen—18 languages supported. Examples of solutions available through Lexmark authorized partners and dealers, or through a Lexmark Professional Services engagement: Background and Idle Screen Change the touch screen background to your corporate logo, a unique message, or select one of the four screens that are preloaded on the device. Showroom Display a customizable, scrolling slideshow on the color touch screen to promote your business or products, or to communicate important messages to your customers or employees. Card Copy Save time and effort in copying identification cards, licenses and insurance cards by automatically scanning, enlarging and printing both sides of a two-sided card onto one side of a sheet of paper. Additional solutions are available Opt-in to Change Language during installation 1. Intuitive color touch screen* The extra large 10-inch class color touch screen allows you to operate your printer with ease and confidence through smart and intuitive navigation, easy access to workflow solutions and shortcuts, and the ability to preview your documents and print jobs at the device. 2. Flexible output options Choose from four output options, including a five-bin mailbox, an offset stacker, a staple finisher, and a staple with hole punch finisher. 3. Duplex automatic document feeder (DADF) Save time by scanning both sides of your document in one pass with robust color-scanning capabilities and an input capacity of up to 75 pages. 4. Direct USB The front USB port allows for convenient walk-up preview, printing and scanning, and is compatible with most printable image file formats. 5. Lexmark solutions Reduce unnecessary printing and simplify work processes through solutions applications preloaded on your device. Choose additional Lexmark solutions to fit your unique workflow needs. 6. Long-lasting toner The Lexmark Extra High Yield Print Cartridge delivers up to 20,000* pages, reducing interventions, cartridge waste and cost. 7. Eco-friendly features Easy-to-access features make it easy to print responsibly, including Eco-Mode to reduce paper and toner consumption, and the Sleep button and Hibernate Mode to help you save energy. Average continuous black or composite CMY declared cartridge yield in accordance with ISO/IEC 19798. ## Color laser multifunction product ### X792 Series \| Part # \| Models \| \|----------\|---------------------------------------------\| \| 47B1000 \| Lexmark X792de \| \| 47B1001 \| Lexmark X792dte \| \| 47B1002 \| Lexmark X792dtfe \| \| 47B1121 \| Lexmark X792dtme \| \| 47B1120 \| Lexmark X792dtpe \| \| 47B1122 \| Lexmark X792dtse \| \| Part # \| Laser toner/print cartridge \| \|----------\|---------------------------------------------\| \| X792X1KG \| X792 Black Extra High Yield Return \| \| \| Program Print Cartridge \| \| X792X1CG \| X792 Cyan Extra High Yield Return \| \| \| Program Print Cartridge \| \| X792X1MG \| X792 Magenta Extra High Yield Return \| \| \| Program Print Cartridge \| \| X792X1YG \| X792 Yellow Extra High Yield Return \| \| \| Program Print Cartridge \| \| C792A1KG \| C792, X792 Black Return Program Print Cartridge \| \| C792A1CG \| C792, X792 Cyan Return Program Print Cartridge \| \| C792A1MG \| C792, X792 Magenta Return \| \| \| Program Print Cartridge \| \| C792A1YG \| C792, X792 Yellow Return Program Print Cartridge \| \| X792X2KG \| X792 Black Extra High Yield Print Cartridge \| \| X792X2CG \| X792 Cyan Extra High Yield Print Cartridge \| \| X792X2MG \| X792 Magenta Extra High Yield Print Cartridge \| \| X792X2YG \| X792 Yellow Extra High Yield Print Cartridge \| \| C792X7TG \| C792, X792 Waste Toner Bottle \| \| 25A0013 \| Staple Cartridges (3 pack) \| \| Part # \| Paper handling \| \|----------\|----------------------------------------------\| \| 47B0110 \| C792, X792 550-sheet drawer \| \| 47B0111 \| C792, X792 2000-sheet high capacity feeder \| \| 47B1101 \| C792, X792 5-bin mailbox \| \| 47B1102 \| C792, X792 100-sheet offset stacker \| \| 47B1100 \| C792, X792 500-sheet staple finisher \| \| 47B1103 \| C792, X792 500-sheet staple, hole punch finisher \| \| 47B0112 \| C792, X792 Spacer \| \| 47B0118 \| X792 Banner media tray \| \| Part # \| Furniture \| \|----------\|----------------------------------------------\| \| 47B0114 \| C792, X792 Caster base \| \| Part # \| Memory options \| \|----------\|----------------------------------------------\| \| 1025041 \| 256MB DDR2-DRAM \| \| 1025042 \| 512MB DDR2-DRAM \| \| 1025043 \| 1024MB DDR2-DRAM \| \| 14F0245 \| 256MB Flash Card \| \| 30G0287 \| Arabic Font Card \| \| 30G0288 \| Japanese Font Card \| \| 30G0285 \| Korean Font Card \| \| 30G0286 \| Simplified Chinese Font Card \| \| 30G0287 \| Traditional Chinese Font Card \| \| Part # \| Application solutions \| \|----------\|----------------------------------------------\| \| 47B1111 \| X792 Card for IPDS \| \| 47B1110 \| X792 Forms and Bar Code Card \| \| Part # \| Connectivity \| \|----------\|----------------------------------------------\| \| 27X0025 \| MarkNet N8250 802.11b/g/n Wireless Print Server \| \| 14F0037 \| MarkNet N8120 Gigabit Ethernet Print Server \| \| 14F0042 \| MarkNet N8130 Fiber Ethernet \| \| \| 100BaseFX, 10BaseFL Print Server \| \| 14T0220 \| MarkNet N8220e Gigabit Ethernet Print Server \| \| 1021294 \| USB Cable (2-meters) \| \| 14F0000 \| Parallel 1284-B Interface Card \| \| 1021231 \| Parallel Cable (10-foot) \| \| 14F0100 \| RS-232C Serial Interface Card \| \| Part # \| Extended warranties \| \|----------\|----------------------------------------------\| \| 2353776 \| X792 2-Years Total Onsite Service, Next Business Day \| \| 2353777 \| X792 3-Years Total Onsite Service, Next Business Day \| \| 2353778 \| X792 4-Years Total Onsite Service, Next Business Day \| \| 2353779 \| X792 5-Years Total Onsite Service, Next Business Day \| \| 2353780 \| X792 1-Year Onsite Service Renewal, Next Business Day \| \| Part # \| User replaceable parts \| \|----------\|----------------------------------------------\| \| 40X7100 \| C792, X792 Fuser Maintenance Kit 110–120V \| \| 40X7103 \| C792, X792 Transfer module Maintenance Kit \| \| 40X7220 \| X792 ADF Maintenance Kit \| \| Part # \| Service parts \| \|----------\|----------------------------------------------\| \| 40X6104 \| Pick Tire for Trays \| \| 40X7178 \| MPF Pick Tires and Wear Strip \| \| Product specifications \| Lexmark X792de \| Lexmark X792dte \| Lexmark X792dtfe \| \|------------------------\|---------------\|-----------------\|------------------\| \| Printing* \| \| \| \| \| Display \| Lexmark e-Task 10-inch (25 cm) class color touch screen \| \| \| \| Print Speed: Up to \| Black: 50 ppm / Color: 50 ppm \| \| \| \| Time to First Page: As fast as \| Black: 8 seconds / Color: 8.5 seconds \| \| \| \| Print Resolution \| Black: 1200 x 1200 dpi, 4800 Color Quality (2400 x 600 dpi) / Color: 1200 x 1200 dpi, 4800 Color Quality (2400 x 600 dpi) \| \| \| \| Memory \| Standard: 1024 MB / Maximum: 2048 MB \| \| \| \| Hard Disk \| Included in configuration \| \| \| \| Recommended Monthly Page Volume¹ \| 2500 - 25000 pages \| \| \| \| Maximum Monthly Duty Cycle: Up to¹ \| 1500000 pages per month \| \| \| \| Copying \| \| \| \| \| Copy Speed: Up to \| Black: 50 cpm / Color: 50 cpm \| \| \| \| Time to First Copy: As fast as \| Black: 10 seconds / Color: 11 seconds \| \| \| \| Scanning \| \| \| \| \| Scanner Type / ADF Scan\| Flatbed scanner with ADF / DADF (single pass Duplex) \| \| \| \| A4/Ltr Simplex Scan Speed: Up to \| Black: 47 / 49 sides per minute / Color: 47 / 49 sides per minute \| \| \| \| Faxing \| \| \| \| \| Modem Speed \| 33.6 Kbps \| \| \| \| Supplies \| \| \| \| \| Cartridge(s) Shipping with Product \| 12,000-page Black and Color (CMY) Starter Return Program Print Cartridges \| \| \| \| Paper Handling \| \| \| \| \| Paper Input Capacity: Up to \| Standard: 650 pages 20 lb or 75 gsm bond / Maximum: 2650 pages 20 lb or 75 gsm bond \| Standard: 1750 pages 20 lb or 75 gsm bond / Maximum: 2300 pages 20 lb or 75 gsm bond \| Standard: 1000 pages 20 lb or 75 gsm bond / Maximum: 1000 pages 20 lb or 75 gsm bond \| \| Paper Output Capacity: Up to \| Standard: 500 pages 20 lb or 75 gsm bond / Maximum: 1000 pages 20 lb or 75 gsm bond \| \| \| \| Media Types Supported \| Glossy Paper, Polyester Labels, Paper Labels, Envelopes, Vinyl Labels, Refer to the Card Stock & Label Guide., Card Stock, Dual Web Labels, Outdoor Media, Integrated Labels, Transparencies, Plain Paper, Banner Paper \| Glossy Paper, Polyester Labels, Paper Labels, Envelopes, Vinyl Labels, Refer to the Card Stock & Label Guide., Card Stock, Dual Web Labels, Outdoor Media, Integrated Labels, Transparencies, Plain Paper \| \| \| Media Sizes Supported \| C5 Envelope, 10 Envelope, Letter, B5 Envelope, Universal, Legal, A5, Folio, 7 3/4 Envelope, Statement, A4, 9 Envelope, Executive, DL Envelope, JIS-B5 \| \| \| \| General Information\| \| \| \| \| Standard Ports \| Ethernet 10/100/1000 BaseTX (RJ-45), Rear USB 2.0 Specification Hi-Speed Certified Port (Type A), USB 2.0 Specification Hi-Speed Certified (Type B), Front USB 2.0 Specification Hi-Speed Certified port (Type A) \| \| \| \| Optional Network Ports / Optional Local Ports \| External MarkNet N7020e Gigabit Ethernet, Internal MarkNet™ N8120 Gigabit Ethernet, Internal MarkNet™ N8130 Fiber Fast Ethernet, Internal MarkNet™ N8250 802.11b/g/n Wireless / Internal 1284-B Bidirectional Parallel, Internal RS-232C serial \| \| \| \| Noise Level: Operating \| Print: 52 dBA / Copy: 53 dBA / Scan: 54 dBA \| \| \| \| Specified Operating Environment \| Altitude: 0 - 3048 Meters (10,000 Feet), Humidity: 8 to 80% Relative Humidity, Temperature: 16 to 32°C (60 to 90°F) \| \| \| \| Limited Warranty - See Statement of Limited Warranty \| 1-Year Onsite Service, Next Business Day \| \| \| \| Size (in. - H x W x D) / Weight (lb.) \| 32.5 x 22.0 x 20.0 in. / 161 lb. \| 47.4 x 24.05 x 25.9 in. / 247 lb. \| 47.4 x 41.55 x 25.9 in. / 283 lb. \| ¹“Recommended Monthly Page Volume” is a range of pages that helps customers evaluate Lexmark’s product offerings based on the average number of pages customers plan to print on the device each month. Lexmark recommends that the number of pages per month be within the stated range for optimum device performance, based on factors including: supplies replacement intervals, paper loading intervals, speed, and typical customer usage. “Maximum Monthly Duty Cycle” is defined as the maximum number of pages a device could deliver in a month using a multitask operation. This metric provides a comparison of robustness in relation to other Lexmark printers and MFPs. This is a Class A device according to the FCC Rules and international electromagnetic emissions standards. This device is not intended for use in residential or domestic environments due to potential interference to radio communications. \| Feature \| Lexmark X792dtme \| Lexmark X792dtpe \| Lexmark X792dtse \| \|-------------------------------\|----------------------------------------------------------------------------------\|----------------------------------------------------------------------------------\|----------------------------------------------------------------------------------\| \| Printing \| \| \| \| \| Display \| Lexmark e-Task 10-inch (25 cm) class color touch screen \| \| \| \| Print Speed: Up to \| Black: 50 ppm / Color: 50 ppm \| \| \| \| Time to First Page: As fast as\| Black: 8 seconds / Color: 8.5 seconds \| \| \| \| Print Resolution \| Black: 1200 x 1200 dpi, 4800 Color Quality (2400 x 600 dpi) / Color: 1200 x 1200 dpi, 4800 Color Quality (2400 x 600 dpi) \| \| \| \| Memory \| Standard: 1024 MB / Maximum: 2048 MB \| \| \| \| Hard Disk \| Included in configuration \| \| \| \| Recommended Monthly Page Volume¹ \| 2500 - 25000 pages \| \| \| \| Maximum Monthly Duty Cycle: Up to² \| 1500000 pages per month \| \| \| \| Copying \| \| \| \| \| Copy Speed: Up to \| Black: 50 cpm / Color: 50 cpm \| \| \| \| Time to First Copy: As fast as\| Black: 10 seconds / Color: 11 seconds \| \| \| \| Scanning \| \| \| \| \| Scanner Type / ADF Scan \| Flatbed scanner with ADF / DADF (single pass Duplex) \| \| \| \| A4/Ltr Simplex Scan Speed: Up to \| Black: 47 / 49 sides per minute / Color: 47 / 49 sides per minute \| \| \| \| Faxing \| \| \| \| \| Modem Speed \| 33.6 Kbps \| \| \| \| Supplies \| \| \| \| \| Cartridge(s) Shipping with Product \| 12,000-page Black and Color (CMY) Starter Return Program Print Cartridges \| \| \| \| Paper Handling \| \| \| \| \| Paper Input Capacity: Up to \| Standard: 1750 pages 20 lb or 75 gsm bond / Maximum: 2300 pages 20 lb or 75 gsm bond \| \| \| \| Paper Output Capacity: Up to \| Standard: 1000 pages 20 lb or 75 gsm bond / Maximum: 1000 pages 20 lb or 75 gsm bond \| \| \| \| Media Types Supported \| Glossy Paper, Polyester Labels, Paper Labels, Envelopes, Vinyl Labels, Refer to the Card Stock & Label Guide., Card Stock, Dual Web Labels, Outdoor Media, Integrated Labels, Transparencies, Plain Paper \| \| \| \| Media Sizes Supported \| C5 Envelope, 10 Envelope, Letter, B5 Envelope, Universal, Legal, A5, Folio, 7 3/4 Envelope, Statement, A4, 9 Envelope, Executive, DL Envelope, JIS-B5 \| \| \| \| General Information \| \| \| \| \| Standard Ports \| Ethernet 10/100/1000 BaseTX (RJ-45), Rear USB 2.0 Specification Hi-Speed Certified Port (Type A), USB 2.0 Specification Hi-Speed Certified (Type B), Front USB 2.0 Specification Hi-Speed Certified port (Type A) \| \| \| \| Optional Network Ports / Optional Local Ports \| External MarkNet N7020e Gigabit Ethernet, Internal MarkNet™ N8120 Gigabit Ethernet, Internal MarkNet™ N8130 Fiber Fast Ethernet, Internal MarkNet™ N8250 802.11b/g/n Wireless / Internal 1284-B Bidirectional Parallel, Internal RS-232C serial \| \| \| \| Noise Level: Operating \| Print: 52 dBA / Copy: 53 dBA / Scan: 54 dBA \| \| \| \| Specified Operating Environment\| Altitude: 0 - 3048 Meters (10,000 Feet), Humidity: 8 to 80% Relative Humidity, Temperature: 16 to 32°C (60 to 90°F) \| \| \| \| Limited Warranty - See Statement of Limited Warranty \| 1-Year Onsite Service, Next Business Day \| \| \| \| Size (in. - H x W x D) / Weight (lb.) \| 47.4 x 41.55 x 25.9 in. / 279 lb. \| 47.4 x 41.55 x 25.9 in. / 285 lb. \| 47.4 x 41.55 x 25.9 in. / 281 lb. \| ¹ "Recommended Monthly Page Volume" is a range of pages that helps customers evaluate Lexmark's product offerings based on the average number of pages customers plan to print on the device each month. Lexmark recommends that the number of pages per month be within the stated range for optimum device performance, based on factors including: supplies replacement intervals, paper loading intervals, speed, and typical customer usage. ² "Maximum Monthly Duty Cycle" is defined as the maximum number of pages a device could deliver in a month using a multishift operation. This metric provides a comparison of robustness in relation to other Lexmark printers and MFPs. This is a Class A device according to the FCC Rules and international electromagnetic emissions standards. This device is not intended for use in residential or domestic environments due to potential interference to radio communications. © 2015 Lexmark and the Lexmark logo are trademarks of Lexmark International, Inc., registered in the United States and/or other countries. All other trademarks are the property of their respective owners. ENERGY STAR® is a U.S. registered mark. 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ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) BETWEEN: DAVID ROBERTSON Applicant - and - PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER section 207 of the Business Corporations Act, R.S.O. 1990, c.B16 MOTION RECORD (APPROVAL AND VESTING ORDER AND ANCILLARY ORDER) (Returnable Wednesday, March 15, 2023) CAMELINO GALESSIERE LLP Barristers and Solicitors 65 Queen Street West Suite 440 Toronto, ON M5H 2M5 Gustavo F. Camelino Law Society No. 45607S Tel: 416-306-3834 Email: email@example.com Lawyers for MNP Ltd. TO: THE SERVICE LIST \| TAB \| DOCUMENT \| PAGE \| \|-----\|--------------------------------------------------------------------------\|------\| \| 1 \| Notice of Motion \| 1 \| \| 2 \| First Report of the Liquidator dated March 10, 2023 \| 9 \| \| \| Table of Contents \| 10 \| \| \| Introduction and Purpose of this Report \| 11 \| \| \| Terms of Reference \| 12 \| \| \| Overview and Background \| 13 \| \| \| Liquidator’s Activities \| 15 \| \| \| The Sale Process \| 17 \| \| \| The Claims Process \| 29 \| \| \| Professional Fees and Disbursements \| 34 \| \| \| Conclusion and Recommendation \| 34 \| \| \| Appendix A – Liquidation Order dated November 23, 2022 \| 36 \| \| \| Appendix B – Schedule of Paidiem Shareholders \| 60 \| \| \| Appendix C – Affidavit of Mailing Notice of Claim \| 61 \| \| \| Appendix D – Shareholders Resolutions (incl. Stalking Horse Agr) \| 122 \| \| \| Sale Process \| 133 \| \| \| Executed Stalking Horse Agreement \| 140 \| \| \| Appendix E – Amending Agreement (Stalking Horse Agr.) \| 169 \| \| \| Appendix F – Teaser and Opportunity Highlights \| 171 \| \| \| Appendix G – Schedule of Claimants \| 173 \| \| \| Appendix H – PPSA Lien Inquiry Report \| 175 \| \| \| Appendix I – Fee Affidavit (MNP Ltd.) \| 178 \| \| \| Appendix J – Fee Affidavit (CG LLP) \| 201 \| \| 3 \| Proposed Approval and Vesting Order \| 212 \| \| \| Blackline Compare to Model Approval and Vesting Order \| 219 \| \| 4 \| Proposed Ancillary Order \| 232 \| ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) BETWEEN: DAVID ROBERTSON Applicant - and - PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER section 207 of the Business Corporations Act, R.S.O. 1990, c.B16 NOTICE OF MOTION (APPROVAL AND VESTING ORDER AND ANCILLARY ORDER) (Returnable Wednesday, March 15, 2023) MNP Ltd. (the “Liquidator”) in its capacity as the court appointed liquidator of the respondent Paidiem Payment Solutions Inc. (“Paidiem”) will make a motion before the Honourable Justice Steele of the Ontario Superior Court of Justice (Commercial List) on Wednesday, March 15, 2023 at 10:00 a.m. or as soon after that time as the motion can be heard. PROPOSED METHOD OF HEARING: The motion is to be heard by videoconference. THE MOTION IS FOR: 1. an order (the “Approval and Vesting Order”) substantially in the form of the draft order attached at TAB 3 of the motion record which, among other things, (a) approves the transaction (the “Transaction”) contemplated by the Stalking Horse Asset Purchase Agreement dated December 21, 2022 as amended (the “145CAN APA”) between MNP Ltd. (solely in its capacity as the court-appointed liquidator of the Corporation) and 14546865 Canada Inc. (“145CAN”) as purchaser; and (b) vests in 145CAN, or as it may direct, all of the rights, title and interest in the assets described in the 154CAN APA (the “Purchased Assets”) free and clear of and from any and all Claims and Encumbrances (each as defined in the Approval and Vesting Order); and 2. an order (the “Ancillary Order”) substantially in the form of the draft order attached at Tab 4 of this motion record which among other things: (1) approves the Liquidator’s first report to the court dated March 10, 2023 (the “Liquidator’s First Report”) and the activities of the Liquidator including the distribution to BDC to satisfy its secured claim and the activities of the Liquidator’s legal counsel as described therein; and (2) approves the fees and disbursements of the Liquidator, including the fees and disbursements of its legal counsel, all as particularized in the Liquidator’s First Report and which directs and authorizes the Liquidator to pay all such fees and disbursements from the available funds of the Corporation. 3. such other and further relief as they Honourable Court deems just. THE GROUNDS FOR THIS MOTION ARE: 4. By order dated November 23, 2022 (the “Liquidation Order”), Mr. Justice Cavanagh of the Commercial List of the Ontario Superior Court of Justice ordered that Paidiem Payment Solutions Inc. (“Paidiem”) be wound up pursuant to Part XVI of the Business Corporations Act, R.S.O. 1990, c. B.16 (the “OBCA”) and appointed MNP Ltd. (the “Liquidator”) to liquidate the assets of Paidiem. 5. Pursuant to subparagraph 3(i) of the Liquidation Order, the Liquidator is empowered to market Paidiem’s property for sale and to solicit offers from prospective purchasers; 6. Pursuant to subparagraph 3(j)(ii) of the Liquidation Order, the Liquidator is empowered to sell Paidiem’s assets; 7. Pursuant to the powers granted to it pursuant to the Liquidation Order, the Liquidator commenced a process to market Paidiem’s assets for sale and to solicit offers from prospective purchasers. More specifically, the Liquidator commenced and carried out a Stalking Horse Sale Process for the sale of the assets of the Corporation pursuant to which: (1) the Liquidator solely in its capacity as the court-appointed liquidator of the Corporation entered into the 145CAN APA with 145CAN (the stalking horse bidder); and (2) commenced a Stalking Horse Sale Process (the “Sale Process”). The 145CAN APA 8. Pursuant to the 145CAN APA, 145CAN agreed to act as the stalking horse bidder in the Sale Process and its bid for the assets of the Corporation (the “Purchased Assets”) is included in the 145CAN APA (the “Stalking Horse Bid”). The Stalking Horse Bid was subject to higher or otherwise better offers received by the Liquidator as part of the Sale Process which had an LOI deadline February 6, 2023 (the “LOI Deadline”) and bid deadline of March 8, 2023. 9. In furtherance of the Sale Process, the Liquidator undertook a process that included: (1) the preparation of an information document (the “Sale Information Document”) describing the opportunity, outlining the Stalking Horse Sale Process and inviting recipients of the Sale Information Document to participate in the Stalking Horse Sale Process; (2) the preparation of a teaser document and a form of NDA for execution by any Prospective Participant that wished to participate in the sales process; (3) with the assistance of Management, the gathering and review of all due diligence materials that it determined to be relevant to Prospective Participants and the establishment of a secure, electronic data room (the “Data Room”), which was maintained and administered by the Liquidator throughout the Sale Process; (4) with the assistance of Management and Robertson, prepared a list of thirty-three (33) Prospective Participants; (5) delivery of the teaser on January 6, 2023 to the identified Prospective Participants, as well as to MNP’s partners, who identified three (3) additional Prospective Participants; (6) in addition to the sending the Teaser to the Prospective Participants identified, the Liquidator: i. on January 17, 2023 published and advertisement of the opportunity in the National Post; ii. provided NDAs to six (6) Prospective Participants who had expressed an interest in the process. The Liquidator received executed NDAs from four of those Prospective Participants; iii. provided access to the Data Room to the four (4) Prospective Participants who had executed NDAs; iv. on or about January 23, 2023 followed-up with the Prospective Participants who had executed NDAs to inquire if there was any additional information, they required to complete their due and to remind them of the LOI Deadline; and v. engaged in various discussions with Prospective Participants regarding the process and Paidiem’s business. 10. After conducting the first stage of Sale Process, the Liquidator received no LOIs, qualified or otherwise. Accordingly, and pursuant to the Sale Process Protocol approved by the Shareholders, as no LOIs are submitted by the LOI Deadline 145CAN as the Stalking Horse Bidder is the Winning Bid pursuant to the 145CAN APS. The Liquidator is now proceeding to close a transaction with the Stalking Horse Bidder. 11. Pursuant to the Sale Process, and subject to a modification related to payment of the purchase price described below, the Liquidator is seeking an order approving the Transaction vesting the Purchased Assets in 145CAN, or as it may direct, free and clear of any claims or encumbrances. Modification of Payment of Purchase Price 12. 145CAN remitted an initial deposit to the Liquidator in the amount of $450,000.00 which is being held in trust by the Liquidator on account of the purchase price under the 145CAN APA. 13. Under the terms of the 145CAN APA, the Transaction is to close within 3 days of the issuance of the Approval and Vesting Order being sought. At closing 145CAN is to remit payment of the balance of the purchase price in the amount of $2,550,000.00. 14. The investors of 145CAN comprise a group of the preferred shareholders of Paidiem. The preferred shareholders have a claim against Paidiem in the amount of approximately $4.48 million. 15. 145CAN’s expectation was that the closing of the 145CAN APA would occur concurrently with the distribution of funds under the liquidation to the claimants. The expectation was that the preferred shareholders of Paidiem would fund their investment in 145CAN with their distribution amounts from the Liquidation. 16. Unfortunately, since the Liquidator’s Claims process is not yet complete the distribution by the Liquidator will not happen prior to the close of the 145CAN APA. 17. As such, 145CAN has asked that it be permitted to pay the balance of the purchase price by way of a secured promissory note to be payable on the earlier of (i) the distribution date; and (ii) 6 months from the closing of the 145CAN APA. 18. The Liquidator believes that 145CAN’s offer in that regard is reasonable since it would not prejudice any other claimant as set out in paragraphs 34 and 35 of the First Report. The Liquidator’s Activities and Professional Fees 19. The additional purpose of the Liquidator’s First Report is to provide information, inter alia: (1) on the activities and conduct of the Liquidator since its appointment to support its request that the Court approval of the activities and conduct of the Liquidator and of its legal counsel as described and recited in the First Report; (2) regarding the distribution made to Paidiem’s only secured creditor Business Development Bank of Canada; (3) regarding the fees and disbursements of the Liquidator and of its legal counsel as set out in the First Report of the Liquidator, and the court’s approval of the payment of the said fees from Paidiem’s available funds; 20. The fees and disbursements of the Liquidator and its legal counsel (as set out in Appendices I and J of the Liquidator’s First Report) are fair and reasonable and justified in the circumstances and reflect the work done by and on behalf of the Liquidator in connection with the liquidation. 21. Part XVI of the OBCLA; 22. Rule 37 of the Rules of Civil Procedure, R.R.O 1990, Reg 194 as amended; and 23. Such further and other grounds as counsel may advise and that to this Honourable Court may appear just. THE FOLLOWING DOCUMENTARY EVIDENCE will be used at the hearing of the motion: (1) The First Report of the Liquidator dated March 10, 2023; (2) such further and other documentary evidence as counsel may advise and that this Honourable Court may admit. Date: March 10, 2023 CAMELINO GALESSIERE LLP Barristers and Solicitors 65 Queen Street West Suite 440 Toronto, ON M5H 2M5 Gustavo F. Camelino Law Society No. 45607S Tel: 416-306-3834 Email: firstname.lastname@example.org Lawyers for MNP Ltd. TO: THE SERVICE LIST DAVID ROBERTSON Applicant and PAIDIEM PAYMENT SOLUTIONS INC. Respondent Court File No.: CV-22-00690376-00CL ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) NOTICE OF MOTION CAMELINO GALESSIERE LLP Barristers & Solicitors 65 Queen Street West Suite 440 Toronto, ON M5C 1H6 Gustavo F. Camelino Law Society No.: 45607S Tel: 416-306-3834 Email: email@example.com Lawyers for MNP Ltd. BETWEEN: DAVID ROBERTSON Applicant - and - PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER SECTION 207 OF THE ONTARIO BUSINESS CORPORATIONS ACT, R.S.O. 1990, C B. 16 FIRST REPORT OF MNP LTD. IN ITS CAPACITY AS COURT-APPOINTED LIQUIDATOR OF THE RESPONDENT March 10, 2023 # TABLE OF CONTENTS INTRODUCTION AND PURPOSE OF THIS REPORT .......................................................... 1 TERMS OF REFERENCE ........................................................................................................... 2 OVERVIEW AND BACKGROUND ......................................................................................... 3 LIQUIDATOR’S ACTIVITIES ................................................................................................. 5 THE SALE PROCESS ............................................................................................................. 7 THE CLAIMS PROCESS ....................................................................................................... 19 PROFESSIONAL FEES AND DISBURSEMENTS ............................................................ 24 CONCLUSION AND RECOMMENDATION ...................................................................... 24 ## APPENDICES \| Appendix “A” \| Liquidation Order, dated November 23, 2022 \| \|--------------\|---------------------------------------------\| \| Appendix “B” \| A schedule of Paidiem Payment Solutions Inc.’s common and preferred shareholders \| \| Appendix “C” \| The affidavit of mailing of the Liquidation and Claims Bar Notice, sworn • \| \| Appendix “D” \| A copy of the fully executed Resolution of the Shareholders, including Stalking Horse Sale Process Protocol and the Agreement of Purchase and Sale, dated December 21, 2022 entered into between the Liquidator and 14546865 Canada Inc. \| \| Appendix “E” \| A copy of the Amending Agreement, dated January 5, 2023 \| \| Appendix “F” \| A copy of the Liquidator’s teaser document \| \| Appendix “G” \| A schedule summarizing the Claimants and the amounts shown on their respective Notices of Claim \| \| Appendix “H” \| Ontario Personal Property Security Act lien/registry search (file currency date of January 15, 2023) \| \| Appendix “I” \| The affidavit of Jerry Henechowicz, sworn March 8, 2023 \| \| Appendix “J” \| The affidavit of Antonella Cerminara, sworn March 10, 2023 \| INTRODUCTION AND PURPOSE OF THIS REPORT 1. On November 23, 2023 (the “Date of Appointment”), the Honourable Mr. Justice Cavanagh of the Ontario Superior Court of Justice (Commercial List) (the “Court”) granted an order (the “Liquidation Order”) ordering the windup of Paidiem Payment Solutions Inc. (“Paidiem” or the “Company” or the “Respondent”) and appointing MNP Ltd. (“MNP” or the “Liquidator”) as liquidator of the Company pursuant to Part XVI and subsection 210(1) of the Ontario Business Corporations Act (“OBCA”), respectively, on the application of David Robertson. (“Robertson” or the “Applicant”). A copy of the Liquidation Order is attached to this Report as Appendix “A”. 2. In addition to the appointment of the Liquidator, the Liquidation Order authorized and directed the Liquidator to sell the Company’s assets and also established the process for determining the claims of Paidiem so that MNP would be in a position to make a distribution to Paidiem’s creditors and shareholders (the “Claims Process”). 3. The purpose of this Report (the “First Report”) is to provide information to the Court in respect of and as applicable, the Liquidator’s comments and/or recommendations concerning: a) the activities of the Liquidator since the Date of Appointment, including the development and implementation of a stalking horse sale process (the “Sale Process”); b) the results of the Sale Process; c) the implementation and administration of the Claims Process; d) the fees and disbursements of the Liquidator and its counsel, CG LLP (as such term is later defined); and e) the Liquidator’s request for an order(s) of the Court, inter alia: i. approving this Report and the activities and actions of the Liquidator, as described herein; ii. approving Stalking Horse Asset Purchase Agreement, dated December 21, 2022 and as amended on January 5, 2023 (the “145CAN APA”) entered into between the Liquidator and the winning bidder of the Sale Process, 14546865 Canada Inc. (“145CAN” or the “Stalking Horse Bidder”), in respect of the Purchased Asses (as such term is defined in the 145CAN APA); iii. vesting title in the Purchased Assets to 145CAN free and clear of all claims and encumbrances upon closing of the transaction contemplated by the 145CAN APA; iv. approving the fees and disbursements of the Liquidator rendered to date, including the fees and disbursements of CG LLP, as detailed herein; v. approving the distribution made to Business Development Bank of Canada (“BDC”), nunc pro tunc; and, vi. such other relief as the Court deems just. TERMS OF REFERENCE 4. In preparing this First Report, and making comments herein, the Liquidator has been provided with, and has relied upon, information (the “Information”) contained in or obtained from: a) various documents filed in this proceeding, including the application record, dated November 21, 2022 (the “Application Record”) which includes the affidavit of Robertson, sworn November 16, 2022 (the “Robertson Affidavit”); b) the Company’s books and records and certain available but unaudited, draft and/or internal financial information obtained by the Liquidator; c) discussions with and information provided by the Company’s directors and management (“Management”); d) discussions and communications with Robertson; e) the Claims Process; f) discussions and communications with the Claimants of Paidiem, including BDC; and, g) other third-party sources or as otherwise available to the Liquidator and its counsel. 5. Except as specifically noted in this Report, the Liquidator has not audited, reviewed, or otherwise verified the accuracy or completeness of the Information in a manner that would wholly or partially comply with Generally Accepted Assurance Standards pursuant to the Canadian Institute of Chartered Professional Accountants Handbook and, accordingly, the Liquidator expresses no opinion or other form of assurance in respect of the Information. 6. Unless otherwise stated all monetary amounts contained herein are expressed in Canadian Dollars. 7. Capitalized terms not defined in the First Report have the meaning ascribed to them in the Liquidation Order. 8. The Liquidator will make a copy of this First Report, and related documents, available on the Liquidator’s website at www.mnpdebt.ca/paidiem (the “Case Website”). OVERVIEW AND BACKGROUND 9. Paidiem was incorporated pursuant to the OBCA on or about June 28, 2019 and was founded by Robertson and Richard Cromie (“Cromie”). The common shares of the Company are principally owned by Robertson and Cromie/Cromie Family Trust, with their holdings representing approximately 54% and 41%, respectively, of the issued and outstanding common shares of the Company. Cromie is the President and CEO of Paidiem. Both Robertson and Cromie are directors of the Company, together with three (3) other individuals. 10. Paidiem is a fintech start-up, providing the payroll payment processes for companies through a proprietary cloud-based workforce management and administration platform (the “Platform”). 11. As noted in the Robertson Affidavit, pursuant to a Special Resolution made on October 14, 2020, the shareholders (both common and preferred shareholders) of Paidiem approved the wind-up of the Company and the appointment by the Court of MNP as Liquidator. 12. At the Date of Appointment, the Company held in various bank accounts a total of approximately $1.7 million, with approximately $104,800 representing funds held in trust associated with monies advanced by Paidiem’s customer to fund upcoming payrolls being processed by the Company. The only other material assets of the Company are its accounts receivables (book value as of November 23, 2022 of $141,072.06) and its intellectual property associated with the Platform (no value capitalized on the books). 13. The known Claimants in Paidiem’s liquidation and their relative order of priority, as of November 23, 2022, the date the Liquidation Order, is summarized as follows: i. BDC was the Company’s only secured creditor and was owed approximately $166,400 as at the December 1, 2022; ii. there were three (3) known unsecured creditors as the Date of Appointment - L-Spark Corporation, Robertson and Shift 8 Inc.$^1$ (“Shift 8”) - who are owed approximately, $39,000, unknown and unknown, respectively as at the Date of Appointment; iii. preferred shareholders comprising various investors$^2$, who invested approximately $4.48 million in Paidiem; and iv. common shareholders. Attached as to this Report as Appendix “B” is a schedule of Paidiem’s common and preferred shareholders (collectively, the “Shareholders”) and their respective share ownership. 14. Under the Liquidation Order, it was contemplated that the Company’s business operations continue uninterrupted, while a sale process is conducted for the business and assets of Paidiem, and a claims process is run. --- $^1$ Shift 8 Inc. is corporation owned by Cromie through which consulting services were provided to the Company. $^2$ The preferred shareholders provided seed financing to the Company in through three (3) series of financing rounds that occurred in March 2021 and April/May 2022. 15. As a start-up company, the business does not generate sufficient revenues to offset its costs, which is primarily payroll costs. As a consequence, Paidiem operating costs exceed its revenues by approximately $105,000 per month (the “Cash Burn”). LIQUIDATOR’S ACTIVITIES 16. Following its appointment, the Liquidator’s activities included: a) establishing procedures and protocols with Management for the approval and monitoring of Paidiem’s on-going business operations, activities and bank accounts$^3$, b) monitoring Paidiem’s on-going business operations and activities, including the approval of the debiting of customer accounts and payment of disbursements/expenses, engaging Dentons LLP, the Company’s legal counsel, to complete a review of its master service agreement documents, and the hiring of a consultant to fill part of the void created following the resignation of one (1) key employee; c) setting-up a trust account at The Toronto-Dominion Bank for the proceeds of the liquidation; d) obtaining electronic copies of the Company’s books and records; e) electronically filing notice with the Ontario Ministry of Public and Business Service Delivery pursuant to Section 210(4) of the OBCA with respect to the Court ordered windup and Liquidator’s appointment; f) establishing the Case Website; g) posting on the Case Website pursuant to Paragraph 27 of the Liquidation Order of the Claims Process Notice and Proof of Claim; h) publishing on December 9, 2022 a notice pursuant to Paragraph 28 of the Liquidation Order of the Liquidation Notice (as defined in the Liquidation Order) in the National Post; --- $^3$ Given existing banking arrangements with customers and to avoid disruption to the business and operations, the Company’s existing bank accounts were left in place, but with some changes in access rights. i) sending pursuant to Paragraph 29 of the Liquidation Order to each person identified on the Company’s books and records as having a claim or own shares of the Company: (a) a copy of the Liquidation Order; (b) a Notice of Claim advising that Person of: (i) the amount shown on the Company books and records as being owed to that Person; and (ii) the number of shares of the Company shown of the Company’s books and records as being owned by that Person as at the Effective Date; and (c) a Proof of Claim form (collectively, the “Liquidation and Claims Bar Notice”). Attached to this Report as Appendix “C” is a copy of the affidavit of mailing of the Liquidation and Claims Bar Notice; j) additionally sending notice of the Claims Process to Robertson and Shift 8 (as such term is later defined) on December 13, 2022, as well to CRA (as such term is later defined) on December 20, 2022, all of whom were identified as potential claimants but who were not sent a Notice of Claim; k) implementing the Claims Process, as contemplated in the Liquidation Order, and as described in greater detail later in this Report – see The Claims Process section below; l) developing and implementing the Sale Process, as contemplated in the Liquidation Order, and as described in greater detail later in this Report – see The Sale Process section below; m) upon Management’s request, implementing a key employee retention plan totalling $30,000 following the resignations of two (2) key employees; n) initiating the preparation of the Company’s Scientific Research and Experimental Development (SR&ED) claim; o) arranging for the implementation of an Anti-Money Laundering compliance program, in connection with the Financial Transactions and Reports Analysis Centre of Canada (“FINTRAC”) assessment of Paidiem of a Money Service Business; p) engaging Mr. Gustavo Camelino of Camelino Galessiere LLP (“CG LLP”) to act as the Liquidator’s legal counsel; and q) the preparation of this Report. THE SALE PROCESS The Development and Approval of the Sale Process 17. On November 18, 2022, prior to the date of the Liquidation Order, Cromie and representatives of GreenSky Accelerator Fund IV, LP (“GreenSky”, and together with Cromie, hereinafter collectively referred to as the “Pref Share Group”), advised MNP that it was a potential purchaser of the business and assets of the Company (collectively, the “Assets”). The Pref Share Group expressed concerns about the timing of and the length of any sale process. Their concerns were that a protracted sale process would likely cause the value of the business to erode, even if a stalking horse arrangement were put into place. As well, they were concerned about the provision of proprietary information and intellectual property (collectively, the “IP”) to potential purchasers and competitors during the course of any sale process. 18. Based on this discussion with the Pref Share Group, the Liquidator determined that the most reasonable and commercially efficient approach to market, solicit interest in the Assets and maximize value would be for the Liquidator (in its capacity as court-appointed Liquidator for the Company) to enter into a stalking horse asset purchase agreement (“Stalking Horse APA”) with a company to be incorporated on behalf of the Pref Share Group, and to then conduct two (2) staged stalking horse based sale process. 19. On November 22, 2022, Cromie, on behalf of a company to be incorporated, sent an offer with the basic terms for the purchase of the Assets under a Stalking Horse APA. 20. Over the following two weeks, the Liquidator, in consultation and input from the Pref Share Group and the Applicant, developed and shared an outline for a two (2) staged stalking horse based sale process protocol (the “Sale Process Protocol”). 21. The Liquidator advised the Pref Share Group and the Applicant that it would require that the Sale Process Protocol and the Stalking Horse APA be either unanimously approved by the Shareholders$^4$ or approved by this Court. The Pref Share Group and the Applicant $^4$ Includes Robertson agreed to proceed on the basis of the Shareholders unanimously resolving to approve the Sale Process Protocol and the Stalking Horse APA. 22. The Sale Process Protocol can be summarized as follows: \| MILESTONE EVENT ACTIVITY \| DEADLINE/TIMING \| \|------------------------------------------------------------------------------------------\|---------------------------------------------------------------------------------\| \| Commencement of the Sale Process \| Immediately following the date on which the Stalking Horse Asset Purchase Agreement and this Sale Process is unanimously approved by the Shareholders (the “Commencement Date”). \| \| Marketing - The Liquidator shall contact parties identified (the “Prospective Participants”) who may be interested in purchasing the Assets and provide those parties with a copy of the teaser document (the “Teaser”) and form of non-disclosure and confidentiality agreement (“NDA”) prepared by the Liquidator. \| Within 3 Business Days following the Commencement Date \| \| Marketing - Arrange for the publication of Opportunity in the National Post and/or such other trade publications or other publications as the Liquidator may deem appropriate or advisable. \| Within ten (10) Business Days following the Commencement Date \| \| First Due Diligence Period - The Liquidator shall make available to each Prospective Participant which has delivered a signed NDA to the Liquidator the following: a) a copy of the Stalking Horse Asset Purchase Agreement; and b) initial access to an electronic data room, to be maintained by the Liquidator, which shall contain information pertaining to the Opportunity, which is in the Liquidator’s possession. \| Commencing on the Commencement Date and after each respective Prospective Participant has executed the NDA \| \| First Deadline – Submission of Non-Binding Letters of Interest (LOIs) • If it is determined by the Liquidator that a Prospective Participant: (i) has a bona fide interest in pursuing a Transaction; and (ii) has delivered an executed NDA acceptable to the \| 5:00 p.m. (Toronto time) on February 6, 2022 (the “LOI Deadline”) \| \| MILESTONE EVENT ACTIVITY \| DEADLINE/TIMING \| \|--------------------------\|-----------------\| \| Liquidator, then such Prospective Participant will be deemed to be a “Qualified Bidder”; \| \| \| • Qualified Bidders shall submit their non-binding proposals for the acquisition of some or all of the Assets (“LOI”) by the LOI Deadline (defined herein); \| \| \| • Each LOI shall be submitted on the provided form (the “LOI Template”), and include among other things, detailed descriptions of: \| \| \| a) the Assets proposed to be acquired; \| \| \| b) the proposed purchase price or other consideration for the Assets to be acquired, including the form of payment; \| \| \| c) the Qualified Bidder’s identity, and the identity of its principals; \| \| \| d) applicable conditions; \| \| \| e) evidence of the ability of the Qualified Bidder to consummate the Transaction, including evidence of financial means; \| \| \| f) the proposed timing for completion of the Transaction; \| \| \| g) the requisite deposit \| \| \| Evaluation of LOIs \| Within three (3) Business Days following the LOI Deadline \| \| • The Liquidator shall evaluate and determine in its sole discretion whether one or more Qualified Bidder to proceed in the Sale Process; \| \| \| • A LOI will only be considered a “Qualified LOI”, if it is submitted before the LOI Deadline and if it meets the following minimum criteria: \| \| \| a) it must be submitted in writing, substantially in the form the LOI Template; \| \| \| b) it must be for a price equal to or greater than the sum of: \| \| \| (i) the Purchase Price; \| \| \| (ii) the Break Fee of $50,000; and \| \| \| (iii)$100,000. \| \| \| c) it must be accompanied by a deposit (the “LOI Deposit”) in the form of a certified cheque or bank draft (or in the form of confirmed wire transfer in the case of \| \| \| MILESTONE EVENT ACTIVITY \| DEADLINE/TIMING \| \|--------------------------\|-----------------\| \| offers submitted electronically) payable to “MNP Ltd., in trust” which is equal to the greater of: (i) $315,000; and (ii) ten (10%) percent of the total purchase price payable under the LOI; and d) it must include written evidence, satisfactory to the Liquidator, that the offeror has the financial means to complete the proposed acquisition; \| \| \| • If only one (1) Qualified LOI is submitted (other than the Stalking Horse Bid) and such LOI is from Robertson or an entity controlled by Robertson, or an entity that Robertson is a member of a group that controls such entity, then the sale process shall proceed to the Auction (as later defined). For greater clarity, there will be no second due diligence period and there will be no Bid Deadline (as later defined). • If no LOIs are submitted by the LOI Deadline or the Liquidator has determined in its sole discretion that there are no Qualified LOIs (other than the Stalking Horse Bid), the sale process shall end, and the Liquidator will proceed to close the Transaction with the Stalking Horse Bidder; \| \| \| Second Due Diligence Period – If one or more Qualified LOIs are received by the LOI Deadline, the Liquidator shall: • extend the due diligence period; • invite those Qualified Bidders who have submitted a Qualified LOI to continue to perform due diligence; • broaden access to the electronic data room and more detailed and sensitive materials for those Qualified Bidders who have submitted a Qualified LOI; \| Commencing on completion of the evaluation of the LOIs \| \| Second Deadline – Submission of Binding Offers \| 5:00 p.m. (Toronto time) on March 8, 2023 (the “Bid Deadline”) \| \| MILESTONE EVENT ACTIVITY \| DEADLINE/TIMING \| \|--------------------------\|-----------------\| \| Evaluation of Qualified Bids \| Within five (5) Business Days following the Bid Deadline \| \| a) An offer will only be considered in this Sale Process, in which case it shall be considered a “Qualified Bid”, if it is submitted before the Bid Deadline and if it meets the following minimum criteria: \| \| \| b) it must be submitted in writing, substantially in the form of Stalking Horse Purchase Agreement, with any changes to the offer blacklined against the Stalking Horse Purchase Agreement; \| \| \| c) it must be for a price equal to or greater than the sum of: \| \| \| a. the Purchase Price; \| \| \| b. the Break Fee of $50,000; and \| \| \| c. $100,000. \| \| \| d) it must be irrevocable until five (5) business days after the Auction (as later defined); \| \| \| e) it includes an acknowledgement that the purchaser has relied solely on its own independent review and investigation and that it has not relied on any representation by the Company, the Liquidator or their respective agents, employees or advisers; \| \| \| f) it must not contain any condition or contingency relating to due diligence or financing or any other material conditions precedent to the offeror’s obligation to complete the transaction; and \| \| \| g) it must be accompanied by an additional deposit (the “Bid Deposit”), if necessary, in the form of a certified cheque or bank draft (or in the form of confirmed wire transfer in the case of offers submitted electronically) payable to “MNP Ltd., in trust”, such that the aggregate of the Bid Deposit and the LOI Deposit is at a minimum equal to the greater of: \| \| \| i. $472,500; and \| \| \| MILESTONE EVENT ACTIVITY \| DEADLINE/TIMING \| \|--------------------------\|-----------------\| \| ii. fifteen (15%) percent of the total purchase price payable under the Qualified Bid; and h) it must include written evidence, satisfactory to the Liquidator, that the offeror has the financial means to complete the proposed acquisition. i) provided however that the Liquidator may, exercising its reasonable discretion, waive compliance with one or more of the foregoing Qualified Bid requirements and deem such non-compliant offer to be a Qualified Bid. j) If no Qualified Bid is received by the Bid Deadline (other than the Stalking Horse Bid), the Auction (as later defined) will not be held, and the Stalking Horse Bid will be the winning Bid (the “Winning Bid”). \| \| \| Auction • If more than one Qualified Bid is received by the Bid Deadline, the Liquidator shall extend invitations by phone, fax and/or email to all bidders who submitted Qualified Bids and to the Stalking Horse Bidder to attend an auction (the “Auction”). • The Auction shall be held at the offices of the Liquidator or by teleconference, video conference or other form of electronic telecommunications, as the Liquidator may deem fit. • The Liquidator shall conduct the Auction. At the Auction, the bidding shall begin initially with the highest Qualified Bid and subsequently continue in multiples of $50,000, or such other amount as the Liquidator determines to facilitate the Auction. Additional consideration in excess of the amount set forth in the highest Qualified Bid must be comprised only of cash consideration. The format and other procedures for the Auction shall be determined by the Liquidator in its sole discretion. \| The Auction is to be held on March 15, 2023 \| \| MILESTONE EVENT ACTIVITY \| DEADLINE/TIMING \| \|-----------------------------------------------------------------------------------------\|----------------------------------------------------------------------------------\| \| Following the conclusion of the Auction (if applicable), the offer received at Auction which is determined by the Liquidator, in its sole discretion, to be the highest and best offer, taking into account all elements of the offers received and the potential impact on the creditors of the estate, which the Liquidator is satisfied, acting reasonably, is capable of being completed shall be the Winning Bid. \| \| \| Sale Approval Motion Date \| As soon as reasonably practical following execution and delivery of one or more definitive agreements \| \| Completion of Transaction(s) \| To be determined based on terms of the definitive agreement(s) \| 23. Among other considerations, the Liquidator takes the position that the Sale Process Protocol was the preferred approach for the following reasons: a) the Stalking Horse APA creates certainty by way of an unconditional bid, and establishes a floor value for the Assets while providing an opportunity to market the Assets for superior realizations than contemplated by the Stalking Horse APA; b) the Stalking Horse APA creates certainty for the employees of the Company that they would have a job in the future; and c) the two (2) stage process addressed the concerns of the Pref Share Group by potentially shortening the sale process if no viable potential bidders materialized in the first stage and by having the more sensitive aspects of the IP being reserved for disclosure to second stage of the sale process. 24. On December 21, 2022 the Liquidator and 145CAN (the company formed by the Pref Share Group) executed the 145CAN APA, wherein 145CAN would be the stalking horse bidder. 25. On December 30, 2022, the Liquidator received a copy of the fully executed Resolution of the Shareholders unanimously approving the Sale Process Protocol and the 145CAN APA (the “Resolution”). Attached to this Report at Appendix “D” is a copy of the Resolution, including the Sale Process Protocol and the 145CAN APA. 26. Due to the holidays and a longer than expected time period to obtain all of the Shareholders’ approval, as well as to address a few other minor inconsistencies in the 145CAN APA as originally drafted, an amending agreement (the “Amending Agreement”) was prepared by the Liquidator’s counsel and executed by 145CAN and the Liquidator on January 5, 2023. Attached to this Report as Appendix “E” is a copy of the Amending Agreement. Implementation of the Sale Process 27. The Liquidator conducted the Sale Process as summarized below: a) the Liquidator prepared the Teaser describing the opportunity, providing key dates in the Sale Process, and inviting parties to participate in the Sale Process; b) the Liquidator prepared the Teaser and a form of NDA for execution by any Prospective Participant that wished to participate in the sales process; c) the Liquidator, with assistance of Management and Robertson, gathered and reviewed all due diligence materials that it determined to be relevant to Prospective Participants and established a secure, electronic data room (the “Data Room”), which was maintained and administered by the Liquidator throughout the Sale Process; d) the Liquidator, with the assistance of Management and Robertson, prepared a list of thirty-three (33) Prospective Participants; e) on January 6, 2023 the Liquidator sent the Teaser to the identified Prospective Participants, as well as to MNP’s partners, who identified three (3) additional Prospective Participants. Attached to this Report as Appendix “F” is a copy of the Teaser; f) in addition to the sending the Teaser to the Prospective Participants identified, the Liquidator: i. on January 17, 2023 published notice of the opportunity in the National Post; ii. provided NDAs to six (6) Prospective Participants that expressed an interest in the opportunity. The Liquidator received executed NDAs from four of those Prospective Participants; iii. provided access to the Data Room to the four (4) Prospective Participants who had executed NDAs; iv. on or about January 23, 2023 followed-up with the Prospective Participants who had executed NDAs to inquire if there was any additional information, they required to complete their due and to remind them of the LOI Deadline; and v. engaged in various discussions with Prospective Participants regarding the process and Paidiem’s business. Results of the Sale Process 28. After conducting the first stage of Sale Process, the Liquidator did not receive any LOIs, qualified or otherwise. Accordingly, and pursuant to the Sale Process Protocol approved by the Shareholders, as no LOIs were submitted by the LOI Deadline 145CAN as the Stalking Horse Bidder was the Winning Bid pursuant to the 145CAN APA. The Liquidator is now proceeding to close a transaction with the Stalking Horse Bidder. 29. The 145CAN APA, as appended by the Resolution (see Appendix “D” to this Report), is an offer to purchase the right, title, and interest of the Company to the Purchased Assets. The salient terms of the 145CAN APA are set out as follows. (To the extent not otherwise defined in this Report, the capitalized terms set out in the table below have the meanings ascribed to them in the 145CAN APA): \| Vendor \| Liquidator \| \|--------\|------------\| \| Purchaser \| 145CAN \| \| Purchase Price/Deposit \| The purchase price for the Purchased Assets will be $3,000,000 (the “Purchase Price”). A deposit in the amount of $450,000. \| \| Proposed Transaction \| Subject to the provisions of the 145CAN APA, including the issuance of an Approval and Vesting Order (the “AVO”) in form and substance satisfactory to the Purchaser and vesting title in the Purchaser on closing on a “free and clear” basis, except for specified assumed liabilities and permitted encumbrances identified in the 145CAN APA, the Purchaser shall acquire the Purchased Assets from the Liquidator (the “Proposed Transaction”). \| \| “As is, where is” \| The Purchased Assets are being acquired on an “as is, where is” and “without recourse” basis \| \| Excluded Assets \| The Excluded Assets is comprised of to (i) all cash or cash equivalents; (ii) all accounts and other amounts due, owing or accruing due to the Company; (iii) all accounts and other amounts due from related parties; (iv) the benefit of any contracts, agreements and/or understandings to which the Company is a party other than those contracts that are assigned to the Purchaser; and (v) original tax records and books and records pertaining thereto, minute books, corporate seals, taxpayer and other identification numbers and other documents relating to the organization, maintenance, capitalization or existence of the Company \| \| Assumed Liabilities \| The Purchaser will assume any and all liabilities with respect to (i) the Assigned Agreements; (ii) the employee obligations, statutory, under common law or otherwise, of the former employees of the Company, who are offered and accept a position with the Purchase; and (iii) any other liability which the Purchaser agrees in writing to assume on or before the Closing Date \| \| Conditions to Closing \| The parties’ respective obligations to consummate the Proposed Transaction is subject to the satisfaction of certain customary conditions, as well as the AVO having been obtained and shall not have been stayed, amended, modified, reversed, or dismissed as at the Closing Date. \| 30. The description of the 145CAN APA terms set out above are only a summary and reference should be made to the 145CAN APA attached to this Report (see Appendix “D” to this Report) for its specific terms. Modification of the Terms for Closing 31. The Liquidator understands that the preferred shareholders of Paidiem (the “Pref S/Hs”) are the principal investors in 145CAN and it was their expectation that the Claim Process would be completed on or before the completion of the Sale Process, such that their distribution from these liquidation proceedings would be directed to and fund their investment in 145CAN, paid concurrently with the closing of the Transaction. 32. As the Claim Process has not been completed (see The Claims Process section below), closing of the Transaction, should the Court approve the 145CAN APA and authorize the Liquidator to complete the Transaction, would need to be delayed until the Claims Process is completed. 33. As a result, and in order to close the Transaction immediately after Court approval, it has been proposed by 145CAN that instead of the balance of the Purchase Price being paid in cash on Closing that a promissory note be provided to the Liquidator by 145CAN, and whose terms shall include but are not limited to the following: a) payable in full on the earlier of i) the date of the distribution to the Pref S/Hs pursuant to an Order of this Court, and ii) six months from the date of Closing; b) secured in full by a first ranking charge/security over all of the property, assets and undertakings of 145CAN; and c) no principal or interest payments to be made during period that the promissory note is outstanding. 34. The Liquidator is supportive of the modification in the terms of the 145CAN APA and the proposed promissory note for the following reasons: a) there are no other bidders for the Assets, and so this continues to be the best offer; b) the closing of the Transaction would occur sooner, which would result in greater cash being available for distribution to the Claimants since the Cash Burn associated with operating the Company would then shift to 145CAN sooner; c) based on the aggregate of the available cash on hand currently (approximately $800,000) and the cash deposit provided by 145CAN ($450,000), there is sufficient cash available to cover the Cash Burn to Closing, the administration cost of these wind-up proceedings and to pay the claims of the unsecured creditors$^5$ to the extent of the amounts claimed/filed under the Claims Process. Accordingly, unsecured creditors would not be prejudiced; and d) the utilization of the promissory note better serves the Pref S/Hs in facilitating their investment in 145CAN; e) with the unsecured creditors to be satisfied by the cash available, as noted above, and given the amount of Purchase Price ($3 million) versus the amount of the Pref S/Hs claims ($4.48 million), it is estimated that only the Pref S/Hs would be expected to receive a distribution in these proceedings, after the payment of unsecured creditors. Accordingly, neither of Shareholders will be prejudiced. Recommendation 35. The Trustee recommends the Court approve the transaction contemplated by the 145CAN APA and the modification of the terms for Closing for the following reasons: a) the duration of the Sale Process for the Assets was sufficient to allow the most likely interested parties an opportunity to perform initial due diligence and submit LOIs; b) the transaction provides for a fair market price for the Assets; c) all of the Shareholders, which includes the Applicant, were consulted and approved the Sale Process and the 145CAN APA; and --- $^5$ Certain of the unsecured creditors are still to be determined, namely Robertson and Shift 8. The actual amount to be paid will be the amount as determined under the Claims Process approved by this Court. d) the modification proposed for the terms for Closing would not prejudice the Claimants for the reasons noted in paragraphs 34(c) and (e) above. THE CLAIMS PROCESS The Claimants 36. As noted earlier in this Report, based on the Company’s books and records and other information, the known Claimants in Paidiem’s liquidation and their relative order of priority, are as follows: a) secured creditor - BDC (approximately $166,400); b) unsecured creditors - L-Spark Corporation ($39,000), Robertson (Not Yet Determined) and Shift 8 (Not Yet Determined); c) Pref S/Hs - various investors (approximately $4.48 million); and d) common shareholders. 37. Notwithstanding that the Company’s books and records showed no debt owing to Canada Revenue Agency (“CRA”) at the Date of Appointment, as a consequence of Paidiem continuing to operate during these wind-up proceedings until a sale transaction can be completed, it still has reporting and remitting statutory obligations, as appropriate, under various Canadian tax legislation. Accordingly, the Liquidator identified CRA as a potential claimant. 38. In addition, it was identified on the Claims Bar Date (as such term is later defined) that MNP LLP$^6$ provided a small amount of tax services to Paidiem prior to the date of the Liquidation Order, but where not reflected in the Company’s books and records when the Claims Process commenced since no account had been rendered at such time. $^6$ MNP LLP is the parent company that wholly owns MNP Ltd. The Implementation of the Claims Process 39. As approved by the Court and as set out in paragraphs 23 to 38 of the Liquidation Order, the Claims Process required: a) the Liquidator Notice be published once in the National Post; b) that within fourteen (14) Business Days of the Date of Appointment, the Liquidator (i) send the Liquidation and Claims Bar Notice, including the Notice of Claim to each person identified on the Company’s books and records as having a claim or own shares of the Company; and (ii) to post the Liquidation and Claims Bar Notice on the Case Website; c) either (i) any Claimant who disagreed with the Notice of Claim received and wished their Claim to be corrected; or (ii) any Claimant who did not receive a Notice of Claim but wished to assert a claim, to file a Proof of Claim with the Liquidator by no later than January 12, 2023 (the “Claims Bar Date”); d) the Liquidator to review any Proofs of Claim filed on or before the Claims Bar Date and determine in each instance whether the Proof of Claim should be either allowed, partially allowed, disallowed or partially disallowed by delivering a Notice of Determination to the Claimant; e) any Claimant that wished to object to the Liquidator’s determination of their claim and contest the Liquidator’s Notice of Determination, was to deliver to the Liquidator a Notice of Objection by no later than fourteen (14) Business Days after the date of the Notice of Determination; and f) the Liquidator to bring a Motion to the Court to establish the process for determine the Claim in the event that it receives a Notice of Objection(s) within the prescribed time period. 40. As noted earlier in this Report, on December 13, 2022 the Liquidator sent the Liquidation and Claims Bar Notice, together with a Proof of Claim form to all known Claimants, Robertson, Shift 8 and subsequently to CRA. Also, the Liquidator published the Liquidation Notice in National Post on December 9, 2022. 41. A schedule summarizing the Claimants and the amounts shown on their respective Notices of Claim that were sent out on December 13, 2022 is attached to this Report at Appendix “G”. The Results of the Claims Process General 42. The Liquidator received three (3) completed proof of claim forms on or before the Claims Bar Date and one (1) after. 43. The Proofs of Claim received are summarized as follows: a) BDC filed a Proof of Claim including an amount different than the amount set out in the Notice of Claim sent to BDC. No other Claimant who was sent a Notice of Claim asserted a Claim different from what was set out in their Notice of Claim; b) each of Robertson and Shift 8 filed a Proof of Claim asserting a claim that was either not in the Company’s books and records or was not initially identified by the Company, and for which no Notices of Claim were sent; and c) MNP LLP filed a Proof of Claim asserting a claim that was not identified in the Company’s books and records and for which no Notice of Claim was sent. MNP LLP’s Proof of Claim was received after the Claims Bar Date (received three (3) minutes after the Claims Bar Date deadline of 5:00 PM). BDC’s Claim 44. The amount claimed by BDC in its Proof of Claim was associated with a loan in the amount of $250,000 obtained on or around February 4, 2021 that was secured by a general security agreement over the Assets and personal guarantees given by Cromie and the Applicant. The Liquidator has conducted an Ontario Personal Property Security Act (the “PPSA”) lien/registry search (file currency date of January 15, 2023) (the “PPSA Search”), which shows a single registration in favour of BDC and dated February 4, 2021. A copy of the PPSA Search is attached to this Report as Appendix “H”. 45. CG LLP has provided to the Liquidator an informal assessment confirming the validity and enforceability of the security held by BDC, provided that BDC properly perfected its security interest by registration under the PPSA. 46. The Notice of Claim sent to BDC reflected balance owing of $166,400, which represented the principal loan balance of December 1, 2022. 47. Subsequent to the Date of the Liquidation Order, the preauthorized debits (PAD) for the monthly loan payments (principal and interest) to BDC were permitted for November (the principal reduction was already reflected in the Notice of Claim figure) and December 2022, totaling $13,299.91. 48. The Proof of Claim filed by BDC in the Claims Process was for $161,200 (reflecting the principal reduction associated with the December 2022 PAD) plus accrued interest and legal costs until repaid in full. 49. Based on a review of BDC’s loan and associated security documents, it was not clear whether BDC would be entitled to receive reimbursement for legal costs incurred, given that there have been no payment defaults and that the legal costs were not incurred in connection with the enforcement of the loan or the security. 50. In the Liquidator’s various discussions with BDC, BDC raised concerns that it was not served with the Application Record, despite the provision in the Liquidation Order which granted an administrative charge in favour of the Liquidator in priority to BDC security. BDC has asserted that as a consequence of this oversight and given the nature of these court proceedings, it was necessary for it to retain legal counsel in order to understand its rights and remedies in these proceedings. 51. Among other considerations, the Liquidator determined it was proper and appropriate to repay the indebtedness to BDC, including the legal costs incurred by BDC, for the following reasons: a) under paragraph 26 of the Liquidation Order, the Liquidator is authorized to enter into settlement negotiations with BDC at any stage of the Claims Process; b) the Claims Process had been run and no Claimants$^7$ were identified which would be entitled to be paid in priority to BDC; c) disputing the payment of the legal costs incurred by BDC, would likely result in greater professional fees being incurred to the detriment of Paidiem’s other stakeholders; d) there were sufficient funds on hand in the Company to repay the indebtedness in full to BDC; e) waiting to repay the indebtedness to BDC would only result in increased interest costs and potentially greater legal costs incurred by BDC to the detriment of other Claimants; and f) the repayment of BDC was supported by the Applicant and the Company based on the Liquidator’s discussions with the parties and the desires for the personal guarantees to be eliminated. 52. Based on the foregoing the Liquidator requested a payout figure from BDC and on January 18, 2023, the Liquidator direct the Company to remit to BDC the sum of $165,456.93, representing principal loan indebtedness of $161,200, accrued interest of $838.68 and legal fees of $3,418.25 (the “BDC Distribution”). 53. The Liquidator respectfully requests that this Court approve the BDC Distribution made to BDC, nunc pro tunc. Other Claims Filed 54. The claims of Robertson and Shift 8 are still under review and determination by the Liquidator. --- $^7$ CRA was sent notice of the liquidation and the Claims Process, but no Proof of Claims was received from CRA. Although not comfort letter or clearance certificate was obtained at the date of the distribution top BDC, a review conducted by the Liquidator of the Company’s CRA accounts for payroll and Harmonized Sales Tax (“HST”) did not identify any current liabilities associated with these potential priority claims. PROFESSIONAL FEES AND DISBURSEMENTS 55. Pursuant to paragraph 18 of the Liquidation Order, the Liquidator and CG LLP are to be paid their reasonable fees and disbursements, unless otherwise ordered by the Court on the passing of accounts. In addition, the Liquidation Order provides for the Liquidator and CG LLP having a first charge on the property, assets and undertakings of the Company (the “Property”) for their reasonable fees and disbursements, in priority to all security interest, trusts, liens, charges and encumbrances. 56. The Liquidator’s accounts for the period from November 1, 2022 to February 28, 2023 total $77,091.20 (exclusive of HST). The affidavit of Jerry Henechowicz, sworn March 8, 2023 as to the fees of the Liquidator is attached hereto as Appendix “I”. 57. CG LLP account for the period from November 19, 2022 to February 28, 2023 total $12,868.50 (exclusive of HST). The affidavit of Antonella Cerminara, sworn March 10, 2023 as to the fees and disbursements of CG LLP in its capacity as legal counsel to the Liquidator is attached hereto as Appendix “J”. 58. The Liquidator is of the view that CG LLP’s accounts are reasonable in the circumstances and respectfully requests this Court approve its fees and disbursements and those of its legal counsel as described above. These professional fees and disbursements have or will be paid by the Company. CONCLUSION AND RECOMMENDATION 59. Based on the foregoing and as outlined in the body of this report, the Liquidator respectfully recommends that the Court make an order granting the relief detailed in paragraph 3(e) of this Report. All of which is respectfully submitted this 10\textsuperscript{th} day of March, 2023 MNP LTD., in its capacity as the Court-appointed Liquidator of Paidiem Payment Solutions Inc. and not in its personal or corporate capacities Per: Matthew Lem, CIRP, LIT Senior Vice President ON THE APPLICATION made by the Applicant for an Order pursuant to section 207 of the Business Corporations Act, RSO 1990, c B.16, as amended (the “OBCA”) directing the winding-up of Paidiem Payment Solutions Inc. (the “Corporation”) and appointing MNP Ltd. (“MNP” or the “Liquidator”) as liquidator was heard via Zoom. ON READING the Affidavit of David Robertson sworn 16 November 2022 and the Exhibits thereto, on hearing the submissions of the lawyers for the Applicant and on reading the consent of MNP to act as the liquidator, SERVICE 1. THIS COURT ORDERS that the time for service of the Notice of Motion and the Motion is hereby abridged and validated so that this motion is properly returnable today and hereby dispenses with further service thereof. WINDING-UP AND APPOINTMENT OF LIQUIDATOR 2. THIS COURT ORDERS that the Corporation shall be wound-up pursuant Part XVI of the OBCA and, for that purpose, MNP is appointed liquidator pursuant to subsection 210(1) of the OBCA. LIQUIDATOR’S POWERS 3. THIS COURT ORDERS that, without limiting or restricting the powers of the Liquidator under section 223 of the OBCA, the Liquidator is hereby empowered and authorized, but not obligated, expressly empowered and authorized to do any of the following where the Liquidator considers it necessary or desirable: (a) to take possession of and exercise control over the assets and property of the Corporation (the “Property”) and any and all proceeds, receipts and disbursements arising out of or from the Property; (b) to receive, preserve, and protect the Property, or any part or parts thereof, including, but not limited to, the changing of locks and security codes, the relocating of Property to safeguard it, the engaging of independent security personnel, the taking of physical inventories and the placement of such insurance coverage as may be necessary or desirable; (c) to manage, operate, and carry on the business of the Corporation, including the powers to enter into any agreements, incur any obligations in the ordinary course of business, cease to carry on all or any part of the business, or cease to perform any contracts of the Corporation; (d) to engage consultants, appraisers, agents, experts, auditors, accountants, managers, counsel and such other persons from time to time and on whatever basis, including on a temporary basis, to assist with the exercise of the Liquidator's powers and duties, including without limitation those conferred by this Order; (e) to receive and collect all monies and accounts now owed or hereafter owing to the Corporation and to exercise all remedies of the Corporation in collecting such monies, including, without limitation, to enforce any security held by the Corporation; (f) to settle, extend or compromise any indebtedness owing to the Corporation; (g) to execute, assign, issue and endorse documents of whatever nature in respect of any of the Property, whether in the Liquidator's name or in the name and on behalf of the Corporation, for any purpose pursuant to this Order; (h) to initiate, prosecute and continue the prosecution of any and all proceedings and to defend all proceedings now pending or hereafter instituted with respect to the Corporation, the Property or the Liquidator, and to settle or compromise any such proceedings, and the authority hereby conveyed shall extend to such appeals or applications for judicial review in respect of any order or judgment pronounced in any such proceeding; (i) to market any or all of the Property, including advertising and soliciting offers in respect of the Property or any part or parts thereof and negotiating such terms and conditions of sale as the Liquidator in its discretion may deem appropriate; (j) to sell, convey, transfer, lease or assign the Property or any part or parts thereof out of the ordinary course of business; (i) without the approval of this Court in respect of any transaction not exceeding $250,000.00, provided that the aggregate consideration for all such transactions does not exceed $500,000.00; and (ii) with the approval of this Court in respect of any transaction in which the consideration or the aggregate consideration exceeds the applicable amount set out in the preceding clause; (k) to apply for any vesting order or other orders necessary to convey the Property or any part or parts thereof to a purchaser or purchasers thereof, free and clear of any liens or encumbrances affecting such Property; (l) to report to, meet with and discuss with such affected Persons (as defined below) as the Liquidator deems appropriate on all matters relating to the Property and the winding-up and to share information, subject to such terms as to confidentiality as the Liquidator deems advisable; (m) to administer the claims procedure established by this Order; and (n) to take any steps reasonably incidental to the exercise of these powers or the performance of any statutory obligations. and in each case where the Liquidator takes any such actions or steps, it shall be exclusively authorized and empowered to do so, to the exclusion of all other Persons (as defined below), including the Corporation, and without interference from any other Person. DUTY TO PROVIDE ACCESS AND CO-OPERATION TO THE LIQUIDATOR 4. THIS COURT ORDERS that (a) the Corporation, (b) all of its current and former directors, officers, employees, agents, accountants, legal counsel and shareholders, and all other persons acting on its instructions or behalf, and (c) all other individuals, firms, corporations, governmental bodies or agencies, or other entities having notice of this Order (all of the foregoing, collectively, being "Persons" and each being a "Person") shall forthwith advise the Liquidator of the existence of any Property in such Person's possession or control, shall grant immediate and continued access to the Property to the Liquidator, and shall deliver all such Property to the Liquidator upon the Liquidator's request. 5. THIS COURT ORDERS that all Persons shall forthwith advise the Liquidator of the existence of any books, documents, securities, contracts, orders, corporate and accounting records, and any other papers, records and information of any kind related to the business or affairs of the Corporation, and any computer programs, computer tapes, computer disks, or other data storage media containing any such information (the foregoing, collectively, the "Records") in that Person's possession or control, and shall provide to the Liquidator or permit the Liquidator to make, retain and take away copies thereof and grant to the Liquidator unfettered access to and use of accounting, computer, software and physical facilities relating thereto, provided however that nothing in this paragraph 5 or in paragraph 6 of this Order shall require the delivery of Records, or the granting of access to Records, which may not be disclosed or provided to the Liquidator due to the privilege attaching to solicitor-client communication or due to statutory provisions prohibiting such disclosure. 6. THIS COURT ORDERS that if any Records are stored or otherwise contained on a computer or other electronic system of information storage, whether by independent service provider or otherwise, all Persons in possession or control of such Records shall forthwith give unfettered access to the Liquidator for the purpose of allowing the Liquidator to recover and fully copy all of the information contained therein whether by way of printing the information onto paper or making copies of computer disks or such other manner of retrieving and copying the information as the Liquidator in its discretion deems expedient, and shall not alter, erase or destroy any Records without the prior written consent of the Liquidator. Further, for the purposes of this paragraph, all Persons shall provide the Liquidator with all such assistance in gaining immediate access to the information in the Records as the Liquidator may in its discretion require including providing the Liquidator with instructions on the use of any computer or other system and providing the Liquidator with any and all access codes, account names and account numbers that may be required to gain access to the information. 7. THIS COURT ORDERS that the Liquidator shall provide each of the relevant landlords with notice of the Liquidator’s intention to remove any fixtures from any leased premises at least seven (7) days prior to the date of the intended removal. The relevant landlord shall be entitled to have a representative present in the leased premises to observe such removal and, if the landlord disputes the Liquidator’s entitlement to remove any such fixture under the provisions of the lease, such fixture shall remain on the premises and shall be dealt with as agreed between any applicable secured creditors, such landlord and the Liquidator, or by further Order of this Court upon application by the Liquidator on at least two (2) days notice to such landlord and any such secured creditors. NO PROCEEDINGS AGAINST THE LIQUIDATOR 8. THIS COURT ORDERS that no proceeding or enforcement process in any court or tribunal (each, a “Proceeding”), shall be commenced or continued against the Liquidator except with the written consent of the Liquidator or with leave of this Court. NO PROCEEDINGS AGAINST THE CORPORATION OR THE PROPERTY 9. THIS COURT ORDERS that no Proceeding against or in respect of the Corporation or the Property shall be commenced or continued except with the written consent of the Liquidator or with leave of this Court and any and all Proceedings currently under way against or in respect of the Corporation or the Property are hereby stayed and suspended pending further Order of this Court. NO EXERCISE OF RIGHTS OR REMEDIES 10. THIS COURT ORDERS that all rights and remedies against the Corporation, the Liquidator, or affecting the Property, are hereby stayed and suspended except with the written consent of the Liquidator or leave of this Court, provided however that nothing in this paragraph shall (a) empower the Liquidator or the Corporation to carry on any business which the Corporation is not lawfully entitled to carry on, (b) exempt the Liquidator or the Corporation from compliance with statutory or regulatory provisions relating to health, safety or the environment, (c) prevent the filing of any registration to preserve or perfect a security interest, or (d) prevent the registration of a claim for lien. NO INTERFERENCE WITH THE LIQUIDATOR 11. THIS COURT ORDERS that no Person shall discontinue, fail to honour, alter, interfere with, repudiate, terminate or cease to perform any right, renewal right, contract, agreement, licence or permit in favour of or held by the Corporation, without written consent of the Liquidator or leave of this Court. CONTINUATION OF SERVICES 12. THIS COURT ORDERS that all Persons having oral or written agreements with the Corporation or statutory or regulatory mandates for the supply of goods and/or services, including without limitation, all computer software, communication and other data services, centralized banking services, payroll services, insurance, transportation services, utility or other services to the Corporation are hereby restrained until further Order of this Court from discontinuing, altering, interfering with or terminating the supply of such goods or services as may be required by the Liquidator, and that the Liquidator shall be entitled to the continued use of the Corporation's current telephone numbers, facsimile numbers, internet addresses and domain names, provided in each case that the normal prices or charges for all such goods or services received after the date of this Order are paid by the Liquidator in accordance with normal payment practices of the Corporation or such other practices as may be agreed upon by the supplier or service provider and the Liquidator, or as may be ordered by this Court. LIQUIDATOR TO HOLD FUNDS 13. THIS COURT ORDERS that all funds, monies, cheques, instruments, and other forms of payments received or collected by the Liquidator from and after the making of this Order from any source whatsoever, including without limitation the sale of all or any of the Property and the collection of any accounts receivable in whole or in part, whether in existence on the date of this Order or hereafter coming into existence, shall be deposited into one or more new accounts to be opened by the Liquidator (the "Post Winding-up Accounts") and the monies standing to the credit of such Post Winding-up Accounts from time to time, net of any disbursements provided for herein, shall be held by the Liquidator to be paid in accordance with the terms of this Order or any further Order of this Court. EMPLOYEES 14. THIS COURT ORDERS that all employees of the Corporation shall remain the employees of the Corporation until such time as the Liquidator, on the Corporation's behalf, may terminate the employment of such employees and, for greater certainty, (a) the appointment of the Liquidator pursuant to this Order is not a "sale" as that term is defined in subsection 9(3) of the Employment Standards Act (the "ESA"); and (b) the Liquidator is not deemed a "purchaser" under Part IV of the ESA by virtue of its appointment pursuant to this Order. PIPEDA 15. THIS COURT ORDERS that: (a) pursuant to clause 7(3)(c) of the Canada Personal Information Protection and Electronic Documents Act, the Liquidator shall disclose personal information of identifiable individuals to prospective purchasers or bidders for the Property and to their advisors, but only to the extent desirable or required to negotiate and attempt to complete one or more sales of the Property (each, a "Sale"); (b) each prospective purchaser or bidder to whom such personal information is disclosed shall maintain and protect the privacy of such information and limit the use of such information to its evaluation of the Sale, and if it does not complete a Sale, shall return all such information to the Liquidator, or in the alternative destroy all such information; and (c) the purchaser of any Property shall be entitled to continue to use the personal information provided to it, and related to the Property purchased, in a manner which is in all material respects identical to the prior use of such information by the Corporation, and shall return all other personal information to the Liquidator, or ensure that all other personal information is destroyed. LIMITATION ON ENVIRONMENTAL LIABILITIES 16. THIS COURT ORDERS that nothing herein contained shall require the Liquidator to occupy or to take control, care, charge, possession or management (separately and/or collectively, "Possession") of any of the Property that might be environmentally contaminated, might be a pollutant or a contaminant, or might cause or contribute to a spill, discharge, release or deposit of a substance contrary to any federal, provincial or other law respecting the protection, conservation, enhancement, remediation or rehabilitation of the environment or relating to the disposal of waste or other contamination including, without limitation, the Canadian Environmental Protection Act, the Ontario Environmental Protection Act, the Ontario Water Resources Act, or the Ontario Occupational Health and Safety Act and regulations thereunder (the "Environmental Legislation"), provided however that nothing herein shall exempt the Liquidator from any duty to report or make disclosure imposed by applicable Environmental Legislation. The Liquidator shall not, as a result of this Order or anything done in pursuance of the Liquidator's duties and powers under this Order, be deemed to be in Possession of any of the Property within the meaning of any Environmental Legislation, unless it is actually in possession. LIMITATION ON THE LIQUIDATOR'S LIABILITY 17. THIS COURT ORDERS that the Liquidator shall incur no liability or obligation as a result of its appointment or the carrying out the provisions of this Order, save and except for any gross negligence or wilful misconduct on its part. LIQUIDATOR'S ACCOUNTS 18. THIS COURT ORDERS that the Liquidator and counsel to the Liquidator shall be paid their reasonable fees and disbursements, in each case at their standard rates and charges unless otherwise ordered by the Court on the passing of accounts, and that the Liquidator and counsel to the Liquidator shall be entitled to and are hereby granted a charge (the "Liquidator's Charge") on the Property, as security for such fees and disbursements, both before and after the making of this Order in respect of these proceedings, and that the Liquidator’s Charge shall form a first charge on the Property in priority to all security interests, trusts, liens, charges and encumbrances, statutory or otherwise, in favour of any Person. 19. THIS COURT ORDERS that the Liquidator and its legal counsel shall pass its accounts from time to time, and for this purpose the accounts of the Liquidator and its legal counsel are hereby referred to a judge of the Commercial List of the Ontario Superior Court of Justice. 20. THIS COURT ORDERS that prior to the passing of its accounts, the Liquidator shall be at liberty from time to time to apply reasonable amounts, out of the monies in its hands, against its fees and disbursements, including legal fees and disbursements, incurred at the standard rates and charges of the Liquidator or its counsel, and such amounts shall constitute advances against its remuneration and disbursements when and as approved by this Court. SERVICE AND NOTICE 21. THIS COURT ORDERS that: (a) the E-Service Protocol of the Commercial List (the “Protocol”) is approved and adopted by reference herein and, in this proceeding, the service of documents made in accordance with the Protocol (which can be found on the Commercial List website at http://www.ontariocourts.ca/scj/practice/practice-directions/toronto/e-service-protocol/) shall be valid and effective service; (b) subject to Rule 17.05 of the Rules of Civil Procedure this Order shall constitute an order for substituted service pursuant to Rule 16.04 of the Rules of Civil Procedure. Subject to Rule 3.01(d) of the Rules of Civil Procedure and paragraph 21 of the Protocol, service of documents in accordance with the Protocol will be effective on transmission; and (c) a Case Website shall be established in accordance with the Protocol with the following URL https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. 22. THIS COURT ORDERS that if the service or distribution of documents in accordance with the Protocol is not practicable, the Liquidator is at liberty to serve or distribute this Order, any other materials and orders in these proceedings, any notices or other correspondence, by forwarding true copies thereof by prepaid ordinary mail, courier, personal delivery or facsimile transmission to the Corporation's creditors or other interested parties at their respective addresses as last shown on the records of the Corporation and that any such service or distribution by courier, personal delivery or facsimile transmission shall be deemed to be received on the next business day following the date of forwarding thereof, or if sent by ordinary mail, on the third business day after mailing. CLAIMS PROCEDURE 23. THIS COURT ORDERS that for the purposes of this Order the following terms shall have the following meanings: (a) “Business Day” means a day, other than a Saturday or a Sunday, on which banks are generally open for business in Toronto, Ontario; “Claim” means: (a) any right or claim of any Person against the Corporation, whether or not asserted, in connection with any indebtedness, liability or obligation of any kind whatsoever of the Corporation in existence on the Effective Date whether or not such right or claim is reduced to judgment, liquidated, unliquidated, fixed, contingent, matured, unmatured, disputed, undisputed, legal, equitable, secured, unsecured, perfected, unperfected, present, future, known or unknown, by guarantee, surety or otherwise, and whether or not such right is executory or anticipatory in nature, including the right or ability of any Person to advance a claim for contribution or indemnity or otherwise with respect to any matter, action, cause or chose in action, whether existing at present or commenced in the future, which indebtedness, liability or obligation is based in whole or in part on facts which existed prior to the Effective Date, and includes any other claims that would have been claims provable in a bankruptcy had the Corporation become bankrupt on the Effective Date; or (b) any legal or equitable right of a Person to shares of the Corporation as at the Effective Date; (b) “Claimant” means a Person: (a) who has asserted a Claim or could have asserted a Claim but for the provisions hereof concerning the Claims Bar Date; or (b) who claims to have a legal or equitable right to shares of the Corporation as at the Effective Date; (c) “Claims Bar Date” means 5:00 PM Eastern Standard Time on a date to be fixed by the Liquidator, provided such date is not earlier than 30 days following the date that the Liquidator sends the Notice of Claim pursuant to paragraph 29 of this Order, or such later date as may be ordered by this Court; (d) “Court” means the Ontario Superior Court of Justice, Commercial List; (e) “Effective Date” means the date of this Order; (f) “Liquidation Notice” means the notice of this Order to be published in accordance with paragraph 28 of this Order, substantially in the form attached as Schedule “A” to this Order; (g) “Notice of Claim” means the notice provided by the Liquidator pursuant to paragraph 29 of this Order, substantially in the form attached as Schedule “B” to this Order (h) “Notice of Determination of Claim” means the notice provided by the Liquidator pursuant to paragraph 33 of this Order, substantially in the form attached as Schedule “C” to this Order; (i) “Notice of Objection” means the notice provided pursuant to paragraph 34 of this Order, substantially in the form attached as Schedule “D” to this Order; (j) “Person” means any individual, corporation, limited or unlimited liability company, general or limited partnership, association, trust, unincorporated organization, joint venture, government or any agency, officer or instrumentality thereof or any other entity; and (k) “Proof of Claim” means the proof of claim referred to herein to be filed by Claimants in connection with any Claim, substantially in the form attached as Schedule “E”. 24. THIS COURT ORDERS that all references as to time herein shall mean local time in Toronto, Ontario, Canada, and any reference to an event occurring on a Business Day shall mean prior to 5:00 p.m. Toronto time on such Business Day unless otherwise indicated herein. 25. THIS COURT ORDERS that any Claim denominated in any currency other than Canadian dollars shall be converted to and constitute obligations in Canadian dollars, such calculation to be effected by the Liquidator using the Bank of Canada noon spot rate on the Effective Date. 26. THIS COURT ORDERS that the Liquidator is authorized to enter into settlement negotiations with a Claimant at any stage of the Claims Process and is further authorized to enter into agreements with such Claimant resolving the value of their Claim. 27. THIS COURT ORDERS that the Liquidator shall cause the Notice of Claim and Proof of Claim to be posted on the Case Website no later than fourteen (14) Business Days after the Effective Date. 28. THIS COURT ORDERS that the Liquidator shall cause the Liquidation Notice to be published once in the National Post. 29. THIS COURT ORDERS that the Liquidator shall, no later than fourteen (14) Business Days after the Effective Date, send to each person identified on the Corporations books and records as having a claim or own shares of the Corporation: (a) a copy of this Order; (b) a Notice of Claim advising that Person of: (i) the amount shown on the Corporations books and records as being owed to that Person; and (ii) the number of shares of the Corporations shown of the Corporation’s books and records as being owned by that Person as at the Effective Date; and (c) a Proof of Claim. 30. THIS COURT ORDERS that: (a) any Person who receives a Notice of Claim that intends to assert a Claim that is different from the Claim set out on the Notice of Claim shall deliver a Proof of Claim, together with all relevant supporting documentation in respect of the Claim, to the Liquidator on or before the Claims Bar Date; and (b) the Claim(s) of any Person who receives a Notice of Claim who does not deliver a Proof of Claim to the Liquidator by the Claims Bar Date shall be deemed to be the Claim set out on the Notice of Claim. 31. THIS COURT ORDERS that: (a) any Person who wishes to assert a Claim against the Corporation and who does not receive Notice of Claim shall deliver a Proof of Claim, together with all relevant supporting documentation in respect of the Claim, to the Liquidator on or before the Claims Bar Date; and (b) the Claim of any Person who does not receive a Notice of Claim and who does not deliver a Proof of Claim to the Liquidator on or before the Claims Bar Date is barred, released and discharged as against the Corporation and the Liquidator may proceed to liquidate the Corporation and distribute the Property without regard to any such Claim. 32. THIS COURT ORDERS that the Liquidator shall: (a) review the Proofs of Claim filed on or before the Claims Bar Date; and (b) determine to either allow, partially allow, partially disallow or disallow each Proof of Claim. 33. THIS COURT ORDERS that, where a Proof of Claim is to be allowed, partially allowed, partially disallowed or disallowed, the Liquidator shall deliver to the Claimant a Notice of Determination of Claim. 34. THIS COURT ORDERS that in the event that a Person objects to the Liquidator’s determination of that Persons’ Proof of Claim and intends to contest the Notice of Determination of Claim, that person shall deliver to the Liquidator a Notice of Objection so that such Notice of Objection is received by the Liquidator by no later than 5:00 p.m. on the day which is fourteen (14) days after the date the Notice of Determination of Claim is deemed to be received. 35. THIS COURT ORDERS that any Person that does not provide the Liquidator with a Notice of Objection within the deadline set forth in paragraph 34 shall be deemed to have agreed with the Notice of Determination of Claim and that Person’s Claim shall, for the purposes of receiving a distribution from the Property, be the Claim as set out on the Notice of Determination of Claim. 36. THIS COURT ORDERS AND DIRECTS that the Liquidator bring a Motion to establish the process for determining the Claims of any Persons that deliver Notices of Objection in accordance with paragraph 34. 37. THIS COURT ORDERS that where a Person who receives a Notice of Determination of Claim agrees to same or where the Person’s Claim is otherwise determined in accordance with paragraph 36 of this Order, the value and status of such Person’s Claim shall, for the purpose of receiving a distribution from the Property, be deemed to be as set out in the Notice of Determination of Claim or as determined in accordance with paragraph 36 of this Order. 38. THIS COURT ORDERS that any document, notice or other communication (including, without limitation, Proofs of Claim) required to be delivered to the Liquidator under this Order shall be in writing and, where applicable, substantially in the form provided for in this Order, and will be sufficiently delivered only if delivered to: MNP Ltd., in its capacity as liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Matthew Lem Phone: 416-596-1711 Fax: 416-596-7894 E-mail: firstname.lastname@example.org GENERAL 39. THIS COURT ORDERS that the Liquidator may from time to time apply to this Court for advice and directions in the discharge of its powers and duties hereunder. 40. THIS COURT HEREBY REQUESTS the aid and recognition of any court, tribunal, regulatory or administrative body having jurisdiction in Canada to give effect to this Order and to assist the Liquidator and its agents in carrying out the terms of this Order, and all courts, tribunals, regulatory and administrative bodies are hereby respectfully requested to make such orders and to provide such assistance to the Liquidator, as an officer of this Court, as may be necessary or desirable to give effect to this Order or to assist the Liquidator and its agents in carrying out the terms of this Order. 41. THIS COURT ORDERS that the Liquidator be at liberty and is hereby authorized and empowered to apply to any court, tribunal, regulatory or administrative body, wherever located, for the recognition of this Order and for assistance in carrying out the terms of this Order, and that the Liquidator is authorized and empowered to act as a representative in respect of the within proceedings for the purpose of having these proceedings recognized in a jurisdiction outside Canada. 42. THIS COURT ORDERS that the Applicant shall have its costs of this Motion, up to and including entry and service of this Order fixed at $5,000.00 and Michael T.R. List/GreenSky Capital shall have his costs of this Motion fixed at $1,000.00. SCHEDULE A NOTICE Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) has been appointed liquidator of Paidiem Payment Solutions Inc. A copy of the Appointment Order can be found on the Liquidator’s website at: https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Matthew Lem Phone: 416-596-1711 Fax: 416-596-7894 E-mail: email@example.com SCHEDULE B NOTICE OF CLAIM Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| \|-----------------\|--------------\| \| \| \| \| \| \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON [DATE] 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Matthew Lem Phone: 416-596-1711 Fax: 416-596-7894 E-mail: firstname.lastname@example.org SCHEDULE C NOTICE OF DETERMINATION OF CLAIM IN THE MATTER OF THE WINDING-UP PROCEEDING OF PAIDIEM PAYMENT SOLUTIONS INC. ("THE "CORPORATION") To: ___________________________________________ (the “Claimant”) Date: _________________________________________ TAKE NOTICE THAT MNP LTD. (the “Liquidator”) has reviewed the Proof of Claim you delivered asserting a Claim against the Corporation and has made the following determination: Claim Determination (Please check and complete all applicable) ☐ Creditor Claim: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|----------------------\| \| \| \| \| Details of the Creditor Claim, including, if applicable, the security held: ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ☐ Shareholder Claim: \| Class of Shares \| Number Owned \| \|-----------------\|--------------\| \| \| \| The Liquidator has made the above-noted determination for the following reason(s): ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ IF YOU DISAGREE WITH THE ABOVE DETERMINATION OF YOUR CLAIM, YOU MUST DELIVER TO THE LIQUIDATOR TO THE ADDRESS BELOW A COMPLETED NOTICE OF OBJECTION (ATTACHED OR ENCLOSED) TO BE RECEIVED BY THE LIQUIDATOR BEFORE 5:00 P.M. ON THE DAY WHICH IS FOURTEEN (14) DAYS AFTER THE DATE THE NOTICE OF DETERMINATION OF CLAIM IS RECEIVED. If you do not dispute the determination of your Claim your Claim will be deemed to be accepted and the Claim shall be a Proven Claim in the amount set forth herein. DATED at ____________________ this ___ day of ________________, 2022 MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Matthew Lem Phone: 416-596-1711 Fax: 416-596-7894 E-mail: email@example.com SCHEDULE E PROOF OF CLAIM IN THE MATTER OF THE WINDING-UP PROCEEDING OF PAIDIEM PAYMENT SOLUTIONS INC. ("THE "CORPORATION") 1. PARTICULARS OF CLAIMANT Full Legal Name of Claimant: _____________________________________________(the “Claimant”) has the Claim against the Corporation described below. Full Mailing Address of the Claimant: ______________________________________________________________ ______________________________________________________________ Telephone Number of Claimant: _______________________________________ Facsimile Number of Claimant: _________________________________________ Attention (Contact Person): ___________________________________________ Email Address: ______________________________________________________ 2. PROOF OF CLAIM: I, ___________________________ [Name of Claimant or Representative of the Claimant], do hereby certify that I am (please check one): ☐ the Claimant; or ☐ am ___________________________ [Position or Office Held] of the Claimant and have personal knowledge of all the circumstances connected with the Claim against the Corporation. 3. PARTICULARS OF CLAIM (Please check and complete all applicable): ☐ Creditor Claim: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|----------------------\| \| \| \| \| \| \| \| \| Details of the Creditor Claim, including, if applicable, the security held: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ☐ Shareholder Claim: \| Class of Shares \| Number Owned \| \|-----------------\|--------------\| \| \| \| \| \| \| \| \| \| IF ADDITIONAL SPACE IS REQUIRED, PLEASE ATTACH A SCHEDULE. THE CLAIMANT SHOULD PROVIDE PARTICULARS OF THE CLAIM AND COPIES OF SUPPORTING DOCUMENTATION. 4. FILING OF CLAIMS: This Proof of Claim together with supporting documentation must be returned and received by the Liquidator, no later than 5:00 p.m. local Toronto time on [Date], to the email address or address listed below. This Proof of Claim must be delivered by email, facsimile, personal delivery, courier or prepaid mail to the following address: Address of the Liquidator MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Matthew Lem Phone: 416-596-1711 Fax: 416-596-7894 E-mail: firstname.lastname@example.org DATED at ________________ this ___ day of ________________, 2022 _________________________________________ _______________________________________ (Signature of Witness) (Signature of individual completing this form) DAVID ROBERTSON -and- PAIDIEM PAYMENT SOLUTIONS INC. Applicant Respondent ONTARIO SUPERIOR COURT OF JUSTICE (Commercial List) (PROCEEDING COMMENCED AT TORONTO) ORDER GOWLING WLG (CANADA) LLP Barristers and Solicitors 1 First Canadian Place 100 King Street West, Suite 1600 Toronto ON M5X 1G5 Christopher Stanek (LSO No.:45127K) email@example.com Tel: 416-862-4369 E. Patrick Shea (LSO No.: 39655K) firstname.lastname@example.org Tel: (416) 369-7399 Fax: (416) 862-7661 Solicitors for the Applicant \| Shareholder \| Total Common Shares \| Total Preferred Shares \| \|-------------------------------------------------\|---------------------\|-----------------------\| \| Armen Meyer \| - \| 154,329 \| \| Berkeley Skydeck Fund I LP \| - \| 641,294 \| \| Capex Group Inc. \| - \| 81,539 \| \| Cromie Family Trust \| 3,833,333 \| - \| \| Daniel Sorger \| 50,000 \| - \| \| David Robertson \| 5,666,667 \| - \| \| DPATAMS Inc. \| - \| 65,231 \| \| Edward D. Andrew \| - \| 65,231 \| \| Frontures Opportunity Fund I LP \| - \| 92,597 \| \| Gary Meltzer \| - \| 41,154 \| \| Giovanni Tavernese and Luigi Tavernese, jointly \| - \| 65,231 \| \| GreenSky Accelerator Fund IV (U.S.), LP \| - \| 1,542,922 \| \| GreenSky Accelerator Fund IV, LP \| - \| 226,484 \| \| HDG Capital Inc. \| - \| 130,463 \| \| Hockey Bags Inc. \| - \| 130,463 \| \| Inari Ventures I GMBH & Co. KG \| - \| 246,927 \| \| James A.T. Clare Prof Corp \| - \| 407,697 \| \| Jason Donville \| - \| 407,697 \| \| Jeff Kilborn \| - \| 26,092 \| \| John Graham \| 125,000 \| 293,541 \| \| JPATAMS Inc. \| - \| 65,231 \| \| L-Spark Corporation \| - \| 391,389 \| \| Mario Carrieri \| - \| 65,231 \| \| Markus Ament \| - \| 102,886 \| \| Myers Lane Investments Ltd. \| - \| 97,846 \| \| Nevcaut Ventures Fund I, LP \| - \| 329,236 \| \| Paul Brindle \| - \| 65,231 \| \| Paul Manias \| 50,000 \| - \| \| Richard Cromie \| 500,000 \| - \| \| RLEA Holdings Inc. \| 50,000 \| - \| \| Stephen Geist \| - \| 187,540 \| \| Tony Wonnacott \| 100,000 \| - \| \| Trinity Capital Partners Corporation \| 125,000 \| - \| \| Verite International Holdings Limited \| - \| 130,463 \| \| Victor Duong \| - \| 187,540 \| \| White Rocks Holdings Inc. \| - \| 603,391 \| \| TOTAL \| 10,500,000 \| 6,844,876 \| I, Jack Salim, of the City of Toronto, in the Province of Ontario, hereby make oath and say: That on the 13th day of December 2022, I did cause to be mailed by prepaid ordinary mail to the claimants, whose names and addresses appear on the paper-writing marked as Exhibit “A” attached hereto, a cover letter, the Order, a Notice of Claim (as individualized for and sent to the respective claimant), and a blank proof of claim form marked as Exhibit “B” attached hereto. SWORN remotely by Jack Salim, stated as being located in the City of Toronto before me at the City of Mississauga, in the Regional Municipality of Peel, on this 9th day of March, 2023, in accordance with O. Reg 431/20, Administering Oath or Declaration Remotely Commissioner for Taking Affidavits Matthew Eric Lem, a Commissioner, etc., Province of Ontario, for MNP Ltd. and MNP LLP. Expires February 21, 2020. JACK SALIM Attached is Exhibit “A” Referred to in the AFFIDAVIT OF JACK SALIM Sworn before me in the City of Toronto, in the Province of Ontario This 9th day of March 2023 Commissioner for taking Affidavits, etc. \| Name \| Address \| \|-----------------------------\|-------------------------------------------------------------------------\| \| Armen Meyer \| # 9 3822 19th Street, San Francisco, California, USA 94114 \| \| Berkeley Skydeck Fund I LP \| Penthouse 1300, 2150 S Hattuck Avenue, Berkeley, California, US 94704 \| \| Capex Group Inc. \| 5276 Knott Crescent, Ottawa, Ontario Canada K4M 1C2 \| \| Cromie Family Trust \| 3302 Myers Lane, Burlington, Ontario Canada L7N 1K7 \| \| Daniel Sorger \| 3045 Bagley Ave., Los Angeles, CA 90034 \| \| David Robertson \| 3704 44 Charles Street West, Toronto, Ontario Canada M4Y 1R8 \| \| DPATAMS Inc. \| 151 Eglinton Avenue, Toronto, Ontario Canada M4R 1A6 \| \| Edward D. Andrew \| 7 Donwood's Drive, Toronto, Ontario Canada M4N 2E9 \| \| Frontures Opportunity Fund I LP \| 129 5214-F Diamond Heights Boulevard, San Francisco, California, United States 94131-2175 \| \| Gary Meltzer \| 100 Barclay Street, New York, New York, United States 10007 \| \| Giovanni Tavernese and Luigi Tavernese, jointly \| 17 Edgar Drive, Brantford, Ontario Canada N3R 6X7 \| \| GreenSky Accelerator Fund IV, LP \| 5th Floor 6 Adelaide Street East, Toronto, Ontario Canada M5C 1H6 \| \| GreenSky Accelerator Fund IV, (U.S.) LP \| 5th Floor 6 Adelaide Street East, Toronto, Ontario Canada M5C 1H6 \| \| HDG Capital Inc. \| 62 Moses Crescent, Markham, Ontario Canada L6C 1W2 \| \| Hockey Bags Inc. \| 85 Lascelles Boulevard, Toronto, Ontario Canada M5P 2E3 \| \| Inari Ventures I GMBH & Co. KG \| 18 Drosse Ibarweg, Erfurt, Thüringen, Germany 99099 \| \| James A.T. Clare Prof Corp \| 3400 First Canadian Place 130, Toronto, Ontario Canada M5X 1A4 \| \| Jason Donville \| # 1302 505 Richmond Street West, Toronto, Ontario Canada M5V 0P4 \| \| Jeff Kilborn \| 1342 Revell Drive, Ottawa, Ontario Canada K4M 1K8 \| \| John Graham \| John Graham 24 Springbrook Gardens, Toronto, Ontario Canada M8Z 3B6 \| \| JPATAMS Inc. \| 151 Eglinton Avenue, Toronto, Ontario Canada M4R 1A6 \| \| L-Spark Corporation \| 140 340 Legget Drive, Kanata, Ontario Canada K2K 1Y6 \| \| Mario Carrieri \| 1371 Northmount Avenue, Mississauga, Ontario Canada L5E 1Y4 \| \| Markus Ament \| 16B Calle Darío Aparicio Madrid, Comunidadde Madrid, Spain 28023 \| \| Myers Lane Investments Ltd.\| 5100 199 Bay Street, Toronto, Ontario Canada M5L 1L5 \| \| Nevcaut Ventures Fund I, LP \| 177 Trillium, Irvine, California, United States 92618 \| \| Paul Brindle \| 646 West Oval Drive, Burlington, Ontario Canada L7T1B9 \| \| Paul Manias \| 57 Rose Park Drive, Toronto, ON M4T 1R2 \| \| Richard Cromie \| 3302 Myers Lane, Burlington, Ontario Canada L7N 1K7 \| \| RLEA Holdings Inc. \| 117 Wimbleton Rd, Toronto, ON M9A3S4 \| \| Name \| Address \| \|-----------------------------\|-------------------------------------------------------------------------\| \| Stephen Geist \| 76 The Kingsway, Toronto Ontario Canada M8X 2T5 \| \| Tony Wonnacott \| 259 Hillsdale Avenue East, Toronto, Ontario M4S 1T7 \| \| Trinity Capital Partners Corporation \| 24 Springbrook Gardens, Toronto Ontario Canada M8Z 3B6 \| \| Verite International Holdings Limited \| 202 4211 Yonge Street, Toronto Ontario Canada M2P 2A9 \| \| Victor Duong \| 73 Winners Circle, Toronto Ontario Canada M4L 3Y7 \| \| White Rocks Holdings Inc. \| 74 Balmoral Avenue, Toronto Ontario Canada M4V 1J4 \| \| Business Development Bank of Canada \| 81 Bay Street, Suite 3700, Toronto, ON M5J 0E7 \| Attached is Exhibit “B” Referred to in the AFFIDAVIT OF JACK SALIM Sworn before me in the City of Toronto, in the Province of Ontario This 9th day of March 2023 [Signature] Commissioner for taking Affidavits, etc. December 13, 2022 SENT BY EMAIL AND/OR REGULAR MAIL TO: THE CLAIMANTS OF PAIDIEM PAYMENT SOLUTIONS INC. (“PAIDIEM”) Dear Sirs/Madam: Please take notice that pursuant to an Order of the Ontario Superior Court of Justice made on November 23, 2022 (the “Appointment Order”), a claims bar process has been established for any Person who wishes to assert a Claim or who wishes to claim a legal or equitable right to shares (common and/or preferred) of Paidiem as of November 23, 2022. Terms not otherwise defined herein shall have the meaning given to them in the Appointment Order. Pursuant to Paragraph 29 of the Appointment Order, please find attached/enclosed the following: (a) a copy of this Appointment Order; (b) a Notice of Claim advising you of: (i) the amount shown on corporation’s books and records as being owed to you; and/or (ii) the number and value (applicable to preferred shares only) of the shares (common and/or preferred) of Paidiem shown on the corporation’s books and records as being owned by you as of the Effective Date; and (c) a Proof of Claim form. If you agree with the figures presented in the attached/enclosed Notice of Claim, no further action is required by you. If you disagree with the figures presented in the attached/enclosed Notice of Claim you must complete and submit to the Liquidator the attached/enclosed Proof of Claim form by no later than 5:00 p.m. (Toronto time) on January 12, 2023 (the “Claims Bar Date”). Should you fail to file a Proof of Claim form in order to correct the figures in the attached/enclosed Notice of Claim by the Claims Bar Date, your entitlement to any distribution of the proceeds realized by the Liquidator will be determined based on the attached/enclosed Notice of Claim. All inquiries with respect to this claims bar process, should be directed to: MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com Yours truly, MNP LTD., in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. Per: Matthew Lem, CIRP, LIT Senior Vice President ON READING the Affidavit of David Robertson sworn 16 November 2022 and the Exhibits thereto, on hearing the submissions of the lawyers for the Applicant and on reading the consent of MNP to act as the liquidator, SERVICE 1. THIS COURT ORDERS that the time for service of the Notice of Motion and the Motion is hereby abridged and validated so that this motion is properly returnable today and hereby dispenses with further service thereof. WINDING-UP AND APPOINTMENT OF LIQUIDATOR 2. THIS COURT ORDERS that the Corporation shall be wound-up pursuant Part XVI of the OBCA and, for that purpose, MNP is appointed liquidator pursuant to subsection 210(1) of the OBCA. LIQUIDATOR’S POWERS 3. THIS COURT ORDERS that, without limiting or restricting the powers of the Liquidator under section 223 of the OBCA, the Liquidator is hereby empowered and authorized, but not obligated, expressly empowered and authorized to do any of the following where the Liquidator considers it necessary or desirable: (a) to take possession of and exercise control over the assets and property of the Corporation (the “Property”) and any and all proceeds, receipts and disbursements arising out of or from the Property; (b) to receive, preserve, and protect the Property, or any part or parts thereof, including, but not limited to, the changing of locks and security codes, the relocating of Property to safeguard it, the engaging of independent security personnel, the taking of physical inventories and the placement of such insurance coverage as may be necessary or desirable; (c) to manage, operate, and carry on the business of the Corporation, including the powers to enter into any agreements, incur any obligations in the ordinary course of business, cease to carry on all or any part of the business, or cease to perform any contracts of the Corporation; (d) to engage consultants, appraisers, agents, experts, auditors, accountants, managers, counsel and such other persons from time to time and on whatever basis, including on a temporary basis, to assist with the exercise of the Liquidator's powers and duties, including without limitation those conferred by this Order; (e) to receive and collect all monies and accounts now owed or hereafter owing to the Corporation and to exercise all remedies of the Corporation in collecting such monies, including, without limitation, to enforce any security held by the Corporation; (f) to settle, extend or compromise any indebtedness owing to the Corporation; (g) to execute, assign, issue and endorse documents of whatever nature in respect of any of the Property, whether in the Liquidator's name or in the name and on behalf of the Corporation, for any purpose pursuant to this Order; (h) to initiate, prosecute and continue the prosecution of any and all proceedings and to defend all proceedings now pending or hereafter instituted with respect to the Corporation, the Property or the Liquidator, and to settle or compromise any such proceedings, and the authority hereby conveyed shall extend to such appeals or applications for judicial review in respect of any order or judgment pronounced in any such proceeding; (i) to market any or all of the Property, including advertising and soliciting offers in respect of the Property or any part or parts thereof and negotiating such terms and conditions of sale as the Liquidator in its discretion may deem appropriate; (j) to sell, convey, transfer, lease or assign the Property or any part or parts thereof out of the ordinary course of business; (i) without the approval of this Court in respect of any transaction not exceeding $250,000.00, provided that the aggregate consideration for all such transactions does not exceed $500,000.00; and (ii) with the approval of this Court in respect of any transaction in which the consideration or the aggregate consideration exceeds the applicable amount set out in the preceding clause; (k) to apply for any vesting order or other orders necessary to convey the Property or any part or parts thereof to a purchaser or purchasers thereof, free and clear of any liens or encumbrances affecting such Property; (l) to report to, meet with and discuss with such affected Persons (as defined below) as the Liquidator deems appropriate on all matters relating to the Property and the winding-up and to share information, subject to such terms as to confidentiality as the Liquidator deems advisable; (m) to administer the claims procedure established by this Order; and (n) to take any steps reasonably incidental to the exercise of these powers or the performance of any statutory obligations. and in each case where the Liquidator takes any such actions or steps, it shall be exclusively authorized and empowered to do so, to the exclusion of all other Persons (as defined below), including the Corporation, and without interference from any other Person. DUTY TO PROVIDE ACCESS AND CO-OPERATION TO THE LIQUIDATOR 4. THIS COURT ORDERS that (a) the Corporation, (b) all of its current and former directors, officers, employees, agents, accountants, legal counsel and shareholders, and all other persons acting on its instructions or behalf, and (c) all other individuals, firms, corporations, governmental bodies or agencies, or other entities having notice of this Order (all of the foregoing, collectively, being "Persons" and each being a "Person") shall forthwith advise the Liquidator of the existence of any Property in such Person's possession or control, shall grant immediate and continued access to the Property to the Liquidator, and shall deliver all such Property to the Liquidator upon the Liquidator's request. 5. THIS COURT ORDERS that all Persons shall forthwith advise the Liquidator of the existence of any books, documents, securities, contracts, orders, corporate and accounting records, and any other papers, records and information of any kind related to the business or affairs of the Corporation, and any computer programs, computer tapes, computer disks, or other data storage media containing any such information (the foregoing, collectively, the "Records") in that Person's possession or control, and shall provide to the Liquidator or permit the Liquidator to make, retain and take away copies thereof and grant to the Liquidator unfettered access to and use of accounting, computer, software and physical facilities relating thereto, provided however that nothing in this paragraph 5 or in paragraph 6 of this Order shall require the delivery of Records, or the granting of access to Records, which may not be disclosed or provided to the Liquidator due to the privilege attaching to solicitor-client communication or due to statutory provisions prohibiting such disclosure. 6. THIS COURT ORDERS that if any Records are stored or otherwise contained on a computer or other electronic system of information storage, whether by independent service provider or otherwise, all Persons in possession or control of such Records shall forthwith give unfettered access to the Liquidator for the purpose of allowing the Liquidator to recover and fully copy all of the information contained therein whether by way of printing the information onto paper or making copies of computer disks or such other manner of retrieving and copying the information as the Liquidator in its discretion deems expedient, and shall not alter, erase or destroy any Records without the prior written consent of the Liquidator. Further, for the purposes of this paragraph, all Persons shall provide the Liquidator with all such assistance in gaining immediate access to the information in the Records as the Liquidator may in its discretion require including providing the Liquidator with instructions on the use of any computer or other system and providing the Liquidator with any and all access codes, account names and account numbers that may be required to gain access to the information. 7. THIS COURT ORDERS that the Liquidator shall provide each of the relevant landlords with notice of the Liquidator’s intention to remove any fixtures from any leased premises at least seven (7) days prior to the date of the intended removal. The relevant landlord shall be entitled to have a representative present in the leased premises to observe such removal and, if the landlord disputes the Liquidator’s entitlement to remove any such fixture under the provisions of the lease, such fixture shall remain on the premises and shall be dealt with as agreed between any applicable secured creditors, such landlord and the Liquidator, or by further Order of this Court upon application by the Liquidator on at least two (2) days notice to such landlord and any such secured creditors. NO PROCEEDINGS AGAINST THE LIQUIDATOR 8. THIS COURT ORDERS that no proceeding or enforcement process in any court or tribunal (each, a “Proceeding”), shall be commenced or continued against the Liquidator except with the written consent of the Liquidator or with leave of this Court. NO PROCEEDINGS AGAINST THE CORPORATION OR THE PROPERTY 9. THIS COURT ORDERS that no Proceeding against or in respect of the Corporation or the Property shall be commenced or continued except with the written consent of the Liquidator or with leave of this Court and any and all Proceedings currently under way against or in respect of the Corporation or the Property are hereby stayed and suspended pending further Order of this Court. NO EXERCISE OF RIGHTS OR REMEDIES 10. THIS COURT ORDERS that all rights and remedies against the Corporation, the Liquidator, or affecting the Property, are hereby stayed and suspended except with the written consent of the Liquidator or leave of this Court, provided however that nothing in this paragraph shall (a) empower the Liquidator or the Corporation to carry on any business which the Corporation is not lawfully entitled to carry on, (b) exempt the Liquidator or the Corporation from compliance with statutory or regulatory provisions relating to health, safety or the environment, (c) prevent the filing of any registration to preserve or perfect a security interest, or (d) prevent the registration of a claim for lien. NO INTERFERENCE WITH THE LIQUIDATOR 11. THIS COURT ORDERS that no Person shall discontinue, fail to honour, alter, interfere with, repudiate, terminate or cease to perform any right, renewal right, contract, agreement, licence or permit in favour of or held by the Corporation, without written consent of the Liquidator or leave of this Court. CONTINUATION OF SERVICES 12. THIS COURT ORDERS that all Persons having oral or written agreements with the Corporation or statutory or regulatory mandates for the supply of goods and/or services, including without limitation, all computer software, communication and other data services, centralized banking services, payroll services, insurance, transportation services, utility or other services to the Corporation are hereby restrained until further Order of this Court from discontinuing, altering, interfering with or terminating the supply of such goods or services as may be required by the Liquidator, and that the Liquidator shall be entitled to the continued use of the Corporation's current telephone numbers, facsimile numbers, internet addresses and domain names, provided in each case that the normal prices or charges for all such goods or services received after the date of this Order are paid by the Liquidator in accordance with normal payment practices of the Corporation or such other practices as may be agreed upon by the supplier or service provider and the Liquidator, or as may be ordered by this Court. LIQUIDATOR TO HOLD FUNDS 13. THIS COURT ORDERS that all funds, monies, cheques, instruments, and other forms of payments received or collected by the Liquidator from and after the making of this Order from any source whatsoever, including without limitation the sale of all or any of the Property and the collection of any accounts receivable in whole or in part, whether in existence on the date of this Order or hereafter coming into existence, shall be deposited into one or more new accounts to be opened by the Liquidator (the "Post Winding-up Accounts") and the monies standing to the credit of such Post Winding-up Accounts from time to time, net of any disbursements provided for herein, shall be held by the Liquidator to be paid in accordance with the terms of this Order or any further Order of this Court. EMPLOYEES 14. THIS COURT ORDERS that all employees of the Corporation shall remain the employees of the Corporation until such time as the Liquidator, on the Corporation's behalf, may terminate the employment of such employees and, for greater certainty, (a) the appointment of the Liquidator pursuant to this Order is not a "sale" as that term is defined in subsection 9(3) of the Employment Standards Act (the "ESA"); and (b) the Liquidator is not deemed a "purchaser" under Part IV of the ESA by virtue of its appointment pursuant to this Order. PIPEDA 15. THIS COURT ORDERS that: (a) pursuant to clause 7(3)(c) of the Canada Personal Information Protection and Electronic Documents Act, the Liquidator shall disclose personal information of identifiable individuals to prospective purchasers or bidders for the Property and to their advisors, but only to the extent desirable or required to negotiate and attempt to complete one or more sales of the Property (each, a "Sale"); (b) each prospective purchaser or bidder to whom such personal information is disclosed shall maintain and protect the privacy of such information and limit the use of such information to its evaluation of the Sale, and if it does not complete a Sale, shall return all such information to the Liquidator, or in the alternative destroy all such information; and (c) the purchaser of any Property shall be entitled to continue to use the personal information provided to it, and related to the Property purchased, in a manner which is in all material respects identical to the prior use of such information by the Corporation, and shall return all other personal information to the Liquidator, or ensure that all other personal information is destroyed. LIMITATION ON ENVIRONMENTAL LIABILITIES 16. THIS COURT ORDERS that nothing herein contained shall require the Liquidator to occupy or to take control, care, charge, possession or management (separately and/or collectively, "Possession") of any of the Property that might be environmentally contaminated, might be a pollutant or a contaminant, or might cause or contribute to a spill, discharge, release or deposit of a substance contrary to any federal, provincial or other law respecting the protection, conservation, enhancement, remediation or rehabilitation of the environment or relating to the disposal of waste or other contamination including, without limitation, the Canadian Environmental Protection Act, the Ontario Environmental Protection Act, the Ontario Water Resources Act, or the Ontario Occupational Health and Safety Act and regulations thereunder (the "Environmental Legislation"), provided however that nothing herein shall exempt the Liquidator from any duty to report or make disclosure imposed by applicable Environmental Legislation. The Liquidator shall not, as a result of this Order or anything done in pursuance of the Liquidator's duties and powers under this Order, be deemed to be in Possession of any of the Property within the meaning of any Environmental Legislation, unless it is actually in possession. LIMITATION ON THE LIQUIDATOR'S LIABILITY 17. THIS COURT ORDERS that the Liquidator shall incur no liability or obligation as a result of its appointment or the carrying out the provisions of this Order, save and except for any gross negligence or wilful misconduct on its part. LIQUIDATOR'S ACCOUNTS 18. THIS COURT ORDERS that the Liquidator and counsel to the Liquidator shall be paid their reasonable fees and disbursements, in each case at their standard rates and charges unless otherwise ordered by the Court on the passing of accounts, and that the Liquidator and counsel to the Liquidator shall be entitled to and are hereby granted a charge (the "Liquidator's Charge") on the Property, as security for such fees and disbursements, both before and after the making of this Order in respect of these proceedings, and that the Liquidator’s Charge shall form a first charge on the Property in priority to all security interests, trusts, liens, charges and encumbrances, statutory or otherwise, in favour of any Person. 19. THIS COURT ORDERS that the Liquidator and its legal counsel shall pass its accounts from time to time, and for this purpose the accounts of the Liquidator and its legal counsel are hereby referred to a judge of the Commercial List of the Ontario Superior Court of Justice. 20. THIS COURT ORDERS that prior to the passing of its accounts, the Liquidator shall be at liberty from time to time to apply reasonable amounts, out of the monies in its hands, against its fees and disbursements, including legal fees and disbursements, incurred at the standard rates and charges of the Liquidator or its counsel, and such amounts shall constitute advances against its remuneration and disbursements when and as approved by this Court. SERVICE AND NOTICE 21. THIS COURT ORDERS that: (a) the E-Service Protocol of the Commercial List (the “Protocol”) is approved and adopted by reference herein and, in this proceeding, the service of documents made in accordance with the Protocol (which can be found on the Commercial List website at http://www.ontariocourts.ca/scj/practice/practice-directions/toronto/e-service-protocol/) shall be valid and effective service; (b) subject to Rule 17.05 of the Rules of Civil Procedure this Order shall constitute an order for substituted service pursuant to Rule 16.04 of the Rules of Civil Procedure. Subject to Rule 3.01(d) of the Rules of Civil Procedure and paragraph 21 of the Protocol, service of documents in accordance with the Protocol will be effective on transmission; and (c) a Case Website shall be established in accordance with the Protocol with the following URL https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. 22. THIS COURT ORDERS that if the service or distribution of documents in accordance with the Protocol is not practicable, the Liquidator is at liberty to serve or distribute this Order, any other materials and orders in these proceedings, any notices or other correspondence, by forwarding true copies thereof by prepaid ordinary mail, courier, personal delivery or facsimile transmission to the Corporation's creditors or other interested parties at their respective addresses as last shown on the records of the Corporation and that any such service or distribution by courier, personal delivery or facsimile transmission shall be deemed to be received on the next business day following the date of forwarding thereof, or if sent by ordinary mail, on the third business day after mailing. CLAIMS PROCEDURE 23. THIS COURT ORDERS that for the purposes of this Order the following terms shall have the following meanings: (a) “Business Day” means a day, other than a Saturday or a Sunday, on which banks are generally open for business in Toronto, Ontario; “Claim” means: (a) any right or claim of any Person against the Corporation, whether or not asserted, in connection with any indebtedness, liability or obligation of any kind whatsoever of the Corporation in existence on the Effective Date whether or not such right or claim is reduced to judgment, liquidated, unliquidated, fixed, contingent, matured, unmatured, disputed, undisputed, legal, equitable, secured, unsecured, perfected, unperfected, present, future, known or unknown, by guarantee, surety or otherwise, and whether or not such right is executory or anticipatory in nature, including the right or ability of any Person to advance a claim for contribution or indemnity or otherwise with respect to any matter, action, cause or chose in action, whether existing at present or commenced in the future, which indebtedness, liability or obligation is based in whole or in part on facts which existed prior to the Effective Date, and includes any other claims that would have been claims provable in a bankruptcy had the Corporation become bankrupt on the Effective Date; or (b) any legal or equitable right of a Person to shares of the Corporation as at the Effective Date; (b) “Claimant” means a Person: (a) who has asserted a Claim or could have asserted a Claim but for the provisions hereof concerning the Claims Bar Date; or (b) who claims to have a legal or equitable right to shares of the Corporation as at the Effective Date; (c) “Claims Bar Date” means 5:00 PM Eastern Standard Time on a date to be fixed by the Liquidator, provided such date is not earlier than 30 days following the date that the Liquidator sends the Notice of Claim pursuant to paragraph 29 of this Order, or such later date as may be ordered by this Court; (d) “Court” means the Ontario Superior Court of Justice, Commercial List; (e) “Effective Date” means the date of this Order; (f) “Liquidation Notice” means the notice of this Order to be published in accordance with paragraph 28 of this Order, substantially in the form attached as Schedule “A” to this Order; (g) “Notice of Claim” means the notice provided by the Liquidator pursuant to paragraph 29 of this Order, substantially in the form attached as Schedule “B” to this Order (h) “Notice of Determination of Claim” means the notice provided by the Liquidator pursuant to paragraph 33 of this Order, substantially in the form attached as Schedule “C” to this Order; (i) “Notice of Objection” means the notice provided pursuant to paragraph 34 of this Order, substantially in the form attached as Schedule “D” to this Order; (j) “Person” means any individual, corporation, limited or unlimited liability company, general or limited partnership, association, trust, unincorporated organization, joint venture, government or any agency, officer or instrumentality thereof or any other entity; and (k) “Proof of Claim” means the proof of claim referred to herein to be filed by Claimants in connection with any Claim, substantially in the form attached as Schedule “E”. 24. THIS COURT ORDERS that all references as to time herein shall mean local time in Toronto, Ontario, Canada, and any reference to an event occurring on a Business Day shall mean prior to 5:00 p.m. Toronto time on such Business Day unless otherwise indicated herein. 25. THIS COURT ORDERS that any Claim denominated in any currency other than Canadian dollars shall be converted to and constitute obligations in Canadian dollars, such calculation to be effected by the Liquidator using the Bank of Canada noon spot rate on the Effective Date. 26. THIS COURT ORDERS that the Liquidator is authorized to enter into settlement negotiations with a Claimant at any stage of the Claims Process and is further authorized to enter into agreements with such Claimant resolving the value of their Claim. 27. THIS COURT ORDERS that the Liquidator shall cause the Notice of Claim and Proof of Claim to be posted on the Case Website no later than fourteen (14) Business Days after the Effective Date. 28. THIS COURT ORDERS that the Liquidator shall cause the Liquidation Notice to be published once in the National Post. 29. THIS COURT ORDERS that the Liquidator shall, no later than fourteen (14) Business Days after the Effective Date, send to each person identified on the Corporations books and records as having a claim or own shares of the Corporation: (a) a copy of this Order; (b) a Notice of Claim advising that Person of: (i) the amount shown on the Corporations books and records as being owed to that Person; and (ii) the number of shares of the Corporations shown of the Corporation’s books and records as being owned by that Person as at the Effective Date; and (c) a Proof of Claim. 30. THIS COURT ORDERS that: (a) any Person who receives a Notice of Claim that intends to assert a Claim that is different from the Claim set out on the Notice of Claim shall deliver a Proof of Claim, together with all relevant supporting documentation in respect of the Claim, to the Liquidator on or before the Claims Bar Date; and (b) the Claim(s) of any Person who receives a Notice of Claim who does not deliver a Proof of Claim to the Liquidator by the Claims Bar Date shall be deemed to be the Claim set out on the Notice of Claim. 31. THIS COURT ORDERS that: (a) any Person who wishes to assert a Claim against the Corporation and who does not receive Notice of Claim shall deliver a Proof of Claim, together with all relevant supporting documentation in respect of the Claim, to the Liquidator on or before the Claims Bar Date; and (b) the Claim of any Person who does not receive a Notice of Claim and who does not deliver a Proof of Claim to the Liquidator on or before the Claims Bar Date is barred, released and discharged as against the Corporation and the Liquidator may proceed to liquidate the Corporation and distribute the Property without regard to any such Claim. 32. THIS COURT ORDERS that the Liquidator shall: (a) review the Proofs of Claim filed on or before the Claims Bar Date; and (b) determine to either allow, partially allow, partially disallow or disallow each Proof of Claim. 33. THIS COURT ORDERS that, where a Proof of Claim is to be allowed, partially allowed, partially disallowed or disallowed, the Liquidator shall deliver to the Claimant a Notice of Determination of Claim. 34. THIS COURT ORDERS that in the event that a Person objects to the Liquidator’s determination of that Persons’ Proof of Claim and intends to contest the Notice of Determination of Claim, that person shall deliver to the Liquidator a Notice of Objection so that such Notice of Objection is received by the Liquidator by no later than 5:00 p.m. on the day which is fourteen (14) days after the date the Notice of Determination of Claim is deemed to be received. 35. THIS COURT ORDERS that any Person that does not provide the Liquidator with a Notice of Objection within the deadline set forth in paragraph 34 shall be deemed to have agreed with the Notice of Determination of Claim and that Person’s Claim shall, for the purposes of receiving a distribution from the Property, be the Claim as set out on the Notice of Determination of Claim. 36. THIS COURT ORDERS AND DIRECTS that the Liquidator bring a Motion to establish the process for determining the Claims of any Persons that deliver Notices of Objection in accordance with paragraph 34. 37. THIS COURT ORDERS that where a Person who receives a Notice of Determination of Claim agrees to same or where the that Person’s Claim is otherwise determined in accordance with paragraph 36 of this Order, the value and status of such Person’s Claim shall, for the purpose of receiving a distribution from the Property, be deemed to be as set out in the Notice of Determination of Claim or as determined in accordance with paragraph 36 of this Order. 38. THIS COURT ORDERS that any document, notice or other communication (including, without limitation, Proofs of Claim) required to be delivered to the Liquidator under this Order shall be in writing and, where applicable, substantially in the form provided for in this Order, and will be sufficiently delivered only if delivered to: MNP Ltd., in its capacity as liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Matthew Lem Phone: 416-596-1711 Fax: 416-596-7894 E-mail: firstname.lastname@example.org GENERAL 39. THIS COURT ORDERS that the Liquidator may from time to time apply to this Court for advice and directions in the discharge of its powers and duties hereunder. 40. THIS COURT HEREBY REQUESTS the aid and recognition of any court, tribunal, regulatory or administrative body having jurisdiction in Canada to give effect to this Order and to assist the Liquidator and its agents in carrying out the terms of this Order, and all courts, tribunals, regulatory and administrative bodies are hereby respectfully requested to make such orders and to provide such assistance to the Liquidator, as an officer of this Court, as may be necessary or desirable to give effect to this Order or to assist the Liquidator and its agents in carrying out the terms of this Order. 41. THIS COURT ORDERS that the Liquidator be at liberty and is hereby authorized and empowered to apply to any court, tribunal, regulatory or administrative body, wherever located, for the recognition of this Order and for assistance in carrying out the terms of this Order, and that the Liquidator is authorized and empowered to act as a representative in respect of the within proceedings for the purpose of having these proceedings recognized in a jurisdiction outside Canada. 42. THIS COURT ORDERS that the Applicant shall have its costs of this Motion, up to and including entry and service of this Order fixed at $5,000.00 and Michael T.R. List/GreenSky Capital shall have his costs of this Motion fixed at $1,000.00. Digitally signed by Mr. Justice Cavanagh NOTICE OF CLAIM Armen Meyer # 9 3822 19th Street San Francisco, California, USA 94114 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 154,329 \| $94,634.54 \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Berkeley Skydeck Fund I LP Penthouse 1300, 2150 S Hattuck Avenue Berkeley California, US 94704 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| 641,294 \| $133,389.15 \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| - \| - \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Capex Group Inc. 5276 Knott Crescent Ottawa Ontario Canada K4M 1C2 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 81,539 \| $49,999.71 \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Cromie Family Trust 3302 Myers Lane Burlington Ontario Canada L7N 1K7 email@example.com firstname.lastname@example.org Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| 3,833,333 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com NOTICE OF CLAIM Daniel Sorger 3045 Bagley Ave, Los Angeles, CA 90034 firstname.lastname@example.org Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| 50,000 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com NOTICE OF CLAIM David Robertson 3704 44 Charles Street West Toronto Ontario Canada M4Y 1R8 firstname.lastname@example.org Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| - \| - \| \| Common Shares \| 5,666,667 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com NOTICE OF CLAIM DPATAMS Inc. 151 Eglinton Avenue Toronto Ontario Canada M4R 1A6 firstname.lastname@example.org Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com NOTICE OF CLAIM Edward D. Andrew 7 Donwood s Drive Toronto Ontario Canada M4N 2E9 firstname.lastname@example.org Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|----------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com NOTICE OF CLAIM Frontures Opportunity Fund I LP 129 5214-F Diamond Heights Boulevard San Francisco California United States 94131-2175 firstname.lastname@example.org Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|-----------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 51,443 \| $31,544.85 \| \| Series Seed-3 Preferred Shares \| 41,154 \| $31,544.54 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com NOTICE OF CLAIM Gary Meltzer 100 Barclay Street New York New York United States 10007 firstname.lastname@example.org Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 41,154 \| $31,544.54 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: email@example.com NOTICE OF CLAIM Giovanni Tavernese and Luigi Tavernese, jointly 17 Edgar Drive Brantford Ontario Canada N3R 6X7 firstname.lastname@example.org email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM GreenSky Accelerator Fund IV, LP 5th Floor 6 Adelaide Street East Toronto Ontario Canada M5C 1H6 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 1,542,922 \| $1,182,649.71 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM GreenSky Accelerator Fund IV, (U.S.) LP 5th Floor 6 Adelaide Street East Toronto Ontario Canada M5C 1H6 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 226,484 \| $173,599.99 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM HDG Capital Inc. 62 Moses Crescent Markham Ontario Canada L6C 1W2 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 130,463 \| $99,999.89 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Hockey Bags Inc. 85 Lascelles Boulevard Toronto Ontario Canada M5P 2E3 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 130,463 \| $99,999.89 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Inari Ventures I GMBH & Co. KG 18 Drosse Ibartweg Erfurt Thüringen Germany 99099 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| 246,927 \| $151,415.64 \| \| Series Seed-3 Preferred Shares\| - \| - \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM James A.T. Clare Prof Corp 3400 First Canadian Place 130 Toronto Ontario Canada M5X 1A4 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|----------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 407,697 \| $249,999.80 \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Jason Donville # 1302 505 Richmond Street West Toronto Ontario Canada M5V 0P4 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| 407,697 \| $249,999.80 \| \| Series Seed-3 Preferred Shares\| - \| - \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Jeff Kilborn 1342 Revell Drive Ottawa Ontario Canada K4M 1K8 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 26,092 \| $19,999.52 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM John Graham John Graham 24 Springbrook Gardens Toronto Ontario Canada M8Z 3B6 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|-----------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 163,078 \| $99,999.43 \| \| Series Seed-3 Preferred Shares \| 130,463 \| $99,999.89 \| \| Common Shares \| 125,000 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM JPATAMS Inc. 151 Eglinton Avenue Toronto Ontario Canada M4R 1A6 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM L-Spark Corporation 140 340 Legget Drive Kanata Ontario Canada K2K 1Y6 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|--------------\|----------------------\| \| $39,000.00 \| Canadian Dollar \| Unsecured \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|--------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 391,389 \| $239,999.73 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Mario Carrieri 1371 Northmount Avenue Mississauga Ontario Canada L5E 1Y4 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Markus Ament 16B Calle Darío Aparicio Madrid Comunidadde Madrid Spain 28023 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 102,886 \| $63,089.70 \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Myers Lane Investments Ltd. 5100 199 Bay Street Toronto Ontario Canada M5L 1L5 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 97,846 \| $74,998.96 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Nevcaut Ventures Fund I, LP 177 Trillium Irvine California United States 92618 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 329,236 \| $252,359.39 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Paul Brindle 646 West Oval Drive Burlington Ontario Canada L7T1B9 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Paul Manias 57 Rose Park Drive Toronto, ON M4T 1R2 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| 50,000 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Richard Cromie 3302 Myers Lane Burlington Ontario Canada L7N 1K7 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| 500,000 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM RLEA Holdings Inc. 117 Wimbleton Rd Toronto, ON M9A3S4 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| 50,000 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Stephen Geist 76 The Kingsway Toronto Ontario Canada M8X 2T5 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 122,309 \| $74,999.88 \| \| Series Seed-3 Preferred Shares \| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Tony Wonnacott 259 Hillsdale Avenue East Toronto, Ontario M4S 1T7 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| 100,000 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Trinity Capital Partners Corporation 24 Springbrook Gardens Toronto Ontario Canada M8Z 3B6 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| - \| - \| \| Series Seed-3 Preferred Shares \| - \| - \| \| Common Shares \| 125,000 \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Verite International Holdings Limited 202 4211 Yonge Street Toronto Ontario Canada M2P 2A9 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares\| - \| - \| \| Series Seed-2 Preferred Shares\| - \| - \| \| Series Seed-3 Preferred Shares\| 130,463 \| $99,999.89 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Victor Duong 73 Winners Circle Toronto Ontario Canada M4L 3Y7 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 122,309 \| $74,999.88 \| \| Series Seed-3 Preferred Shares \| 65,231 \| $49,999.56 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM White Rocks Holdings Inc. 74 Balmoral Avenue Toronto Ontario Canada M4V 1J4 email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|---------------------\| \| \| \| \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|-----------------------\|--------------\|-------------------\| \| Series Seed-1 Preferred Shares \| - \| - \| \| Series Seed-2 Preferred Shares \| 407,697 \| $249,999.80 \| \| Series Seed-3 Preferred Shares \| 195,694 \| $149,999.45 \| \| Common Shares \| - \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org NOTICE OF CLAIM Business Development Bank of Canada Attn: Corey Zalcman email@example.com Pursuant to an Order of the Ontario Superior Court dated November 23, 2022 (the “Appointment Order”), MNP Ltd. (the “Liquidator”) was appointed as liquidator of Paidiem Payment Solutions Inc. (the “Corporation”). A copy of the Appointment Order can be found at https://mnpdebt.ca/en/corporate/corporate-engagements/paidiempaymentsolutions. Based on the books and records of the Corporation, the Liquidator believes that you have the following Claim: Amount owing to you by the Corporation: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|--------------\|----------------------\| \| $166,400.00 \| Canadian Dollar \| Secured \| Shares of the Corporation owned by you: \| Class of Shares \| Number Owned \| Amount (CAD$) \| \|----------------------------------\|--------------\|---------------\| \| Series Seed-1 Preferred Shares \| N/A \| - \| \| Series Seed-2 Preferred Shares \| N/A \| - \| \| Series Seed-3 Preferred Shares \| N/A \| - \| \| Common Shares \| N/A \| - \| If you agree that you are owed only the amount identified above or own only the shares of the Corporation identified above, you do not have to do anything. IF YOU BELIEVE THAT THE CORPORATION OWES YOU MORE MONEY OR THAT YOU OWN MORE (OR DIFFERENT) SHARES OF THE CORPORATION, YOU ARE REQUIRED TO SEND A PROOF OF CLAIM (ENCLOSED OR ATTACHED) TO THE LIQUIDATOR TO BE RECEIVED BY 5:00 P.M. LOCAL TORONTO TIME ON JANUARY 12 2022 (THE “CLAIMS BAR DATE”). MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. 111 Richmond Street West, Suite 300 Toronto, ON M5H 2G4 Attention: Akhil Kapoor Phone: 647-475-4573 Fax: 416-596-7894 E-mail: firstname.lastname@example.org SCHEDULE E PROOF OF CLAIM IN THE MATTER OF THE WINDING-UP PROCEEDING OF PAIDIEM PAYMENT SOLUTIONS INC. (“THE “CORPORATION”) 1. PARTICULARS OF CLAIMANT Full Legal Name of Claimant: __________________________________________ (the “Claimant”) has the Claim against the Corporation described below. Full Mailing Address of the Claimant: ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ Telephone Number of Claimant: _______________________________________ Facsimile Number of Claimant: _________________________________________ Attention (Contact Person): ___________________________________________ Email Address: ______________________________________________________ 2. PROOF OF CLAIM: I, ___________________________ [Name of Claimant or Representative of the Claimant], do hereby certify that I am (please check one): ☐ the Claimant; or ☐ am ___________________________ [Position or Office Held] of the Claimant and have personal knowledge of all the circumstances connected with the Claim against the Corporation. 3. PARTICULARS OF CLAIM (Please check and complete all applicable): ☐ Creditor Claim: \| Amount of Claim \| Currency \| Secured or Unsecured \| \|-----------------\|----------\|----------------------\| \| \| \| \| \| \| \| \| Details of the Creditor Claim, including, if applicable, the security held: ___________________________________________________________________ ☐ Shareholder Claim: \| Class of Shares \| Number Owned \| \|-----------------\|--------------\| \| \| \| \| \| \| \| \| \| IF ADDITIONAL SPACE IS REQUIRED, PLEASE ATTACH A SCHEDULE. THE CLAIMANT SHOULD PROVIDE PARTICULARS OF THE CLAIM AND COPIES OF SUPPORTING DOCUMENTATION. 4. FILING OF CLAIMS: This Proof of Claim together with supporting documentation must be returned and received by the Liquidator, no later than 5:00 p.m. local Toronto time on [Date], to the email address or address listed below. This Proof of Claim must be delivered by email, facsimile, personal delivery, courier or prepaid mail to the following address: Address of the Liquidator MNP Ltd. in its capacity as court-appointed Liquidator of Paidiem Payment Solutions Inc. Attention: Phone: Fax: E-mail: DATED at _______________ this ______ day of ________________, 2022 (Signature of Witness) (Signature of individual completing this form) RESOLUTION OF THE SHAREHOLDERS OF PAIDIEM PAYMENT SOLUTIONS INC. (the “Corporation”) WHEREAS pursuant to the order of the Honourable Mr. Justice Cavanagh of the Ontario Superior Court of Justice (Commercial List) dated November 23, 2022 (Court File No. CV-22-00690376 - 00CL): (i) the Corporation was ordered to be wound-up pursuant to Part XVI of the Ontario Business Corporations Act, R.S.O. 1990, c.B.16; and (ii) MNP Ltd. (the “Liquidator”) was appointed as liquidator with the power, inter alia, to sell, the assets of the Corporation. AND WHEREAS the Liquidator intends to implement a stalking-horse based sales process on the terms outlined in the sales process protocol annexed hereto as Schedule “A” (the “Sales Process Protocol”) AND WHEREAS the Liquidator (on behalf of the Corporation) as Vendor has negotiated the terms of a stalking-horse asset purchase agreement dated December 21, 2022 with 14546865 Canada Inc. as Purchaser in the form annexed hereto as Schedule “B” (the “Stalking Horse Asset Purchase Agreement”) NOW THEREFORE BE IT RESOLVED THAT: (i) the Corporation is satisfied that the Sales Process Protocol provides for a commercially reasonable process for the sale of the Corporation’s assets, and it is hereby approved; and (ii) the Corporation is satisfied that the Stalking Horse Asset Purchase Agreement entered into on its behalf by the Liquidator is commercially reasonable and it is hereby approved. THE FOREGOING RESOLUTION is hereby consented to by the shareholders of the Corporation entitled to vote thereon at a meeting of shareholders as evidenced by their signatures hereto in accordance with the Articles of the Corporation (as amended) and with the provisions of the Ontario Business Corporations Act, R.S.O. 1990, c.B.16, this ___ day of December, 2022. A. HOLDERS OF COMMON SHARES DocuSigned by: Richard Cromie Cromie Family Trust Per: Richard Cromie I have authority to bind the trust DocuSigned by: David Robertson David Robertson Trinity Capital Partners Corporation Per: John Graham Title: President I have authority to bind the corporation DocuSigned by: Tony Wonnacott Tony Wonnacott DocuSigned by: Daniel Sorger Daniel Sorger DocuSigned by: John Graham John Graham DocuSigned by: RIDEA Holdings Inc. Per: Aaron Wolfe Title: Director DocuSigned by: Paul Manias Paul Manias B. HOLDERS OF SERIES SEED-1 PREFERRED SHARES DocuSigned by: Ziqiang Tang Berkley Skydeck Fund I LP Per: Ziqiang Tang Title: Managing Member I have authority to bind the partnership A. HOLDERS OF COMMON SHARES Cromie Family Trust Per: I have authority to bind the trust David Robertson Trinity Capital Partners Corporation Per: John Graham Title: President I have authority to bind the corporation Tony Wonnacott Daniel Sorger Richard Cromie John Graham B. HOLDERS OF SERIES SEED-1 PREFERRED SHARES Berkley Skydeck Fund I LP Per: Title: I have authority to bind the partnership C. HOLDERS OF SERIES SEED-2 PREFERRED SHARES John Graham Jason Donville Victor Duong CapEx Group Inc. Per: Jennifer Boyle Title: Chief Executive Officer I have authority to bind the corporation Inari Ventures I GmbH & C. KG Per: Christian Stiebner Title: Managing Director I have authority to bind the corporation Armen Meyer White Rocks Holdings Inc. Per: Peter Shippen Title: Director I have authority to bind the corporation James A.T. Clare Professional Corp. Per: James Clare Title: President I have authority to bind the corporation Stephen Geist Frontures Opportunity Fund I LP Per: Samir Ghosh Title: Manager I have authority to bind the partnership Markus Ament C. HOLDERS OF SERIES SEED-2 PREFERRED SHARES John Graham White Rocks Holdings Inc. Per: Title: I have authority to bind the corporation Jason Donville James A.T. Clare Professional Corp. Per: Title: I have authority to bind the corporation Victor Duong Stephen Geist CapEx Group Inc. Per: Title: I have authority to bind the corporation Frontures Opportunity Fund I LP Per: Title: I have authority to bind the partnership Inari Ventures I GmbH & C. KG Per: Title: I have authority to bind the corporation Markus Ament Armen Meyer C. HOLDERS OF SERIES SEED-2 PREFERRED SHARES John Graham White Rocks Holdings Inc. Per: Title: I have authority to bind the corporation Jason Donville James A.T. Clare Professional Corp. Per: James Clare Title: President I have authority to bind the corporation Victor Duong Stephen Geist CapEx Group Inc. Per: Title: I have authority to bind the corporation Frontures Opportunity Fund I LP Per: Title: I have authority to bind the partnership Inari Ventures I GmbH & C. KG Per: Title: I have authority to bind the corporation Markus Ament Armen Meyer D. HOLDERS OF SERIES SEED-3 PREFERRED SHARES John Graham L-Spark Corporation Per: Leo Lax Title: Managing Director I have authority to bind the corporation White Rocks Holdings Inc. Per: Peter Shippen Title: Director I have authority to bind the corporation Victor Duong Frontures Opportunity Fund I LP Per: Samir Ghosh Title: Manager I have authority to bind the partnership GreenSky Accelerator Fund IV, LP Per: Michael T. R. List Title: Director I have authority to bind the partnership GreenSky Accelerator Fund IV (US), LP Per: Michael T.R. List Title: Director I have authority to bind the partnership Verite International Holdings Limited Per: William S. Fielding Title: President and Secretary I have authority to bind the corporation JPATAMS Inc. Per: Jeffrey Preszler Title: Authorized Signatory I have authority to bind the corporation DPATAMS Inc. Per: David Preszler Title: Authorized Signatory I have authority to bind the corporation Paul Brindle DocuSigned by: Michael T R List Hockey Bags Inc. Per: Michael T. R. List Title: Director I have authority to bind the corporation DocuSigned by: HDG Capital Inc. Per: Derrick Milne Title: Director I have authority to bind the corporation DocuSigned by: Nevcaut Ventures Fund I, LP Nevcaut Ventures Fund I, LP Per: Title: I have authority to bind the partnership DocuSigned by: Myers Lane Investments Ltd. Per: David Saverie Title: Sole Director and President I have authority to bind the corporation DocuSigned by: Luigi Tavernese Luigi Tavernese DocuSigned by: Giovanni Tavernese Giovanni Tavernese DocuSigned by: Edward D. Andrew Edward D. Andrew DocuSigned by: Mario Carrieri Mario Carrieri DocuSigned by: Gary Meltzer Gary Meltzer DocuSigned by: Jeff Killborn Jeff Killborn Hockey Bags Inc. Per: Title: I have authority to bind the corporation HDG Capital Inc. Per: Title: I have authority to bind the corporation Nevcaut Ventures Fund I, LP Per: Dan Quan Title: General Partner I have authority to bind the partnership Myers Lane Investments Ltd. Per: Title: I have authority to bind the corporation Luigi Tavernese Giovanni Tavernese Edward D. Andrew Mario Carrieri Gary Meltzer Jeff Killborn Sales Process Protocol STALKING HORSE SALE PROCESS Paidiem Payment Solutions (the “Company”) Defined Terms 1. These terms and conditions, and the process described herein shall collectively be hereinafter referred to as the “Sale Process”. 2. All capitalized terms contained herein but not otherwise defined herein shall have the meanings ascribed thereto in the Agreement to which this schedule is appended. 3. For purposes hereof, “Stalking Horse Bid” shall mean the transaction for the business and assets of the Company (the “Transaction”) contemplated by the stalking horse asset purchase agreement (the “Stalking Horse Purchase Agreement”) between MNP Ltd. (the “Liquidator”), solely in its capacity as the Court-appointed Liquidator of the Company, as vendor, and 14546865 Canada Inc., as purchaser, (the “Stalking Horse Bidder”) approved by the Shareholders of the Company. Commencement of the Sale Process 4. The Sale Process shall commence immediately following the date on which the Stalking Horse Purchase Agreement and this Sale Process is unanimously approved by the Company’s shareholders (the “Commencement Date”). 5. Within three (3) business days of the Commencement Date, the Liquidator shall contact parties identified (the “Prospective Participants”) who may be interested in purchasing the business and assets of the Company (collectively, the “Assets”) and provide those parties with a copy of a “teaser” document and the form of non-disclosure and confidentiality agreement (the “NDA”). The teaser document shall contain general details about the opportunity to purchase the Assets (the “Opportunity”) as well as some general background information about the Company’s business. 6. Within ten business (10) days of the Commencement Date, or as soon thereafter as is practical, if the Liquidator deems it advisable and cost-effective, the Liquidator shall arrange for the publication of a notice advertising the Opportunity in the National Post and/or such other trade publications or other publications as the Liquidator may deem appropriate or advisable. First Due Diligence Period 7. Commencing on the Commencement Date (and after each respective Prospective Participant has executed the NDA), the Liquidator shall make available to the Prospective Participant the following: a) a copy of the Stalking Horse Purchase Agreement; and b) initial access to an electronic data room, maintained by the Liquidator, which shall contain information pertaining to the Opportunity, which is in the Liquidator’s possession. 8. If a Prospective Participant has delivered an executed NDA acceptable to the Liquidator, then such Prospective Participant will be deemed to be a “Qualified Bidder”. 9. Notwithstanding the foregoing, neither the Liquidator, nor the Company or their respective representatives will be obligated to furnish any information relating to the Assets or the Company to any person, including to parties who the Liquidator reasonably believes are not likely to be serious offerors. The Liquidator makes no representation or warranty, express or implied, as to the information provided through this due diligence process or otherwise. First Deadline – Submission of Non-Binding Letters of Interest 10. All Qualified Bidders must submit their non-binding letter of interest (“LOI”) in writing to and received by the Liquidator at 1 Adelaide Street East, Suite 1900, Toronto, ON, M5C 2V9, attention: Matthew Lem, or electronically to email@example.com by no later than 5:00 p.m. (Toronto time) on February 6, 2023 (the “LOI Deadline”). 11. Each LOI shall be submitted on the provided form (the “LOI Template”), and include among other things, detailed descriptions of: a) the Assets proposed to be acquired; b) the proposed purchase price or other consideration for the Assets to be acquired, including the form of payment; c) the Qualified Bidder’s identity, and the identity of its principals; d) applicable conditions; e) evidence of the ability of the Qualified Bidder to consummate the Transaction, including evidence of financial means; f) the proposed timing for completion of the Transaction; and g) the requisite deposit Qualified LOIs 12. A LOI will only be considered a “Qualified LOI”, if it is submitted before the LOI Deadline and if it meets the following minimum criteria: a) it must be submitted in writing, substantially in the form the LOI Template; b) it must be for a price equal to or greater than the sum of: (i) the Purchase Price under the Stalking Horse Purchase Agreement; (ii) the Break Fee (as defined herein) of $50,000; and (iii) $100,000. c) it must be accompanied by a deposit (the “LOI Deposit”) in the form of a certified cheque or bank draft (or in the form of confirmed wire transfer in the case of offers submitted electronically) payable to “MNP Ltd., in trust” which is equal to the greater of: (i) $315,000; and (ii) ten (10%) percent of the total purchase price payable under the LOI; and d) it must include written evidence, satisfactory to the Liquidator, that the offeror has the financial means to complete the proposed acquisition. Evaluation of LOIs 13. Within three (3) Business Days following the LOI Deadline, the Liquidator shall evaluate the LOIs and determine in its sole discretion whether there are one or more Qualified LOIs. 14. If only one (1) Qualified LOI is submitted (other than the Stalking Horse Bid) and such LOI is from David Robertson (“Robertson”) or an entity controlled by Robertson, or an entity that Robertson is a member of a group that controls such entity, then the sale process shall proceed to the Auction (as later defined). For greater clarity, there will be no second due diligence period and there will be no Bid Deadline (as defined herein). 15. If no LOIs are submitted by the LOI Deadline or the Liquidator has determined in its sole discretion that there are no Qualified LOIs (other than the Stalking Horse Bid), the sale process shall end, and the Liquidator will proceed to close the Transaction with the Stalking Horse Bidder. Second Due Diligence Period 16. If one or more Qualified LOIs are received by the LOI Deadline, the Liquidator shall: a) extend the due diligence period to March 8, 2023; b) invite those Qualified Bidders who have submitted a Qualified LOI to continue to perform further due diligence; c) broaden access to the electronic data room and more detailed and sensitive materials for those Qualified Bidders who have submitted a Qualified LOI; Bid Deadline 17. All offers must be submitted in writing to and received by the Liquidator at 1 Adelaide Street East, Suite 1900, Toronto, ON, M5C 2V9, attention: Matthew Lem, or electronically to firstname.lastname@example.org by no later than 5:00 p.m. (Toronto time) on March 8, 2023 (the “Bid Deadline”). Qualified Bids 18. An offer will only be considered in this Sale Process, in which case it shall be considered a “Qualified Bid”, if it is submitted before the Bid Deadline and if it meets the following minimum criteria: a) it must be submitted in writing, substantially in the form of Stalking Horse Purchase Agreement, with any changes to the offer blacklined against the Stalking Horse Purchase Agreement; b) it must be for a price equal to or greater than the sum of: (i) the Purchase Price under the Stalking Horse Purchase Agreement; (ii) the Break Fee (as defined herein) of $50,000; and (iii) $100,000. c) it must be irrevocable until five (5) business days after the Auction (as defined herein); d) it must be accompanied by an additional deposit (the “Bid Deposit”), if necessary, in the form of a certified cheque or bank draft (or in the form of confirmed wire transfer in the case of offers submitted electronically) payable to “MNP Ltd., in trust”, such that the aggregate of the Bid Deposit and the LOI Deposit is at a minimum equal to the greater of: (i) $472,500; and (ii) fifteen (15%) percent of the total purchase price payable under the Qualified Bid e) it includes an acknowledgement that the offeror has relied solely on its own independent review and investigation and that it has not relied on any representation by the Company, the Liquidator or their respective agents, employees or advisers; f) it must not contain any condition or contingency relating to due diligence or financing or any other material conditions precedent to the offeror’s obligation to complete the transaction; and g) it must include written evidence, satisfactory to the Liquidator, that the offeror has the financial means to complete the proposed acquisition, provided however that the Liquidator may, exercising its reasonable discretion, waive compliance with one or more of the foregoing Qualified Bid requirements and deem such non-compliant offer to be a Qualified Bid. Evaluation of Qualified Bids 19. Within Five (5) Business Days following the Bid Deadline, the Liquidator shall evaluate the offers received (other than the Stalking Horse Bid), if any, and determine in its sole discretion whether there are one or more Qualified Bids. 20. The Stalking Horse Bid shall be deemed to be a Qualified Bid. 21. Offers for all or part of the Assets will be considered. 22. If no Qualified Bid is received by the Bid Deadline (other than the Stalking Horse Bid), the Auction (as defined herein) will not be held. Auction 23. If more than one Qualified Bid is received by the Bid Deadline, the Liquidator shall extend invitations by phone, fax and/or email by 10:00 a.m. E.S.T. on March 15, 2023 to all bidders who submitted Qualified Bids and to the Stalking Horse Bidder to attend an auction (the “Auction”). The Auction shall be held at 10:00 a.m. on March 22, 2023 at the offices of the Liquidator or by teleconference, video conference or other form of electronic telecommunications, as the Liquidator may deem fit. 24. The Liquidator shall conduct the Auction. At the Auction, the bidding shall begin initially with the highest Qualified Bid and subsequently continue in multiples of $50,000, or such other amount as the Liquidator determines to facilitate the Auction. Additional consideration in excess of the amount set forth in the highest Qualified Bid must be comprised only of cash consideration. The format and other procedures for the Auction shall be determined by the Liquidator in its sole discretion. Selection of the Winning Bid 25. The winning bid (the “Winning Bid”) shall be, either: a. in the event that no other Qualified Bid is received by the Bid Deadline, the Stalking Horse Bid; or, b. in the event that multiple Qualified Bids are received, following the conclusion of the Auction (if applicable), the party submitting the highest and best offer through the Auction, which the Liquidator is satisfied, acting reasonably, is capable of being completed as required by the Liquidator. Court Approval 26. As soon as practicable after the determination of the Winning Bid and following execution and delivery of a definitive agreement, the Liquidator will make a motion to the Court (the “Approval Motion”) for an approval and vesting order in respect of the Winning Bid and the underlying purchase agreement (the “Final APA”). Other Terms 27. Closing of the Transaction will occur once the Approval and Vesting Order is granted by the Court and in accordance with the terms of the Final APA. 28. All deposits received (except such deposit forming part of the Winning Bid) shall be held by the Liquidator “in trust”. All deposits submitted by Prospective Participants who did not submit the Winning Bid shall be returned, without interest, as soon as practicable following the date on which any such offers are rejected hereunder. The deposit forming part of the Winning Bid shall be dealt with in accordance with the Final APA. 29. In the event that a deposit is forfeited for any reason it shall be forfeited as liquidated damages and not as a penalty. 30. All Qualified Bids (other than the Winning Bid) shall be deemed rejected once the Approval and Vesting Order is granted by the Court and becomes a final non-appealable order. 31. The Liquidator shall have the right to adopt such other rules, not inconsistent with the Sale Process described herein, that, in its reasonable discretion, will better promote the goals of the Sale Process. 32. In the event that the Stalking Horse Bid is not the Winning Bid, then the Stalking Horse Bidder shall be entitled to a break fee of $50,000 (the “Break Fees”) which shall be payable by the Liquidator on the closing of the Winning Bid. Stalking Horse Asset Purchase Agreement STALKING HORSE ASSET PURCHASE AGREEMENT This stalking horse asset purchase agreement is dated December 21, 2022 between MNP Ltd. (“MNP”), solely in its capacity as the Court-appointed Liquidator of Paidiem Payment Solutions Inc., (referred to herein as the “Vendor” or the “Liquidator”) and 14546865 Canada Inc. (the “Purchaser”, collectively with the Vendor, the “Parties” and either one, a “Party”). RECITALS: (a) Pursuant to an Order, dated November 23, 2022, granted by the Honourable Mr. Justice Cavanagh of the Ontario Superior Court of Justice (Commercial List) (the “Court”), Paidiem Payment Solutions Inc. (the “Company”) was ordered to be wound-up pursuant to Part XVI of the Business Corporations Act (Ontario) (the “OBCA”) and MNP was appointed as liquidator pursuant to subsection 210(1) of the OBCA; (b) The Vendor wishes to sell, and the Purchaser has agreed to purchase, the Purchased Assets, upon the terms and conditions contained in this Agreement; and (c) The Vendor intends to seek the approval from all of the Company’s Shareholders to enter into this Agreement and to conduct a marketing and sale process in accordance with the Stalking Horse Sales Process (as such term is later defined). In consideration of the above and for other good and valuable consideration, the Parties agree as follows. ARTICLE 1 INTERPRETATION Section 1.1 Definitions. As used in this Agreement, including the recitals hereto, the following terms have the following meanings: “Agreement” means this stalking horse asset purchase agreement, including all schedules annexed hereto, as the same may be amended, supplemented or otherwise modified from time to time in accordance with the terms hereof. “Approval and Vesting Order” means an approval and vesting order of the Court in form and substance acceptable to the Parties, acting reasonably, that, among other things, approves this Agreement and the transactions contemplated hereby, and vests in and to the Purchaser the Purchased Assets free and clear of and from any and all Encumbrances. “Assigned Agreement” means each agreement listed in Schedule “B”, which the Company is a party and the benefit of which is assigned to the Purchaser in accordance with Article 4 or by way of an Assignment Order. “Assignment Order” means an order or orders of the Court authorizing the assignment to the Purchaser of the Assigned Agreements, in form and substance satisfactory to the Purchaser and the Vendor, each acting reasonably. “Assumed Liabilities” shall have the meaning defined in Section 3.1. “Bid Deadline” means 5:00 p.m.(Toronto time) on the date, as set out in the Stalking Horse Sales Process. “Break Fee” means the compensation in consideration for the Purchaser’s expenditure of time and money in submitting this Stalking Horse Bid in the event that such bid is not the Winning Bid approved by the Court. “Business” means the business of the Company of developing and marketing the Paidiem software platform and providing an end-to-end solution for the contingent workforce ecosystem. “Business Day” means any day of the year, other than a Saturday, Sunday or any day on which Canadian chartered banks are closed for business in Toronto, Ontario. “Closing” shall have the meaning defined in Section 11.1. “Closing Date” means the date that is three (3) Business Days after the conditions of Closing in Article 10 of this Agreement are satisfied or waived, or such earlier or later date that the Parties, acting reasonably, may mutually agree. “Consent Required Agreements” means the agreements to which the Company is a party, and which are not assignable in whole or in part without the consent, approval or waiver of the applicable parties. “Court” shall have the meaning defined in the Recitals or such other court having jurisdiction. “Deposit” shall have the meaning defined in Section 5.1. “Encumbrances” means any mortgage, charge, pledge, hypothec, security interest, assignment, lien (statutory or otherwise), easement, license, right of first refusal or first offer, title retention agreement or arrangement, conditional sale, deemed or statutory trust, restrictive covenant, execution, levies, or other financial or monetary claims or encumbrances of any nature (whether at Law or equity), and any contract, option, right or privilege (whether by Law, contract or otherwise) capable of becoming any of the foregoing. “ETA” shall have the meaning defined in Section 6.1. “Excluded Assets” shall have the meaning defined in Section 2.2. “Excluded Liabilities” shall have the meaning defined in Section 3.2(1). “Governmental Authority” means: (i) any governmental or public department, central bank, court, minister, governor-in-council, cabinet, commission, tribunal, board, bureau, agency, commissioner or instrumentality, whether international, multinational, national, federal, provincial, state, county, municipal, local, or other; (ii) any subdivision or authority of any of the above; and (iii) any quasi-governmental or private body exercising any regulatory, expropriation or taxing authority under or for the account of any of the above. “GST/HST” means all goods and services tax and harmonized sales tax imposed under Part IX of the ETA. “Intellectual Property” means domestic and foreign: (i) patents, applications for patents and reissues, divisions, continuations, renewals, extensions and continuations-in-part of patents or patent applications; (ii) proprietary and non-public business information, including inventions (whether patentable or not), invention disclosures, improvements, discoveries, trade secrets, confidential information, know-how, methods, processes, designs, technology, technical data, schematics, formulae and customer lists, and documentation relating to any of the foregoing; (iii) copyrights, copyright registrations and applications for copyright registration; (iv) mask works, mask work registrations and applications for mask work registrations; (v) designs, design registrations, design registration applications and integrated circuit topographies; (vi) trade names, business names, corporate names, domain names, website names and world wide web addresses, common law trade-marks, trade-mark registrations, trade mark applications, trade dress and logos, and the goodwill associated with any of the foregoing; (vii) computer software and programs (both source code and object code form), all proprietary rights in the computer software and programs and all documentation and other materials related to the computer software and programs; and (viii) any other intellectual property and industrial property. “ITA” means the Income Tax Act (Canada). “Laws” means any principle of common law and all applicable: (i) laws, constitutions, treaties, statutes, codes, ordinances, orders, decrees, rules, regulations and by-laws; (ii) judgments, orders, writs, injunctions, decisions, awards and directives of any Governmental Authority; and (iii) to the extent that they are treated as binding by the Governmental Authority or have the force of law, policies, guidelines, notices and protocols of any Governmental Authority. “Liability” means any debt, loss, damage, adverse claim, fines, penalties, liability or obligation (whether direct or indirect, known or unknown, asserted or unasserted, absolute or contingent, accrued or unaccrued, matured or unmatured, determined or determinable, disputed or undisputed, liquidated or unliquidated, or due or to become due, and whether in or under statute, contract, tort, strict liability or otherwise), and includes all costs and expenses relating thereto (including all fees, disbursements and expenses of legal counsel, experts, engineers and consultants and costs of investigation) (collectively, “Liabilities”). “LOI” has the meaning given in the Stalking Horse Sales Process. “LOI Deadline” means 5:00 p.m.(Toronto time) on the date, as set out in the Stalking Horse Sales Process. “Notice” shall have the meaning defined in Section 13.1. “Parties” shall have the meaning defined in the Recitals. “Person” includes an individual, partnership, association, body corporate, Liquidator, executor, administrator, legal representative, government (including any Governmental Authority) or any other entity, whether or not having legal status. “Purchase Price” shall have the meaning defined in Section 5.1. “Purchased Assets” shall have the meaning defined in Section 2.1. “Purchaser” shall have the meaning defined in the Recitals. “Qualified Bid(s)” has the meaning given in the Stalking Horse Sales Process. “Qualified LOI(s)” has the meaning given in the Stalking Horse Sales Process. “Shareholders” means all of the shareholders of the Company who hold one or more common and/or preferred shares of the Company as of November 23, 2022. “Stalking Horse Sales Process” means the sales process attached as Schedule “A”. “Stalking Horse Bid” shall have the meaning defined in Section 10.1(a). “Tangible Personal Property” means, collectively, equipment, supplies, computers, telephones and other tangible personal property. “Tax” means: (i) any and all taxes, duties, fees, excises, premiums, assessments, imposts, levies and other charges or assessments of any kind whatsoever imposed by any Governmental Authority, whether computed on a separate, consolidated, unitary, combined or other basis, including those levied on, or measured by, or described with respect to, income, gross receipts, profits, gains, windfalls, capital, capital stock, production, recapture, transfer, land transfer, license, gift, occupation, wealth, environment, net worth, indebtedness, surplus, sales, goods and services, harmonized sales, use, value-added, excise, special assessment, stamp, withholding, business, franchising, real or personal property, health, employee health, payroll, workers’ compensation, employment or unemployment, severance, social services, social security, education, utility, surtaxes, customs, import or export, and including all license and registration fees and all employment insurance, health insurance and government pension plan premiums or contributions; (ii) all interest, penalties, fines, additions to tax or other additional amounts imposed by any Governmental Authority on or in respect of amounts of the type described in clause (i) above or this clause (ii); (iii) any liability for the payment of any amounts of the type described in clauses (i) or (ii) as a result of being a member of an affiliated, consolidated, combined or unitary group for any period; and (iv) any liability for the payment of any amounts of the type described in clauses (i) or (ii) as a result of any express or implied obligation to indemnify any other Person or as a result of being a transferee or successor in interest to any Party. “Time of Closing” means 12:01 a.m. (Toronto time) on the Closing Date, or such other time as the Parties may agree. “Transfer Taxes” shall have the meaning defined in Section 6.2. “Liquidator’s Certificate” shall have the meaning defined in Section 11.1(3). “Vendor” shall have the meaning defined in the Recitals. “Winning Bid” has the meaning given in the Stalking Horse Sales Process. “Winning Bidder” shall have the meaning defined in Section 10.1(b). Section 1.2 References to Vendor and Purchaser References in this Agreement to the “Vendor”, shall mean both the Vendor and the Company, as the context may require. References in this Agreement to the “Purchaser” shall mean the Purchaser or a Person to whom title is directed on Closing, as the context may require. Section 1.3 Date for Any Action. If the date on which any action is required to be taken hereunder by a Party is not a Business Day, such action shall be required to be taken on the next succeeding day which is a Business Day. Section 1.4 Gender and Number. Any reference in this Agreement to gender includes all genders. Words importing the singular number only shall include the plural and vice versa. Section 1.5 Headings, etc. The division of this Agreement into Articles and Sections and the insertion of headings are for convenient reference only and are not to affect its interpretation. Section 1.6 Currency. All references in this Agreement to dollars or to $ are expressed in Canadian currency unless otherwise specifically indicated. Section 1.7 Certain Phrases, etc. In this Agreement (i) the words “including”, “includes” and “include” mean “including (or includes or include) without limitation”, and (ii) the phrase “the aggregate of”, “the total of”, “the sum of”, or a phrase of similar meaning means “the aggregate (or total or sum), without duplication, of”. Unless otherwise specified, the words “Article” and “Section” followed by a number mean and refer to the specified Article or Section of this Agreement. Section 1.8 Statutes. Except as otherwise provided in this Agreement, any reference in this Agreement to a statute refers to such statute and all rules, regulations and interpretations made under it, as it or they may have been or may from time to time be modified, amended or re-enacted. Section 1.9 Schedules. The schedules attached to this Agreement form an integral part of this Agreement for all purposes of it. ARTICLE 2 PURCHASED ASSETS Section 2.1 Purchased Assets. Subject to the terms and conditions of this Agreement, except for the Excluded Assets, the Vendor agrees to sell, assign and transfer to the Purchaser and the Purchaser agrees to purchase from the Vendor, on the Closing Date, effective as of the Time of Closing, all tangible and intangible assets of the Company in the connection with the operation of the Business including, without limitation, all property of the Company set out below (collectively, the “Purchased Assets”), free and clear of all Encumbrances: (a) all Tangible Personal Property; (b) all Intellectual Property, including software and source code related to the Paidiem platform; (c) all prepaid expenses and deposits (including rent deposits), if any; (d) the benefit of all of the Assigned Agreements, provided that such benefit shall not be sold, transferred and assigned until the relevant agreement becomes an Assigned Agreement in accordance with Article 4 or pursuant to an Assignment Order; (e) to the extent transferrable, all orders, authorizations, approvals, licenses or permits of any Governmental Authority, if any, owned, held or used by the Company; (f) all information in any form relating to, or used in connection with, the Business, including books of account, financial and accounting information and records, personnel records, sales and purchase records, customer and supplier lists, business reports, operating guides and manuals, plans and projections, marketing and advertising materials, corporate records, and all other documents, files, correspondence and other information (whether in written, printed, electronic or computer printout form, or stored on computer discs or other data and software storage and media devices); (g) all telephone numbers; (h) the goodwill of the Company, including the exclusive right of the Purchaser to represent itself as carrying on the Business in continuation of and in succession to the Company; (i) all rights to the business names related to the Business including “Paidiem”; and (j) all warrant rights and equity interests in Paidiem Technologies Inc. Section 2.2 Excluded Assets. Notwithstanding anything herein contained to the contrary, the Purchaser shall not purchase the Vendor’s right, title and interest in and to the following assets (collectively, the “Excluded Assets”): (a) all cash or cash equivalents on hand or in any bank account, held by the Liquidator or to which the Liquidator is otherwise entered to collect on behalf of the estate of the Company, as at Closing; (b) all accounts and other amounts due, owing or accruing due to the Company, including but not limited all accounts receivable, receivables from any governmental authority and any tax refunds, income taxes recoverable or other tax credits, as at Closing; (c) all accounts and other amounts due from related parties; (d) the benefit of any contracts, agreements and/or understandings to which the Company is a party other than those contracts that are assigned to the Purchaser pursuant to Article 4 or an Assignment Order; and (e) original tax records and books and records pertaining thereto, minute books, corporate seals, taxpayer and other identification numbers and other documents relating to the organization, maintenance, capitalization or existence of the Company. The Purchaser may, at its option, prior to Closing, exclude any of the Purchased Assets from the transactions contemplated hereby by delivering to the Vendor written notice of same, whereupon such asset(s) shall be deemed to form part of the Excluded Assets. ARTICLE 3 ASSUMED LIABILITIES Section 3.1 Assumed Liabilities. Subject to the Closing, and except for the Excluded Liabilities, the Purchaser shall assume, as of the Time of Closing, all of the obligations and Liabilities of the Company’s estate and of the Vendor (and no other obligations or Liabilities) relating to (collectively, the “Assumed Liabilities”): (a) the Assigned Agreements; (b) the employee obligations, statutory, under common law or otherwise, of the former employees of the Company, who are offered and accept a position with the Purchaser; and (c) any other Liability which the Purchaser agrees in writing to assume on or before the Closing Date. Section 3.2 Excluded Liabilities. (1) Other than the Assumed Liabilities, the Purchaser shall not assume and shall have no obligation to discharge, perform or fulfill any Liability or obligation of the Company or the Vendor or in connection with the Purchased Assets or the Business (the “Excluded Liabilities”), whether known, unknown, direct, indirect, absolute, contingent or otherwise arising out of facts, circumstances or events, in existence on or prior to the Time of Closing or, subject to Article 4, on or prior to the date on which a contract to which the Vendor is a party becomes an Assigned Agreement, respectively. (2) Without limiting the generality of Section 3.2(1), the Purchaser shall not assume and shall have no obligation in respect of any of the Excluded Assets nor shall the Purchaser assume or be responsible for the payment of salaries, benefits, vacation entitlement, commission or any other compensation with respect to the employees of the Company that accrued prior to the Closing Date, unless and to the extent as mutually agreed to by the parties. ARTICLE 4 ASSIGNMENT AND ASSUMPTION OF AGREEMENTS Section 4.1 Assignment of Assigned Agreements. Subject to Section 4.2, on Closing the Vendor shall be deemed to have assigned the benefit of any Assigned Agreements and the Purchaser shall be deemed to have assumed, all of the Company’s obligations and Liabilities relating to such Assigned Agreements arising and accruing in respect of the period after Closing and not related to any default existing at, prior to or as a consequence of the Closing or of the assignment of such Assigned Agreements (collectively, the “Agreements Assumed Liabilities”). Section 4.2 Consent Required Agreements. (1) Nothing in this Agreement shall be construed as an agreement to assign any Consent Required Agreements, unless the consent, approval or waiver required to assign such Consent Required Agreements has been given or an Assignment Order has been made with respect to such Consent Required Agreements. (2) The Vendor and the Purchaser shall use reasonable commercial efforts to obtain the consents, approvals and waivers required for the assignment of the Consent Required Agreements that are designated as Assigned Agreements on or before Closing. (3) Upon the Purchaser’s request, the Vendor shall make an application or applications to a court of competent jurisdiction for an Assignment Order(s), should the Purchaser and Vendor not otherwise obtain any of the consents provided for in Section 4.2(2) above. Costs and expenses associated with obtaining the Assignment Order(s) shall be at the Vendor’s cost. ARTICLE 5 PURCHASE PRICE Section 5.1 Purchase Price. The aggregate purchase price for the Purchased Assets shall be THREE MILLION DOLLARS AND ZERO CENTS ($3,000,000.00) (the “Purchase Price”), exclusive of Transfer Taxes. Section 5.2 Payment of Purchase Price. The Purchase Price shall be satisfied by the Purchaser as follows, and the Vendor hereby directs the Purchaser to make the payments of the Purchase Price in accordance with this Section 5.2 and this shall be the Purchaser’s good and sufficient authority for so doing: (a) A deposit in the amount of FOUR HUNDRED AND FIFTY THOUSAND DOLLARS AND ZERO CENTS ($450,000.00) (the “Deposit”) by certified cheque, bank draft and/or wire transfer, on the execution in full of the Shareholders’ resolution approving this Agreement and the Stalking Horse Sale Process; and (b) as to the amount referred to in Section 5.1, less the amount of the Deposit, payable by cheque, certified cheque, bank draft and/or wire transfer, on Closing. Section 5.3 Allocation of Purchase Price. The Parties shall agree upon the allocation of the Purchase Price in respect of the Purchased Assets, both acting reasonably, prior to Closing. The Parties shall each report the purchase and sale of the Purchased Assets for all federal, provincial and local tax purposes in accordance with the agreed upon allocation and this Agreement. Section 5.4 Adjustments of Purchase Price. Except as otherwise provided in this Agreement, the Purchase Price shall not be adjusted in any manner whatsoever. ARTICLE 6 TAX MATTERS Section 6.1 ETA Elections. The Purchaser and the Vendor shall, if applicable, jointly elect under subsection 167(1) of the Excise Tax Act (Canada) (the “ETA”) and any equivalent or comparable corresponding provision under any applicable provincial or territorial legislation, in the form prescribed for the purposes of each such provision, in respect of the sale and transfer of the Purchased Assets and the Purchaser shall file such elections with the applicable tax authorities within the time and in the manner required by the applicable Law. Notwithstanding such elections, in the event it is determined by a Governmental Authority that there is a Liability of the Purchaser to pay, or of the Vendor to collect and remit, GST/HST (or similar provincial or territorial value-added or multi-staged Tax) in respect of the purchase and sale of the Purchased Assets hereunder, the Purchaser shall forthwith pay such GST/HST (and any similar provincial or territorial value-added or multi-staged Tax) to the applicable Governmental Authority, or to the Vendor for remittance to the appropriate Governmental Authority, as the case may be, and shall indemnify and save harmless the Vendor from any penalties and interest which may be payable by or assessed against the Vendor (or its representatives, agents, employees, directors or officers) under the ETA (and any applicable provincial or territorial legislation) in respect thereof. Section 6.2 Transfer Taxes. Subject to any available elections or exemptions contemplated by Section 6.1, the Purchaser shall be liable for and shall pay all federal and provincial sales taxes, transfer taxes, excise taxes, value-added taxes and all other similar Taxes or other like charges of any jurisdiction ("Transfer Taxes") (for greater certainty, excluding all income or capital taxes of the Vendor) properly payable in connection with the transfer of the Purchased Assets by the Vendor to the Purchaser. ARTICLE 7 EMPLOYEE MATTERS Section 7.1 Employment Matters The Purchaser shall have no obligation to offer employment to any employees of the Company nor shall it be considered a successor employer for any employees who are not offered or who are offered but do not accept a position with the Purchaser. Notwithstanding the foregoing, the Purchaser acknowledges and agrees that the Liquidator makes no representation nor warranty as to the application of any employment laws and whether or not any employee of the Company may or may not assert a claim (successful or not) as against the Purchaser under any such laws. ARTICLE 8 REPRESENTATIONS AND WARRANTIES Section 8.1 Vendor Representations and Warranties. The Vendor represents and warrants as follows to the Purchaser at the date of this Agreement and at the Closing Date and acknowledges and confirms that the Purchaser is relying upon such representations and warranties in connection with the purchase of the Purchased Assets and the assumption of the Assumed Liabilities: (1) Authority to Complete. Subject to obtaining the Approval and Vesting Order prior to Closing, on Closing the Vendor shall have the power and authority to complete the transactions contemplated hereby, in accordance with the terms and conditions of this Agreement and the Approval and Vesting Order. (2) Enforceability of Obligations. Subject to the Court issuing the Approval and Vesting Order and any other orders required by the Court in connection with the transactions contemplated hereby, this Agreement constitutes a valid and legally binding obligation of the Vendor enforceable against the Vendor in accordance with its terms. (3) Residence. The Vendor is not a non-resident of Canada for purposes of the ITA. (4) Registration. The Vendor is registered under Part IX of the ETA and its registration number is 784253676 RT0001. (5) Employees. There are no employees of the Company that the Liquidator has continued to employ. Section 8.2 Purchaser’s Representations and Warranties. The Purchaser represents and warrants as follows to the Vendor at the date of this Agreement and at the Closing Date and acknowledges and confirms that the Vendor is relying on such representations and warranties in connection with the sale by the Vendor of the Purchased Assets: (1) Incorporation and Qualification. The Purchaser is an entity duly incorporated and existing under the Laws of its jurisdiction of incorporation and has the corporate power to enter into and perform its obligations under this Agreement. (2) Corporate Authority. The execution and delivery of and performance by the Purchaser of this Agreement and the consummation of the transactions contemplated by it have been authorized by all necessary corporate action on the part of the Purchaser. (3) Execution and Binding Obligation. This Agreement has been duly executed and delivered by the Purchaser and constitutes a legal, valid and binding agreement of the Purchaser, enforceable against it in accordance with its terms subject only to: (A) as of the date hereof, any limitation under applicable Laws relating to the discretion that a court may exercise in the granting of equitable remedies such as specific performance and injunction; and (B) as of the Closing Date, the issuance of the Approval and Vesting Order. (4) Registration. The Purchaser will, prior to Closing, be registered under Part IX of the ETA and under comparable provincial legislation in each other province where the Purchaser is required to be registered for purposes of any election to be made pursuant to Section 6.1. Section 8.3 Survival. The representations and warranties contained in this Agreement shall merge on Closing. Section 8.4 No Other Representations or Warranties of the Vendor; “As Is, Where Is”. (1) The representations and warranties given by the Vendor in Article 8 are the sole and exclusive representations and warranties of the Vendor in connection with this Agreement and the transactions contemplated by it. Except for the representations and warranties given by the Vendor in Article 8, the Purchaser did not rely upon any statements, representations, promises, warranties, conditions or guarantees whatsoever, whether express or implied (by operation of Law or otherwise), oral or written, legal, equitable, conventional, collateral or otherwise, regarding the assets to be acquired or liabilities to be assumed or the completeness of any information provided in connection therewith. (2) The Purchaser hereby acknowledges and agrees as follows: (a) except as expressly provided herein, the Purchased Assets are being purchased on an “as is, where is” and “without recourse” basis as the Purchased Assets shall exist on Closing, subject to the terms of the Approval and Vesting Order; (b) all written and oral information obtained by the Purchaser from the Vendor or any of its directors, officers, employees, professional consultants, advisors or representatives with respect to the Purchased Assets or otherwise relating to the transactions contemplated in this Agreement has been obtained for the convenience of the Purchaser only and is not warranted to be accurate or complete; (c) the Purchaser has conducted such inspections of the condition of and title to the Purchased Assets as it deemed appropriate and has satisfied itself with regard to these and all matters; (d) except as expressly set forth in this Agreement, the Vendor makes no representations or warranties in favour of the Purchaser concerning the Purchased Assets, which the Purchaser acknowledges are being acquired on an “as is, where is” basis, whether express or implied, statutory or collateral, arising by operation of Laws or otherwise, including but not limited to express or implied warranties of merchantability, fitness for a particular purpose, title, description, quantity, condition or quality, and that any and all conditions and warranties expressed or implied by the Sale of Goods Act (Ontario) or other Laws do not apply to the transactions contemplated herein and are hereby waived by the Purchaser; and (e) the Vendor shall be under no obligation to deliver the Purchased Assets to the Purchaser and that it shall be the Purchaser's responsibility to take possession of the Purchased Assets wherever situated on the Closing Date. ARTICLE 9 COVENANTS The Vendor hereby agrees to use its best efforts to maintain the Business, assets, and operations of the Company as an on-going concern in accordance with past practices between the date of this Offer and the Closing Date, including taking all commercially reasonable efforts to maintain existing customer relationships and contracts and to manage and advance the relationship with bona fide prospective customers. ARTICLE 10 SALES PROCESS AND CONDITIONS OF CLOSING Section 10.1 Sales Process (a) The Vendor shall obtain a resolution of the Shareholders of the Company’s estate to seek authorization to enter into this Agreement and to conduct a marketing and sale process in accordance with the Stalking Horse Sales Process on or before December 22, 2022. It is acknowledged that the within offer by the Purchaser and Purchase Price as a baseline or "stalking horse bid" (the "Stalking Horse Bid"). The Purchaser acknowledges and agrees that the aforementioned process is in contemplation of determining whether a superior bid can be obtained for the Purchased Assets. (b) If one or more Qualified LOIs are received by the LOI Deadline, the Liquidator shall extend the due diligence period and invite those Qualified Bidders who have submitted a Qualified LOI to continue to perform further due diligence. If only one (1) Qualified LOI is submitted (other than the Stalking Horse Bid) and such LOI is from David Robertson (“Robertson”) or an entity controlled by Robertson, or an entity that Robertson is a member of a group that controls such entity, then the sale process shall proceed to the Auction. For greater clarity, there will be no second due diligence period and there will be no Bid Deadline. If no LOIs are submitted by the LOI Deadline or the Liquidator has determined in its sole discretion that there are no Qualified LOIs (other than the Stalking Horse Bid), the sale process shall end, and the Liquidator will proceed to close the transaction with the Purchaser. (c) In the event that one or more Persons submits a Qualified Bid on or before the Bid Deadline, the Liquidator shall conduct the Auction for the determination and selection of a Winning Bid (the Person submitting such bid being the “Winning Bidder”). Upon the selection of the Winning Bidder, there shall be a binding agreement of purchase and sale between the Winning Bidder and the Vendor (subject to Court approval). The Vendor shall forthwith bring a motion following the selection of the Winning Bidder for an order approving the agreement reached with the Winning Bidder and to vest the purchased assets contemplated by such agreement in the Winning Bidder and, if granted, shall proceed with closing the transaction forthwith. (d) In the event that the Purchaser is not the Winning Bidder, the Purchaser shall be entitled to a Break Fee in the amount of FIFTY THOUSAND DOLLARS ($50,000.00). (e) Notwithstanding anything contained herein to the contrary, in the event that the Purchaser is not the Winning Bidder, then upon the making of the order by the Court contemplated in Section 10.1(b) above to approve a transaction with such Winning Bidder, this Agreement shall be terminated and neither Party hereto shall have any further Liability or obligation, except as expressly provided for in this Agreement. (f) If no Qualified Bids are received by the Bid Deadline (other than the Stalking Horse Bid), then the Stalking Horse Bid shall be deemed to be the Winning Bid, and the Vendor shall forthwith bring a motion to the Court to obtain the Approval and Vesting Order and, if granted, shall proceed with completing the transactions contemplated hereby forthwith. Section 10.2 Conditions for the Benefit of both Parties. The purchase and sale of the Purchased Assets is subject to the following conditions to be fulfilled or performed on or before the Closing Date: (1) Shareholders’ Approval. The approval of this Agreement and the Stalking Horse Sales Process shall have been obtained by the Vendor by no later than December 22, 2022. (2) No Court Orders. No provision of any applicable Law and no judgment, injunction, order or decree that prohibits the consummation of the purchase of the Purchased Assets pursuant to this Agreement shall be in effect; (3) Approval and Vesting Order. The Approval and Vesting Order shall have been issued and shall not have been stayed, amended, modified, reversed or dismissed as at the Closing Date; and (4) Proceedings by Governmental Authority. No motion, action or proceedings shall be pending by or before a Governmental Authority to restrain or prohibit the completion of the transactions contemplated by this Agreement. Section 10.3 Conditions for the Benefit of the Purchaser. The purchase and sale of the Purchased Assets is subject to the following conditions to be fulfilled or performed on or before the Closing Date, which conditions are for the exclusive benefit of the Purchaser and may be waived, in whole or in part, by the Purchaser in its sole discretion: (1) Representations and Warranties. The representations and warranties of the Vendor contained in this Agreement shall be true and correct as of the Closing Date in all material respects, with the same force and effect as if such representations and warranties had been made on and as of such date; (2) Covenants. The Vendor shall have fulfilled or complied with all covenants contained in this Agreement required to be fulfilled or complied with by it in all material respects at or prior to the Closing Date, including delivery by the Vendor of the documents and instruments contemplated by Section 11.2; and (3) Assignment Order. The Assignment Order, if requested by the Purchaser, shall have been issued and entered in form and substance satisfactory to the Purchaser. Section 10.4 Conditions for the Benefit of the Vendor. The purchase and sale of the Purchased Assets is subject to the following conditions to be fulfilled or performed on or before the Closing Date, which are for the exclusive benefit of the Vendor and which may be waived, in whole or in part, by the Vendor in its sole discretion: (1) Representations and Warranties. The representations and warranties of the Purchaser contained in this Agreement shall be true and correct as of the Closing Date in all material respects, with the same force and effect as if such representations and warranties had been made on and as of such date; and (2) Covenants. The Purchaser shall have fulfilled or complied with all covenants contained in this Agreement required to be fulfilled or complied with by it in all material respects at or prior to the Closing Date, including delivery by the Purchaser of the documents and instruments contemplated by Section 11.3. ARTICLE 11 CLOSING Section 11.1 General. (1) The completion of the transactions of purchase, sale and assumption contemplated by this Agreement (the “Closing”) shall take place electronically on the Closing Date. (2) As soon as practicable following the determination that this Agreement is the Winning Bid pursuant to the Stalking Horse Sales Process, the Vendor shall file motion materials seeking the issuance of the Approval and Vesting Order, provided that the Purchaser has had a reasonable opportunity to review and comment upon such materials, acting reasonably, in advance of filing with the Court. The Vendor shall serve notice of the motion seeking the issuance and entry of the Approval and Vesting Order on all Persons determined reasonably necessary by the Purchaser and shall provide reasonable advance notice of any Court appearances so that the Purchaser may make arrangements to attend if it so desires. (3) The Parties hereby acknowledge and agree that the Liquidator shall be entitled in accordance with the Approval and Vesting Order to file a certificate, substantially in the form attached to the Approval and Vesting Order (the “Liquidator’s Certificate”), with the Court upon receiving written confirmation from the Vendor and the Purchaser that all conditions of Closing have been satisfied or waived. Section 11.2 Vendor’s Closing Deliveries. At the Closing, the Vendor shall execute and/or deliver or cause to be delivered to the Purchaser the following: (a) the Purchased Assets, which shall be delivered in situ wherever located as of the Closing; (b) a true and complete copy of the Approval and Vesting Order, as issued by the Court; (c) if requested by the Purchaser, a true and complete copy of any Assignment Order, as issued by the court of competent jurisdiction; (d) true and complete copies of the Assigned Agreements to which the Company is a party; (e) such executed Tax elections as are required pursuant to Article 6; (f) an executed general conveyance agreement evidencing the transfer of the Purchased Assets; (g) an executed assignment and assumption agreement evidencing the assumption by the Purchaser of the Assumed Liabilities; (h) a true and complete copy of the Liquidator’s Certificate executed by the Liquidator (such Liquidator’s Certificate to be filed with the Court by the Liquidator following Closing and a copy of such filed Liquidator’s Certificate shall be delivered to the Purchaser promptly thereafter); and (i) any other documents necessary or desirable in the opinion of the Purchaser, acting reasonably. Section 11.3 Purchaser’s Closing Deliveries. At the Closing, the Purchaser shall execute and/or deliver or cause to be delivered to the Vendor, or as the Vendor may direct, the following: (a) the payment contemplated by Sections 5.2; (b) evidence of payment of any applicable Transfer Taxes; (c) such executed Tax elections as are required pursuant to Article 6; (d) an executed assignment and assumption agreement evidencing the assumption by the Purchaser of the Assumed Liabilities; and (e) any other documents necessary or desirable in the opinion of the Vendor, acting reasonably. ARTICLE 12 TERMINATION Section 12.1 Termination of Agreement. This Agreement may by notice in writing given prior to or on the Closing Date be terminated: (a) by mutual consent of the Vendor and the Purchaser; (b) by the Purchaser or the Vendor if the Approval and Vesting Order, once granted, shall have been amended or modified in a manner adverse to such Party, or if it is stayed, reversed, dismissed or ceases to be in full force and effect; and (c) by the Purchaser if the Assignment Order, if requested and once granted, shall have been amended or modified in a manner adverse to the Purchaser, or if it is stayed, reversed or ceases to be in full force and effect. In the event that the Purchaser is not the Winning Bidder, this Agreement shall automatically be terminated. Section 12.2 Effect of Termination. (1) In the event that the Agreement is terminated in accordance with Section 12.1, then the Vendor shall forthwith return the Deposit to the Purchaser and thereafter each of the Parties shall be relieved of its duties and obligations arising under this Agreement, effective as of the date of such termination and such termination shall be without Liability to the Purchaser and the Vendor, including without limitation in respect of any Liabilities accrued from the date of execution of this Agreement to the date of termination. (2) Under no circumstances shall either of the Parties, their representatives or their respective directors, officers, employees or agents be liable for any special, punitive, exemplary, consequential or indirect damages (including loss of profits) that may be alleged to result, in connection with, arising out of, or relating to this Agreement or the transactions contemplated herein. Section 12.3 Dispute Resolution. If any dispute arises with respect to any matter related to the transactions contemplated herein or the interpretation or enforcement of this Agreement such dispute will be determined by the Court, or by such other Person or in such other manner as the Court may direct. Section 12.4 Reservation of Rights. The Parties acknowledge and agree that nothing herein shall constitute a waiver or release of any of the Operators rights to claim that any Operator is a subtenant of the Company. ARTICLE 13 MISCELLANEOUS Section 13.1 Notices. Any notice, direction or other communication given regarding the matters contemplated by this Agreement (each a “Notice”) must be in writing, sent by personal delivery, courier or electronic mail and addressed: (a) to the Vendor: MNP Ltd. 1 Adelaide Street East, Suite 1900, Toronto, ON M5C 2V9 Attention: Matthew Lem Email: email@example.com with a copy to Vendor’s counsel: Camelino Galessiere LLP 65 Queen Street West, Suite 440 Toronto, ON M5H 2M5 Attention: Gustavo F. Camelino Email: firstname.lastname@example.org (b) to the Purchaser: 14546865 Canada Inc. 3302 Myers Lane Burlington ON L7N 1K7 Attention: Richard Cromie Email: email@example.com with a copy to Purchaser’s counsel: Dentons Canada LLP 99 Bank Street, Suite 1420 Ottawa, ON K1P 1H4 Attention: Julien Bourgeois Email: firstname.lastname@example.org A Notice is deemed to be given and received if sent by personal delivery, courier or electronic mail, on the date of delivery if it is a Business Day and the delivery was made prior to 4:00 p.m. (local time in place of receipt) and otherwise on the next Business Day. A Party may change its address for service from time to time by providing a Notice in accordance with the foregoing. Any subsequent Notice must be sent to the Party at its changed address. Any element of a Party’s address that is not specifically changed in a Notice will be assumed not to be changed. Sending a copy of a Notice to a Party’s legal counsel as contemplated above is for information purposes only and does not constitute delivery of the Notice to that party. The failure to send a copy of a Notice to legal counsel does not invalidate delivery of that Notice to a Party. Section 13.2 Assignment. Neither this Agreement nor any of the rights or obligations under this Agreement may be assigned or transferred, in whole or in part, by any Party without the prior written consent of the other Parties. Notwithstanding the foregoing, on Closing the Purchaser shall be entitled to direct title to any of the Purchased Assets to one or more Persons. Section 13.3 Survival. Any provision of this Agreement which contemplates performance or the existence of obligations after the Closing Date shall not be deemed to be merged into or waived by the execution, delivery or performance of this Agreement or documents delivered in connection herewith or Closing, but shall expressly survive the execution, delivery and performance of this Agreement, Closing and the execution, delivery and performance of any and all documents delivered in connection with this Agreement and shall be binding upon the Party or Parties obligated thereby (including any Liquidator-in-Company appointed in respect of such Party) in accordance with the terms of this Agreement. Section 13.4 Time of the Essence. Time shall, in all respects, be of the essence hereof, provided that the time for doing or completing any matter provided for herein may be extended or abridged by an agreement in writing signed by the Vendor and the Purchaser. Section 13.5 Enurement. This Agreement becomes effective when executed by the Vendor and the Purchaser. After that time, it will be binding upon and enure to the benefit of the Parties and their respective successors, legal representatives and permitted assigns. Section 13.6 Entire Agreement. This Agreement and the other documents executed in connection herewith constitutes the entire agreement between the Parties with respect to the transactions contemplated in this Agreement and supersedes all prior agreements, understandings, negotiations and discussions, whether oral or written, of the Parties with respect to such transactions. There are no representations, warranties, covenants, conditions or other agreements, express or implied, collateral, statutory or otherwise, between the Parties in connection with the subject matter of this Agreement, except as specifically set forth in this Agreement. The Parties have not relied and are not relying on any other information, discussion or understanding in entering into and completing the transactions contemplated by this Agreement. Section 13.7 Waiver. No waiver of any of the provisions of this Agreement will constitute a waiver of any other provision (whether or not similar). No waiver will be binding unless executed in writing by the Party to be bound by the waiver. A Party’s failure or delay in exercising any right under this Agreement will not operate as a waiver of that right. A single or partial exercise of any right will not preclude a Party from any other or further exercise of that right or the exercise of any other right it may have. Section 13.8 Amendments. This Agreement may only be amended, supplemented or otherwise modified by written agreement signed by the Vendor and the Purchaser. Section 13.9 Further Assurances. From the Closing Date, each of the Parties covenants and agrees to do such things, to attend such meetings and to execute such further conveyances, transfers, documents and assurances as may be deemed necessary or advisable from time to time in order to effectively transfer the Purchased Assets and the Assumed Liabilities to the Purchaser and carry out the terms and conditions of this Agreement in accordance with their true intent. Section 13.10 Severability. If any provision of this Agreement is determined to be illegal, invalid or unenforceable, by any court of competent jurisdiction from which no appeal exists or is taken, that provision will be severed from this Agreement and the remaining provisions will remain in full force and effect. Section 13.11 Governing Law. This Agreement is governed by, and will be interpreted and construed in accordance with, the Laws of the Province of Ontario and the federal Laws of Canada applicable therein. Section 13.12 Jurisdiction. The Parties hereby irrevocably attorn to the exclusive jurisdiction of the courts of the Province of Ontario with respect to any matter arising under or related to this Agreement. Section 13.13 Counterparts. This Agreement may be executed in any number of counterparts, each of which is deemed to be an original, and such counterparts together constitute one and the same instrument. Transmission of an executed signature page by email or other electronic means is as effective as a manually executed counterpart of this Agreement. [signature page follows] IN WITNESS WHEREOF the Parties hereto have duly executed this Agreement as of the date first written above. 14546865 CANADA INC. Per: ____________________________ Name: Richard Cromie Title: Director MNP LTD. (solely in its capacity as Liquidator in Company of Paidiem Payment Solutions Inc., without personal or corporate liability) Per: ____________________________ Name: Matthew Lem Title: Senior Vice President Schedule “A” Stalking Horse Sales Process See attached. STALKING HORSE SALE PROCESS Paidiem Payment Solutions (the “Company”) Defined Terms 1. These terms and conditions, and the process described herein shall collectively be hereinafter referred to as the “Sale Process”. 2. All capitalized terms contained herein but not otherwise defined herein shall have the meanings ascribed thereto in the Agreement to which this schedule is appended. 3. For purposes hereof, “Stalking Horse Bid” shall mean the transaction for the business and assets of the Company (the “Transaction”) contemplated by the stalking horse asset purchase agreement (the “Stalking Horse Purchase Agreement”) between MNP Ltd. (the “Liquidator”), solely in its capacity as the Court-appointed Liquidator of the Company, as vendor, and 14546865 Canada Inc., as purchaser, (the “Stalking Horse Bidder”) approved by the Shareholders of the Company. Commencement of the Sale Process 4. The Sale Process shall commence immediately following the date on which the Stalking Horse Purchase Agreement and this Sale Process is unanimously approved by the Company’s shareholders (the “Commencement Date”). 5. Within three (3) business days of the Commencement Date, the Liquidator shall contact parties identified (the “Prospective Participants”) who may be interested in purchasing the business and assets of the Company (collectively, the “Assets”) and provide those parties with a copy of a “teaser” document and the form of non-disclosure and confidentiality agreement (the “NDA”). The teaser document shall contain general details about the opportunity to purchase the Assets (the “Opportunity”) as well as some general background information about the Company’s business. 6. Within ten business (10) days of the Commencement Date, or as soon thereafter as is practical, if the Liquidator deems it advisable and cost-effective, the Liquidator shall arrange for the publication of a notice advertising the Opportunity in the National Post and/or such other trade publications or other publications as the Liquidator may deem appropriate or advisable. First Due Diligence Period 7. Commencing on the Commencement Date (and after each respective Prospective Participant has executed the NDA), the Liquidator shall make available to the Prospective Participant the following: a) a copy of the Stalking Horse Purchase Agreement; and b) initial access to an electronic data room, maintained by the Liquidator, which shall contain information pertaining to the Opportunity, which is in the Liquidator’s possession. 8. If a Prospective Participant has delivered an executed NDA acceptable to the Liquidator, then such Prospective Participant will be deemed to be a “Qualified Bidder”. 9. Notwithstanding the foregoing, neither the Liquidator, nor the Company or their respective representatives will be obligated to furnish any information relating to the Assets or the Company to any person, including to parties who the Liquidator reasonably believes are not likely to be serious offerors. The Liquidator makes no representation or warranty, express or implied, as to the information provided through this due diligence process or otherwise. First Deadline – Submission of Non-Binding Letters of Interest 10. All Qualified Bidders must submit their non-binding letter of interest (“LOI”) in writing to and received by the Liquidator at 1 Adelaide Street East, Suite 1900, Toronto, ON, M5C 2V9, attention: Matthew Lem, or electronically to email@example.com by no later than 5:00 p.m. (Toronto time) on February 6, 2023 (the “LOI Deadline”). 11. Each LOI shall be submitted on the provided form (the “LOI Template”), and include among other things, detailed descriptions of: a) the Assets proposed to be acquired; b) the proposed purchase price or other consideration for the Assets to be acquired, including the form of payment; c) the Qualified Bidder’s identity, and the identity of its principals; d) applicable conditions; e) evidence of the ability of the Qualified Bidder to consummate the Transaction, including evidence of financial means; f) the proposed timing for completion of the Transaction; and g) the requisite deposit Qualified LOIs 12. A LOI will only be considered a “Qualified LOI”, if it is submitted before the LOI Deadline and if it meets the following minimum criteria: a) it must be submitted in writing, substantially in the form the LOI Template; b) it must be for a price equal to or greater than the sum of: (i) the Purchase Price under the Stalking Horse Purchase Agreement; (ii) the Break Fee (as defined herein) of $50,000; and (iii) $100,000. c) it must be accompanied by a deposit (the “LOI Deposit”) in the form of a certified cheque or bank draft (or in the form of confirmed wire transfer in the case of offers submitted electronically) payable to “MNP Ltd., in trust” which is equal to the greater of: (i) $315,000; and (ii) ten (10%) percent of the total purchase price payable under the LOI; and d) it must include written evidence, satisfactory to the Liquidator, that the offeror has the financial means to complete the proposed acquisition. Evaluation of LOIs 13. Within three (3) Business Days following the LOI Deadline, the Liquidator shall evaluate the LOIs and determine in its sole discretion whether there are one or more Qualified LOIs. 14. If only one (1) Qualified LOI is submitted (other than the Stalking Horse Bid) and such LOI is from David Robertson (“Robertson”) or an entity controlled by Robertson, or an entity that Robertson is a member of a group that controls such entity, then the sale process shall proceed to the Auction (as later defined). For greater clarity, there will be no second due diligence period and there will be no Bid Deadline (as defined herein). 15. If no LOIs are submitted by the LOI Deadline or the Liquidator has determined in its sole discretion that there are no Qualified LOIs (other than the Stalking Horse Bid), the sale process shall end, and the Liquidator will proceed to close the Transaction with the Stalking Horse Bidder. Second Due Diligence Period 16. If one or more Qualified LOIs are received by the LOI Deadline, the Liquidator shall: a) extend the due diligence period to March 8, 2023; b) invite those Qualified Bidders who have submitted a Qualified LOI to continue to perform further due diligence; c) broaden access to the electronic data room and more detailed and sensitive materials for those Qualified Bidders who have submitted a Qualified LOI; Bid Deadline 17. All offers must be submitted in writing to and received by the Liquidator at 1 Adelaide Street East, Suite 1900, Toronto, ON, M5C 2V9, attention: Matthew Lem, or electronically to firstname.lastname@example.org by no later than 5:00 p.m. (Toronto time) on March 8, 2023 (the “Bid Deadline”). Qualified Bids 18. An offer will only be considered in this Sale Process, in which case it shall be considered a “Qualified Bid”, if it is submitted before the Bid Deadline and if it meets the following minimum criteria: a) it must be submitted in writing, substantially in the form of Stalking Horse Purchase Agreement, with any changes to the offer blacklined against the Stalking Horse Purchase Agreement; b) it must be for a price equal to or greater than the sum of: (i) the Purchase Price under the Stalking Horse Purchase Agreement; (ii) the Break Fee (as defined herein) of $50,000; and (iii) $100,000. c) it must be irrevocable until five (5) business days after the Auction (as defined herein); d) it must be accompanied by an additional deposit (the “Bid Deposit”), if necessary, in the form of a certified cheque or bank draft (or in the form of confirmed wire transfer in the case of offers submitted electronically) payable to “MNP Ltd., in trust”, such that the aggregate of the Bid Deposit and the LOI Deposit is at a minimum equal to the greater of: (i) $472,500; and (ii) fifteen (15%) percent of the total purchase price payable under the Qualified Bid e) it includes an acknowledgement that the offeror has relied solely on its own independent review and investigation and that it has not relied on any representation by the Company, the Liquidator or their respective agents, employees or advisers; f) it must not contain any condition or contingency relating to due diligence or financing or any other material conditions precedent to the offeror’s obligation to complete the transaction; and g) it must include written evidence, satisfactory to the Liquidator, that the offeror has the financial means to complete the proposed acquisition, provided however that the Liquidator may, exercising its reasonable discretion, waive compliance with one or more of the foregoing Qualified Bid requirements and deem such non-compliant offer to be a Qualified Bid. Evaluation of Qualified Bids 19. Within Five (5) Business Days following the Bid Deadline, the Liquidator shall evaluate the offers received (other than the Stalking Horse Bid), if any, and determine in its sole discretion whether there are one or more Qualified Bids. 20. The Stalking Horse Bid shall be deemed to be a Qualified Bid. 21. Offers for all or part of the Assets will be considered. 22. If no Qualified Bid is received by the Bid Deadline (other than the Stalking Horse Bid), the Auction (as defined herein) will not be held. Auction 23. If more than one Qualified Bid is received by the Bid Deadline, the Liquidator shall extend invitations by phone, fax and/or email by 10:00 a.m. E.S.T. on March 15, 2023 to all bidders who submitted Qualified Bids and to the Stalking Horse Bidder to attend an auction (the “Auction”). The Auction shall be held at 10:00 a.m. on March 22, 2023 at the offices of the Liquidator or by teleconference, video conference or other form of electronic telecommunications, as the Liquidator may deem fit. 24. The Liquidator shall conduct the Auction. At the Auction, the bidding shall begin initially with the highest Qualified Bid and subsequently continue in multiples of $50,000, or such other amount as the Liquidator determines to facilitate the Auction. Additional consideration in excess of the amount set forth in the highest Qualified Bid must be comprised only of cash consideration. The format and other procedures for the Auction shall be determined by the Liquidator in its sole discretion. Selection of the Winning Bid 25. The winning bid (the “Winning Bid”) shall be, either: a. in the event that no other Qualified Bid is received by the Bid Deadline, the Stalking Horse Bid; or, b. in the event that multiple Qualified Bids are received, following the conclusion of the Auction (if applicable), the party submitting the highest and best offer through the Auction, which the Liquidator is satisfied, acting reasonably, is capable of being completed as required by the Liquidator. Court Approval 26. As soon as practicable after the determination of the Winning Bid and following execution and delivery of a definitive agreement, the Liquidator will make a motion to the Court (the “Approval Motion”) for an approval and vesting order in respect of the Winning Bid and the underlying purchase agreement (the “Final APA”). Other Terms 27. Closing of the Transaction will occur once the Approval and Vesting Order is granted by the Court and in accordance with the terms of the Final APA. 28. All deposits received (except such deposit forming part of the Winning Bid) shall be held by the Liquidator “in trust”. All deposits submitted by Prospective Participants who did not submit the Winning Bid shall be returned, without interest, as soon as practicable following the date on which any such offers are rejected hereunder. The deposit forming part of the Winning Bid shall be dealt with in accordance with the Final APA. 29. In the event that a deposit is forfeited for any reason it shall be forfeited as liquidated damages and not as a penalty. 30. All Qualified Bids (other than the Winning Bid) shall be deemed rejected once the Approval and Vesting Order is granted by the Court and becomes a final non-appealable order. 31. The Liquidator shall have the right to adopt such other rules, not inconsistent with the Sale Process described herein, that, in its reasonable discretion, will better promote the goals of the Sale Process. 32. In the event that the Stalking Horse Bid is not the Winning Bid, then the Stalking Horse Bidder shall be entitled to a break fee of $50,000 (the “Break Fees”) which shall be payable by the Liquidator on the closing of the Winning Bid. Schedule “B” Assigned Agreements All of the contracts with any customer or vendor of the Company, including without limitation all customer agreements, partner or partnership agreements, vendor agreements, software licenses, hosting agreements and any lease and including any 1. customer agreement; 2. vendor agreements / software licenses / hosting agreements / partnership agreements, etc.; and 3. any lease (for real estate or assets) and, excluding any bank accounts or loans AMENDING AGREEMENT (Dated January 5, 2023) BETWEEN: MNP LTD. in its capacity as the Court-Appointed Liquidator of Paidiem Payment Solutions Inc. (hereinafter the “Vendor”) - and - 14546865 CANADA INC. (herein referred to as “Purchaser”) WHEREAS the parties entered into a Stalking Horse Agreement dated December 21, 2022 (the “Stalking Horse Agreement”); AND WHEREAS the parties wish to amend the Stalking Horse Agreement on the terms and conditions set out herein; NOW THEREFORE in consideration of the covenants and agreement contained herein and for other good and valuable consideration, the parties agree as follows: 1. Subsection 8.1(5) of the Stalking Horse Agreement is hereby deleted in its entirety. 2. Subsection 10.1(a) of the Stalking Horse Agreement is hereby deleted in its entirety and replaced with the following: (a) The Vendor shall obtain a resolution of the Shareholders of the Company’s estate to seek authorization to enter into this Agreement and to conduct a marketing and sale process in accordance with the Stalking Horse Sales Process on or before January 6, 2023. It is acknowledged that the within offer by the Purchaser and Purchase Price is a baseline or “stalking horse bid” (the “Stalking Horse Bid”). The Purchase acknowledged and agrees that the aforementioned process is in contemplation of determining whether a superior bid can be obtained for the Purchased Assets. 3. Subsection 10.2(1) of the Stalking Horse Agreement is hereby deleted in its entirety and replaced with the following: (1) Shareholders’ Approval. The approval of this Agreement and Stalking Horse Sales Process shall have been obtained by the Vendor by no later than January 6, 2023. 4. Section 23 of Schedule “A” to the Stalking Horse Agreement is hereby deleted in its entirety and replaced with the following: 23. If Paragraph 14 above does not apply and if more than one Qualified Bid is received by the Bid Deadline, the Liquidator shall extend invitations by phone, fax and/or email by 10:00 a.m. E.S.T. on March 15, 2023 to all bidders who submitted Qualified Bids and to the Stalking Horse Bidder to attend an auction (the “Auction”). The Auction shall be held at 10:00 a.m. on March 22, 2023 at the offices of the Liquidator or by teleconference, video conference or other form of electronic telecommunications, as the Liquidator may deem fit. If Paragraph 14 above does apply, the Auction shall be held at 10:00 a.m. within ten (10) Business Days of LOI Deadline, or such other date as the Liquidator may determine in its sole discretion, at the offices of the Liquidator or by teleconference, video conference or other form of electronic telecommunications, as the Liquidator may deem fit. 5. All other provisions of the Stalking Horse Agreement remain unaltered and in force. IN WITNESS WHEREOF the parties hereto have duly executed this Agreement 1454685 CANADA INC. Per: ____________________________ Name: Richard Cromie Title: Director I have authority to bind the Corporation MNP LTD. (solely in its capacity as Court-Appointed Liquidator of Paidiem Payment Solutions Inc., without personal or corporate liability) Per: ____________________________ Name: Matthew Lem Title: Senior Vice President I have authority to bind the Corporation Founded in 2019 by staffing and finance industry experts, Paidiem Payment Solutions Inc. (“Paidiem”) is “The All-In-One Financial Operating System and Workforce Management Platform” built and designed to focus on enabling growth and financial well-being for companies with contingent workforces – contract and freelance workers. Based in Toronto, Ontario Canada, Paidiem (www.paidiem.com) is a fintech start-up that is revolutionizing the payment processes for companies with contingent workforces by offering an industry-leading cloud-based administration platform and on-demand payments and other financial products to alleviate the associated administrative burdens of managing and paying contingent workers. Pursuant to a Court Order dated November 23, 2022, MNP Ltd. (the “Liquidator”), solely in its capacity as the court-appointed liquidator of Paidiem, is soliciting offers for the purchase of the assets and going concern business of Paidiem. The Liquidator is implementing a stalking-horse based sale process (the “Sale Process”) on the terms outlined in the sale process protocol, which can be found in the data room and summarized on the Acquisition Opportunity Highlights (attached). To qualify to participate in the Sale Process, interested parties are required to first complete a confidentiality and non-disclosure agreement (the “NDA”) available from the Liquidator. Upon the execution and return of the NDA, interested parties will be provided with access to the Sale Process’ virtual data room where more details on the opportunity and information concerning Paidiem, its business, assets and the Sale Process can be found. The initial deadline for the submission of non-binding letters of interest is on or before 5:00 p.m. (Toronto, Ontario time) on February 6, 2023. All offers are subject to the terms and conditions of sale which will be available in the data room. To obtain further information about this opportunity and/or to request a copy of the NDA, please contact Matthew Lem at email@example.com. Disclaimer: This Teaser is for informational purposes only in connection with the Sale Process. The information contained in this Teaser pertaining to Paidiem, its assets or business is based on data provided by Paidiem’s management, or its website and the Liquidator has not expressly verified the veracity of such information. The information contained in this Teaser may be subject to change, revision or republishing and may thus change materially. Paidiem and the Liquidator make no representations or warranties, expressed or implied, as to the accuracy, completeness, or reliability of the information contained in this Teaser. Furthermore, Paidiem and the Liquidator are neither obligated to provide any additional information to interest parties, nor update or correct any inaccuracies or errors that may be contained in this Teaser. Opportunity Highlights - Significant Investments in the Platform: Paidiem has raised close to C$5 million, a substantial portion of which has been invested into R&D to develop and make platform improvements. - Significant Transaction Volume: Paidiem has processed over C$15 million of transactions. - Robust Pipeline of Opportunities: Paidiem is ready for expansion and has over 25 opportunities in its pipeline (representing a cumulative $100M in GMV and 10,000+ workers). - Huge Market Potential: Built around servicing companies with contingent workers and professional staffing agencies, alike. Of the estimated 53M contingent workers in the US (freelancers, 1099, solopreneurs, contractors, etc.), roughly 16M are placed by professional staffing agencies every year. - A Suite of Invoice and Workflow Automation Tools: Paidiem earns recurring SaaS-revenues through its suite of invoice and workflow automation tools which solve critical problems for both agencies and workers, without disrupting client workflows and systems. - Multiple Financing Revenue Streams: Stemming from the fact that Paidiem is inserted in the employment workflow, the client company has the requisite information to provide Earned Wage Access (EWA) and instant financing solutions for both workers and their staffing agency partners. - Paidiem’s EWA Advantage: Paidiem focuses on white collar, high-earning contingent workers and contractors - an often overlooked segment of workers. Because Paidiem inserts itself directly into the employment workflow, pay advances and any associated financing activities related thereto can be meaningfully de-risked. - Data Ingestions: Paidiem has integrated with popular agency Applicant Tracking Systems (ATS); Bullhorn and can ingest data from SAP Fieldglass and Beeline. ### Stalking-Horse Based Sale Process Highlights \| Event \| Date/Time \| \|--------------------------------\|------------------------------------------------\| \| Commencement of Sale Process \| January 6, 2022 \| \| Minimum Offer Price \| It must be for a price equal to or greater than the sum of: (i) the Purchase Price under the Stalking Horse Purchase Agreement; (ii) the Break Fee of $50,000; and (iii) $100,000. \| \| First Bid Deadline – Non-binding LOI Submission \| February 6, 2023 – 5:00 p.m. (Toronto time) \| \| Second Bid Deadline – Formal Binding Offer Submission \| March 8, 2023 – 5:00 p.m. (Toronto time) \| \| Company \| Signatory \| Amount of Claim* \| Currency \| Security \| \|-------------------------------\|-------------\|------------------\|----------\|----------\| \| Business Development Bank of Canada \| Corey Zalcman \| $166,400.00 \| CAD \| Secured \| \| L-Spark Corporation \| Leo Lax \| $39,000.00 \| CAD \| Unsecured\| Current as at December 1, 2022 \| Type of Search \| Business Debtor \| \|----------------\|-----------------\| \| Search Conducted On \| PAIDIEM PAYMENT SOLUTIONS \| \| File Currency \| 15JAN 2023 \| \| File Number \| Family \| of Families \| Page \| of Pages \| Expiry Date \| Status \| \|-------------\|--------\|--------------\|------\|----------\|-------------\|--------\| \| 769676976 \| 1 \| 1 \| 1 \| 1 \| 04FEB 2030 \| \| FORM 1C FINANCING STATEMENT / CLAIM FOR LIEN* \| File Number \| Caution Filing \| Page of Total Pages \| Motor Vehicle Schedule \| Registration Number \| Registered Under \| Registration Period \| \|-------------\|----------------\|---------------------\|------------------------\|---------------------\|------------------\|--------------------\| \| 769676976 \| \| 001 \| 1 \| \| P PPSA \| 09 \| \| Individual Debtor \| Date of Birth \| First Given Name \| Initial \| Surname \| \|-------------------\|---------------\|------------------\|---------\|---------\| \| \| \| \| \| \| \| Business Debtor \| Business Debtor Name \| Ontario Corporation Number \| \|----------------\|----------------------\|----------------------------\| \| \| PAIDIEM PAYMENT SOLUTIONS INC. \| \| \| Address \| City \| Province \| Postal Code \| \|---------\|------\|----------\|-------------\| \| 33 SHEFFLEY CRES. \| ETOBICOKE \| ON \| M9R 2W5 \| \| Individual Debtor \| Date of Birth \| First Given Name \| Initial \| Surname \| \|-------------------\|---------------\|-----------------\|---------\|---------\| \| \| \| \| \| \| \| Business Debtor \| Business Debtor Name \| Ontario Corporation Number \| \|-------------------\|----------------------\|----------------------------\| \| \| \| \| \| Address \| City \| Province \| Postal Code \| \|------------------\|------\|----------\|-------------\| \| \| \| \| \| \| Secured Party \| Secured Party / Lien Claimant \| \|------------------\|-------------------------------\| \| BUSINESS DEVELOPMENT BANK OF CANADA \| \| 121 KING STREET WEST, SUITE 1200 \| TORONTO ON M5H 3T9 \| \| Collateral Classification \| Consumer Goods \| Inventory \| Equipment \| Accounts \| Other \| Motor Vehicle Included \| Amount \| Date of Maturity or \| No Fixed Maturity Date \| \|---------------------------\|----------------\|-----------\|-----------\|----------\|-------\|------------------------\|---------\|---------------------\|------------------------\| \| \| X \| X \| X \| X \| X \| \| \| \| \| \| Motor Vehicle Description \| Year \| Make \| Model \| V.I.N. \| \|---------------------------\|------\|------\|-------\|--------\| \| \| \| \| \| \| \| General Collateral Description \| General Collateral Description \| \|--------------------------------\|--------------------------------\| \| \| \| \| Registering Agent \| Registering Agent \| \|-------------------\|-------------------\| \| BUSINESS DEVELOPMENT BANK OF CANADA (SBI-206515-01) \| \| 121 KING STREET WEST, SUITE 1200 \| TORONTO ON M5H 3T9 \| This service is tested daily with McAfee SECURE™ to ensure the security of the transaction and information. At ServiceOntario, we respect your right to privacy and value the trust you place in us. [Read more about ServiceOntario's Privacy Statement](#). ServiceOntario Contact Centre Web Page ID: WEnqResult System Date: 16JAN2023 Last Modified: June 19, 2022 [Privacy](#) [FAQ](#) [Accessibility](#) [Terms of Use](#) © Queen's Printer for Ontario 2015 ONTOARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) BETWEEN: DAVID ROBERTSON Applicant - and - PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER SECTION 207 OF THE ONTARIO BUSINESS CORPORATIONS ACT, R.S.O. 1990, C B. 16 AFFIDAVIT OF JERRY HENECHOWICZ (Sworn March 8th, 2023) I, Jerry Henechowicz, of the City of Markham, in the Regional Municipality of York, in the Province of Ontario, MAKE OATH AND SAY AS FOLLOWS: 1. I am a Senior Vice President with MNP Ltd. (“MNP”) the court-appointed Liquidator of Paidiem Payment Solutions Inc. (the “Company”) and as such have knowledge of the matters deposed to herein, except where such knowledge is stated to be based on information and belief, in which case I state the source of the information and verily believe such information to be true. 2. On November 23, 2023, on application made by David Robertson, the Ontario Superior Court of Justice (Commercial List) issued an Order to wind-up the Company pursuant to Part XVI of the Ontario Business Corporations Act (the “OBCA”) and appointing MNP as liquidator of the Company (in this capacity, the “Liquidator”) pursuant to subsection 210(1) of The OBGA 3. The Liquidator has prepared Statements of Account in connection with its appointment as Liquidator detailing its services rendered and disbursements incurred for the period from November 1, 2022 to February 28, 2023. Attached hereto and marked as Exhibit “A” to this my Affidavit is a summary of the Statements of Account, which indicates total fees of the Liquidator for this period totaling $77,091.20, exclusive of Harmonized Sales Tax. 4. Attached hereto and marked as Exhibit “B” are copies of the Statements of Account. The weighted average hourly rate in respect of the account is $571.47. 5. The particulars of the professionals who performed the work, the time spent and fees associated with such work are contained in the attached Statement of Account. 6. I hereby confirm that the information detailed herein and attached accurately reflects the services provided by the Liquidator in this proceeding and the fees and disbursements claimed by it. 7. This affidavit is sworn in support of a motion to, inter alia, approve the costs of administration, and an interim taxation of the Liquidator’s accounts and for no other or improper purpose. SWORN remotely by Jerry Henechowicz, stated as being located in the City of Markham, in the Regional Municipality of York, before me at the Town of Erin, in the County of Wellington on this 8th day of March, 2023, in accordance with O. Reg 431/20, Administering Oath or Declaration Remotely Commissioner for Taking Affidavits JERRY HENECHOWICZ Attached is Exhibit “A” Referred to in the AFFIDAVIT OF JERRY HENECHOWICZ Sworn before me This 8th day of March 2023 Commissioner for taking Affidavits, etc ## SUMMARY OF STATEMENTS OF ACCOUNT \| Invoice Date \| Invoice Number \| Invoice Period \| Hours \| Amount \| Disbursements \| HST \| Total \| \|----------------\|----------------\|------------------------------\|--------\|------------\|---------------\|----------\|-------------\| \| January 13 2023\| 10734025 \| November 1, 2022 to December 31, 2022 \| 84.70 \| $45,875.80 \| - \| $5,963.85 \| $51,839.65 \| \| February 28 2023\| 10818808 \| January 1, 2023 to January 31, 2023 \| 50.20 \| $27,062.00 \| - \| $3,518.06 \| $30,580.06 \| \| March 08 2023 \| 10829675 \| February 1, 2023 to February 28, 2023 \| 4,153.40 \| $4,153.40 \| - \| $539.94 \| $4,693.34 \| TOTAL 134.90 $77,091.20 $ - $10,021.85 $87,113.05 Average Hourly Rate $571.47 Attached is Exhibit “B” Referred to in the AFFIDAVIT OF JERRY HENECHOWICZ Sworn before me This 8th day of March 2023 Commissioner for taking Affidavits, etc Invoice Invoice Number: 10734025 Client Number: 0976685 Invoice Date: Jan 13 2023 Invoice Terms: Due Upon Receipt Paidiem Payment Solutions Inc. 325 Front Street West, Suite 400 Toronto, ON M5V 2Y1 For Professional Services Rendered: For the period from 1 November 2022 to 31 December 2022, in connection with us acting as the Court-appointed Liquidator of Paidiem Payment Solutions Inc. (detailed time descriptions attached) OUR FEE in all 51,944.80 LESS: Rate Adjustment Discount -6,069.00 Sub Total: 45,875.80 Harmonized Sales Tax: 5,963.85 Total (CAD): 51,839.65 HST Registration Number: 103697215 RT 0001 Invoices are due and payable upon receipt. Thank you for your business. We sincerely appreciate your trust in us. \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|---------------\|-------\|-------------------------------------------------------------------------------------------\| \| 01-Nov-2022\| Sheldon Title \| .70 \| Call with F. Mackinnon Blair and emails with P. Shea/F. Mackinnon Blair on sale thresholds being inserted into order. \| \| 05-Nov-2022\| Sheldon Title \| .40 \| Emails to F. Mackinnon Blair on arranging call and list of agenda points, email to J. Ormston and email to P. Shea re independent counsel. \| \| 11-Nov-2022\| Sheldon Title \| .40 \| Call with F. Mackinnon Blair. \| \| 12-Nov-2022\| Sheldon Title \| .40 \| Review of claims forms and email to P. Shea with comments. \| \| 16-Nov-2022\| Matthew Lem \| 1.60 \| Discussion with S. Title re file and next steps. Review information concerning Paidiem's business. Review notice requirements under OBCLA and draft order. Attend to Notice of Liquidator's appointment. \| \| 16-Nov-2022\| Sheldon Title \| 1.00 \| Email to F. Mackinnon Blair and review of information and call with M. Lem on same. Email to/from F. Mackinnon Blair to arrange meeting. \| \| 17-Nov-2022\| Matthew Lem \| 1.60 \| Call to Service Ontario re Notice of Windup issue. Conference call with R. Cromie and F. McKinnon Blair, together with S. Title. Follow-up discussion with S. Title re next steps. Several follow-up discussions with Service Ontario re BCN. \| \| 17-Nov-2022\| Sheldon Title \| .90 \| Call with F. MacKinnon Blair and R. Cromie, together with M. Lem. \| \| 18-Nov-2022\| Akhil Kapoor \| 2.00 \| Discussion with M. Lem re scope of work, reviewing docs, draft court order/report to understand the file. Reviewing the information available and providing updated on work plan re items on claim process, statutory requirements as per OBCLA, among others. Initial review of financials as at Oct 31 2022, revenue sources, domains, suppliers, IP, SRED claim, among others. \| \| 18-Nov-2022\| Matthew Lem \| 2.10 \| Preparation of work plan. Discussion with A. Kapoor re same. Update OBC notice form. Call with J. Ormston, F. Mackinnon. R. Cromie and M. List, together with S. Title. Follow-up discussion with S. Title. Review claims forms. \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|----------------\|-------\|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------\| \| 18-Nov-2022\| Sheldon Title \| 1.00 \| Call with F. Mackinnon Blair, M. List, J. Ormston, R. Cromie, and J. Bourgeois, together with M. Lem. Call with M. Lem, review of documents sent by R. Cromie. \| \| 19-Nov-2022\| Matthew Lem \| 1.20 \| Call with G. Camelino, together with S. Title. Update forms for claims process. \| \| 21-Nov-2022\| Akhil Kapoor \| 2.00 \| Reviewing the information received from M. Lem re cash flows with schedules, AP, AR, suppliers, bank accounts, credit cards among others. Preparing a monthly cash budget reflecting month on month and cumulative cash burn amount from Nov 2022 to April 2023. Preparing notes and queries for each line item in the cash flow for the purpose of discussion with the management. Glancing through the financial statements to understand the IS and BS numbers. Sharing the monthly cash budget with M. Lem for review. \| \| 21-Nov-2022\| Matthew Lem \| 1.20 \| Preparation of sale process outline and forward to S. Title. Discussion with S. Title re same. Review correspondence. Arrange for website and email address set-up for process. \| \| 22-Nov-2022\| Matthew Lem \| .90 \| Preparation of list of data room information. Discussions with S. Title re file and motion. \| \| 22-Nov-2022\| Sheldon Title \| .50 \| Review of sale process. Call with A. Kapoor. \| \| 23-Nov-2022\| Chahna Nathwani\| .20 \| Uploading documents on webpage. \| \| 23-Nov-2022\| Matthew Lem \| 1.00 \| Discussion with S. Title re next steps. Arrange for posting of Liquidation Order and Endorsement. Call to and discussion with R. Cromie. Forward sale process outlines and information request to R. Cromie. Arrange for access to online banking with J. Kilborn. \| \| 23-Nov-2022\| Sheldon Title \| .70 \| Receipt and review of order. Calls/emails with M. Lem on first steps. Email to/from J. Ormston. \| \| 24-Nov-2022\| Matthew Lem \| 1.50 \| Call with J. Kilborn re banking and financial matters. \| \| 25-Nov-2022\| Akhil Kapoor \| .30 \| Discussion re tasks to be done including preparing claim process details to be sent to all stakeholders. Discussion re certain matters and reviewing some aspects. \| \| 25-Nov-2022\| Matthew Lem \| 5.00 \| Prepare schedule of operational processes. Preparation for meeting with R. Cromie. Meet with R. Cromie, together with S. Title re sale process. Several discussions with J. Kilborn re processing payments and \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|--------------\|-------\|-------------------------------------------------------------------------------------------\| \| \| \| \| rent invoice. Discussion with R. Cromie re rent issue. Update discussion with S. Title re next steps and file matters. Discussion with A. Kapoor re claims process. Update 210(4) notice and request Company Key from Service Ontario. Attend to banking set-up matters. Start draft Stalking horse agreement. \| \| 25-Nov-2022\| Sheldon Title\| 1.00 \| Call with R. Cromie and M. Lem. \| \| 27-Nov-2022\| Matthew Lem \| .50 \| Preparation of draft stalking horse agreement. \| \| 28-Nov-2022\| Matthew Lem \| .80 \| Various discussions and review of information received from J. Kilborn re payments to be approved. Discussions with J. Kilborn and R. Cromie re access to online banking. Calls to, email and discussion with D. Robertson re arranging a meeting. Email to R. Cormier re sale process. \| \| 29-Nov-2022\| Matthew Lem \| 1.80 \| Review documents uploaded to data room. Conduct CIPO search; video call with J. Kilborn and R. Cromie review data room documents and CIPO search. Adjust and send sale process outline to D. Robertson. \| \| 30-Nov-2022\| Matthew Lem \| 1.30 \| Discussions with J. Kilborn re payments and debits. Meeting with D. Robertson re sale process and other. Call with R. Cromie and M. List. \| \| 30-Nov-2022\| Sheldon Title\| .90 \| Meeting with D. Robertson and M. Lem to discuss process/obtain background. Planning call with M. Lem. \| \| 01-Dec-2022\| Akhil Kapoor \| .50 \| Glancing through the claim process docs and noting down points of discussion. Detailed discussion with M. Lem re claim process, next steps, timelines among others. \| \| 01-Dec-2022\| Matthew Lem \| .40 \| Discussion with S. Title. Correspondence and discussions with J. Kilborn re claims process. Approval of disbursements. \| \| 01-Dec-2022\| Sheldon Title\| .30 \| Call with M. Lem on planning. \| \| 02-Dec-2022\| Matthew Lem \| 1.80 \| Review correspondence received re new potential client and MSA review by Dentons. Review order re same. Discussion with R. Cromie re Dentons review, employee retention and CIPO search. Update discussion with S. Title. Review and respond to correspondence from D. Robertson re sale process. Discussion with G. Camellino. Update to R. Cromie. Follow-up with J. Kilborn re approvals and information for claims process. \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|---------------\|-------\|-------------------------------------------------------------------------------------------\| \| 04-Dec-2022\| Matthew Lem \| 2.10 \| Finalize draft stalking horse agreement. Forward same and other documents to G. Camelino for review and comments. Update file. \| \| 05-Dec-2022\| Akhil Kapoor \| 1.50 \| Review of information - Court Order, Notice requirement. Notice of claim among others to understand the timing of sending the notice to creditors and shareholders. Reviewing secured, unsecured and shareholder information which needs to be incorporated in the notice of claim. Discussion with C. Nathwani re mail merging and updating Notice of Claims. Glancing through other docs in the folder. Email communication with M. Lem re the above updates. \| \| 05-Dec-2022\| Matthew Lem \| 2.10 \| Call with K. Philips and J. Kilborn re SRED Filing. Discussion with S. Title re sale process and stalking agreement terms. Review comments back and discussion with G. Camelino re sale process outline and stalking horse agreement terms and S. Title's comments. Finalize drafts of same and forward to R. Cromie. Attend to commission of affidavits of mailing. \| \| 06-Dec-2022\| Matthew Lem \| .30 \| Correspondence with D. Robertson re sale process and shareholder resolutions to approve same, correspondence with G. Camelino. \| \| 07-Dec-2022\| Akhil Kapoor \| 1.30 \| Review of information and finalization of information to be sent to all stakeholders. Advising C. Nathwani about the package to be sent to parties and to prepare the notices via mail merge. Discussion with M. Lem re mismatch between claim document and balance sheet and fixing it with the company. Receipt and review of revised financials as at Nov 23 2022. Discussion and finalization of newspaper proof and quote \| \| 07-Dec-2022\| Chahna Nathwani\| .30 \| Discussion with A. Kapoor on newspaper notice, forward notice to S. MacFarlane for getting quote for National post \| \| 07-Dec-2022\| Matthew Lem \| .80 \| Discussion with A. Kapoor re notice for claims process and other. Review correspondence from and discussion J. Kilborn re same for claims process. \| \| 08-Dec-2022\| Akhil Kapoor \| .50 \| Discussion with M. Lem re information available to send notices, status of notices, review of cap table, claim documents, newspaper notice among others. \| \| 08-Dec-2022\| Matthew Lem \| 1.60 \| Attend to correspondence. Discussion with A. Kapoor re claim process and notice in newspaper. Attend to \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|--------------\|-------\|-------------------------------------------------------------------------------------------\| \| \| \| \| filing of notice of liquidator with Service Canada. Review of payrolls for approval. Discussion with J. Kilborn re same and shareholders meeting. Correspondence with R. Cromie re Domain registrations. \| \| 09-Dec-2022\| Matthew Lem \| .30 \| Discussion with R. Cromie re stalking horse agreement and information claims process and resolutions for sales process. Correspondence with G. Camelino re same. \| \| 11-Dec-2022\| Matthew Lem \| .40 \| Attend to correspondence to G. Camelino; \| \| 12-Dec-2022\| Akhil Kapoor \| .30 \| Discussion with M. Lem re mailing to be done, arranging addresses, reviewing draft notices and advising C. Nathwani re adjustment to notices. \| \| 12-Dec-2022\| Chahna Nathwani \| 1.30 \| Finalising mailing list and notice of claims to each shareholder. Forwarded drafts to A. Kapoor \| \| 12-Dec-2022\| Matthew Lem \| .60 \| Review correspondence from G. Camelino re shareholders resolution. Discussion with S. Title re same. Review credit card payment request. Review and approval payroll for staff. \| \| 13-Dec-2022\| Akhil Kapoor \| .60 \| Discussion re finalization of notice, cover letter, emailing to BDC, and address discrepancies. \| \| 13-Dec-2022\| Chahna Nathwani \| 3.50 \| Update webpage for claim bar process and upload schedule A to E as per court order. Email sent to M. Lem. Finalising notices for mailing. Teams call with A. Kapoor and M. Lem. Revising amounts as per call with M. Lem. Sent revised notices to Branch office for mailing. Prepare mailing labels. Assemble notices for forwarding by email. \| \| 13-Dec-2022\| Matthew Lem \| 2.30 \| Review Notices of Claim. Prepare cover letter. Discussion with C. Nathwani and A. Kapoor re same. Discussions with J. Kilborn re preference share valuation. \| \| 13-Dec-2022\| Sheldon Title \| .20 \| Call with M. Lem and review of cover letter \| \| 14-Dec-2022\| Matthew Lem \| .90 \| Various correspondence with J. Kilborn. Attend disbursement approval. Review and finalize shareholder resolutions. Discussion with G. Camelino re same. Circulate draft resolution to D. Robertson and R. Cromie. Attend to call from R. Thomson of BDC. \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|----------------\|-------\|-------------------------------------------------------------------------------------------\| \| 15-Dec-2022\| Akhil Kapoor \| .20 \| Discussion re Paidiem notices, opening bank account, expenses to be paid. Call from BDC re notice sent to them and directing them to M. Lem \| \| 15-Dec-2022\| Chahna Nathwani\| .30 \| Attend to bank account set-up for liquidation. \| \| 15-Dec-2022\| Matthew Lem \| 2.40 \| Discussion with R. Thomson of BDC. Review stalking horse agreement. Discussion with R. Cromie re same and the claims process. Call to D. Robertson re claims. Approve payments. Discussion with J. Kilborn re BDC requests, SRED and reconciling entries. \| \| 16-Dec-2022\| Matthew Lem \| 2.40 \| Update tracking schedule and discussions with J. Kilborn re same, CRA and other. Review correspondence re BDC. Discussion with G. Camelino re stalking horse agreement and BDC. Discussion with R. Thompson of BDC. Prepare letter to potential claims. \| \| 16-Dec-2022\| Sheldon Title \| .30 \| Emails with G. Camelino on BDC claim. \| \| 18-Dec-2022\| Matthew Lem \| .80 \| Review correspondence from J. Kilborn re Paidiem Technologies. Upload information to data room. Review correspondence from J. Kilborn re CRA account status. Finalize letter to potential claimants and review order for claims process. Discussion with C. Nathwani re website postings; \| \| 19-Dec-2022\| Matthew Lem \| 1.80 \| Correspondence with G. Camelino re shareholders resolution. Review documents re preferred shareholders’ voting rights. Correspondence with J. Kilborn re directors. Discussion with R. Cromie re stalking horse agreement. Attend to finalization of same documents and forward to R. Cromie. Disbursement authorizations. \| \| 19-Dec-2022\| Sheldon Title \| .40 \| Call with J. Ormston. \| \| 20-Dec-2022\| Chahna Nathwani\| .30 \| Prepared mailing a Letter to Potential Claimant - CRA. Attend to mailing of same. \| \| 20-Dec-2022\| Matthew Lem \| 4.80 \| Review and adjust resolutions and update stalking horse agreement. Forward to R Cromie. Correspondence with G. Camelino. Discussion with R, Cromie. Update data room. Assemble documents for sale process. Preparation of NDA. Update sale process protocol. Forward documents to R. Cromie. \| \| 21-Dec-2022\| Matthew Lem \| 3.20 \| Preparation of NDA. Finalization of shareholders resolutions form. Discussion with R. Cromie and J. Kilborn re same and collection of signatures. \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|--------------\|-------\|-------------------------------------------------------------------------------------------\| \| \| \| \| Preparation of stalking horse protocol for resolution. Discussion with S. Title and R. Cromie re same. \| \| 21-Dec-2022\| Sheldon Title\| 1.20 \| Call with M. Lem on sale process, terms, review of sale process. \| \| 22-Dec-2022\| Matthew Lem \| 3.10 \| Preparation of teaser. Arrange call with D. Robertson. Forward application record to R. Thompson at BDC. Discussions and correspondence with G. Camelino re BDC and its counsel Miller Thomson. Disbursement approval. Forward to J. Kilborn for comments. \| \| 22-Dec-2022\| Sheldon Title\| .50 \| Call with M. Lem. Review of teaser. Email to M. Lem re same. Email from Lem re application record. \| \| 23-Dec-2022\| Matthew Lem \| 1.20 \| Call with D. Robertson re review sale process and stalking horse agreement for sign-off on shareholders resolution update teaser and prepare opportunity highlights. Payroll approval. Discussion with R. Cromie. \| \| 23-Dec-2022\| Sheldon Title\| .40 \| Further review/consideration of teaser/requested changes to APA. \| \| 28-Dec-2022\| Matthew Lem \| .60 \| Approval of disbursements. Correspondence with D. Robertson re resolutions. \| \| 29-Dec-2022\| Matthew Lem \| 1.20 \| Discussion with D. Robertson re resolution and other issues. Discussion with J. Kilborn re sale process and other issues. Approval of disbursements. Calls to R. Cromie and J. Kilborn re information for sale process and other. Review information received from K. Kilborn. Discussion with R. Cromie re sale process and information still required. \| \| 30-Dec-2022\| Chahna Nathwani\| .30 \| Preparation of affidavit of mailing, Forwarded to M. Lem for review and commissioning. \| \| 30-Dec-2022\| Matthew Lem \| 1.60 \| Update Teaser and opportunity highlight. Discussions with S. Title re same. Discussion with J. Kilborn re various issues. Payment approvals. \| \| 30-Dec-2022\| Sheldon Title\| .30 \| Review/comments on teaser document, email to G. Camelino. \| \| 31-Dec-2022\| Matthew Lem \| .60 \| Discussion with J. Kilborn re bank and client account reconciliations and other. Correspondence with J. Kilborn. Review of BMO statements. \| ## SUMMARY OF TIME CHARGES \| Professional \| Average Hourly Rate \| Hours \| Amount \| \|--------------------------------------------------\|---------------------\|-------\|----------\| \| Sheldon Title, Partner and Senior Vice President \| $740.00 \| 11.50 \| $8,510.00\| \| Matthew Lem, Partner and Senior Vice President \| $650.00 \| 57.80 \| $37,570.00\| \| Akhil Kapoor, Manager \| $469.00 \| 9.20 \| $4,314.80\| \| Chahna Nathwani, Estate Administrator \| $250.00 \| 6.20 \| $1,550.00\| TOTAL $51,944.80 Invoice Invoice Number: 10818808 Client Number: 0976685 Invoice Date: Feb 28 2023 Invoice Terms: Due Upon Receipt Paidiem Payment Solutions Inc. 325 Front Street West, Suite 400 Toronto, ON M5V 2Y1 For Professional Services Rendered: For the period from 1 January 2023 to 31 January 2023, in connection with us acting as the Court-appointed Liquidator of Paidiem Payment Solutions Inc. (detailed time descriptions attached) OUR FEE in all 30,989.00 LESS: Rate Adjustment Discount -3,927.00 Sub Total: 27,062.00 Harmonized Sales Tax: 3,518.06 Total (CAD): 30,580.06 HST Registration Number: 103697215 RT 0001 Invoices are due and payable upon receipt. Thank you for your business. We sincerely appreciate your trust in us. \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|----------------\|-------\|-------------------------------------------------------------------------------------------\| \| 01-Jan-2023\| Matthew Lem \| .70 \| Call with J. Kilborn and R. Cromie re sale process and additional information for same. \| \| 03-Jan-2023\| Matthew Lem \| 3.20 \| Call with Greensky and R. Cromie re sale process and APS terms. Forward stalking horse APS to M. List and others. Attend to disbursement approvals. Assemble potential bidder list. Update teaser and opportunity sheet. Discussion and review comments form J. Kilborn and R. Cromie re same. \| \| 03-Jan-2023\| Sheldon Title \| .30 \| Call with M. Lem on status. \| \| 04-Jan-2023\| Akhil Kapoor \| .80 \| Discussion with M. Lem re potential bidders list. Attend to address missing information for potential bidders list. Updating M. Lem. \| \| 04-Jan-2023\| Matthew Lem \| 1.10 \| Discussion with A. Kapoor re sale process. Discussion with S. Title. Follow-up with M. List re APS, sale process and deposit. Attend to potential bidder list. Discussion with A. Kapoor re same. Update teaser. \| \| 04-Jan-2023\| Sheldon Title \| 1.50 \| Call with G. Camelino. Call to J. Ormston. Call with M. Lem on sale process. Receipt of and review G. Camelino account. Call with G. Camelino on account and BDC (Van Klink). Email to C. Nathwani re account. \| \| 05-Jan-2023\| Matthew Lem \| 1.00 \| Respond to email form M. List. Correspondence with G. Camelino re amendment required. Review draft amendment. Forward draft amendment to R. Cromie. Review and approve disbursements and debit. Discussion with R. Cromie re amendments. \| \| 06-Jan-2023\| Akhil Kapoor \| .20 \| Discussion with corporate finance team re additional contacts for list of potential bidders. Discussion with C. Nathwani re potential bidder list. \| \| 06-Jan-2023\| Chahna Nathwani\| 1.40 \| Updating potential bidder's list with phone numbers/emails. Forward updated list to A. Kapoor. \| \| 06-Jan-2023\| Matthew Lem \| 4.80 \| Review correspondence from G. Camelino re Miller Thompson/BDC. Call with R. Thomson of BDC. Attend to launch of sale process and email to prospective bidders and MNP partner group. Attend to receipt of deposit from stalking horse bidder. Review precedent for LOI and forward to G. Camelino. Review and update data room documents. Attend to amending \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|----------------\|-------\|-------------------------------------------------------------------------------------------\| \| \| \| \| agreement with stalking horse bidder. Follow-up with D. Robertson re claim. \| \| 06-Jan-2023\| Sheldon Title \| .30 \| Call with M. Lem on various matters, including the sale process/BDC/etc. Forward template LOI to M. Lem for consideration. \| \| 07-Jan-2023\| Matthew Lem \| .20 \| Attend to email from prospective bidders. \| \| 08-Jan-2023\| Matthew Lem \| .20 \| Send out teaser to other MNP partners. \| \| 09-Jan-2023\| Chahna Nathwani\| .90 \| Online search for contact details for potential bidders, and update list. \| \| 09-Jan-2023\| Matthew Lem \| 6.60 \| Review and update data room documents. Various discussion with R. Cromie re same. Attend to correspondence from prospective bidders re request for NDA. Follow-up with R. Cromie re claim. \| \| 10-Jan-2023\| Akhil Kapoor \| .20 \| Discussion re claim document received and advertisement to be prepared for sale process; Forward revised potential bidder list with M. Lem. \| \| 10-Jan-2023\| Matthew Lem \| 5.90 \| Update documents in data room. Various discussion with R. Cromie re same. Set data room live and grant access to potential bidders. Review draft LOI template and provide comments. Finalize template LOI and post to data room. Discussions with R. Cromie re CTO and chief of staff positions. Follow-up with D. Robertson re claim and participation in process. \| \| 11-Jan-2023\| Akhil Kapoor \| .20 \| Discussion with M. Lem re advertisement requirements and options. \| \| 11-Jan-2023\| Matthew Lem \| 1.10 \| Disbursement approvals. Review correspondence from R. Cromie. Discussion with R. Cromie. Follow-up re payroll. Review RBC account activity. Return call to potential bidder. Address Denton invoice and correspondence. \| \| 12-Jan-2023\| Akhil Kapoor \| .50 \| Preparation of ad for Paidiem sale process. Discussion with C. Nathwani re to obtain a quote for ad. \| \| 12-Jan-2023\| Chahna Nathwani\| .10 \| Send request to TD bank for opening new trust account. \| \| 12-Jan-2023\| Matthew Lem \| 2.20 \| Correspondence with D. Robertson re filing claim and participating in sale process. Correspondence and discussion with R. Sakauye re MNP claims. Attend to correspondence from Dentons re legal bill for the Company. Discussion with R. Cromie re same. \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|----------------\|-------\|-------------------------------------------------------------------------------------------\| \| \| \| \| Correspondence and discussion with R. Cromie re overpayment by client. \| \| 13-Jan-2023\| Akhil Kapoor \| .50 \| Finalization of newspaper ad and forward to M. Lem for review. Exploring the option of also placing a Post Media web ad. \| \| 13-Jan-2023\| Chahna Nathwani\| .50 \| Calls and email communication with Postmedia on newspaper advertisement rates/quotes and size limitation. Forward the final draft of newspaper ad for publishing; received proof. Reviewed proof and forwarded to M. Lem. Forwarded confirmation to Postmedia for publishing. \| \| 13-Jan-2023\| Matthew Lem \| 1.90 \| Approval disbursements. Review banking activity. Discussion with Paidiem and R. Cromie re same. Discussion with R. Cromie re payment of BDC. Call to R. Thompson of BDC re request payout. Call to G. Camelino. Attend to invoice from Dentons. Review revised NDA from potential bidder. Respond to same. \| \| 16-Jan-2023\| Akhil Kapoor \| .10 \| Adjust newspaper ad and confirming National Post team for January 17, 2023 publication. \| \| 16-Jan-2023\| Matthew Lem \| 1.20 \| Review PPSA search re BDC and forward same to G. Camelino. Follow-up with D. Robertson re sale process. Attend to disbursement and debit approvals. Review and approve National Post advertisement re sale process. Discussion with S. Title re payout of BDC. \| \| 16-Jan-2023\| Sheldon Title \| .20 \| Discussion with M. Lem on BDC claim/payout. \| \| 17-Jan-2023\| Matthew Lem \| .40 \| Correspondence with potential bidder. Attend to disbursement approvals. \| \| 18-Jan-2023\| Matthew Lem \| 2.10 \| Review correspondence from G. Camelino re BDC payout. Review order and discussion with G. Camelino re payment of amount claimed. Discussion with S. Title re same. Email to J. Kilborn and R. Cromie re payment of BDC claim. Review and approve disbursements. Discussions with R. Thomson of BDC re payout. Attend to various correspondence from J. Kilborn and R. Thomson re payout of BDC. Correspondence with J. Kilborn and R. Cromie re KERP. \| \| 19-Jan-2023\| Matthew Lem \| 3.00 \| Discussion with R. Thomson of BDC re discharge and release. Preparation of draft KERP letter. Forward same to counsel for review and comments. Discussion with R. Cromie re same and BDC. Discussion with J. Kilborn re information concerning receivable from \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|--------------\|-------\|-------------------------------------------------------------------------------------------\| \| \| \| \| Robertson & Co. and claims process. Review correspondence re same, disbursement approvals. Review comments on KERP letter from G. Camelino and forward same to R. Cromie and J. Kilborn for comments. \| \| 19-Jan-2023\| Sheldon Title\| .20 \| Emails to/from M. Lem re: KERP letter and irrevocable direction. \| \| 20-Jan-2023\| Akhil Kapoor \| .60 \| Discussion with M. Lem re potential bidder. Forward the teaser with a new potential bidder. Initial review of the claim field by Shift 8. \| \| 20-Jan-2023\| Matthew Lem \| .20 \| Correspondence with potential bidder. Correspondence with J. Kilborn re HST refund. \| \| 23-Jan-2023\| Akhil Kapoor \| .80 \| Discussion with M. Lem re emails to be sent to the 4 potential bidders who have signed NDA and have access to the data room. Follow-up emails to the potential bidders, enquiring if they have any queries and to remind them about bid deadline. Emails with a couple of potential bidders re their queries on deposit and concerns around IP. Discussion with M. Lem re same. \| \| 23-Jan-2023\| Matthew Lem \| .20 \| Approve transfer re deposit funds previously received. Update discussion with S. Title re sale process. \| \| 23-Jan-2023\| Sheldon Title\| .20 \| Call with J. Ormston followed by call with M. Lem. \| \| 24-Jan-2023\| Matthew Lem \| .20 \| Correspondence with potential bidder. \| \| 25-Jan-2023\| Matthew Lem \| 2.20 \| Review information for approval and discussion re same. Review approval tracking. Call with Paideim re cash tracking. Approve debits. Discussion with J. Kilborn re KERP letter. Review and adjust KERP letter. Forward to J. Kilborn and R. Cromie. \| \| 26-Jan-2023\| Akhil Kapoor \| .10 \| Emails with prospective bidders re their queries, passing on the opportunity and sharing them with M. Lem. \| \| 26-Jan-2023\| Matthew Lem \| 1.20 \| Disbursement approval. Review payroll. Discussion it J. Kilborn re payroll, BDC and KERP. \| \| 27-Jan-2023\| Matthew Lem \| .30 \| Disbursement approval. Respond to potential bidder inquiry. \| \| 30-Jan-2023\| Matthew Lem \| .40 \| Disbursement approval. Review correspondence. Discussion with potential bidder. \| \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|-------------------------------\|-------\|-------------------------------------------------------------------------------------------\| \| 31-Jan-2023\| Matthew Lem \| .30 \| Call with SRED Team. Call to J. Kilborn re same and other matters. Approval of disbursements. Discussion with R. Cromie re KERP. \| SUMMARY OF TIME CHARGES \| Professional \| Average Hourly Rate \| Hours \| Amount \| \|--------------------------------------------------\|----------------------\|-------\|-----------\| \| Sheldon Title, Partner and Senior Vice President \| $740.00 \| 2.70 \| $1,998.00 \| \| Matthew Lem, Partner and Senior Vice President \| $650.00 \| 40.60 \| $26,390.00\| \| Akhil Kapoor, Manager \| $469.00 \| 4.00 \| $1,876.00 \| \| Chahna Nathwani, Estate Administrator \| $250.00 \| 2.90 \| $725.00 \| \| TOTAL \| \| 50.20 \| $30,989.00 \| Invoice Invoice Number: 10829675 Client Number: 0976685 Invoice Date: Mar 8 2023 Invoice Terms: Due Upon Receipt Paidiem Payment Solutions Inc. 325 Front Street West, Suite 400 Toronto, ON M5V 2Y1 For Professional Services Rendered: For the period from 1 February 2023 to 28 February 2023, in connection with us acting as the Court-appointed Liquidator of Paidiem Payment Solutions Inc. (detailed time descriptions attached) OUR FEE in all 4,520.90 LESS: Rate Adjustment Discount -367.50 Sub Total: 4,153.40 Harmonized Sales Tax: 539.94 Total (CAD): 4,693.34 HST Registration Number: 103697215 RT 0001 Invoices are due and payable upon receipt. Thank you for your business. We sincerely appreciate your trust in us. \| DATE \| PROFESSIONAL \| HOURS \| DETAILED TIME DESCRIPTIONS \| \|------------\|--------------\|-------\|-------------------------------------------------------------------------------------------\| \| 01-Feb-2023\| Akhil Kapoor \| .10 \| Email communication with a potential bidder re interest in opportunity. \| \| 01-Feb-2023\| Matthew Lem \| .10 \| Call with J. Kilborn re outstanding file matters and SRED claim filing. \| \| 02-Feb-2023\| Matthew Lem \| .40 \| Review and adjust KERP letter. Forward to J. Kilborn for comments. Disbursement approval. \| \| 06-Feb-2023\| Matthew Lem \| .30 \| Attend to correspondence re SRED claim preparation. Update email with G. Camelino re sale process. Attend to call from R. Cromie re sale process. \| \| 07-Feb-2023\| Matthew Lem \| .30 \| Discussion with AML group re FINTRAC MSB registration. Disbursement approval. \| \| 08-Feb-2023\| Matthew Lem \| .20 \| Disbursement and debit approvals. \| \| 10-Feb-2023\| Sheldon Title\| .40 \| Review email from J. Ormston re: impact of Robertson & Co accounts receivable and D. Robertson’s claim. \| \| 15-Feb-2023\| Matthew Lem \| 1.60 \| Disbursement and debit approvals. Call with Gnarly Books and J. Kilborn. Call with J. Kilborn and AML team. Attend to KERP letters. Discussion with J. Kilborn re same. \| \| 16-Feb-2023\| Matthew Lem \| .10 \| Disbursement approvals. \| \| 21-Feb-2023\| Sheldon Title\| .20 \| Call with J. Ormston. \| \| 22-Feb-2023\| Matthew Lem \| .20 \| Discussion with J. Kilborn. Approval of debit and disbursements. \| \| 23-Feb-2023\| Matthew Lem \| .10 \| Disbursement approval. \| \| 24-Feb-2023\| Matthew Lem \| 1.30 \| Disbursement approval. Review of claim of D. Robertson. \| \| 27-Feb-2023\| Matthew Lem \| 1.20 \| Preparation of first report to court. Disbursement approval. \| \| 28-Feb-2023\| Matthew Lem \| .40 \| Correspondence with J. Kilborn re Robertson Claim. Discussion with J. Kilborn. Discussion with S. Title re closing sale and claims process. \| ## SUMMARY OF TIME CHARGES \| Professional \| Average Hourly Rate \| Hours \| Amount \| \|--------------------------------------------------\|---------------------\|-------\|---------\| \| Sheldon Title, Partner and Senior Vice President \| $740.00 \| .60 \| $444.00 \| \| Matthew Lem, Partner and Senior Vice President \| $650.00 \| 6.20 \| $4,030.00 \| \| Akhil Kapoor, Manager \| $469.00 \| .10 \| $46.90 \| \| TOTAL \| \| 6.90 \| $4,520.90 \| AFFIDAVIT OF ANTONELLA CERMINARA (Sworn on March 10, 2023) I, ANTONELLA CERMINARA, of the City of Vaughan in the Province of Ontario, MAKE OATH AND SAY: 1. I am a legal assistant employed by the law firm of Camelino Galessiere LLP (“CGLLP”), the lawyers for the court-appointed liquidator MNP Ltd. (the “Liquidator”) and as such have knowledge of the matters to which I hereinafter depose. Where such knowledge is based upon the information of others I verily believe such information to be true. 2. CGLLP was initially retained by the Liquidator on November 19, 2022. 3. I am advised by Gustavo Camelino, the lawyer with carriage of this matter for CGLLP, and verily believe that the work undertaken by CGLLP’s as counsel for the Liquidator in the period from its initial engagement up to and including February 28, 2023 is briefly summarized as follows: - the review and revision of the Liquidation Order; - consultations with the Liquidator regarding a sales process; • the review, revision and finalization of the proposed stalking horse agreement; • the review, revision and finalization of the Sale Process; • the preparation of a common shareholder resolution re the Stalking Horse Agreement; • the preparation of a common shareholder resolution re the Stalking Horse Agreement; • the review and revision of a Non-Disclosure Agreement to be used in the Sale Process; • communication with counsel for secured creditor BDC including a review of its security documents; • consult with the Liquidator regarding Key Employment Retention; and • begin preparation of materials for motion for approval and vesting order. 4. CGLLP issued three invoices for its fees for the period beginning November 19, 2022 and ending on February 28, 2023.$^1$ The aggregate total of fees and taxes in those three invoices was $14,541.41 particularized as follows: \| Date \| Inv. No. \| Fees \| Disb. \| HST \| Total \| \|------------\|----------\|----------\|-------\|--------\|---------\| \| 2022-12-31 \| 2809 \| $6,831.00\| $0 \| $888.03\| $7,719.03\| \| 2023-01-31 \| 2870 \| $4,410.00\| $0 \| $573.30\| $4,983.30\| \| 2023-02-28 \| 2915 \| $1,627.50\| $0 \| $211.58\| $1,839.08\| \| \| \| $12,868.50\| $0 \| $1672.91\| $14,541.41\| 5. A review of the invoices reveal that all of CGLLP’s work relating to this engagement was undertaken by Mr. Camelino who was called to the bar in February 2002. $^1$ Hereto annexed and marked as Exhibit 1 to this my affidavit is a copy of the three invoices issued by CGLLP. 6. Mr. Camelino’s hourly billing rate and hours worked during the currency of CGLLP’s engagement as counsel for the Liquidator for the period commencing November 19, 2022 and ending February 28, 2023 is as follows. \| \| Hourly Rate \| Hours Invoiced \| Amount Invoiced (excluding HST) \| \|-------\|-------------\|----------------\|---------------------------------\| \| 2022 \| $495.00 \| 13.8 \| $6,831.00 \| \| 2023 \| $525.00 \| 11.5 \| $6,037.50 \| 7. Mr. Camelino’s average effective hourly billing rate during the period is $508.56. 8. I make this affidavit in support of the Liquidator’s motion for, inter alia, the approval of the fees of the Liquidator’s counsel. SWORN before me at the City of Toronto, in the Province of Ontario, this 10th day of March, 2023. ANTONELLA CERMINARA Commissioner for Taking Affidavits Gustavo F. Camelino THIS IS EXHIBIT 1 TO THE AFFIDAVIT OF ANTONELLA CERMINARA SWORN BEFORE ME AT THE CITY OF TORONTO, THIS 10TH DAY OF MARCH, 2023. Commissioner for Taking Affidavits Gustavo F. Camelino TO PROFESSIONAL SERVICES RENDERED with respect to the above matter during the period ending December 31, 2022 including: FEES \| Date \| Person \| Description \| Hours \| Rate \| Amount \| \|------------\|--------\|-----------------------------------------------------------------------------\|-------\|--------\|---------\| \| Nov-19-22 \| GFC \| initial consultation; receive and review proposed wind-up order; conference call with Mr. Title re same; \| 2.00 \| 495.00 \| 990.00 \| \| Nov-21-22 \| GFC \| correspond with Mr. Title re proposed changes to Liquidation Order; correspondence from Mr. Title to Mr. Shea re same; correspondence from Mr. Shea re same; exchange emails with Mr. Shea and Mr. Title throughout the morning; \| 1.60 \| 495.00 \| 792.00 \| \| Nov-22-22 \| GFC \| correspondence from Mr. Shea re Liquidation Order; correspond with Mr. Title re same; \| 0.40 \| 495.00 \| 198.00 \| \| Nov-23-22 \| GFC \| receive and review signed Liquidation Order; correspond with Mr. Title re same; \| 0.40 \| 495.00 \| 198.00 \| \| Dec-05-22 \| GFC \| receive and review draft stalking horse agreement, draft sales process and offer; provide mark-ups to client; receive and review MNP mark-up of stalking horse and sales process; \| 1.50 \| 495.00 \| 742.50 \| \| Dec-06-22 \| GFC \| exchange emails with Mr. Lem re status; \| 0.20 \| 495.00 \| 99.00 \| \| Dec-09-22 \| GFC \| exchange emails with Mr. Lem re OBCA shareholder resolutions; receive and review Denton’s suggested revisions to the Stalking Horse Agreement; correspond with Mr. Lem enclosing comments to same; correspondence from Mr. Lem requesting draft shareholder’s resolution for stalking horse and sales process; prepare draft proposal and correspond with Mr. Lem re same; \| 2.00 \| 495.00 \| 990.00 \| \| Dec-16-22 \| GFC \| receive and review company’s proposed changes to the stalking horse agreement; correspond with Mr. Lem providing my comments; exchange emails with Mr. VanKlink and Mr. Shea; confer with Mr. VanKlink (BDC); confer with Mr. Lem; correspondence from Mr. VanKlink re application; forward same to Mr. Lem; \| 1.50 \| 495.00 \| 742.50 \| \| Dec-19-22 \| GFC \| receive and review Voting Agreement (Paidiem) re preferred shareholders; \| 1.00 \| 495.00 \| 495.00 \| \| Dec-20-22 \| GFC \| prepare resolution for preferred shareholders; \| 1.00 \| 495.00 \| 495.00 \| \| Date \| Code \| Description \| Hours \| Rate \| Amount \| \|------------\|------\|-----------------------------------------------------------------------------\|-------\|-------\|----------\| \| Dec-21-22 \| GFC \| confer with Mr. Lem re final versions of agreement; review same and correspond with Mr. Lem; receive and review proposed NDA; correspond with Mr. Lem re same; \| 1.00 \| 495.00\| \| \| Dec-22-22 \| GFC \| correspondence from Mr. Van Klink re status of payment; correspond with Mr. Lem re same; correspondence from Mr. Van Klink \| 0.40 \| 198.00\| \| \| Dec-23-22 \| GFC \| confer with Mr. Lem re status; \| 0.40 \| 198.00\| \| \| Dec-28-22 \| GFC \| receive and review information from Mr. Lem (for affidavit); correspond with Mr. Lem re same; \| 0.40 \| 198.00\| \| TOTALS \| \| \| \| 13.80 \| $6,831.00 \| \| \|-------\|-------\|-------------------------------\|-------\|-----------\|----------\| Total HST on Fees \| \| \| \| \| \| 888.03 \| \|-------\|-------\|-------------------------------\|-------\|-----------\|----------\| TOTAL FEES, DISBURSEMENTS AND HST: \| \| \| \| \| \| $7,719.03\| \|-------\|-------\|-------------------------------\|-------\|-----------\|----------\| TOTAL DUE AND OWING (CAD Funds) \| \| \| \| \| \| $7,719.03\| \|-------\|-------\|-------------------------------\|-------\|-----------\|----------\| HST Registration #: 75733 6714 RT0001 Total HST: $888.03 (entries with an asterisk are tax-exempt) This is our account herein CAMELINO GALESSIERE LLP Per: Gustavo F. Camelino THIS ACCOUNT BEARS INTEREST AT THE RATE OF 18% PER ANNUM IN ACCORDANCE WITH THE PROVISIONS OF THE SOLICITORS ACT, R.S.O. 1990 C.S. 15. MNP Ltd. 111 Richmond Street West Suite 300 Toronto, ON M5H 2G4 Canada Attention: Sheldon Title Re: Paidiem Payments Solutions Inc. Liquidation Proceedings (OBCA) January 31, 2023 TO PROFESSIONAL SERVICES RENDERED with respect to the above matter during the period ending January 31, 2023 including: FEES \| Date \| Code \| Description \| Hours \| Rate \| Amount \| \|------------\|------\|-----------------------------------------------------------------------------\|-------\|--------\|---------\| \| Jan-04-23 \| GFC \| confer with Mr. Title re disclosure to bidders; \| 0.30 \| 157.50 \| \| \| Jan-05-23 \| GFC \| telephone call to Mr. VanKlink re status; confer with Mr. Lem re amending agreement (to Stalking Horse Agreement) and LOI; prepare amending agreement; correspond with Mr. Lem enclosing same; \| 2.00 \| 1,050.00 \| \| \| Jan-06-23 \| GFC \| exchange emails with Mr. Van Klink re status; correspond with Mr. Lem re same; confer with Mr. Lem re BDC; correspondence from Mr. Lem enclosing signed Amending Agreement; \| 1.00 \| 525.00 \| \| \| Jan-09-23 \| GFC \| prepare first draft of LOI and Checklist for review by Mr. Lem; \| 2.00 \| 1,050.00 \| \| \| Jan-10-23 \| GFC \| finalize drafts of LOI and Checklist; correspond with Mr. Lem forwarding same for his review; exchange emails with Mr. Lem re same; \| 1.00 \| 525.00 \| \| \| Jan-13-23 \| GFC \| confer with Mr. Lem; review BDC loan and security documents; correspond with Mr. Lem re same; \| 0.80 \| 420.00 \| \| \| Jan-16-23 \| GFC \| exchange emails with Mr. Lem re BDC claim and security; \| 0.40 \| 210.00 \| \| \| Jan-18-23 \| GFC \| receive and review BDC payout statement; correspond with Mr. Lem re same; \| 0.40 \| 210.00 \| \| \| Jan-19-23 \| GFC \| exchange emails with Mr. Lem re KERP letter; \| 0.50 \| 262.50 \| \| TOTALS Total HST on Fees $4,410.00 $573.30 TOTAL FEES, DISBURSEMENTS AND HST: $4,983.30 TOTAL DUE AND OWING (CAD Funds) $4,983.30 HST Registration #: 75733 6714 RT0001 Total HST: $573.30 (entries with an asterisk are tax-exempt) This is our account herein CAMELINO GALESSIERE LLP Per: [Signature] Gustavo F. Camelino THIS ACCOUNT BEARS INTEREST AT THE RATE OF 18% PER ANNUM IN ACCORDANCE WITH THE PROVISIONS OF THE SOLICITORS ACT, R.S.O. 1990 C.S. 15. February 28, 2023 MNP Ltd. 111 Richmond Street West Suite 300 Toronto, ON M5H 2G4 Canada Attention: Sheldon Title Re: Paidiem Payments Solutions Inc. Liquidation Proceedings (OBCA) TO PROFESSIONAL SERVICES RENDERED with respect to the above matter during the period ending February 28, 2023 including: FEES \| Date \| Attorney \| Description \| Hours \| Amount \| \|------------\|----------\|-----------------------------------------------------------------------------\|-------\|----------\| \| Feb-08-23 \| GFC \| begin preparation of motion materials for an approval and vesting order; \| 1.00 \| 525.00 \| \| Feb-20-23 \| GFC \| continue preparing motion materials for vesting order; begin preparation of order approving liquidator’s first report, approving fees, and distributing sale proceeds; \| 1.50 \| 787.50 \| \| Feb-21-23 \| GFC \| continue preparation of notice of motion re approval and vesting, first report and interim distribution; \| 0.60 \| 315.00 \| TOTALS \| \| \| \| \| \| \|----------\|----------\|------------------------------\|-------\|----------\| \| \| \| TOTALS \| 3.10 \| $1,627.50\| \| \| \| Total HST on Fees \| \| 211.58 \| TOTAL FEES, DISBURSEMENTS AND HST: $1,839.08 TOTAL DUE AND OWING (CAD Funds) $1,839.08 HST Registration #: 75733 6714 RT0001 Total HST: $211.58 (entries with an asterisk are tax-exempt) This is our account herein CAMELINO GALESSIERE LLP Per: ____________________________ Gustavo F. Camelino THIS ACCOUNT BEARS INTEREST AT THE RATE OF 18% PER ANNUM IN ACCORDANCE WITH THE PROVISIONS OF THE SOLICITORS ACT, R.S.O. 1990 C.S. 15. ONTOARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) AFFIDAVIT OF ANTONELLA CERMINARA (SWORN MARCH 10, 2023) CAMELINO GALESSIERE LLP Barristers & Solicitors 65 Queen Street West Suite 440 Toronto, ON M5C 1H6 Gustavo F. Camelino Law Society No.: 45607S Tel: 416-306-3834 Email: firstname.lastname@example.org Lawyers for MNP Ltd. TAB 3 ON READING the First Report of the Liquidator dated March 10, 2023 and on hearing submissions of counsel for the parties and for the Liquidator, no one appearing for any other person on the service list, although served as appears from the affidavit of Linda Galessiere sworn on March 10, 2023. 1. THIS COURT ORDERS* that the time for services of the Notice of Motion and Motion Record is hereby abridged and validated so that this motion is properly returnable today and hereby dispenses with further service thereof. 2. THIS COURT ORDERS AND DECLARES that the Transaction is hereby approved, and the execution of the 145CAN APS by the Liquidator is hereby authorized and approved with a minor amendment concerning the payment of the balance of purchase price by secured promissory note on the terms as the Liquidator and 145CAN may agree but which will include the following basic terms: (1) that it be payable in full on the earlier of i) the distribution to the Pref S/Hs pursuant to an Order of this Court, and ii) six months from the date of Closing; (2) that it be secured in full by a first ranking charge/security over all of the property, assets and undertakings of 145CAN; and (3) that no principal or interest payments to be made during period that the promissory note is outstanding 3. THIS COURT ORDERS AND DIRECTS that the Liquidator, 145CAN and Paidiem take such additional steps and execute such additional documents as may be necessary or desirable for the completion of the Transaction and for the conveyance of the Purchased Assets to 145CAN. 4. THIS COURT ORDERS AND DECLARES that upon delivery of a Liquidator’s certificate to 145CAN substantially in the form attached as Schedule A hereto (the “Liquidator’s Certificate”), all of Paidiem’s right, title and interest in and to the Purchased Assets described in the 145CAN APS shall vest absolutely in 145CAN, free and clear of any and all security interests (whether contractual, statutory, or otherwise), hypothecs, mortgages, trusts or deemed trusts (whether contractual, statutory or otherwise), liens, executions, levies, charges, or other financial or monetary claims, whether or not they have attached or been perfected, registered or filed and whether secured, unsecured or otherwise (collectively, the “Claims”) including, without limiting the generality of the foregoing: (i) encumbrances or charges created by the order of the Honourable Mr. Justice Cavanagh dated November 23, 2022; (ii) all charges, security interests or claims evidenced by registrations pursuant to the Personal Property Security Act (Ontario) or any other personal property registry system (all of which are collectively referred to as “Encumbrances” and, for greater certainty, this court orders that all of the Encumbrances affecting or relating to the Purchased Assets are hereby expunged and discharged against the Purchased Assets. 5. THIS COURT ORDERS that for the purposes of determining the nature and priority of Claims, the net proceeds from the sale of the Purchased Assets shall stand in the place and stead of the Purchased Assets, and that from and after delivery of the Liquidator’s Certificate all Claims and Encumbrances shall attach to the net proceeds from the sale of the Purchased Assets with the same priority as they had with respect to the Purchased Assets immediately prior to the sale, as if the Purchased Assets had not been sold and remained in the possession or control of the person having that possession or control immediately prior to the sale. 6. THIS COURT ORDERS AND DIRECTS the Liquidator to file with the court a copy of the Liquidator’s Certificate forthwith after delivery thereof. 7. THIS COURT ORDERS that pursuant to clause 7(3)(c) of the Canada Personal Information Protection and Electronic Documents Act, the Liquidator and Paidiem is authorized and permitted to disclose and transfer to 145CAN all human resources and payroll information in Paidiem’s records pertaining to Paidiem’s past and current employees. 145CAN shall maintain and protect the privacy of such information and shall be entitled to use the personal information provided to it in a manner which is in all material respect identical to the prior use of such information by Paidiem. 8. THIS COURT ORDERS that notwithstanding: (1) the pendency of these proceedings; (2) any applications for a bankruptcy order now or hereafter issued pursuant to the Bankruptcy and Insolvency Act (Canada) (the “BIA”) in respect of Paidiem and any bankruptcy order issued pursuant to any such applications; and (3) any assignment in bankruptcy made in respect of Paidiem. the vesting of the Purchased Assets in 154CAN pursuant to this order shall be binding on any trustee in bankruptcy that may be appointed in respect of Paidiem and shall not be void or voidable by creditors of Paidiem, nor shall it constitute not be deemed to be a fraudulent preference, assignment, fraudulent conveyance, transfer at undervalue, or other reviewable transaction under the BIA or any other applicable federal or provincial legislation, nor shall it constitute oppressive or unfairly prejudicial conduct pursuant to applicable federal or provincial legislation. 9. THIS COURT HEREBY REQUESTS the aid and recognition of any court, tribunal, regulator or administrative body having jurisdiction in Canada or in the United States to give effect to this Order and to assist Paidiem and the Liquidator and their agents to carry out the terms of this order. All courts, tribunals, regulatory and administrative bodies are hereby respectfully requested to make such order and to provide such assistance to Paidiem and the Liquidator, as an officer of this court, as may be necessary or desirable to give effect to this order or to assist Paidiem and the Liquidator and their agents in carrying out the terms of this order. SCHEDULE A – FORM OF LIQUIDATOR’S CERTIFICATE Court File No. CV-22-00690376-00CL ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) BETWEEN: DAVID ROBERTON Applicant - and - PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER section 207 of the Business Corporations Act, R.S.O. 1990, c.B16 LIQUIDATOR’S CERTIFICATE RECITALS A. David Robertson commenced these proceedings under part XVI of the Ontario Business Corporations Act by order of the Honourable Mr. Justice Cavanagh dated November 23, 2023 (the “Liquidation Order”); B. MNP Ltd. (the “Liquidator”) was appointed as liquidator of the respondent Paidiem Payment Solutions Inc. (“Paidiem”) pursuant to the Liquidation Order; C. Pursuant to the order of the court dated March 15, 2023 (the “Approval and Vesting Order”), the court approved the agreement of purchase and sale dated December 21, 2022 as amended (the “154CAN APS”) between MNP Ltd. (solely in its capacity as the court-appointed liquidator of Paidiem) as vendor and 14546865 Canada Inc. (“145CAN”) as purchaser and provided for the vesting in 145CAN of Paidiem’s right, title and interest in and to the Purchases Assets, which vesting is to be effective with respect to the Purchased Assets upon delivery by the Liquidator to 145CAN of a certificate confirming: (i) the payment by 154CAN of the Purchase Price for the Purchased Assets; (ii) that the conditions of Closing set out in the 154CAN APS have been satisfied or waived by the parties (as applicable); and (iii) the Transaction has been completed to the satisfaction of the Liquidator. D. Unless otherwise indicated herein, capitalized terms shall have the same meaning as set out in the 154CAN APS. THE LIQUIDATOR CERTIFIES the following: 1. The conditions of Closing applicable under the 154CAN APS have been satisfied and/or waived, as applicable; 2. The Liquidator received the required promissory note and security from 154CAN to satisfy the payment of the purchase price under the 154CAN APS; 3. The Transaction has been completed to the satisfaction of the Liquidator. 4. This Certificate was delivered by the Liquidator at __________(time) on __________ (date). MNP Ltd, solely in its capacity as court appointed liquidator of Paidiem Payment Solutions Inc. and not in its personal capacity _____________________________________ Name: Title: I have authority to bind the corporation DAVID ROBERTSON and PAIDIEM PAYMENT SOLUTIONS INC. Applicant and Respondent Court File No.: CV-22-00690376-00CL ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) APPROVAL AND VESTING ORDER CAMELINO GALESSIERE LLP Barristers & Solicitors 65 Queen Street West Suite 440 Toronto, ON M5C 1H6 Gustavo F. Camelino Law Society No.: 45607S Tel: 416-306-3834 Email: email@example.com Lawyers for MNP Ltd. ONTOARIO SUPERIOR COURT OF JUSTICE {COMMERCIAL LIST} THE HONOURABLE ——— JUSTICE ——— JUSTICE STEELE ) WEEKDAY, WEDNESDAY, THE # } 15th DAY OF MONTH, 20YR ) MARCH, 2023 BETWEEN: PLAINTIFF DAVID ROBERTSON Applicant - and - DEFENDANT PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER section 207 of the Business Corporations Act, R.S.O. 1990, c.B16 APPROVAL AND VESTING ORDER THIS MOTION, made by [RECEIVER’S NAME]MNP Ltd. (the “Liquidator”) in its capacity as the court-appointed receiver (the “Receiver”)/liquidator of the undertaking, property and assets of {DEBTOR} (the “Debtor”)/respondent Paidiem Payment Solutions Inc. (“Paidiem”) for an order approving the sale transaction (the “Transaction”) contemplated by an a stalking horse agreement of purchase and sale (the “Sale Agreement”) dated December 21, 2022 as amended (the “145CAN APS”) between the Receiver and [NAME OF PURCHASER] (the “Purchaser”) dated [DATE] and appended to the Report of the Receiver dated [DATE] (the "Report"), and MNP Ltd. (solely in its capacity in its capacity as the court appointed liquidator of the respondent Paidiem) as vendor and 14546865 Canada Inc. ("145CAN") as purchaser, vesting in the Purchaser the Debtor's 145CAN all of Paidiem's right, title and interest in and to the assets described in the Sale Agreement 145CAN APS (the "Purchased Assets"), was heard this day at 330 University Avenue, Toronto, Ontario via videoconference. ON READING the Report First Report of the Liquidator dated March 10, 2023 and on hearing the submissions of counsel for the Receiver, [NAMES OF OTHER PARTIES APPEARING], parties and for the Liquidator, no one appearing for any other person on the service list, although properly served as appears from the affidavit of [NAME] Linda Galessiere sworn [DATE] filed on March 10, 2023, 1. THIS COURT ORDERS that the time for services of the Notice of Motion and Motion Record is hereby abridged and validated so that this motion is properly returnable today and hereby dispenses with further service thereof. 2. THIS COURT ORDERS AND DECLARES that the Transaction is hereby approved, and the execution of the Sale Agreement 145CAN APS by the Receiver/Liquidator is hereby authorized and approved, with such minor amendments as the Receiver/amendment concerning the payment of the balance of purchase price by secured promissory note on the terms as the Liquidator and 145CAN may deem necessary. The Receiver is hereby authorized and directed agree but which will include the following basic terms: (1) that it be payable in full on the earlier of i) the distribution to the Pref S/Hs pursuant to an Order of this Court, and ii) six months from the date of Closing; --- 1 This model order assumes that the time for service does not need to be abridged. The motion seeking a vesting order should be served on all persons having an economic interest in the Purchased Assets, unless circumstances warrant a different approach. Counsel should consider attaching the affidavit of service to this Order. 2 In some cases, notably where this Order may be relied upon for proceedings in the United States, a finding that the Transaction is commercially reasonable and in the best interests of the Debtor and its stakeholders may be necessary. Evidence should be filed to support such a finding, which finding may then be included in the Court's endorsement. 3 In some cases, the Debtor will be the vendor under the Sale Agreement, or otherwise actively involved in the Transaction. In those cases, care should be taken to ensure that this Order authorizes either or both of the Debtor and the Receiver to execute and deliver documents and take other steps. (2) that it be secured in full by a first ranking charge/security over all of the property, assets and undertakings of 145CAN; and (3) that no principal or interest payments to be made during period that the promissory note is outstanding. 4.3. THIS COURT ORDERS AND DIRECTS that the Liquidator, 145CAN and Paidiem take such additional steps and execute such additional documents as may be necessary or desirable for the completion of the Transaction and for the conveyance of the Purchased Assets to the Purchaser 145CAN. 4.4. THIS COURT ORDERS AND DECLARES that upon the delivery of a Receiver’s Liquidator’s certificate to the Purchaser 145CAN substantially in the form attached as Schedule A hereto (the “Receiver’s Liquidator’s Certificate”), all of the Debtor’s Paidiem’s right, title and interest in and to the Purchased Assets described in the Sale Agreement (and listed on Schedule B hereto)$^4$ 145CAN APS shall vest absolutely in the Purchaser 145CAN, free and clear of and un from any and all security interests (whether contractual, statutory, or otherwise), hypothecs, mortgages, trusts or deemed trusts (whether contractual, statutory, or otherwise), liens, executions, levies, charges, or other financial or monetary claims, whether or not they have attached or been perfected, registered or filed and whether secured, unsecured or otherwise (collectively, the “Claims”)$^5$, including, without limiting the generality of the foregoing: (i) any encumbrances or charges created by the order of the Honourable Mr. Justice [NAME] Cavanagh dated [DATE]; November 23, 2022; (ii) all charges, security interests or claims evidenced by registrations pursuant to the Personal Property Security Act (Ontario) or any other personal property registry system; and (iii) those Claims listed on Schedule C hereto (all of which are collectively referred to as the “Encumbrances”, which term shall not include the permitted encumbrances, easements and restrictive covenants listed on Schedule D)$^6$, and, for greater certainty, this court orders that all of the --- $^4$ To allow this Order to be free-standing (and not require reference to the Court record and/or the Sale Agreement), it may be preferable that the Purchased Assets be specifically described in a Schedule. $^5$ The “Claims” being vested-out may, in some cases, include ownership claims, where ownership is disputed and the dispute is brought to the attention of the Court. Such ownership claims would, in that case, still continue as against the net proceeds from the sale of the claimed asset. Similarly, other rights, titles or interests could also be vested out, if the Court is advised what rights are being affected, and the appropriate persons are served. It is the Subcommittee’s view that a non-specific vesting out of “rights, titles and interests” is vague and therefore undesirable. $^6$ DOCSTOR: 1201927v14 Encumbrances affecting or relating to the Purchased Assets are hereby expunged and discharged as against the Purchased Assets. 1. THIS COURT ORDERS that upon the registration in the Land Registry Office for the [Registry Division of {LOCATION} of a Transfer/Deed of Land in the form prescribed by the Land Registration Reform Act duly executed by the Receiver][Land Titles Division of {LOCATION} of an Application for Vesting Order in the form prescribed by the Land Titles Act and/or the Land Registration Reform Act], the Land Registrar is hereby directed to enter the Purchaser as the owner of the subject real property identified in Schedule B hereto (the “Real Property”) in fee simple, and is hereby directed to delete and expunge from title to the Real Property all of the Claims listed in Schedule C hereto. 3.5. THIS COURT ORDERS that for the purposes of determining the nature and priority of Claims, the net proceeds$^2$ from the sale of the Purchased Assets shall stand in the place and stead of the Purchased Assets, and that from and after the delivery of the Receiver’s Liquidator’s Certificate all Claims and Encumbrances shall attach to the net proceeds from the sale of the Purchased Assets with the same priority as they had with respect to the Purchased Assets immediately prior to the sale$^3$, as if the Purchased Assets had not been sold and remained in the possession or control of the person having that possession or control immediately prior to the sale. 4.6. THIS COURT ORDERS AND DIRECTS the Receiver/Liquidator to file with the court a copy of the Receiver’s Liquidator’s Certificate, forthwith after delivery thereof. 5.7. THIS COURT ORDERS that, pursuant to clause 7(3)(c) of the Canada Personal Information Protection and Electronic Documents Act, the Receiver/Liquidator and Paidiem is authorized and permitted to disclose and transfer to the Purchaser$^{145CAN}$ all human resources and payroll information in the Company’s Paidiem’s records pertaining to the Debtor’s Paidiem’s past and current employees, including personal information of those employees listed on Schedule “A” to the Sale Agreement. The Purchaser, 145CAN shall maintain and protect the privacy of such information and --- $^6$ Elect the language appropriate to the land registry system (Registry vs. Land Titles). $^2$ The Report should identify the disposition costs and any other costs which should be paid from the gross sale proceeds, to arrive at “net proceeds”. $^3$ This provision crystallizes the date as of which the Claims will be determined. If a sale occurs early in the insolvency process, or potentially secured claimants may not have had the time or the ability to register or perfect proper claims prior to the sale, this provision may not be appropriate, and should be amended to remove this crystallization concept. DOCSTOR: 1201927\\|4 shall be entitled to use the personal information provided to it in a manner which is in all material respects identical to the prior use of such information by the Debtor Paidiem. 6.8 THIS COURT ORDERS that, notwithstanding: (1) the pendency of these proceedings; (2) any applications for a bankruptcy order now or hereafter issued pursuant to the Bankruptcy and Insolvency Act (Canada) (the “BIA”) in respect of the Debtor Paidiem and any bankruptcy order issued pursuant to any such applications; and (3) any assignment in bankruptcy made in respect of the Debtor Paidiem the vesting of the Purchased Assets in the Purchaser 154 CAN pursuant to this order shall be binding on any trustee in bankruptcy that may be appointed in respect of the Debtor Paidiem and shall not be void or voidable by creditors of the Debtor Paidiem, nor shall it constitute nor not be deemed to be a fraudulent preference, assignment, fraudulent conveyance, transfer at undervalue, or other reviewable transaction under the Bankruptcy and Insolvency Act (Canada) BIA or any other applicable federal or provincial legislation, nor shall it constitute oppressive or unfairly prejudicial conduct pursuant to any applicable federal or provincial legislation. 7. THIS COURT ORDERS AND DECLARES that the Transaction is exempt from the application of the Bulk Sales Act (Ontario): 7.9 THIS COURT HEREBY REQUESTS the aid and recognition of any court, tribunal, regulator or administrative body having jurisdiction in Canada or in the United States to give effect to this Order and to assist the Receiver Paidiem and its agents in carrying out the terms of this order. All courts, tribunals, regulatory and administrative bodies are hereby respectfully requested to make such orders and to provide such assistance to Paidiem and the Receiver Liquidator, as an officer of this court, as may be necessary or desirable to give effect to this order or to assist the Receiver Paidiem and its agents in carrying out the terms of this order. Revised: January 21, 2014 SCHEDULE A – FORM OF Receiver’s LIQUIDATOR’S CERTIFICATE Court File No. __________CV-22-00690376-00CL ONTARIO SUPERIOR COURT OF JUSTICE {COMMERCIAL LIST} BETWEEN: PLAINTIFF DAVID ROBERTON Applicant - and - DEFENDANT RECEIVER’S PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER section 207 of the Business Corporations Act, R.S.O. 1990, c.B16 LIQUIDATOR’S CERTIFICATE RECITALS A. Pursuant to an Order David Robertson commenced these proceedings under part XVI of the Ontario Business Corporations Act by order of the Honourable [NAME-OF-JUDGE] of the Ontario Superior Court of Mr. Justice (the “Court”) Cavanagh dated [DATE-OF-ORDER], [NAME-OF-RECEIVER] November 23, 2023 (the “Liquidation Order”); B. MNP Ltd. (the “Liquidator”) was appointed as the receiver (liquidator of the “Receiver”) of the undertaking, property and assets of [DEBTOR] (the “Debtor”) respondent Paidiem Payment Solutions Inc. (“Paidiem”) pursuant to the Liquidation Order; BC. Pursuant to an order of the court dated [DATE] March 15, 2023 (the “Approval and Vesting Order”), the court approved the agreement of purchase and sale made dated December 21, 2022 as of [DATE-OF-AGREEMENT] amended (the “Sale Agreement”) between the Receiver [Debtor] MNP Ltd. (solely in its capacity as the court-appointed liquidator of Paidiem) as vendor and [NAME-OF-PURCHASER] (the “Purchaser”) 14546865 Canada Inc. (“145CAN”) as purchaser and provided for the vesting in the Purchaser 145CAN of the Debtor’s Paidiem’s right, title and interest in and to the Purchased Purchases Assets, which vesting is to be effective with respect to the Purchased Assets upon the delivery by the Receiver Liquidator to the Purchaser 145CAN of a certificate confirming: (i) the payment by the Purchaser 145CAN of the Purchase Price for the Purchased Assets; (ii) that the conditions to of Closing as set out in section - of the Sale Agreement 154CAN APS have been satisfied or waived by the Receiver and the Purchaser parties (as applicable); and (iii) the Transaction has been completed to the satisfaction of the Receiver Liquidator. CD. Unless otherwise indicated herein, capitalized terms with initial capitals shall have the meaning same meaning as set out in the Sale Agreement 154CAN APS. THE RECEIVER LIQUIDATOR CERTIFIES the following: 1. The Purchaser has paid and the Receiver has received the Purchase Price for the Purchased Assets payable on the Closing Date pursuant to the Sale Agreement; 1. 2. The conditions to Closing as set out in section - of the Sale Agreement Closing applicable under the 154CAN APS have been satisfied and/or waived by the Receiver, as applicable; 1.2. The Liquidator received the required promissory note and the Purchaser, and security from 154CAN to satisfy the payment of the purchase price under the 154CAN APS; 2.3. The Transaction has been completed to the satisfaction of the Receiver Liquidator. 3.4. This Certificate was delivered by the Receiver Liquidator at ________ [TIME] on _______ [DATE], _________ (time) on __________ (date). [NAME-OF-RECEIVER], MNP Ltd., solely in its capacity as Receiver court appointed liquidator of the undertaking, property and assets of {DEBTOR}, Paidiem Payment Solutions Inc, and not in its personal capacity Per: ________________________________ Name: ________________________________ Title: Name: Title: I have authority to bind the corporation Schedule B—Purchased Assets Revised: January 21, 2014 Schedule C—Claims to be deleted and expunged from title to Real Property Revised: January 21, 2014 Schedule D—Permitted Encumbrances, Easements and Restrictive Covenants related to the Real Property (unaffected by the Vesting Order) TAB 4 ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) THE HONOURABLE JUSTICE STEELE WEDNESDAY, THE 15th DAY OF MARCH, 2023 BETWEEN: DAVID ROBERTSON Applicant - and - PAIDIEM PAYMENT SOLUTIONS INC. Respondent APPLICATION UNDER section 207 of the Business Corporations Act, R.S.O. 1990, c.B16 ANCILLARY ORDER THIS MOTION made by MNP Ltd. (the “Liquidator”) in its capacity as the court appointed liquidator of the respondent Paidiem Payment Solutions Inc. (“Paidiem”) for an order approving was heard this day via videoconference. ON READING the First Report of the Liquidator dated March 10, 2023 and on hearing submissions of counsel for the parties and for the Liquidator, no one appearing for any other person on the service list, although served as appears from the affidavit of Linda Galessiere sworn on March 10, 2023. SERVICE 1. THIS COURT ORDERS that the time for services of the Notice of Motion and Motion Record is hereby abridged and validated so that this motion is properly returnable today and hereby dispenses with further service thereof. APPROVAL OF THE FIRST REPORT OF THE LIQUIDATOR AND THE LIQUIDATOR’S ACTIVITIES 2. THIS COURT ORDERS that the First Report of the Liquidator dated March 10, 2023 and the activities referred to therein, including the distribution of funds to BDC to satisfy its secured claim, be and are hereby approved; provided, however, that only the Liquidator, in its personal capacity and only with its own personal liability, shall be entitled to rely upon or utilize in any way such approval. APPROVAL OF PROFESSIONAL FEES 3. THIS COURT ORDERS that the professional fees of the Liquidator and the Liquidator’s counsel for the period ending February 28, 2023 as set on in appendices I and J of the First Report of the Monitor are hereby approved. DAVID ROBERTSON Applicant and PAIDIEM PAYMENT SOLUTIONS INC. Respondent Court File No.: CV-22-00690376-00CL ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) ANCILLARY ORDER CAMELINO GALESSIERE LLP Barristers & Solicitors 65 Queen Street West Suite 440 Toronto, ON M5C 1H6 Gustavo F. Camelino Law Society No.: 45607S Tel: 416-306-3834 Email: firstname.lastname@example.org Lawyers for MNP Ltd. DAVID ROBERTSON and PAIDIEM PAYMENT SOLUTIONS INC. Applicant and Respondent Court File No.: CV-22-00690376-00CL ONTARIO SUPERIOR COURT OF JUSTICE (COMMERCIAL LIST) MOTION RECORD RETURNABLE MARCH 15, 2023 CAMELINO GALESSIERE LLP Barristers & Solicitors 65 Queen Street West Suite 440 Toronto, ON M5C 1H6 Gustavo F. 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Each tablet contains: Acetazolamide, USP 125 mg This package not for household consumption. USUAL DOSAGE: See package insert for full prescribing information. Store at 20° to 25°C (68° to 77°F) (see USP Controlled Room Temperature). Dispense in well-closed containers as defined in the USP. Keep this and all medications out of the reach of children. NDC 64380-833-06 AcetaZOLAMIDE Tablets, USP 125 mg Strides Pharma Inc. 100 Tablets Rx only Manufactured by: Strides Pharma Sequence Ltd. Kanpur - 208 014, India. PON/DRUGS/16 13 4192 Distributed by: Strides Pharma Inc. East Brunswick, NJ 08816 022019 Non Varnish Area (18 x 40 mm) LOT: Exp: un wind direction of label roll ARTWORK DETAIL LABEL \| Product \| AcetaZOLAMIDE Tablets, USP 125mg \| \|--------------------------\|----------------------------------\| \| Buyer/Country \| Strides Pharma Inc. / USA \| \| \| Component \| \| \| Container Label \| \| Dimension \| 105 x 40 mm \| \| New Item Code \| 1037830 \| \| \| Old Item Code \| \| \| 1035132 \| \| Colour Shades \| PMS 154C PMS 340C BLACK \| \| \| No. of Colours \| \| \| 3 \| \| Change Control No. \| PC-PYF/2019/020 \| \| \| Record Number: 207434 \| \| \| Artwork Version \| \| \| 2.0 \| \| Design/Style \| Self adhesive labels in Roll-form with Rounded Corners. \| \| Substrate \| PSA Label Stock. 80 GSM Paper (Rafalatac/Avery Dennison) 16-22 GSM adhesive / 32 GSM PET (Polyester) release liner / Spot aqueous varnish. \| \| Special Instructions \| Printing clarity should be clear and sharp. \| \| Autocartonator Requirements \| NA \| Caution to the printer: Before processing, please ensure that the ARTWORK received for printing is exactly in line with APPROVED ARTWORK provided to you. In case of any FONTS/DESIGN are Mis-matching with the APPROVED ARTWORK, please inform PDC for further action. DO NOT MAKE ANY CHANGE TO THE ARTWORK WITHOUT WRITTEN INSTRUCTIONS FROM PDC.	00604972-1478-482c-a9b2-026788bc0724	CC-MAIN-2021-04	http://www.stridespharmausa.com/wp-content/uploads/2020/03/Acetazolamide-Tablets-USP-125mg-100ct-Label.pdf	2021-01-18T12:52:58+00:00	crawl-data/CC-MAIN-2021-04/segments/1610703514796.13/warc/CC-MAIN-20210118123320-20210118153320-00293.warc.gz	166,085,280	551	eng_Latn	eng_Latn	0.914083	eng_Latn	0.914083	[ "eng_Latn" ]	true	rolmOCR	[ 2467 ]	[ 0.419921875 ]	[ 1.4140625 ]	[ 1.4453125 ]	[ 2.515625 ]	3	0	HuggingFaceFW/finepdfs
Erfassung von seltenen pädiatrischen Erkrankungen bei in Spitälern behandelten Kindern Swiss Paediatric Surveillance Unit Recherche de maladies pédiatriques rares chez les enfants traités en milieu hospitalier Sponsors: Swiss Society of Paediatrics (SSP) and Federal Office of Public Health (FOPH) KAWASAKI DISEASE IN CHILDREN 1 YEAR FOLLOW-UP FORM A) Patient information 1. Date of birth ____/_____(mm/yy) 2. Date of follow-up ____/____/_____(dd/mm/yyyy) 3. Weight: …………….. kg Height: …..….. cm B) Outcome 1 year after Kawasaki disease a. Clinical evolution: Recurrent Kawasaki disease after initial KD Y N If yes: date ____/____/_____ (dd/mm/yyyy) Treatment: Immunoglobulins 2 g/kg Aspirine anti-inflammatory dose ___ antithrombotic dose ___ Symptoms: Asymptomatic Y N Heart failure Y N Chest pain at rest Y N upon exertion Y N Dyspnoe at rest Y N upon exertion Y N Death Y N if yes: autopsy Y N If autopsy: cardiac findings: …………………………………………………. b. Cardiac investigations: ECG: nl abnl: if abnl specify ………………………… Echocardiogram: date ____/____/_____(dd/mm/yyyy) Right coronary artery nl dilated aneurysm size: …… (mm) Left coronary artery nl dilated aneurysm size: …… (mm) Others: perivascular brightness: Y N effusion: Y N Myocarditis : Y N valvular regurgitation : Y N c. Other imaging studies : MRI Y N if yes: nl abnl If abnl specify…………………………………………………………. CT-Scan Y N if yes: nl abnl If abnl specify…………………………………………………………. Coronary angiography Y N if yes: nl abnl If abnl specify…………………………………………………………. C) Current treatment : 1. Aspirine Y N a. Dose: ……………………….… mg/kg/d 2. Others: ………………………………… mg/kg/d………….. D) Follow- up care: Pediatrician: ………………………… Pediatric cardiologist: …………………………….. Date: ____/____/_____(dd/mm/yyyy) We would like to thank you for the precious collaboration! Please send this questionnaire to:	<urn:uuid:a24df664-9dcb-4c59-90a9-f33c69d780b6>	CC-MAIN-2019-43	https://www.bag.admin.ch/dam/bag/de/dokumente/mt/msys/studien/kawasaki-disease_%20fragebogen_follow-up1.pdf.download.pdf/.pdf	2019-10-24T05:04:05Z	crawl-data/CC-MAIN-2019-43/segments/1570987841291.79/warc/CC-MAIN-20191024040131-20191024063631-00156.warc.gz	787,446,763	708	eng_Latn	eng_Latn	0.493114	eng_Latn	0.528987	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 1308, 2029 ]	[ 0.734375 ]	[ 1.8125 ]	[ 1.6328125 ]	[ 1.2265625 ]	2	0	HuggingFaceFW/finepdfs
The Winning Brief 100 Tips for Persuasive Briefing in Trial and Appellate Courts BOOK DETAILS * Author : Bryan A. Garner * Pages : 800 Pages * Publisher : Oxford University Press * Language : English • ISBN : 0199378355 BOOK SYNOPSIS Good legal writing wins court cases. It its first edition, The Winning Brief proved that the key to writing well is understanding the judicial readership. Now, in a revised and updated version of this modern classic, Bryan A. Garner explains the art of effective writing in 100 concise, practical, and easy-to-use sections. Covering everything from the rules for planning and organizing a brief to openers that can capture a judges attention from the first few words, these tips add up to the most compelling, orderly, and visually appealing brief that an advocate can present. In Garners view, good writing is good thinking put to paper. "Never write a sentence that you couldnt easily speak," he warns-and demonstrates how to do just that. Beginning each tip with a set of quotable quotes from experts, he then gives masterly advice on building sound paragraphs, drafting crisp sentences, choosing the best words ("Strike pursuant to from your vocabulary."), quoting authority, citing sources, and designing a document that looks as impressive as it reads. Throughout, he shows how to edit for maximal impact, using vivid before-and-after examples that apply the basics of rhetoric to persuasive writing. Filled with examples of good and bad writing from actual briefs filed in courts of all types, The Winning Brief also covers the new appellate rules for preparing federal briefs. Constantly collecting material from his seminars and polling judges for their preferences, the second edition delivers the same solid guidelines with even more supporting evidence. Including for the first time sections on the ever-changing rules of acceptable legal writing, Garners new edition keeps even the most seasoned lawyers on their toes and writing briefs that win cases. An invaluable resource for attorneys, law clerks, judges, paralegals, law students and their teachers, The Winning Brief has the qualities that make all of Garners books so popular: authority, accessibility, and page after page of techniques that work. If youre writing to win a case, this book shouldnt merely be on your shelf--it should be open on your desk. THE WINNING BRIEF 100 TIPS FOR PERSUASIVE BRIEFING IN TRIAL AND APPELLATE COURTS - Are you looking for Ebook The Winning Brief 100 Tips For Persuasive Briefing In Trial And Appellate Courts? You will be glad to know that right now The Winning Brief 100 Tips For Persuasive Briefing In Trial And Appellate Courts is available on our online library. With our online resources, you can find Applied Numerical Methods With Matlab Solution Manual 3rd Edition or just about any type of ebooks, for any type of product. Best of all, they are entirely free to find, use and download, so there is no cost or stress at all. The Winning Brief 100 Tips For Persuasive Briefing In Trial And Appellate Courts may not make exciting reading, but Applied Numerical Methods With Matlab Solution Manual 3rd Edition is packed with valuable instructions, information and warnings. We also have many ebooks and user guide is also related with The Winning Brief 100 Tips For Persuasive Briefing In Trial And Appellate Courts and many other ebooks. We have made it easy for you to find a PDF Ebooks without any digging. And by having access to our ebooks online or by storing it on your computer, you have convenient answers with The Winning Brief 100 Tips For Persuasive Briefing In Trial And Appellate Courts. To get started finding The Winning Brief 100 Tips For Persuasive Briefing In Trial And Appellate Courts, you are right to find our website which has a comprehensive collection of manuals listed.	<urn:uuid:901359f7-d308-44b8-a20f-6971b8f6dd41>	CC-MAIN-2017-43	http://motownradio.us/pdf/getbook/The%20Winning%20Brief%20%20100%20Tips%20for%20Persuasive%20Briefing%20in%20Trial%20and%20Appellate%20CourtsBook%20Download.PDF	2017-10-21T10:14:04Z	crawl-data/CC-MAIN-2017-43/segments/1508187824733.32/warc/CC-MAIN-20171021095939-20171021115939-00605.warc.gz	256,613,712	805	eng_Latn	eng_Latn	0.690888	eng_Latn	0.998233	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 224, 3853 ]	[ 1.015625 ]	[ 2.65625 ]	[ 0.240234375 ]	[ 1 ]	1	1	HuggingFaceFW/finepdfs
Grid Certificate Authorities meeting Date/Time: from Thursday 12 June 2003 (14:00) to Friday 13 June 2003 (17:00) Location: CERN Chairperson: Kelsey, D Description: VRVS video conference booked for Friday all day, but not Thursday Friday's VRVS in room "Desert" Phone conference available for Thursday afternoon, but not Friday. Call +41 22 767 7000 and ask for conference "Grid Certificates" Different rooms on the 2 days - beware! Material: minutes Thursday 12 June 2003 Friday 13 June 2003 1 ``` 09:00 Presentations from new CAs (1h00') ASCC, Taiwan (15') ( documents transparencies ) Tein Horng Yuan FNAL root CA (and CP/CPS for KCA) (15') ( document transparencies ) Skow, D Hungary (15') ( transparencies ) Kadlecsik, J 10:00 Changes to existing CA's (30') Portugal (10') ( document ) Gomes, J CESNET (10') ( documents ) Sova, M Ireland (10') O'Callaghan, D 10:30 Minimum Requirements for traditional CA's - Part 2 (1h00') New document for EDG TB2/3 (and LCG-1) 11:30 Future plans for CA PMA (1h00') EGEE, GGF etc ```	<urn:uuid:7b1674ca-b154-42d8-ab1e-d5494b957b4f>	CC-MAIN-2019-22	http://www.eugridpma.info/meetings/2003-06/agenda-2003-06.pdf	2019-05-26T10:57:50Z	crawl-data/CC-MAIN-2019-22/segments/1558232259126.83/warc/CC-MAIN-20190526105248-20190526131248-00288.warc.gz	264,445,091	322	eng_Latn	eng_Latn	0.600136	eng_Latn	0.805308	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 511, 1041 ]	[ 0.361328125 ]	[ 0.640625 ]	[ 1.4609375 ]	[ 1.1796875 ]	1	2	HuggingFaceFW/finepdfs
Generalization of Kuramoto model in vector product form Hyun Keun Lee$^1$ and Hyunsuk Hong$^2$, * $^1$Department of Physics, Sungkyunkwan University, Suwon 16419, Korea $^2$Department of Physics and Research Institute of Physics and Chemistry, Jeonbuk National University, Jeonju 54896, Korea (Dated: August 16, 2022) We generalize the Kuramoto model of coupled phase oscillators in 3-dimensional space, via a vector product form. It is demonstrated that the standard Kuramoto model can be transformed to a vector product form. This form gives the generalized model as the phase and the natural frequency of oscillator are respectively, represented by position on unit sphere and 3-dimensional frequency vector. The long-term collective states are predicted, which are amenable with the geometric intuition motivated by the model structure, the vector product form. Our prediction shows a good consistency with numerical observations. We illustrate the conventional numerical integration method for the Kuramoto model in 3-dimension is accompanied by unavoidable ambiguity, and show this problem is resolved in the new method direct from our model equation. PACS numbers: 05.45.-a, 89.65.-s I. INTRODUCTION Kuramoto model [1] is one of the prototypes for the study of the synchronization phenomena frequently observed in nature [2–4]. It is a mathematical model for describing the collective behavior in the population of coupled oscillators. The model is composed of the coupling terms depicting the interaction among the phase oscillators and the natural frequencies randomly distributed according to a distribution function such as Gaussian or Lorentzian one. When the coupling is strong enough to overcome the diversity of the natural frequencies, synchronization appears. Variants of the Kuramoto model have been suggested from the aspect of time delay [5], inertia effect [6, 7], presence of noise [8], and so forth, which is basically a reflection of reality or a generalization of the Kuramoto model. Coupled oscillator models have provided frameworks in the theoretical and practical study of swarming [9–14] or flocking [15, 16] behavior of natural and artificial systems. One of the interests in the generalizations of the Kuramoto model is to increase the dimension of the phase variable, equivalently, that of the embedding space. The pioneering work in this direction is the consensus models where individual’s opinion is represented by vector in general [17]. Later, it is reported that the generalization can be direct from the algebra of rotation group theory [18–21]. After equipped with this algebraic tool, Kuramoto model in higher dimension has been steadily studied [22–28]. In those studies, the theoretical predictions and numerical data are usually illustrated in 3-dimensional space, above which a sensible visualization is not allowed. The geometrical sense or intuition in 3-dimension plays the non-replaceable role in examining the results. Therefore, a solid description and understanding on the model in 3-dimension is necessary. In the present paper, we report that there is another route to the generalization of the Kuramoto model to 3-dimension. We demonstrate that the standard Kuramoto model can be understood with a vector product form composed of the positions on unit sphere and 3-dimensional natural frequency vectors. The original Kuramoto model is recovered when initial position and natural frequency are properly chosen. We survey a few long-term states predictable through the model structure, the vector product form. This theoretical understanding is supported by numerical observations. It is finally illustrated that the model equation we have recognized this time directly gives a new numerical integration method free from such ambiguity that is inevitable in the conventional numerical method. This paper is organized as follows. In Sec. II, our generalization of the Kuramoto model to 3-dimension is presented. Two extreme features of the model are shown in Sec. III, and this is used for the understanding of the long-term states of the model in Sec. IV. The new numerical method by our model equation is explained in Sec. V. This work finishes in Sec. VI with a brief summary. II. GENERALIZATION OF KURAMOTO MODEL The Kuramoto model is given by a differential equation for the dynamics of coupled phase oscillators: $$\dot{\theta}_i = \omega_i + \frac{K}{N} \sum_{j=1}^{N} \sin(\theta_j - \theta_i),$$ where $\theta_i \in (0, 2\pi)$ is the phase of oscillator $i$ and $\omega_i$ is its natural frequency. The $K > 0$ represents the coupling constant and $N$ is the number of oscillators in the system. We consider a circle of unit radius at the origin of $x$-$y$ plane in 3-dimensional space. Then, in Cartesian coordinate system, we introduce the position vector for oscillator $i$ of phase $\theta_i$ on the circle: $\mathbf{r}_i = (x_i, y_i, 0) = (\cos \theta_i, \sin \theta_i, 0)$. This way, the oscillator of phase $\theta_i$ can be also identified with a particle or an agent at position $\mathbf{r}_i$. Below, for convenience, we interchangeably use oscillator, particle, or agent. Similarly, for oscillator $j$, it reads that $\mathbf{r}_j = (\cos \theta_j, \sin \theta_j, 0)$. For $\mathbf{r}_i$ and $\mathbf{r}_j$ written this way, one can observe that i) $\dot{\mathbf{r}}_i = (-\sin \theta_i, \cos \theta_i, 0)\theta_i$, ii) $\mathbf{w}_i \times \mathbf{r}_i = (-\sin \theta_i, \cos \theta_i, 0)\omega_i$ for $\mathbf{w}_i = (0, 0, \omega_i)$ and vector product operator $\times$ [21], and iii) $(\mathbf{r}_i \times \mathbf{r}_j) \times \mathbf{r}_i = (-\sin \theta_i, \cos \theta_i, 0)\sin(\theta_j - \theta_i)$. These observations lead us to convert Eq. (1) in a vector product form given by $$\dot{\mathbf{r}}_i = \mathbf{w}_i \times \mathbf{r}_i + \frac{K}{N} \sum_{j=1}^{N} (\mathbf{r}_i \times \mathbf{r}_j) \times \mathbf{r}_i . \quad (2)$$ This formula is straightforwardly derived in use of the observations listed above after applying $(-\sin \theta_i, \cos \theta_i, 0)$ on both sides of Eq. (1). Equation (2) is the spatial-coordinate representation of the standard Kuramoto model in Eq. (1) when subject to the restriction of $\mathbf{r}_i = (\cos \theta_i, \sin \theta_i, 0)$ and $\mathbf{w}_i = (0, 0, \omega_i)$. For a compact expression of Eq. (2), we introduce $\mathbf{k} \equiv K \sum_j \mathbf{r}_j / N = K \mathbf{r}_{CM}$, where $\mathbf{r}_{CM}$ is the position center of the agents in the system. For this $\mathbf{k}$, Eq. (2) is simply rewritten as $$\dot{\mathbf{r}}_i = (\mathbf{w}_i - \mathbf{k} \times \mathbf{r}_i) \times \mathbf{r}_i . \quad (3)$$ The minus sign on the right hand side of Eq. (3) comes from $\mathbf{r}_i \times \mathbf{r}_j = -\mathbf{r}_j \times \mathbf{r}_i$. As a 3-dimensional vector equation, Eq. (3) is the generalized Kuramoto model, which we will study in this work. To explore the properties of Eq. (3) in the aspect of a generalized phase, we consider $\mathbf{r}_i$ on the unit sphere centered at the origin, and use general $\mathbf{w}_i = (\omega_{i,x}, \omega_{i,y}, \omega_{i,z})$ that is not necessarily parallel to z-axis. Equation (3) is structured as $\dot{\mathbf{r}}_i = \mathbf{a} \times \mathbf{r}_i$, for a vector $\mathbf{a}$. Then, in the fact that $\dot{\mathbf{r}}_i \perp \mathbf{r}_i$, $\mathbf{r}_i$ resides forever on the unit sphere if initially provided that $\|\|\mathbf{r}_i(0)\|\| = 1$ for all $i$. This initial condition is also a part of the generalized Kuramoto model. We point out that $\|\|\mathbf{r}_i\|\| = 1$ for $t > 0$ is not a condition for the model equation Eq. (3) but a consequence from it equipped with the initial condition. Therefore, $\mathbf{r}_i$ can be interpreted as spherical phase of agent $i$, and its differential equation Eq. (3) governs the dynamics of the spherical phase. We remark that Eq. (3) has its concrete meaning in 3-dimensional space where the vector product is well defined. Since the vector product $\times$ is a linear operation, one may consider a matrix $W_i$ that satisfies $W_i \mathbf{r}_i = \mathbf{w}_i \times \mathbf{r}_i$. From the detail of the operation $\times$, it is given that $$W_i = \begin{pmatrix} 0 & -\omega_{i,z} & \omega_{i,y} \\ \omega_{i,z} & 0 & -\omega_{i,x} \\ -\omega_{i,y} & \omega_{i,x} & 0 \end{pmatrix}. \quad (4)$$ Additionally, by the identity $\mathbf{a} \times (\mathbf{b} \times \mathbf{c}) = (\mathbf{a} \cdot \mathbf{c})\mathbf{b} - (\mathbf{a} \cdot \mathbf{b})\mathbf{c}$ [21], Eq. (3) is rewritten as $$\dot{\mathbf{r}}_i = W_i \mathbf{r}_i + \mathbf{k} - (\mathbf{k} \cdot \mathbf{r}_i) \mathbf{r}_i . \quad (5)$$ We note that Eq. (5) is identical to the expression pioneered in Ref. [17] for $\mathbf{w}_i = 0$ and also to what formulated in Ref. [18, 23] for general $\mathbf{w}_i$. As stated, our vector product form in Eq. (3) can be rewritten as the conventional one in Eq. (5). We however do not use this conventional one in the present work. Instead, we exploit the edges of the vector product form over the conventional equation in studying the long-term states of the Kuramoto model in 3-dimension. The vector product form we have recognized this time is expected to be an useful and intuitive tool from the geometrical point of view. In the following, it will be demonstrated that the vector product form plays the compact and neat role in the analytic and numerical study of the Kuramoto model in 3-dimension. ### III. TWO EXTREME BEHAVIORS We first consider the motion of the agents subject to the natural frequency part only. This is the case when $K = 0$ in Eq. (3). The equation of motion is then simply given by $$\dot{\mathbf{r}}_i = \mathbf{w}_i \times \mathbf{r}_i = W_i \mathbf{r}_i. \quad (6)$$ Consider $\mathbf{u}_{i,2} = \mathbf{w}_i / \|\|\mathbf{w}_i\|\|$, and let $\mathbf{u}_{i,1}$ and $\mathbf{u}_{i,2}$ be the unit vectors chosen to satisfy $\mathbf{u}_{i,1} \times \mathbf{u}_{i,2} = \mathbf{u}_{i,3}$. Then, linear algebra gives the solution as $$\mathbf{r}_i(t) = \mathbf{u}_{i,1} \rho_i \cos(\omega_i t + \phi_i) + \mathbf{u}_{i,2} \rho_i \sin(\omega_i t + \phi_i) + \mathbf{u}_{i,3} l_i , \quad (7)$$ where $\omega_i = \|\|\mathbf{w}_i\|\|$, $l_i = \mathbf{u}_{i,3} \cdot \mathbf{r}_i(0)$, $\rho_i = \sqrt{1 - l_i^2}$, and $\phi_i$ is a value determined by $\mathbf{r}_i(0)$ and the choice of $\mathbf{u}_{i,2}$. Equation (7) corresponds to a rotation on the surface of unit sphere, a limit cycle, at latitude $l_i$ assigned along the $\mathbf{u}_{i,3}$-axis. All decoupled oscillators by $K = 0$ display their own rotations on the surface. We call the behavior by Eq. (6) spinning. On the other hand, when $\mathbf{w}_i = 0$ in Eq. (3) for all $i$, the dynamics is governed by $$\dot{\mathbf{r}}_i = -(\mathbf{k} \times \mathbf{r}_i) \times \mathbf{r}_i. \quad (8)$$ For this nonlinear differential equation, one can expect the steady state with $\dot{\mathbf{r}}_i = 0$ for all $i$. By the structure of Eq. (8), the steady state is only accompanied with $\mathbf{k} \times \mathbf{r}_i = 0$. There are two possibilities: the system may approach to such configuration of $\mathbf{k} \propto \sum_j \mathbf{r}_j = 0$ or, otherwise, may form such $\mathbf{k}$ that is parallel to $\mathbf{r}_i$. We consider that the first case is hard to have dynamic stability. Compared to this, the second case is natural because the positive coupling ($K > 0$) drives the agents get closer to the others, which readily achieves a complete gathering together. It is thus expected that $\mathbf{r}_i = \mathbf{r}_j$ for all $i$ and $j$ in the $t \to \infty$ limit. Such gathering behavior was studied in [17], and this was later called the synchronization in [23]. We also numerically observe the similar behavior as shown in Fig. 1. We call the close aggregation by Eq. (8) converging. FIG. 1. (Color Online) Numerical observation of converging behavior by coupling term only. The destination that all the trajectories heading to is the fixed-point solution of Eq. (8). Each trajectory represents an agent’s motion, and the arrow line is the displacement during unit time. For numerical integration, a new method by the model equation [Eq. (3)] is used instead of the conventional one (the new method applied through this work is explained in Sec. V). We use $\Delta t = 0.01$ for time-mesh and $K = 1$. Initially, the oscillators are randomly distributed on the surface of unit sphere following uniform distribution (the same initial condition is applied to all numerical calculations in this work). We show the trajectory in the system of $N = 10$ oscillators for clarity (see the movie “fig1-100.gif” for $N = 100$ in the supplementary material). The two extreme behaviors mentioned above are, respectively, the limiting properties of the differential equation in Eq. (3). These provide basic understanding or predicting blocks of the long-term states expected for the generalized Kuramoto model in 3-dimension, as demonstrated below. IV. LONG-TERM STATES In this section, we examine a few long-term states of Eq. (3) where the term for spinning and that for converging play their roles simultaneously. For this, it is considered from now on that $K > 0$ and $w_i \neq 0$ at least for an $i$. We restrict our interest to such states that are arguable with the geometrical meaning of the vector product and also with numerical data. For the arguable collective behaviors, we focus on the rather simple situation with $\\|r_{\text{CM}}\\| \approx 1$ after initial transient period. A. Identical frequency ($w_i = w$) We first consider the case of $w_i = w$ for all $i$. For this setting, what called the dynamical synchronization was reported as a long-term state [23], which is realized through a limit cycle of the clustered oscillators. In the present study, we also obtain similar numerical data as shown in Fig. 2. We understand it as the spinning of the sufficiently aggregated oscillators by the converging. First, all agents gather before long; the data points at $t = 10$ in Fig. 2, already, almost look like a single point (the deviation of all agents’ locations is much smaller than the size of the point). Thereafter, $r_i \approx r_{\text{CM}}$ so that $k \times r_i \approx 0$. When these approximations are applied to Eq. (3), it follows that $\dot{r}_{\text{CM}} \approx w \times r_{\text{CM}}$ whose structure is similar to that of Eq. (6). Then, $r_{\text{CM}}$ readily gives the limit cycle like Eq. (7). Since $\\|r_{\text{CM}}\\| \to 1^-$, all agents form the almost fully synchronized state, and the resultant cluster rotates at a constant latitude assigned on the $w/\\|w\\|$-axis. In analytic point of view, if considered in the rotating frame of angular velocity $w$, the behavior is simply a converging like what shown in Fig. 1. Its compact mathematical proof is given in [23]. The limit cycle for the dynamical synchronization was already predicted [18, 23] in the system of nonzero identical natural frequency vectors, and the supporting numerical data were also mentioned [18] or displayed [23]. However, contrary to the simple and convincing argument for the existence of such limit cycle, the numerical evidence was rather restricted. For example, a rather small system of $N \leq 10$ is suggested [18] or the numerical data of [23] is for $N = 4$. Compared to this, our numerical tests generate the dynamical synchronization independent of $N$. We consider that our reliable numerical realization is attributed to the new numerical method as a direct application of our model equation Eq. (3). This issue regarding the comparison between our numerical method and that used in the previous studies will be separately discussed below in Sec. V. B. Parallel frequency ($w_i \propto w_j$) The next case is that all $w_i$s are not identical but parallel with each other, i.e., $w_i \propto w_j$ for all $i$ and $j$. In this case, it seems that the oscillators do not show a converging behavior due to heterogeneous spinning strengths by the different magnitudes of $w_i$s. In brief, different spinnings of agents may prevent their converging, and vice versa. We here note that there are two locations where the spinning and the converging do not contradict each other. The places are the poles, the two intersection points between the axis of spinning (this axis is unique because all $w_i$s are parallel) and the surface of the sphere. This is because the spinning on the poles does not give any actual motion. Then, the conflict between spinning and converging will vanish as all the agents approach to one of the poles. If this takes place, the system finally shows the fixed point solution at the pole. Figure 3 is the numerical observation where the trajectory of the position center finally forms a spiral to the fixed point (SFP). In early stage, a limit cycle seems to appear, but this arrives at a fixed point in the end. Although a cycle lasts longer for larger $K$ and smaller $N$, it finally disappears in the numerical tests. The data obtained for $K = 32$ and $N = 10$ are shown in Fig. 3. As long as $K$ is not infinite, no place except the poles can be the fixed point due to the conflict between spinning and converging. In the numerical simulations, we have not observed the other kind of long-term state except SFP for nonidentical parallel $w_i$s. A similar numerical observation was also reported in [18]. However, that was classified therein as a limit cycle in the mention that the parallel $w_i$s is a necessary condition for the limit cycle. In contrast, we have not observed such limit cycle in the numerical simulations. We here indicate that necessary condition does not guarantee consequence. In our numerical tests, the ultimate feature is not the limit cycle but a fixed point regardless of the early stage patterns, and this is consistent with our understanding on the role of pole as a fixed point solution. Although a seemingly limit cycle lasts for long time in some cases, its eventual shape is supposed to be a spiral to the fixed point at pole. We add that our argument for the approach to the pole does not require a threshold of coupling strength. In our numerical analysis, spiral to the pole always shows up for various values of $K$. We thus conjecture that the spiral to the pole occurs for any $K > 0$. Because the pole as a fixed point is on the surface of the unit sphere, the order parameter of spatial synchronization approaches 1 following the spiral, i.e., $\\|r_{\text{CM}}\\| \to 1^-$ as $t \to \infty$. The exception is only when all agents are initially at the equator determined by the pole. Remind that this initialization with parallel natural frequency recovers the standard Kuramoto model. Under this exceptional setup, a finite coupling-strength threshold is required for a synchronization as well-known for the standard Kuramoto model [1–4]. We here remark that synchronization on the equator needs a coupling-strength threshold to overcome the different spinnings, which is not the case for the synchronization at pole. We thereby consider that such finite threshold is not a generic property of synchronization for the 3-dimensional model in the sense that the initialization at equator only is measure zero out of the possible configurations on the unit sphere. C. General frequency & strong coupling For general $ \mathbf{w}_i $'s, it is not easy to predict the long-term behavior in an intuitive way. In order to see what happens in the system, we restrict our interest to the case of large $ K $, by which a close gathering of oscillators is expected. When the oscillators are sufficiently close to the others, it reads that $ \mathbf{r}_i \approx \mathbf{r}_{\text{CM}} $ for all $ i $. Then, since $ \mathbf{k} $ is parallel to $ \mathbf{r}_{\text{CM}} $ by definition, it reads that $ (\mathbf{k} \times \mathbf{r}_i) \times \mathbf{r}_i \approx 0 $. When this is applied to Eq. (3), $ \dot{\mathbf{r}}_i \approx \mathbf{w}_i \times \mathbf{r}_i $ seems to follow. However, this approximation is unacceptable as follows. Most of all, ignoring $ (\mathbf{k} \times \mathbf{r}_i) \times \mathbf{r}_i $ in Eq. (3) can be also caused by weak coupling with small $ K $. Obviously, $ \dot{\mathbf{r}}_i \approx \mathbf{w}_i \times \mathbf{r}_i $ is immediate from Eq. (3) for sufficiently small $ K $. Note that the negligible coupling by $ K \approx 0 $ is opposite to the strong one by large $ K $, and we are interested in the latter case. Therefore, if $ (\mathbf{k} \times \mathbf{r}_i) \times \mathbf{r}_i $ is ignored by close gathering, the condition that the system is in the strong coupling regime of large $ K $ should be reflected somewhere in Eq. (3). Only $ \mathbf{w}_i \times \mathbf{r}_i $ part that remains after ignoring $ (\mathbf{k} \times \mathbf{r}_i) \times \mathbf{r}_i $ can provide a room for the reflection. We here suggest that, after initial transient period, $ \mathbf{w}_i $ could be simply replaced with an effective one $ \mathbf{w}_{\text{eff}} = \alpha \mathbf{w}_i $ for a proper $ \alpha $. In the meantime, since we also expect $ \mathbf{r}_i \approx \mathbf{r}_{\text{CM}} $ for large $ K $, it follows that $ \dot{\mathbf{r}}_i \approx \alpha \mathbf{w}_i \times \mathbf{r}_{\text{CM}} $ from Eq. (3). Taking its average over $ i $ leads to \[ \dot{\mathbf{r}}_{\text{CM}} \approx \alpha \mathbf{w}_{\text{m}} \times \mathbf{r}_{\text{CM}}, \] (9) where $ \mathbf{w}_{\text{m}} \equiv \frac{1}{N} \sum_i \mathbf{w}_i / N $ is the mean of the natural frequency vectors. As the simple steady state of Eq. (9), one may expect the fixed point of $ \mathbf{r}_{\text{CM}} $. When $ \dot{\mathbf{r}}_{\text{CM}} = 0 $ is considered at a fixed point $ \mathbf{r}_{\text{CM}}^* $, $ \\| \mathbf{r}_{\text{CM}}^* \\| \approx 1 $ and $ \mathbf{w}_{\text{eff}} \times \mathbf{r}_{\text{CM}} \approx 0 $ gives \[ \mathbf{r}_{\text{CM}}^* \approx \pm \hat{\mathbf{w}}_{\text{m}}, \] (10) where $ \hat{\mathbf{w}}_{\text{m}} \equiv \mathbf{w}_{\text{m}} / \\| \mathbf{w}_{\text{m}} \\| $. The fixed point $ \mathbf{r}_{\text{CM}}^* $ in Eq (10) covers what argued for the parallel $ \mathbf{w}_i $'s in Sec. IVB. An implication of Eq (10) is that the location of the fixed points, intuitively argued in Sec. IVB, can be generalized to the direction vector of the average of natural frequency vectors or its antipodal opposite (note that there is $ \pm $ sign in front of $ \hat{\mathbf{w}}_{\text{m}} $). Accordingly, the SFP is also expected for general natural frequency when the coupling is strong enough. In Fig. 4, we display the numerical observation where a purple spiral, the trajectory of position center, heads to a red solid circle at $ \mathbf{r}_{\text{CM}}^* = -\hat{\mathbf{w}}_{\text{m}} $ (see the upper hemisphere). This is the numerical evidence that the SFP, discussed in Sec. IVB for parallel $ \mathbf{w}_i $, can be a rather general phenomenon. As the other long-term state of Eq. (9), a limit cycle is possible. This is because the non-steady state solution like Eq. (7) can be expected (see Eq. (9) has the same structure as that of Eq. (6)). We numerically observe that the trajectory of the position center approaches to the limit cycle whose rotation axis is $ \hat{\mathbf{w}}_{\text{m}} $. Interestingly, the targeted limit cycles are always the great circles in the numerical tests. So, the observed trajectory after initial period is the rotation approaching to great circle (RGC). An instance is the green curve that spans the upper and lower hemispheres in Fig. 4. Therein, the trajectory very close to the great circle gives $ \alpha < 0.2 $. Whether a system will show SFP or RGC depends on initial condition and natural frequency, respectively, randomly chosen from certain distributions (see the caption in Fig. 4 for the detail specification). Although obtained in an arguable way, Eq. (9) captures a few interesting properties of the long-term states of Eq. (3), as illustrated. We expect that this approach and findings will provide a guide in the further study of the long-term solutions. For a background of the present study, a rigorous examination on the validity of Eq. (9) itself will be meaningful. In the meantime, different from Sec. IVB, a threshold of coupling strength seems necessary for the onset of the long-term states found here in Sec. IV C. Existence of such threshold is one of the interesting issues, and (if exists) exploring the states below that will be also an interesting work. V. NUMERICAL METHOD FOR ON-SPHERE SMOOTH MOTION In the numerical study, $ \mathbf{r}(t + \Delta t) $ is determined with $ \mathbf{r} = \mathbf{r}(t) $ and $ \dot{\mathbf{r}} = \dot{\mathbf{r}}(t) $ for a small time-mesh $ \Delta t $ (we below omit the index of agent for simplicity unless confusing). For a given $ \Delta s = \dot{\mathbf{r}} \Delta t $ at $ \mathbf{r} $, exploiting the property $ \Delta s \perp \mathbf{r} $, the conventional method chooses the point where the position vector $ \mathbf{r} + \Delta s $ penetrates the unit sphere centered at origin as $ \mathbf{r}(t + \Delta t) $. This is the method suggested in the seminal work [17]. At a glance, this method seems to have no ambiguity in choosing $ \mathbf{r}(t + \Delta t) $ for the given $ \Delta s $. However, this is not the case, as will be explained below. Before going further, we remark that the numerical result in [17] is still valid because natural frequency is not taken into account therein. This point will also become clear in the following. A. Instantaneous rotation Smooth motion on sphere is a continuous patch of infinitesimal arcs of own curvatures. Thus when $ \Delta s $ is given, numerical method should specify a circle on the sphere, which is tangential to $ \Delta s $. Then, $ \mathbf{r}(t + \Delta t) $ is given by the intersection point between the circle and the line segment from the circle’s center to the endpoint of the position vector $ \mathbf{r} + \Delta s $. Here, we emphasize that such circle is not unique, and thereby the position update becomes different depending on the circles. In order to illustrate this point, we draw the purple and green circles in Fig. 5, which are tangential to the black bold arrow at the starting point (this arrow represents $ \Delta s $ and its starting point is $ \mathbf{r} $). Since the green one is a great circle (see the caption), if position update is considered on it, this corresponds to the method in [17]. However, this is merely a choice replaceable with what by the purple circle on the upper hemisphere. There is no reason to prefer the green one to the purple circle. Furthermore, there can be infinite number of circles, each of which is tangential to the bold arrow at the same point. Figure 5 thereby implies that infinite number of choices are possible in numerically specifying the position update for given $ \Delta s $. Therefore, any numerical method that updates the position with $ \Delta s $ only is basically incomplete. Thus, to obtain the proper displacement, one should specify the rotation axis that gives the circle along which the position update takes place. Our formula Eq. (3) has the advantage that it explicitly shows that axis. The rotation axis is no more than the direction vector of $ \mathbf{v}_i = (\mathbf{w}_i - \mathbf{k} \times \mathbf{r}_i) $, the leading factor of the right hand side of Eq. (3). This is because Eq. (3), we have formulated for model equation, is structured as $ \dot{\mathbf{r}} = \mathbf{\Omega} \times \mathbf{r} $ that states a particle at $ \mathbf{r} $ rotates by angular velocity $ \mathbf{\Omega} $ along the rotation axis $ \mathbf{\Omega}/\|\|\mathbf{\Omega}\|\| $ [29]. Consequently, the rotation axis we are seeking for is $ \hat{\mathbf{v}}_i = \mathbf{v}_i/\|\|\mathbf{v}_i\|\| $. We remark that this axis itself dynamically evolves in time because $ \dot{\mathbf{v}}_i = (\mathbf{w}_i - \mathbf{k} \times \mathbf{r}_i) $ is attributed to the set of dynamic variables $ \{ \mathbf{r}_i \} $. B. Finite rotation as numerical integration This way, $ \dot{\mathbf{r}}_i = \mathbf{v}_i \times \mathbf{r}_i $ for $ \mathbf{v}_i = (\mathbf{w}_i - \mathbf{k} \times \mathbf{r}_i) $ explicitly shows how the position update of agent $ i $ takes place. It is thus not necessary to use $ \Delta s_i (= \mathbf{v}_i \times \mathbf{r}_i \Delta t) $ that way like in the conventional method. Instead, we are now able to directly implement the rotation to know the position at $ t + \Delta t $, and this is given by \[ \mathbf{r}_i(t + \Delta t) = R_{\mathbf{n}_i}(\\|\mathbf{v}_i \times \mathbf{r}_i \Delta t\\|)\mathbf{r}_i(t), \] where $ R_{\mathbf{n}}(a) $ is the rotation matrix along $ \mathbf{n} $-axis by $ a $. For the construction of $ R_{\mathbf{n}}(a) $, one may refer to Euler angles [21]. We adopt Heun’s scheme [30] to reduce the artifact caused by discretization with finite $ \Delta t $. When $ \mathbf{w}_i = 0 $, the updated position $ \mathbf{r}_i(t + \Delta t) $ by Eq. (11) is on a great circle starting from $ \mathbf{r}_i(t) $ because $ \mathbf{v}_i \perp \mathbf{r}_i $ for vanishing natural frequency. Therefore, in this case, the update method Eq. (11) is restored to that suggested in [17]. However, as soon as the natural frequency comes in, the position update does not necessarily take place on a great circle. In general, the new position can be on a various circle, in size and direction, as informed in Eq. (3). Position update as a finite rotation along a proper axis is an inherent feature of the smooth motion on sphere when interpreted for numerical time-mesh $\Delta t$. It is hard to tell the dynamically changing rotation axis when the equation of motion is written in the conventional formula Eq. (5). In analytic point of view, the model equations Eqs. (3) and (5) are same. However, their numerical integration calculated for a finite time-mesh $\Delta t$ may show a difference depending on the used methods. The new method based on Eq. (3) chases the rotation axis specifying the motion on sphere while the conventional one based on Eq. (5) does not. When the position update by the conventional one is denoted with $r_c(t + \Delta t)$, the discrepancy from the new method [Eq. (11)] is assessed as $r(t + \Delta t) = r_c(t + \Delta t) + O(\Delta t^2)$ provided $r(t) = r_c(t)$. The discrepancy $O(\Delta t^2)$ comes from the ambiguity of the rotation axis in the conventional method. This asymptotic behavior is readily arguable in Fig. 5 focusing on the geometrical condition among the three objects at the starting point of the black bold arrow. Above-mentioned discrepancy of $O(\Delta t^2)$ informs that a numerical scheme of accuracy finer than second order in $\Delta t$ is required to overcome the ambiguity in rotation axis of the conventional method. For example, the Runge-Kutta 3rd order scheme [30] is at least required for the conventional method. Compared to this, the efficient Heun’s scheme basically a case of Runge-Kutta 2nd order scheme is allowed to the new method Eq. (11) equipped with the rotation axis. We remark that, when the discrepancy is not properly reduced, the conventional method could bring about the limited or unreliable numerical realizations of the generic properties of the model, and this again results in the unclear interpretation on the numerical observations. In this work, we mainly focus on the near-full synchronization of $\\|r_{CM}\\| \approx 1$ for parallel natural frequency or for strong coupling. But, the other states that do not necessarily show $\\|r_{CM}\\| \approx 1$ are expected for general natural frequency and coupling. However, for this general setting, it is hard to argue the results in an analytic or intuitive way. In this situation, a solid, practical, and reliable numerical method is necessary as an indispensable research methodology. We expect that the new numerical integration method encapsulated in Eq. (11) will play this important role in a competitive way. VI. SUMMARY In this paper, we have demonstrated that the standard Kuramoto model can be transformed to the vector product form. This naturally leads to a generalization of the model for the dynamics of 3-dimensional spatial coordinate of agent on unit sphere or, equivalently, that of 2-dimensional spherical phase. Long-term states of the model are surveyed with the geometrical meaning of the vector product form, and the theoretical prediction is numerically supported. We remark that the numerical integration method proposed in the beginning of this field shows an ambiguity when natural frequency is taken into account in the model. A new numerical method free from such ambiguity is illustrated as a direct utilization of our model equation that is composed of vector products in a compact and informative form. VII. ACKNOWLEDGMENTS This research was supported by the NRF Grant No. 2018R1D1A1B07049254 (H.K.L.) and 2021R1A2B5B01001951 (H.H). REFERENCES [1] Y. Kuramoto, in International Symposium on Mathematical Problems in Theoretical Physics, edited by H. Araki, Lecture Notes on Physics, 30 (Springer, New York, 1975), p.420; Chemical Oscillations, Waves, and Turbulence (Springer, Berlin, 1984). [2] S. H. Strogatz, Physica D 143, 1 (2000); Sync (Hyperion, New York, 2000). [3] A. Pikovsky, M. Rosenblum, and J. Kurths, Synchronization: A universal Concept in Nonlinear Sciences (Cambridge University Press, 2003). [4] J. A. Acebron, L. L. Bonilla, C. J. Perez Vicente, F. Ritort, and R. Spigler, Rev. Mod. Phys. 77, 137 (2005). [5] M. Y. Choi, H. J. Kim, D. Kim, and H. Hong, Phys. Rev. E 61, 371 (2000). [6] J. A. Acebron, L. L. Bonilla, and R. Spigler, Phys. Rev. E 62, 3457 (2000). [7] H. Hong, M. Y. Choi, J. Yi, and K.-S. Soh, Phys. Rev. E 59, 353 (1999). [8] H. Hong, M. Y. Choi, B. G. Yoon, K. Park, and K. S. Soh, J. Phys. A 32, L9 (1999). [9] M. Iwasa and D. Tanaka, Phys. Rev. E 81, 066214 (2010). [10] K. P. O’Keeffe, H. Hong, and S. H. Strogatz, Nature Comm. 8 1504 (2017). [11] K. P. O’Keeffe and C. Bettstetter, A review of swarmalators and their potential in bio-inspired computing, in Proc. SPIE 10982, Micro- and Nanotechnology Sensors, Systems, and Applications XI (2019) p. 10982. [12] H. K. Lee, K. Yeo, and H. Hong, Chaos 31, 033134 (2021). [13] H. Hong, K. Yeo, and H. K. Lee, Phys. Rev. E 104, 044214 (2021). [14] A. Baris and C. Bettstetter, IEEE Access 8, 218752 (2020). [15] D. Levis, I. Pagonabarraga, and B. Liebchen, Phys. Rev. Research 1, 023026 (2019). [16] D. Escaff and R. Delpiano, Chaos 30, 083137 (2020). [17] R. Olfati-Saber, Swarm on Sphere: A Programmable Swarm with Synchronous Behaviors like Oscillator Networks, in Proc. 45th IEEE Conference on Decision and Control (2006), p. 5060. [18] M. A. Lohe, J. Phys. A: Math. Theor. 42, 395101 (2009). [19] W. K. Tung, Group Theory in Physics (World Scientific, New Jersey, 1985). [20] J. J. Sakurai, Modern Quantum Mechanics (Addison-Wesley, Massachusetts, 1994). [21] G. B. Arfken and H. J. Weber, Mathematical Methods for Physicists, 6th ed. (Elsevier, Amsterdam, 2005). [22] M.A. Lohe, J. Phys. A: Math. Theor. 43, 465301 (2010). [23] J. Zhu, Phys. lett. A 377, 2939 (2013). [24] D. Chi, S.-H. Choi, and S.-Y. Ha, J. Math. Phys. 55, 052703 (2014). [25] S.-H. Choi and S.-Y. Ha, J. Nonlinear Sci. 25, 1257 (2015). [26] M.A. Lohe, J. Phys. A: Math. Theor. 51, 225101 (2018). [27] J. Markdahl, J. Thunberg, and J. Goncalves, Automatica 113, 108736 (2020). [28] M. C. Porter, R. Mirolo, and S. H. Strogatz, Chaos 31, 063113 (2021). [29] H. Goldstein, Classical Mechanics, 2nd ed. (Addison-Wesley, Massachusetts, 1980). [30] W. H. Press, S. A. Teukolsky, W. T. Vetterling, and B. P. Flannery, Numerical Recipes in C, 2n ed. 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Furthermore, it is the duty of the general contractor to assure that all required inspections are scheduled in advance and approved buy the City Inspectors. * Permits are valid for 180 days and must be posted in visible location . * I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or conceal the provisions of any other state or local law regulating construction or the performance of construction and that I make this statement under penalty of perjury. Businesses must obtain a current City of Oak Grove Business License prior to beginning any project. 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Series AZK– 105°C 3000h Capacitors PCB type –DIN style Solder Pins * AZK DIN 4/5 pins * Capacitance Tolerance: -20 + 20% – standard (M) * Case: 30x40 – 40x100 * Climatic category: 40/105/56 * Temperature – 40°C + 105°C Mechanical Outlines * Case: aluminium made * No insulated bottom * Sealing: hermetic on Rubber Bakelite cover * Terminals: solder pin * Sleeve: self-extinguishing thermo shrinkable * Pressure Release Vent: onto aluminium case * Size: see enclosed drawings * External Material UL94-V0 The allowable values of ripple current in Ampères, are related to the temperature and frequency by following equation: Where: * IRipple@105°C is the limit given by tables, @ 105°C/100HZ C Ripple@105 f t Ripple I K K I ° • • = * Kt is the Temperature Correlation Factor * Kf is the Frequency Correlation Factor Note .Superimposed alternating voltage summed to DC volage must not exceed rated voltage, rated ripple current must not be exceeded and no reverse polarity is allowed \| °C \| 50 \| 65 \| 75 \| 85 \| 95 \| \|---\|---\|---\|---\|---\|---\| \| Kt \| 2.4 \| 2.2 \| 2.1 \| 1.8 \| 1.3 \| Table 1-Kt Values \| \| Kf \| \|---\|---\| \| Vn/Hz \| V>160 \| \| 50 \| 0.88 \| \| 100 \| 1.00 \| \| 300 \| 1.20 \| \| 400 \| 1.25 \| \| 500 \| 1.35 \| \| >1000 \| 1.40 \| Table 2-Kf Values Aluminium Electrolytic Capacitors – Series AZK 83 84 Expected Lifetime End of Life Criteria During useful life typical electrical parameters of electrolytic capacitor are subject to change. End of Life criteria, when rated temperature, voltage and ripple are applied, are: C 30% C t0 ≤ Δ Equation 1 ESR t0 ESR 3• ≤ Equation 2 I t0 f f I ≤ Equation 3 where t0 is the initial value Voltage Endurance Test Requirements On Voltage Endurance Test are based Expected Lifetime Curves. End of Life criteria, when rated temperature, and voltage are applied for 2'000hrs, are where t 0 is the initial value Expected Lifetime Vs Temperature and Ripple Current Leakage Current After the rated voltage has been applied to the capacitor for 5 minutes the leakage current must be within those limits. Where: If=leakage current [µA], C=capacitance [µF], \| Maximum limit \| @25°C \| If≤0,004xCxV \| \|---\|---\|---\| \| Operating limit \| @25°C \| If≤0,001xCxV \| V=rated voltage [V] Surge Voltage \| Working Voltage \| 200 \| 250 \| 400 \| \|---\|---\|---\|---\| \| Surge Voltage \| 230 \| 290 \| 440 \| Aluminium Electrolytic Capacitors – Series AZK \| \| Capacitance \| Case \| Diam \| Height \| Tanδ \| ESRmax \| typ \| \| Zmax \| Iripple @100Hz \| \| Ordering Code \| \|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\| \| \| [µF]@100Hz \| \| [mm] \| [mm] \| [%]@100Hz \| [mΩ]@100Hz \| \| [mΩ]@10KHz \| [A]@85°C \| [A]@105°C \| \| \| \| \| 470 \| NB \| 35 \| 40 \| 0,10 \| 271 \| 217 \| 203 \| 3,2 \| 1,8 \| AZK471M200NB1 \| \| \| \| 680 \| NC \| 35 \| 50 \| 0,10 \| 187 \| 150 \| 141 \| 4,2 \| 2,3 \| AZK681M200NC1 \| \| \| \| 1000 \| NC \| 35 \| 50 \| 0,10 \| 127 \| 102 \| 96 \| 5,1 \| 2,8 \| AZK102M200NC1 \| \| \| 200 \| \| NE \| 35 \| 75 \| 0,10 \| 85 \| 68 \| 64 \| 7,4 \| 4,1 \| AZK152M200NE1 \| \| \| \| 1500 \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| PC \| 40 \| 50 \| 0,10 \| 85 \| 68 \| 64 \| 6,7 \| 3,7 \| AZK152M200PC1 \| \| \| \| 2200 \| PE \| 40 \| 100 \| 0,10 \| 58 \| 46 \| 43 \| 11,0 \| 6,1 \| AZK222M200PE1 \| \| \| \| 3300 \| PG \| 40 \| 100 \| 0,10 \| 39 \| 31 \| 29 \| 13,5 \| 7,5 \| AZK332M200PG1 \| \| \| \| 470 \| MB \| 30 \| 40 \| 0,10 \| 271 \| 217 \| 203 \| 2,9 \| 1,6 \| AZK471M250MB1 \| \| \| \| 680 \| NB \| 35 \| 40 \| 0,10 \| 187 \| 150 \| 141 \| 3,8 \| 2,1 \| AZK681M250NB1 \| \| \| 250 \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| 1000 \| PC \| 40 \| 50 \| 0,10 \| 127 \| 102 \| 96 \| 5,5 \| 3,1 \| AZK102M250PC1 \| \| \| \| 1500 \| PE \| 40 \| 75 \| 0,10 \| 85 \| 68 \| 64 \| 8,0 \| 4,4 \| AZK152M250PE1 \| \| \| \| 2200 \| PG \| 40 \| 100 \| 0,10 \| 58 \| 46 \| 43 \| 11,0 \| 6,1 \| AZK222M250PG1 \| \| \| \| 330 \| NB \| 30 \| 50 \| 0,10 \| 386 \| 309 \| 290 \| 2,7 \| 1,5 \| AZK331M400NB1 \| \| \| \| 470 \| NC \| 30 \| 50 \| 0,10 \| 271 \| 217 \| 203 \| 3,2 \| 1,8 \| AZK471M400NC1 \| \| \| \| \| NE \| 40 \| 40 \| 0,10 \| 187 \| 150 \| 141 \| 4,1 \| 2,3 \| AZK681M400NE1 \| \| \| \| 680 \| \| \| \| \| \| \| \| \| \| \| \| \| 400 \| \| PC \| 35 \| 50 \| 0,10 \| 187 \| 150 \| 141 \| 4,2 \| 2,3 \| AZK681M400PC1 \| \| \| \| \| NE \| 35 \| 75 \| 0,10 \| 127 \| 102 \| 96 \| 6,1 \| 3,4 \| AZK102M400NE1 \| \| \| \| 1000 \| PE \| 35 \| 50 \| 0,10 \| 127 \| 102 \| 96 \| 5,1 \| 2,8 \| AZK102M400PE1 \| \| \| \| \| PG \| 40 \| 50 \| 0,10 \| 127 \| 102 \| 96 \| 5,5 \| 3,1 \| AZK102M400PG1 \| \| \| \| 1500 \| PG \| 40 \| 75 \| 0,10 \| 85 \| 68 \| 64 \| 8,0 \| 4,4 \| AZK152M400PG1 \| \| \| \| 220 \| NB \| 30 \| 40 \| 0,10 \| 579 \| 463 \| 434 \| 2,0 \| 1,1 \| AZK221M450NB1 \| \| \| \| 330 \| NC \| 35 \| 50 \| 0,10 \| 386 \| 309 \| 290 \| 2,9 \| 1,6 \| AZK331M450NC1 \| \| \| \| 470 \| NC \| 35 \| 50 \| 0,10 \| 271 \| 217 \| 203 \| 3,5 \| 1,9 \| AZK471M450NC1 \| \| \| \| 560 \| PC \| 40 \| 50 \| 0,10 \| 227 \| 182 \| 171 \| 4,1 \| 2,3 \| AZK561M450PC1 \| \| \| 450 \| \| NE \| 35 \| 75 \| 0,10 \| 227 \| 182 \| 171 \| 4,5 \| 2,5 \| AZK561M450NE1 \| \| \| \| \| NE \| 35 \| 75 \| 0,10 \| 187 \| 150 \| 141 \| 5,0 \| 2,8 \| AZK681M450NE1 \| \| \| \| 680 \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| PE \| 40 \| 75 \| 0,10 \| 187 \| 150 \| 141 \| 5,4 \| 3,0 \| AZK681M450PE1 \| \| \| \| 1000 \| PG \| 40 \| 100 \| 0,10 \| 127 \| 102 \| 96 \| 7,4 \| 4,1 \| AZK102M450PG1 \| \| \| \| 1200 \| PG \| 40 \| 100 \| 0,10 \| 106 \| 85 \| 80 \| 8,1 \| 4,5 \| AZK122M450PG1 \| \| 85 85 Dimension, Quantity and Weight for box All dimensions in mm, torque in Nm, weight in kg \| Case \| \| Connections \| Packaging \| \| \|---\|---\|---\|---\|---\| \| Code \| DxL \| PIN- DIN Type \| Pcs/Box \| Weight/box \| \| \| \| Number \| \| \| \| NB \| 35x40 \| 4 \| 100 \| 6-8 \| \| NC \| 35x50 \| 4 \| 100 \| 6-8 \| \| NN \| 35x60 \| 4 \| 100 \| 5-7 \| \| NE \| 35x75 \| 4 \| 50 \| 6-8 \| \| PB \| 40x40 \| 5 \| 100 \| 6-8 \| \| PC \| 40x50 \| 5 \| 100 \| 8-9 \| \| PN \| 40x60 \| 5 \| 100 \| 8-10 \| \| PE \| 40x75 \| 5 \| 50 \| 9-11 \| \| PG \| 40x100 \| 5 \| 50 \| 6-8 \|	<urn:uuid:b89acb9b-5e8a-49c8-adb1-852ed7a4112c>	CC-MAIN-2018-17	http://www.itelcond.it/wp-content/uploads/2016/10/13_Serie-AZK-2016.pdf	2018-04-21T18:54:41Z	crawl-data/CC-MAIN-2018-17/segments/1524125945317.36/warc/CC-MAIN-20180421184116-20180421204116-00439.warc.gz	427,853,369	2,693	eng_Latn	eng_Latn	0.862293	eng_Latn	0.904532	[ "eng_Latn", "eng_Latn", "unknown", "eng_Latn" ]	false	docling	[ 1305, 2405, 5209, 5719 ]	[ 0.83203125 ]	[ 2.234375 ]	[ 2.984375 ]	[ 0.26953125 ]	1	1	HuggingFaceFW/finepdfs
MASTER PLAN OF EVANGELISM REVIEWS BY MEREDITH! "I finally read 'The Master Plan of Evangelism,'" Laura admitted to me. (I thought she had read it years ago.) "Did you like it?" I asked, dying to ask her why she had waited so long to read it when I had been begging her to read the book for nine years! "I tried to read it several times, but it isn't really light reading material," she informed me. I nodded in agreement. It isn't light reading material. In fact, while most books we read are written at a fifth to eighth grade level, this book is written for college students so it is a more challenging read. "I loved the book!" Laura broke into my thoughts. "You were right about it making you see all of life in a new way." "Really?" "Really. I'm so glad I read it. I'll never be the same!" I read The Master Plan of Evangelism by Robert E. Coleman when I was a sophomore in college. This book changed my life! I have my children read it in high school for one of their Bible classes. It is a book that I would like to see more Christians read, especially homeschooling parents. Robert, born in 1928, grew up in Texas, attending a Methodist church. He pastored for six years and moved into teaching. He has a Masters in Theology from Princeton, a PhD from the University of Iowa, and a Doctorate of Divinity from Trinity International University. His writing style is academic, but don't let them keep you from reading this book. Along the way, Dr. Coleman became convinced that schools were not the answer to raising up mighty men of God. He carefully studied the life of Jesus, coming to the conclusion that Jesus knew exactly what He was doing in laying a foundation for the Church. Dr. Coleman values Jesus' pattern of ministry and embraces it in his own life. The Body of Christ is called to fulfill the Great Commission by spreading the good news, leading people to Christ, and making disciples. We are called to evangelism. But, Dr. Coleman wants to make it clear that Jesus' definition of evangelism is broader than our own and involves mentoring people to a place of maturity. Jesus spent His life calling people to repent and believe while healing the sick and injured, performing all kinds of miracles, and teaching His beloved people. However, He invested in a small group of men, His disciples. These He gave focused time and attention to for three years. He imparted to them truth and modeled a lifestyle that they could imitate. What a blessing to take a closer look at the life of Jesus! Coleman lays out six principles of Jesus' ministry that we can use as a pattern in our own lives as we fulfill the Great Commission: Selection (choosing who to mentor); Association (spending time with those you mentor); Consecration (full surrender to Christ); Impartation (teaching); Demonstration (showing them how to minister to others); Delegation (give tasks & assignments); Supervision (watching over them ministering to others); and Reproduction (sending them out!). Jesus carefully chose His disciples and then poured His life and love into them. He imparted His wisdom and vision into their lives, modeling how to make disciples and apprenticing them. What a perfect plan for us! His ways make perfect sense. You learn to be like the people you hang out with whether you want to or not. Who doesn't want to be like Jesus? In my homeschooling and mothering, I have sought to impart love and wisdom to my children by investing time and energy into them as a priority in my life. I hug them, teach them, feed them, and share my life with them. With all my heart, I try to model a godly lifestyle and effective patterns of ministry. When they get older, I begin to mentor and apprentice them to walk in the call of God on their own lives. What a joy to make disciples in my own home! When I read this book, I jumped for joy! This pattern found in the life of Jesus was the pattern I wanted for my entire life. I wanted to minister in the local church by making disciples of other women. I wanted to parent by making disciples of my children. I shared the Gospel differently after reading this book. My purpose became to call my unsaved friends to be born again and live wholeheartedly for Jesus. I mentored the friends I led to Jesus and saw them grow up in the Lord and lead others to Christ. What joy filled my heart as I followed the Master DiscipleMaker! © 2009 Meredith Curtis. All Rights Reserved. This article first appeared on Takerootandwrite.com in the Homeschooling Curriculum column. Used by permission. Years later, I married the man of my dreams and God gave us five lovely children to raise for His glory. Again, I decided to follow that plan laid out in this book in my parenting. That sounds kind of strange, doesn't it? What a strange parenting book--a theological examination of the life of Jesus, focusing on how He makes disciples. But I have found it to be the best parenting book ever; in fact, it is a great book on homeschooling too. Because, you see, my heartbeat is to pass the baton of faith to the next generation and I cannot think of a more effective plan than the one Jesus used to mentor His disciples and build His church.	<urn:uuid:edbaacae-3c42-4da7-833e-c8f9e7eef981>	CC-MAIN-2017-26	http://joyfulandsuccessfulhomeschooling.com/homeschooling/pdfs/reviews_masterplan.pdf	2017-06-29T07:10:19Z	crawl-data/CC-MAIN-2017-26/segments/1498128323889.3/warc/CC-MAIN-20170629070237-20170629090237-00509.warc.gz	205,266,374	1,132	eng_Latn	eng_Latn	0.998061	eng_Latn	0.998478	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 2996, 5189 ]	[ 1.1953125 ]	[ 2.5 ]	[ 2.03125 ]	[ 2.546875 ]	1	0	HuggingFaceFW/finepdfs
DIRECT CARE CLINIC DASHBOARD INDICATORS SPECIFICATIONS MANUAL Last Revised 11/20/10 1. ACT Fidelity 3. ISP Quality 2. ISP Current 4. Recipient Satisfaction 6. Staffing – Case Manager 5. Staffing – Physician 7. Case Manager Case Loads 9. Competitive Employment 8. COT Adherence 10. Meaningful Activities 12. Adverse Incidents per 1000 Enrollees 11. Complaints per 1000 Enrollees 13. PCP Coordination 15. Level I Admissions per 1000 Enrollees 14. Follow-Up after Discharge within 7 Days 16. Re-admissions within 30 Days 18. Encountering 17. Title XIX Ratio Also Includes a Section for Interpreting and Utilizing the Dashboard Gauges and Features 1. ACT FIDELITY Assertive Community Treatment Teams meet fidelity to the ACT model as outlined in the court approved Maricopa County Case Management and Clinical Team Plan. DEFINITIONS 1. Small Caseload: Client/CM/CL ratio of 12:1 3. Program Meeting: Program meets frequently to plan and review services for each client. 2. Team Approach: Provider group functions as a team; team members know and work with all clients. 4. Appropriate Transitions to and from Supportive Teams: The program has a clearly identified mission to serve a particular population; it uses measurable and operationally defined criteria to screen out inappropriate referrals. Admission criteria should be pointedly targeted toward the individuals who typically do not benefit from usual services. In addition to these very general criteria, an ACT team should have some further admission guidelines tailored to their treatment setting. 6. Responsibility for crisis services: Program has 24-hour responsibility for covering all psychiatric crises. 5. Full responsibility for treatment services: ACT team directly provides psychiatric services, medication management, housing support, substance abuse treatment, employment/rehabilitative services, ILS services, transportation services, peer support services and case management services. 7. Responsibility for hospital admissions: All members of the ACT Team are expected to be involved in the admission process and discharge planning process. ACT Team members are expected to put services in place to meet the needs of the Recipient in the community, if necessary, to divert the hospitalization. 9. Responsibility for Incarcerations: ACT team is closely involved with the jail system when a service recipient is arrested and in planning for Jail releases. The Case Manager or another member of the clinical team shall visit the incarcerated consumer within 72 hours of notification of incarceration and at least one face-to-face contact one time per month or as frequently as determined necessary during consumer's period of incarceration. The clinical team shall ensure that a member of the clinical team attends the staffing(s) to assist in the coordination of care and services. 8. Responsibility for hospital discharge planning: The clinical team actively participates and coordinates with the inpatient treatment team to identify discharge plans through a staffing. The recipient is seen within 72 hours of being admitted and weekly while inpatient. A member of the clinical team shall maintain daily contact with the person via telephonic and/or face-to-face contact during the first five (5) working days following discharge. 10. Responsibility for jail discharge planning: Program is involved in planning for jail discharges. Upon release from General Population, the consumer shall see the Behavioral Health Medical Practitioner (BHMP) within 72 hours. Consumers released from LBJ IP Psych Unit shall be seen by a BHMP on the day of release (or the next business day, if the release occurs on a Saturday or Sunday). The clinical team shall provide services to the consumer in accordance with the plan for release and in order to ensure, promote and/or maintain the consumer's: Safety; Security; symptom reduction; Physical health; and Recovery and rehabilitation. 11. Community-based services: Program works to monitor status, develop skills in the community, rather than in office. 12. Frequency of contact: High number of face-to-face service contacts as needed. 14. Substance Abuse engagement/treatment groups: The ACT Team refers to Substance Abuse Specialist and/or Co-Located Substance Abuse Specialist to identifying if an individual needs Co-Occurring Residential Treatment vs. outpatient services in the community. The CoLocated staff also provide outreach and engagement and services are expected to be out in the community as well as in the office. 13. Individualized substance abuse engagement/treatment: One or more members of the team provide direct treatment/engagement and substance abuse treatment/engagement for clients with substance use disorders. 15. Meaningful Community Employment: One or more members of the team will work in conjunction with the service recipient to determine level of readiness for community employment 16. Meaningful Community Activity: One or more members of the team will work in conjunction with the service recipient to determine level of readiness for community integration 17. Housing: Housing needs should be determined and how much housing supports are needed to maintain a person in the community METHODOLOGY Population Direct care clinical teams serving individuals on an Assertive Community Treatment (ACT) team (i.e., ACT Teams). Inclusion Criterion All ACT Teams (currently includes 14 teams) Review Period Quarterly Sample Selection: All (100%) ACT teams are selected for review each quarter. The sample frame consists of all recipients assigned to an ACT Team. The designated clinical reviewer randomly selects 10 records from a de-identified client list provided by each ACT Team leader. The sample is stratified and consistent across all 14 ACT Teams. The request for the sample is initiated by the clinical reviewer at the time the reviewer presents to the direct care clinic to conduct the fidelity review. The sample is neither representative nor proportional, but rather reflects the agreed upon methodology that was determined by Magellan and ADHS. Data Source Interviews with ACT team members and reviews of sampled behavioral health recipient medical records utilizing the ACT fidelity review tool. The consumer to staff ratio report is utilized to identify all relevant ACT team members. Data Collection: Data is collected by the assigned QI clinical reviewer from interviews with ACT team members and from the behavioral health recipients' medical record using the ACT Team Fidelity Tool. The information is collected at the time of the quarterly on-site clinic visit. Data is gathered from the following materials: Behavioral Health Recipient Medical Record (progress notes for the past 30 days, ISP and Assessment) * Ratio Reports * Encounter Data * Operating Protocol * Interview with the clinical coordinator, substance abuse specialist, rehab specialist, and housing specialist * Team Meeting Observation Scoring Guidelines: * Each item on the scale is rated on a 3-point scale ranging from 1 ("Not implemented") to 3 ("Fully implemented"). * The scale ratings are based on current behavior and activities not planned or intended behavior. * Overall scoring for ACT Fidelity will be completed as follows: # of items on ACT Fidelity tools receiving a rating of "3" Total # of items rated on ACT Fidelity tools Scoring for each item on the tool is as follows: o 1 for 16:1 or more 1. Small Caseload – from the staff-consumer ratio report and clinical coordinator interview, calculate the number of clients presently served to the number of FTE staff. Rate the team as follows: o 2 for 13:1 – 15:1 2. Team Approach – from the clinical coordinator interview and record review, calculate the percent of recipients that had face-to-face contact with 3 or more team members within 30 day review period. Rate the team as follows: o 3 for 12:1 or less o 1 for 0-59% o 3 for 90-100% o 2 for 60-89% 3. Program Meeting – from the clinical coordinator interview, record review, direct observation of morning meeting, and morning meeting log, determine how frequently the team meets in the morning meeting to review all recipients. Rate the team as follows: o 2 for 3 or more times a week, but does not review all recipients o 1 for less than 3 times per week o 3 for 4 or more times a week and discusses all recipients o 1 for team has no clear understanding of the admission or discharge criteria or barriers to transition 4. Appropriate Transitions to and from Supportive Teams – from the clinical coordinator interview, assess how well the team understands the admission and discharge criteria and if there are any significant barriers to appropriate transition. Rate the team as follows: o 2 for team has some understanding of the admission and discharge criteria with minimal barriers to transition o 3 for team has clear understanding by the clinical team members of the admission and discharge criteria and no significant barriers to appropriate transition o 1 for 5 or less of the services 5. Full Responsibility for Treatment Services – from the clinical coordinator interview and record review, determine how many of the ACT services the team provides to recipients (see definition). Rate the team as follows: o 2 for 6-9 of the services 6. Responsibility for Crisis Services – from the clinical coordinator interview, record review, and on call review, assess how well the team provides 24-hr crisis intervention. Rate the team as follows: o 3 for 9-10 of the services o 1 for team has no responsibility for crisis services after hours o 3 for program provides 24-hr coverage and responds on site after hours o 2 for consultant role via phone for crisis services after hours 7. Responsibility for Hospital Admissions – from the clinical coordinator interview, chart review, and inpatient policy review, assess how well the clinical team follows the inpatient policy and involvement in the admission process. Rate the team as follows: o 2 for clinical team was aware of inpatient admission, but did not follow the protocol o 1 for clinical team was not aware of the inpatient admission and did not follow the protocol o 3 for clinical team followed the policy and was actively involved in the admission process o 1 for clinical team was not involved in discharge planning and did not follow the discharge policy 8. Responsibility for hospital discharge planning – from the clinical coordinator interview, chart review, and inpatient discharge policy review, assess how well the clinical team actively participated in the discharge planning of the recipient and met all requirements in the policy. Rate the team as follows: o 2 for clinical team had little involvement in discharge planning and did not follow the policy 9. Responsibility for Incarcerations – from the clinical coordinator interview, chart review, and continuity of care for incarcerated consumers policy review, assess how well the team followed the policy and was actively involved in the incarceration process. Rate the team as follows: o 3 for clinical team followed the policy and was actively involved in the discharge planning process o 1 for clinical team was not aware of incarceration and did not follow the policy o 3 for clinical team followed the policy and was actively involved in the incarceration process o 2 for clinical team had little involvement when the recipient was incarcerated and did not follow the policy as expected 10. Responsibility for jail discharge planning – from the clinical coordinator interview, chart review, and continuity of care for incarcerated consumers policy review, assess how well the team followed the policy and was actively involved in discharge planning. Rate the team as follows: o 1 for clinical team was not aware of incarceration and did not participate in discharge planning o 2 for clinical team saw the recipient, but had minimal involvement in discharge planning 11. Community-based services – from the clinical coordinator review, chart review, and encounters, calculate the percent of face-to-face contacts that occur in the community. Rate the team as follows: o 3 for clinical team followed the policy and was actively involved in discharge planning o 1 for less than 40% of contacts occur in the community o 3 for 75-100% of contacts occur in the community o 2 for 40-74% of contacts occur in the community 12. Frequency of Contact – from the record review and encounters, calculate the number of clinical team/recipient face-to-face contacts per month. Rate the team as follows: o 2 for 2-3 face to face contacts per month o 1 for 0-1 face to face contacts per month o 3 for 4 or more face to face contacts per month o 1 for clinical team does not assess the recipient's substance abuse history, readiness for change or services needed 13. Individualized Substance Abuse Engagement/Treatment – from the clinical coordinator interview, substance abuse specialist interview, and record review, determine how well the clinical team adequately assesses the recipient's substance abuse history, readiness for change, and provides services needed based on level of readiness. Rate the team as follows: o 2 for clinical team assesses the recipient's substance abuse history and readiness for change, but does not provide services needed based on level of readiness. 14. Substance Abuse Engagement/Treatment Groups – from the clinical coordinator interview, substance abuse specialist interview, and record review, determine how well substance abuse is actively assessed and if there is continual engagement and regular groups available. Rate the team as follows: o 3 for clinical team adequately assesses the recipient's substance abuse history, readiness for change, and provides services needed based on level of readiness. o 1 for substance abuse is not address – no engagement – no groups o 3 for substance abuse actively assessed and continual engagement – regular groups available o 2 for some substance abuse services are offered, but no regular engagement into groups 15. Meaningful Community Employment – from the rehab/employment specialist interview, assess how well meaningful community employment is actively addressed and continual engagement occurs. Rate the team as follows: o 2 for meaningful community employment services are offered, but no regular engagement o 1 for meaningful community employment is not addressed – no engagement o 3 for meaningful community employment actively assessed and continual engagement o 1 for meaningful community activity is not addressed – no engagement 16. Meaningful Community Activity – from the rehab/employment specialist interview, assess how well meaningful community activity is actively assessed and continual engagement occurs. Rate the team as follows: o 2 for meaningful community activity services are offered, but no regular engagement o 3 for meaningful community activity actively assessed and continual engagement 17. Housing – from the housing specialist interview, assess how well housing issues are addressed/service offered/recipient in stable housing/continued supports and engagement. Rate the team as follows: o 2 for housing issues/services offered with no regular engagement o 1 for housing issues not addressed/no engagement o 3 for housing issues addressed/service offered/recipient in stable housing/continued supports and engagement QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation On a quarterly basis, the Outcomes Director and ACT Team Manager will conduct on-site observations of one ACT Team Fidelity review per designated clinical reviewer to ensure the appropriate application of the review tool, interviews and collaborating evidence to assess fidelity with the ACT model. In addition, every six months, all clinical reviewers participate in an inter-rater reliability case that includes a sample medical record, team responses to interview questions and other required information necessary to fully apply the ACT Team Fidelity Tool. Scores are compared for consistency and training/technical assistance is provided as indicated. Clinical reviewers who consistently fail to meet accepted ranges of variability are subjected to additional training and oversight. 2. ISP CURRENT The ISP is considered current if it has been completed and/or updated within the past 12 months and includes the person's signature and one other clinical team member's signature. DEFINITIONS 1. ISP: Individual Service Plan 3. Current: A current ISP is one that has been completed and/or updated within the past 12 months and has been accepted in the Claim Trak Client Information System. 2. Accepted ISP: An accepted ISP is an ISP that is completed via the Claim Trak Client Information System and designated as completed by the assigned case manager, clinical coordinator or clinical director. In order for the ISP to be deemed accepted, the ISP must be current and signed by the behavioral health recipient as well as at least one other clinical team member. METHODOLOGY Population All Title XIX/XXI eligible behavioral health recipients determined to be SMI with an open episode of care with Magellan and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI eligible behavioral health recipients determined to be SMI with an open episode of care with Magellan, assigned to a Direct Care Clinic and have a current and accepted ISP in the Claim Trak Client Information System. Review Period Monthly Sample Selection: All SMI Title XIX/XXI eligible behavioral health recipients with an open episode of care in the RBHA and assigned to a Direct Care Clinic (100% of the population). The sample is accessed and reviewed on the 5 th day of the month following the completion of the reporting month. (e.g., October data is accessed on November 5th) by the Chief Quality Officer or designee. Each of the direct care clinics is represented in the sample proportionate to their assigned SMI recipients. Data Source DCC ClaimTrak. Claim Trak is Magellan's Client Information System and serves as an electronic medical record and reporting application. A report has been programmed within Claim Trak that depicts a point-in-time status of all accepted ISPs (both counts and as a percent of the total SMI recipient assignment at each of the direct care clinics). Data Collection: Data is queried from the DCC ClaimTrak system on the 5 th day of the month following the completion of the reporting month (e.g., October data is accessed on November 5th) by the Chief Quality Officer or designee. By utilizing the ISP Production Report within Claim Trak, each clinic's percent of accepted ISPs is derived and recorded on the DCC dashboard data collection spreadsheet. Scoring Guidelines: * Overall scoring for ISP Current will be completed as follows: * Each ISP is assessed to determine if the ISP is current # of ISPs determined to be current Total # of open episode Title XIX/XXI eligible clients assigned to a DCC QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation On a monthly basis, Magellan QI reconciles a representative sample by Adult PNO. By utilizing the monthly ISP Quality sample each month, Magellan is able to determine if ISPs indicated as "accepted" or current in the Claim Trak application meet expectations for a current ISP (complete within the past 12 months, signed by the behavioral health recipient and signed by at least one clinical team member). When discrepancies are identified, the information is shared by the designated clinical reviewer with the clinic leadership team as part of the ISP quality audit debriefing that occurs at each clinic each month. 3. ISP QUALITY DEFINITIONS 1. ISP: Individual Service Plan 3. Current: A current ISP is one that has been completed and/or updated within the past 12 months and has been accepted in the Claim Trak Client Information System. 2. Accepted ISP: An accepted ISP is an ISP that is completed via the Claim Trak Client Information System and designated as completed by the assigned case manager, clinical coordinator or clinical director. In order for the ISP to be deemed accepted, the ISP must be current and signed by the behavioral health recipient as well as at least one other clinical team member. METHODOLOGY Population All Title XIX/XXI eligible behavioral health recipients determined to be SMI with an open episode of care with Magellan and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI eligible behavioral health recipients determined to be SMI with an open episode of care with Magellan, assigned to a Direct Care Clinic and have a current and accepted ISP in the Claim Trak Client Information System. Review Period Monthly Sample Selection: Magellan IT generates a report of ISPs completed within the past 45 days in ClaimTrak on the 5 th day of the month following the completion of the reporting month (e.g., October data is accessed on November 5th). Utilizing the ISP completion report, Magellan QI Reporting generates a random sample with representation from all direct care clinics (14 records per direct care clinic per month). The final sample is compared it to the previous 3 reporting periods to ensure no duplication of names. In the event that replacement records are needed, Magellan QI Reporting will randomly query available records associated with the identified direct care clinic from the IT ISP completion report. Data Source DCC ClaimTrak. Claim Trak is Magellan's Client Information System and serves as an electronic medical record and reporting application. A report has been programmed within Claim Trak that generates a list of accepted ISPs across all direct care clinics specific to an identified date range (e.g., September 15, 2011 through October 31, 2011). The ISP completion report serves as the sampling frame for each direct care clinic (14 records are randomly selected). Data Collection: Data will be collected by the designated clinical reviewer from the sampled recipient medical record by reviewing the ISP, assessment documentation and progress notes using the ISP Quality/Outcomes Tool. Results are entered into a standardized data collection tool that generates clinic by clinic results over the past 6 months. The Chief Quality Officer or designee then records the final results on the DCC dashboard data collection spreadsheet. Scoring Guidelines: d. The treatment plan has specific objectives to address the identified needs of the individual * Selected materials are reviewed to determine if the recipient ISP complies with the following criteria: e. The treatment plan is based on the current assessment g. The types and intensity of services are based on the needs of the individual f. The treatment plan lists the specific services and frequency of services to be provided to achieve the objective Sample calculations are queried from the ISP current indicator and include: # of ISPs determined to be accepted over the past 45 days * Scoring will be completed as follows for each of the 4 criteria: # of ISPs meeting each criterion Total # of ISPs reviewed The results of each of the criteria are then averaged for each direct care clinic to determine a final value. (e.g., criterion d. 80%; criterion e. 100%, criterion f. 80%, criterion g. 100% = 360/4 – overall average score is 90%) * Scores are aggregated over the previous six months and reported monthly QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation: All clinical reviewers participate in an inter-rater reliability case that includes a sample progress notes, assessment and ISP. Scores are compared for consistency and training/technical assistance is provided as indicated. Clinical reviewers who consistently fail to meet accepted ranges of variability are subjected to additional training and oversight. 4. RECIPIENT SATISFACTION The purpose of the recipient satisfaction survey is to assess the level of satisfaction with experiences and quality of services at the direct care clinics. DEFINITIONS Rate of positive responses for the following survey questions during the reporting month: In the past week, I was able to get the services I thought I needed; I felt respected by staff; I was seen in a timely manner; and I believe I can grow, change and recover at this clinic. METHODOLOGY Population All open episode of care recipients assigned to a direct care clinic have access to a satisfaction survey tool when presenting at the clinic. Inclusion Criterion Any behavioral health recipient that completes and submits a satisfaction survey tool during the review period. Review Period Monthly Sample Selection: Direct care clinics must demonstrate evidence that, at a minimum, tools were completed for 2% of the total assigned number of recipients at the clinic during the review period. The measure is not calculated at any clinic that does not meet the 2% threshold. Data Source Each PNO Clinic is required to submit all completed satisfaction survey tools to Magellan QI by the 5 th day following the reporting month. Data Collection: Survey tools are made available at each direct care clinic. Recipients interested in completing the survey may complete one before or after their clinic appointment. Each clinic has provided secure and anonymous receptacles in the waiting area of the clinic. Scoring Guidelines: The average rate of positive responses for the following survey questions are calculated during the reporting month for each direct care clinic that meets the minimum 2% response rate: Consumer Questionnaire Please review the answer options below and indicate your answer by circling it. 1. In the past week I was able to get the services I thought I needed. o Strongly Disagree o Neutral o Disagree o Agree o Strongly Agree 2. I felt respected by Staff o Strongly Disagree o Neutral o Disagree o Agree o Strongly Agree 3. I was seen in a timely manner. o Strongly Disagree o Neutral o Disagree o Agree o Strongly Agree 4. I believe I can grow, change, and recover at this clinic. o Strongly Disagree o Neutral o Disagree o Agree o Strongly Agree A positive response is considered to be any response that includes a selection of "agree" or "strongly agree". QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Magellan QI collects all original satisfaction survey tools that are completed and utilized to calculate performance for each direct care clinic. Duplicate surveys, illegible surveys and surveys submitted without evidence of the assigned direct care clinic are not included in the calculation. 5. STAFFING – PHYSICIAN Percent of behavioral health medical practitioner positions filled, including MDs, NPs, and PAs DEFINITIONS Behavioral health medical practitioner means an individual licensed and authorized by law to use and prescribe medication and devices defined in A.R.S. § 32-1901, and who is one of the following with at least one year of full-time behavioral health work experience: b. A physician assistant, or a. A physician, c. A nurse practitioner. METHODOLOGY Population All behavioral health medical practitioner targeted positions. Inclusion Criterion All behavioral health medical practitioners who are actively employed by or contracted with a PNO. Review Period Monthly Sample Selection: 100% of employed behavioral health medical practitioners Data Source Month end PNO Staffing Reports and MDNS009M_A_DCC_Case_Load_Report_Detail from the Claim Trak SQL Server Reporting Services. Data Collection: MDNS009M_A_DCC_Case_Load_Report_Detail from the Claim Trak SQL Server Reporting Services and reviewed on the 5 th day for activity that occurred over the previous month. Data is collected from the Month end PNO Staffing Reports and Scoring Guidelines: Scoring will be completed as follows: # of actively employed behavioral health medical practitioner Total # behavioral health medical practitioner targeted positions QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Behavioral health medical practitioner staffing data is concurrently validated by comparing clinic self-reported data to BHMP affiliations available via the Claim Trak Client Information System. When discrepancies are identified, the information is sent to the designed clinic and PNO for correction before the final calculations are produced. 6. STAFFING – CASE MANAGER Percent of case manager positions filled. METHODOLOGY All case manager targeted positions. Population Inclusion Criterion All case managers who are actively employed by a PNO. Review Period Monthly Sample Selection: 100% of employed case managers. Data Source Month end PNO Staffing Reports and MDNS009M_A_DCC_Case_Load_Report_Detail from the Claim Trak SQL Server Reporting Services. Data Collection: MDNS009M_A_DCC_Case_Load_Report_Detail from the Claim Trak SQL Server Reporting Services and reviewed on the 5 th day for activity that occurred over the previous month. Data is collected from the Month end PNO Staffing Reports and Scoring Guidelines: Scoring will be completed as follows: # of actively employed case managers Total # case manager targeted positions QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Case manager staffing data is concurrently validated by comparing clinic self-reported data to case manager affiliations available via the Claim Trak Client Information System. When discrepancies are identified, the information is sent to the designed clinic and PNO for correction before the final calculations are produced. 7. CASE MANAGER CASE LOADS Percent of supportive case management caseloads less than or equal to established ratios for supportive teams. DEFINITIONS Supportive Case Management Treatment Supportive Treatment is delivered and coordinated by multi-disciplinary staff based in mental health centers in various locations throughout Maricopa County. Supportive services are generally available Monday through Friday, 8:00 a.m. to 5:00 p.m. It is a recovery-focused and outcome oriented model of community psychiatric treatment. Interventions are designed to foster learning and growing in a supportive community atmosphere, focusing on consumer strengths as the springboard for all service planning and delivery. After-hours crisis services are available by contacting RBHA Crisis Phone Clinicians, who coordinate, as needed, with on-call Supportive Treatment clinicians, as well as with other providers within the contracted Crisis Network. Average caseload size is 30. METHODOLOGY Population All supportive case managers who are actively employed by an Adult PNO and have an assigned supportive caseload. Inclusion Criterion All case managers who are actively employed by an Adult PNO and have an assigned supportive caseload that meets the following Case Management and Clinical Team Services Plan requirements: -Supportive: 1:30 Review Period Monthly Sample Selection: All supportive case managers who are actively employed by an Adult PNO and have an assigned caseload. Data Source The Staff-Consumer Ratio report is compiled each month via self-reported data by each direct care clinic site administrator or designee. A reporting template is provided to each clinic which identifies all supportive clinical teams, all case managers, clinical liaison, clinical coordinator and clinical director staff member's name, FTE status, reporting relationships and assigned caseloads. The reporting template must be submitted to Magellan QI by the 5 th day of each month. Data is reconciled by QI Reporting by comparing the clinic self-reported data to case manager caseload affiliations available via the Claim Trak Client Information System. Data Collection: Data is collected from Staff-Consumer Ratio Report and complied by QI Reporting into a table that depicts each direct care clinic, the number of supportive case loads assigned to each clinic and the percentage of case loads that are less than or equal to the required ratio. Scoring Guidelines: Scoring will be completed as follows: # of case managers with a supportive caseload less than or equal to 30 Total # case managers with a supportive caseload QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Caseload data is concurrently validated by comparing clinic self-reported data to case manager caseload affiliations available via the Claim Trak Client Information System. When discrepancies are identified, the information is sent to the designed clinic and PNO for correction before the final calculations are produced. 8. COT ADHERENCE Percent of Title XIX/XXI eligible COT recipients seen face-to-face by a case manager within the past 30 days. DEFINITIONS Contact Guidelines: The recipient is seen as frequently as indicated in the ISP, but never less than one face-to-face contact per month by the Case Manager. METHODOLOGY Population All Title XIX/XXI eligible recipients who are receiving court ordered treatment and are assigned to a direct care clinic. Inclusion Criterion All Title XIX/XXI eligible recipients who received a face-to-face contact by a case manager within the past 30 days. Review Period Monthly Sample Selection: 100% of Title XIX/XXI eligible recipients who are receiving court ordered treatment. Data Source COT Adherence Report from DCC Claim Trak Data Collection: Data is queried from DCC Claim Trak and identifies COT recipients' last case manager face-toface contact. Scoring Guidelines: Scoring will be completed as follows: # of COT Title XIX/XXI eligible recipients who had case manager face-to-face contact in past 30 days Total # Title XIX/XXI eligible COT recipients QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Every six months, a random sample of COT adherence cases that indicated a face-to-face contact with the case manager occurred in the past 30 days will be validated by Magellan QI by reviewing the electronic medical record via Claim Trak. Results and discrepancies will be shared with the Adult PNOs for follow-up as appropriate. 9. COMPETITIVE EMPLOYMENT Percent of Title XIX/XXI eligible open episode of care behavioral health recipients determined to be SMI who are employed DEFINITIONS 1. Employed: Demographic employment status field indicates recipient is employed full time without support; employed part time without support; employed full time with support; employed part time with support; competitively employed full time; or competitively employed part time METHODOLOGY Population All Title XIX/XXI eligible behavioral health recipients determined to be SMI with an open episode of care with a PNO and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI eligible behavioral health recipients determined to be SMI with an open episode of care with a PNO, assigned to a Direct Care Clinic and have been indicated via the data demographic data set to meet the definition of employed. Review Period Monthly Sample Selection: All Title XIX/XXI eligible SMI behavioral health recipients with an open episode of care in the RBHA and assigned to a direct care clinic who have a complete data demographic record entered in the Magellan data demographic data warehouse. Data Source Data Demographic Data Set – via electronic transmissions, direct care clinics submit data demographic forms to Magellan which are downloaded to the data demographic data warehouse. The data demographic forms include a field that indicates the affiliated recipient's employment status. Data Collection: Data is queried from enrollment demographics table on the data warehouse that identifies the recipients' employment status. The data is collected by Magellan IT on the 5 th day of the month following the reporting month. The data is complied into a table that depicts the name of each direct care clinic and the percent of recorded data demographic forms that meet the definition of employed against the total Title XIX/XXI eligible SMI behavioral health recipient count at each clinic. Scoring Guidelines: Scoring will be completed as follows: # of employed Title XIX/XXI eligible SMI recipients Total # Title XIX/XXI eligible SMI recipients QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Every six months, Magellan conducts data validation reviews for a random sample of behavioral health recipient records representative at the PNO level. The data validation reviews are conducted by Magellan QI clinical reviewers and assess the current data demographic information for selected fields (inclusive of the employment field) and compare with available medical record documentation for the same recipient. PNO level reports are generated and shared with PNOs and clinics. Any PNO that demonstrates more than a 5% discrepancy are required to implement actions to improve future performance. 10. MEANINGFUL ACTIVITIES Percent of Title XIX/XXI eligible behavioral health recipients who are involved in meaningful activities DEFINITIONS Meaningful Activities: Demographic employment status field indicates recipient is a student, a volunteer, a homemaker, in unpaid rehabilitation activities, in work adjustment training, or in transitional employment placement. METHODOLOGY Population All Title XIX/XXI eligible SMI recipients with an open episode of care with a PNO and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI eligible SMI recipients with an open episode of care with a PNO, assigned to a Direct Care Clinic and have been indicated via the data demographic data set to be engaged in a meaningful activity. Review Period Monthly Sample Selection: All Title XIX/XXI eligible SMI recipients with an open episode of care in the RBHA and assigned to a direct care clinic who have a complete data demographic record entered in the Magellan data demographic data warehouse. Data Source Data Demographic Data Set – via electronic transmissions, direct care clinics submit data demographic forms to Magellan which are downloaded to the data demographic data warehouse. The data demographic forms include a field that indicates the affiliated recipient's meaningful activity status. Data Collection: Data is queried from enrollment demographics table on the data warehouse that identifies the recipients' meaningful activity status. The data is collected by Magellan IT on the 5 th day of the month following the reporting month. The data is complied into a table that depicts the name of each direct care clinic and the percent of recorded data demographic forms that meet the definition of meaningful activity against the total Title XIX/XXI eligible SMI behavioral health recipient count at each clinic. Scoring Guidelines: Scoring will be completed as follows: # of Title XIX/XXI eligible SMI recipients involved in meaningful activities Total # Title XIX/XXI eligible SMI recipients QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Every six months, Magellan conducts data validation reviews for a random sample of behavioral health recipient records representative at the PNO level. The data validation reviews are conducted by Magellan QI clinical reviewers and assess the current data demographic information for selected fields (inclusive of meaningful activities) and compares with available medical record documentation for the same recipient. PNO level reports are generated and shared with PNOs and clinics. Any PNO that demonstrates more than a 5% discrepancy are required to implement actions to improve future performance. 11. COMPLAINTS PER 1000 ENROLLEES Number of complaints received per 1000 enrollees DEFINITIONS Complaint: A member's expression of dissatisfaction with any aspect of their care other than an action. Action: The denial or limited authorization of a requested service, including the type or level of service; * The denial, in whole or in part, of payment of service; * The reduction, suspension or termination of a previously authorized service; * The failure to provide services in a timely manner; * The denial of the Title XIX/XXI eligible person's request to obtain services outside the network. * The failure to act within established timeframes for resolving an appeal or complaint and providing notice to affected parties; and METHODOLOGY Population All behavioral health recipients with an open episode of care with a PNO and assigned to a direct care clinic. Inclusion Criterion All behavioral health recipients with an open episode of care with a PNO, assigned to a direct care clinic and are affiliated with a reported complaint to Magellan over the review period. Review Period Quarterly Sample Selection: 100% of behavioral health recipients with an open episode of care with a PNO and assigned to a direct care clinic. Data Source QI Complaint Tracking Database. Data Collection: Data is queried from the QI Complaint Tracking Database and stratified into counts of complaints by direct care clinic. Scoring Guidelines: Scoring will be completed as follows: (# of complaints / Total # open episode recipients) * 1000 QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation Complaint data is tracked, trended and reported each quarter. Fluctuations in data are reviewed and investigated to ensure consistency and accuracy of reporting. The Complaint Resolution Manager ensures that all reported complaints are entered into the QI Complaint Tracking Database. To ensure complaint categorization validity the QI Complaint Manager audits the top complaint categories for each population. This validity audit is conducted at the end of each quarter. The QI Complaint Manager reads all of the selected complaint files and makes the determination of whether the correct complaint category was applied by the QI Resolution Specialist. The results of the audit reviews are then presented to the QI Customer Service Committee. In addition, this information is shared among the content experts for each population for further review and to initiate an improvement plan. 12. ADVERSE INCIDENTS PER 1000 ENROLLEES Number of adverse incidents reported from each direct care clinic per 1000 enrollees DEFINITIONS 1. Adverse Incidents: Adverse Incidents include the following reported incidents: * Abuse or neglect reported to Adult Protective Services; * Deaths; * Adverse Reaction to Medication; * Member Rights Violation: Abuse; * Medication Error(s); * Member Rights Violation: Coercion; * Member Rights Violation: Exploitation; * Member Rights Violation: Discrimination; * Member Rights Violation: Manipulation; * Physical Abuse/Allegation; * Member Rights Violation: Neglect; * Physical Injury; * Self-Inflicted Injury; * Physical injury as result of restraint; * Sexual Abuse/Allegation; and * Suicide Attempt METHODOLOGY Population All behavioral health recipients with an open episode of care with a PNO and assigned to a direct care clinic. Inclusion Criterion All behavioral health recipients with an open episode of care with a PNO, assigned to a direct care clinic and are affiliated with a reported adverse incident to Magellan over the review period. Review Period Quarterly Sample Selection: 100% of behavioral health recipients with an open episode of care with a PNO and assigned to a direct care clinic. Data Source QI Risk Management Tracking Database Data Collection: Data is initially reported by direct care clinic to Magellan Risk Management utilizing the Incident, Accident and Death Reporting Form. Data is then entered, queried from the QI Risk Management Tracking Database and stratified into counts of adverse incidents by direct care clinic Scoring Guidelines: Scoring will be completed as follows: (# of adverse incidents / Total # open episode recipients) * 1000 QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability& Validation QI Risk Management ensures that all identified adverse incidents are reported by the assigned direct care clinic and that the reports are timely, accurate and complete. Data is tracked, trended and reported each quarter. Fluctuations in data are reviewed and investigated to ensure consistency and accuracy of reporting. Each quarter, a reconciliation of all reported incident, accident and death forms is compared to information entered into the Risk Management Tracking Database to ensure all reported adverse incidents are present. 13. PCP COORDINATION For all Title XIX/XXI eligible behavioral health recipients assigned to a direct care clinic, there is evidence that the person's diagnosis and current prescribed medications has been provided to the person's assigned PCP at least annually. DEFINITIONS Coordination of Care Standard 2/COC 2 (Communication): Behavioral health service providers communicate with and attempt to coordinate care with the behavioral health recipient's acute Health Plan/PCP. METHODOLOGY Population All Title XIX/XXI eligible behavioral health recipients with an open episode of care with a PNO and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI behavioral health recipients with an open episode of care with a PNO and assigned to a direct care clinic. Review Period Monthly Sample Selection: The same sample utilized for the ISP Quality measure is utilized for the PCP Coordination review. Magellan IT generates a report of ISPs completed within the past 45 days in ClaimTrak on the 5 th day of the month following the completion of the reporting month (e.g., October data is accessed on November 5th). Utilizing the ISP completion report, Magellan QI Reporting generates a random sample with representation from all direct care clinics (14 records per direct care clinic per month). The final sample is compared it to the previous 3 reporting periods to ensure no duplication of names. In the event that replacement records are needed, Magellan QI Reporting will randomly query available records associated with the identified direct care clinic from the IT ISP completion report. Data Source Behavioral health recipient medical record as assessed by the QI Clinical Reviewer Team. Data Collection: Data will be collected from the behavioral health recipient medical record using the ISP Quality Validation and Coordination of Care Review Tool. Scoring Guidelines: Scoring will be completed as follows: # of records determined to show appropriate PCP coordination over the most recent 6 months # of records reviewed over the most recent 6 months QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation All clinical reviewers participate in an inter-rater reliability case each quarter. Scores are compared for consistency and training/technical assistance is provided as indicated. Clinical reviewers who consistently fail to meet accepted ranges of variability are subjected to additional training and oversight. 14. FOLLOW-UP AFTER DISCHARGE WITHIN 7 DAYS Percent of Title XIX/XXI eligible behavioral health recipients receiving a follow-up service within 7 days of discharge from a Level I facility. DEFINITIONS Level I Facility: A program licensed per 9 A.A.C. 20 and includes a psychiatric acute hospital (including a psychiatric unit in a general hospital), a residential treatment center for persons under the age of 21, or a sub-acute facility. METHODOLOGY Population All Title XIX/XXI eligible behavioral health recipients with an open episode of care with a PNO and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI eligible behavioral health recipients with an open episode of care with a PNO, assigned to a Direct Care Clinic and discharged from a Level I facility and who received a follow-up service within 7 days of discharge during the reporting period. Review Period Quarterly Sample Selection: 100% of Title XIX/XXI eligible behavioral health recipients discharged from a Level I facility over the review period. Data Source Integrated Provider Data System Data Collection: Data is queried from the Integrated Provider Data System and identifies the recipients discharge date from level I facility and the date of the follow-up service. Scoring Guidelines: Scoring will be completed as follows: # Title XIX/XXI eligible recipients receiving a follow-up service within 7 days of discharge # of Title XIX/XXI eligible recipients discharge from level I facility Behavioral health recipients can be assigned to a direct care clinic before or during the Level I admission. QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation The Integrated Provider Data System includes information that is validated through the use of automated edit checks, qualitative reviews, control chart analyses, comparisons with similar or identical data sources and reviewed by functional leads serving as subject matter experts. 15. LEVEL I ADMISSIONS PER 1000 ENROLLEES Number of Title XIX/XXI eligible behavioral health recipients admissions to a Level I facility per 1000 enrollees DEFINITIONS Level I Facility: A program licensed per 9 A.A.C. 20 and includes a psychiatric acute hospital (including a psychiatric unit in a general hospital), a residential treatment center for persons under the age of 21, or a sub-acute facility. METHODOLOGY Population All Title XIX/XXI eligible behavioral health recipients with an open episode of care with a PNO and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI eligible behavioral health recipients with an open episode of care with a PNO, assigned to a Direct Care Clinic and discharged from a Level I facility during the reporting period. Review Period Quarterly Sample Selection: 100% of Title XIX/XXI eligible behavioral health recipients discharged from a Level I facility over the review period. Data Source Integrated Provider Data System Data Collection: Data is queried from the Integrated Provider Data System and stratified as count of Level I discharges within the report period Scoring Guidelines: Scoring will be completed as follows: (# level I discharges / Total # open episode Title XIX/XXI eligible recipients) * 1000 Behavioral health recipients can be assigned to a direct care clinic before or during the Level I admission. QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation The Integrated Provider Data System includes information that is validated through the use of automated edit checks, qualitative reviews, control chart analyses, comparisons with similar or identical data sources and reviewed by functional leads serving as subject matter experts. 16. READMISSIONS WITHIN 30 DAYS Percent of Title XIX/XXI eligible behavioral health recipients readmitted to a Level I facility within 30 days of discharge DEFINITIONS Level I Facility: A program licensed per 9 A.A.C. 20 and includes a psychiatric acute hospital (including a psychiatric unit in a general hospital), a residential treatment center for persons under the age of 21, or a sub-acute facility. METHODOLOGY Population All Title XIX/XXI eligible behavioral health recipients with an open episode of care with a PNO and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX/XXI eligible behavioral health recipients with an open episode of care with a PNO, assigned to a Direct Care Clinic, discharged from a Level I facility and re-admitted to the same level of care within 30 days during the reporting period. Review Period Quarterly Sample Selection: 100% of Title XIX/XXI eligible behavioral health recipients discharged from a Level I facility and re-admitted to the same level of care within 30 days over the review period. Data Source Integrated Provider Data System Data Collection: Data will be queried from the Integrated Provider Data System and identifies the recipient discharge date and succeeding admission dates. Scoring Guidelines: Scoring will be completed as follows: # Readmissions within 30 days of discharge Total # discharges QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation The Integrated Provider Data System includes information that is validated through the use of automated edit checks, qualitative reviews, control chart analyses, comparisons with similar or identical data sources and reviewed by functional leads serving as subject matter experts. 17. TITLE XIX RATIO Ratio of SMI open episode of care behavioral health recipients who are Title XIX eligible compared to the total open episode of care SMI population assigned to each direct care clinic. DEFINITIONS Title XIX: Refers to Title 19 of the Social Security Act, a program jointly funded by the states and the federal government that reimburses hospitals, physicians and other qualified providers for providing care to persons who meet the program's eligibility criteria METHODOLOGY Population All behavioral health recipients determined to be SMI with an open episode of care with a PNO and assigned to a Direct Care Clinic. Inclusion Criterion All Title XIX eligible behavioral health recipients determined to be SMI with an open episode of care with a PNO and assigned to a Direct Care Clinic. Review Period Monthly Sample Selection: 100% of behavioral health recipients determined to be SMI with an open episode of care with a PNO and assigned to a Direct Care Clinic. Data Source Maricopa RBHA Monthly Episode of Care Summary Data Collection: Data will be collected from the Maricopa RBHA Monthly Episode of Care Summary and identifies all behavioral health recipients determined to be SMI and their Title XIX eligibility status. Scoring Guidelines: Scoring will be completed as follows: # of SMI recipients who are Title XIX eligible Total # of SMI recipients QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation At least annually, Magellan QI conducts validation audits utilizing the Treatment Record Review Tool to verify if a sample of SMI recipients reported as Title XIX eligible are in fact Title XIX eligible. Data discrepancies are reported to the PNO and Magellan's Eligibility Department for research and reconciliation. 18. ENCOUNTERING Percentage of all encounters based on funding provided. DEFINITIONS Encounter: A record of a covered service rendered by a provider to a person with an open episode of care with a capitated PNO on the date of service. METHODOLOGY Population All adult PNO submitted encounters recorded and adjudicated during the reporting period. Inclusion Criterion All adult PNO submitted encounters recorded and adjudicated during the reporting period. Review Period Monthly Sample Selection: 100% of adult PNO covered service encounters recorded and adjudicated during the reporting period. Data Source ClaimTrak and CAPS data system. Data Collection: Data is collected from the ClaimTrak and CAPS data systems and stratified into the financial amount of encounters submitted by each direct care clinic. Scoring Guidelines: Scoring will be completed as follows: Financial amount of encounters submitted and adjudicated during the reporting period Allocated direct service funding QUALITY CONTROL CONFIDENTIALITY PLAN All data accessed for calculation of this performance measure is confidential and HIPAA compliant. All data is aggregated at the DCC and/or RBHA level, and is not presented at an individual client level. Inter-Rater Reliability & Validation All encounter and financial related reports are independently verified and validated. INTERPRETING AND UTILIZING THE DASHBOARD GAUGES AND FEATURES * The trend arrow in the upper left corner of the dashboard compares the current month's number of metrics met/exceeded with the previous two months' average. * The large dark blue gauge located in the upper left corner of the dashboard represents the overall performance of the agency or site selected. The percentage is weighted to show the number of metrics achieved (as evidenced by success in either the white or green zones). The number of successful metrics is divided into 90% of the total available (17 or 18 per clinic depending on whether Assertive Community Treatment is applicable). * The list of agencies located at the middle left side of the dashboard allows the user to select the RBHA, PNO, or DCC to be viewed. * The drop down menu located at the bottom left side of the dashboard allows the user to select a metric and a brief description of the metric will appear in the box below the menu. * The report periods (months) scrolling across the top of the dashboard allow the user to select a monthly report period to be viewed. * The green "Guide" button located at the upper right of the dashboard allows the user to access the "Guide to Using My Provider Outcomes Dashboard". * The red "Records" button located at the upper right of the dashboard allows the user to access the "Dashboard Records and Top Performers". * The specifications drop-down located at the upper right of the dashboard allows the user to select what type of specifications to be viewed in the top center of the metric gauges of the dashboard. The specification options include the following: o Show – the target for each metric is shown in the gauges o Don't show – no specifications are shown in the gauges o Sample Size – the sample size for each metric is shown in the gauges o Frequency – the frequency of data collection for each metric is shown in the gauges o Weight – the weight or sample size selection method for each metric is shown in the gauges o Data Source – the data source for each metric is shown in the gauges * The 18 metric gauges located throughout the dashboard are arranged into 4 groups: I) Clinical, II) Recovery, III) Coordination and IV) Accountability and Administrative. o A gauge needle appearing in the red or yellow areas indicate the metric did not meet the goal or target. o The target for each metric is located at the top of the gauge where the white and yellow colors meet (due north). o A gauge needle appearing in the white or green areas indicates the metric met or exceeded the goal or target. o Gauge color ranges for each metric are described below: o A checkbox appearing at the bottom right of the gauge indicates the metric met or exceeded the goal or target. [x] ACT Fidelity * Green Zone – 86.95% and above * Target – 74.9% [x] * White Zone – 74.9% to 86.95% * Red Zone – below 62.85% * Yellow Zone – 62.85% to 74.9% ISP Current * Green Zone – 94.45% and above * Target – 89.9% * White Zone – 89.9% to 94.45% * Red Zone – below 85.335% * Yellow Zone – 85.335% to 89.9% [x] ISP Quality 12 * Green Zone – 67.5% and above * Target – 60% * White Zone – 60% to 67.5% * Red Zone – below 52.5% * Yellow Zone – 52.5% to 60% [x] Customer Satisfaction * Green Zone – 92% and above * Target – 85% * White Zone – 85% to 92% * Red Zone – below 78% * Yellow Zone – 78% to 85% [x] Employment * Green Zone – 32.5% and above * Target – 25% * White Zone – 25% to 32.5% * Red Zone – below 17.5% * Yellow Zone – 17.5% to 25% [x] Community * Green Zone – 32.5% and above * Target – 25% * White Zone – 25% to 32.5% * Red Zone – below 17.5% * Yellow Zone – 17.5% to 25% [x] Complaints/1000 * Green Zone – 1 or fewer * Target – 2 * White Zone – 2 to 1 * Red Zone – more than 3 * Yellow Zone – 3 to 2 [x] Adverse/1000 * Green Zone – 0.05 or fewer * Target - 0.1 * White Zone – 0.1 to 0.05 * Red Zone – more than 0.15 * Yellow Zone – 0.15 to 0.1 [x] Primary Care (COC2) * Target – 95% * White Zone – 95% to 97% * Green Zone – 97% and above * Yellow Zone – 93% to 95% [x] Physician Follow-Up * Red Zone – below 93% * Target – 95% * White Zone – 95% to 97% * Green Zone – 97% and above * Yellow Zone – 93% to 95% [x] Admissions/1000 * Red Zone – below 93% * Target – 37.5 * White Zone – 25 to 12.5 * Green Zone – 12.5 or fewer * Yellow Zone – 37.5 to 25 [x] No 30d Readmit * Red Zone – more than 37.5 * Target – 90% * White Zone – 90% to 94.5% * Green Zone – 94.5% and above * Yellow Zone – 85.5% to 90% [x] Title XIX * Red Zone – below 85.5% * Target – 63% * White Zone – 63% to 66.5% * Green Zone – 66.5% and above * Yellow Zone – 59.5% to 63% [x] COT Adherence * Red Zone – below 59.5% * Target – 95% * White Zone – 95% to 97% [x] * Green Zone – 97% and above * Yellow Zone – 93% to 95% Case Load Ratios * Red Zone – below 93% * Target – 60% * White Zone – 60% to 79.5% * Green Zone – 79.5% and above * Yellow Zone – 40.5% to 60% [x] Staffing Physicians * Red Zone – below 40.5% * Target – 95% * White Zone – 95% to 97% * Green Zone – 97% and above * Yellow Zone – 93% to 95% * Red Zone – below 93% * Target – 95% [x] Staffing Case Mgrs * Green Zone – 97% and above * Yellow Zone – 93% to 95% * White Zone – 95% to 97% * Red Zone – below 93% * Target – 85% [x] Encounters * Green Zone – 92% and above * Yellow Zone – 78% to 85% * White Zone – 85% to 92% * Red Zone – below 78% * Dashboard Glitch – Some users have noted and reported a bug in the Business Objects Xcelsius software used to create this cutting-edge interactive dashboard. By clicking the mouse directly on an individual gauge, the information resets. This is because the tool is drawing from the latest user queries, which are initiated by selecting a month from the scrolling ticker at the top and an agency/site from the list at left. 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The Perfect Storm of Education Reform: High-Stakes Testing and Teacher Evaluation Author(s): Sheryl J. Croft, Mari Ann Roberts and Vera L. Stenhouse Source: Social Justice, 2015, Vol. 42, No. 1 (139) (2015), pp. 70-92 Published by: Social Justice/Global Options Stable URL: https://www.jstor.org/stable/24871313 JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact firstname.lastname@example.org. Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at https://about.jstor.org/terms Social Justice/Global Options is collaborating with JSTOR to digitize, preserve and extend access to Social Justice The Perfect Storm of Education Reform: High-Stakes Testing and Teacher Evaluation Sheryl J. Croft, Mari Ann Roberts & Vera L. Stenhouse* No Child Left Behind (NCLB), Race To The Top (RT3), and now Common Core embody over a decade of federal and state education reform purportedly designed to address inequities for global majority$^1$ and low-income students. However, these policies have in fact expanded inequities and exacerbated a discourse of failure regarding teachers, public schools, and teacher preparation programs. Consequently, public confidence in teachers, teacher preparation programs, and student performance is at an all-time low. We contend that current reform initiatives (i.e., high-stakes testing and teacher evaluation from K-12 through higher education) are not, in fact, discrete singular efforts. Instead, they represent a confluence of systematic and orchestrated education reform efforts that are akin to storm fronts. These fronts comprise a perfect storm that is eroding the bedrock of public education in the United States through neoliberal policies. Neoliberal principles prescribe that market forces should determine the success or failure of any entity or organization; they support a reduction in public services; and they promote choice, competition, and accountability. Using the state of Georgia as a case study, we present three interconnected fronts: political climate change, the testing industrial complex, and the resulting mesoscale evaluation system. We propose these fronts as a means to illuminate the gulf between the stated policy intentions of corporate reformers and the actual educational outcomes for public education and teacher education. Following our analysis of the interconnected fronts, we challenge the assertion that the alignment of the reforms will lead to the claimed outcome—that is, an increase of academic achievement/success and global competitiveness for students, teachers, and the United States as a whole. Instead, we assert that the orchestrated * Sheryl J. Croft (email: email@example.com) is a former Emory University postdoctoral fellow and incoming Assistant Professor of Educational Leadership at Kennesaw State University, with an emphasis on educational leadership and state policy. She also serves as the Director of Teaching in the Urban South (TTUS), Georgia. Mari Ann Roberts (email: firstname.lastname@example.org) is an Associate Professor of Multicultural Education at Clayton State University, where she serves as Director of the Master of Arts in Teaching program. Vera L. Stenhouse (email: email@example.com) is an independent researcher, currently Internal Evaluator and Research Coordinator at Georgia State University. Areas of focus include multicultural education, teacher education, and teacher preparation. alignment is actually being experienced as an assault on the intended beneficiaries. We conclude with responses by students, teachers, and professors to the elements of the perfect storm of education reform and our recommendations for K-12 and higher education practitioners to not just stem but turn the tides. Political Climate Change: Setting the Historical Context A perfect storm develops within the context of climate change. We posit that political climate change emerges as a series of orchestrated political and legislative efforts intended to drive policy and practice on the national, state, or local levels. The ongoing struggles between those who support equity in education and those who would lay the groundwork to destroy it have led to the juxtaposition of two political climates in Georgia, epitomized by the terms of Governors Barnes and Perdue, respectively. Georgia’s political climate has been gradually changing for over a decade from one of confidence and investment in public education to one of skepticism and funding deprivation. The implications of the political climate change illustrated within Georgia are being experienced nationwide (e.g., in California, Hawaii, Louisiana, New York, North Carolina, Tennessee, and Washington). During the terms of Governor Roy Barnes, from 1998 to 2002, and Governor Sonny Perdue, from 2003 to 2010, legislation in Georgia has exemplified two distinct types of educational reform: one inspired by equity and the other by inequity.$^2$ Barnes’s A+ Reform package, influenced by the gubernatorial P-16 summit, pursued equity (Croft 2013, 83; Rochford 2007, 18), whereas the legislation passed by his successor, Perdue, seemed mostly influenced by private interests and corporations (Croft 2013). 2000–2002: Ensuring Equity for All Students Through the introduction of his A+ Education Reform Act, during the second half of his tenure (2000–2002) Governor Barnes initiated a system of educational policies designed to insure accountability and to provide resources that supported systemic equity in public schools. Prior to and unlike the mandated and underfunded NCLB, Barnes’s measures coupled accountability with equity by legislating financial as well as structural supports to enhance student learning. For example, after decreasing class size, Barnes appropriated increased capital outlay to support the anticipated need for additional classrooms. Structurally, his policies provided early intervention programs for all K-3 to K-12, extended the school day for middle school students to enhance instruction, and encouraged and financed dropout prevention initiatives for high school students. In terms of our climate change metaphor, Barnes’s tenure represented relatively calm seas for enhancing student achievement. 2003–2010: Laying the Foundation for Educational Inequity Conversely, the two-term tenure of Sonny Perdue from 2003 to 2010 stunted the momentum achieved by his predecessor. His term represented a change from Barnes’s political climate to an orchestration of inequalities, particularly for students of the global majority (i.e., African American and low-income students). Augmented by NCLB and corporations, Perdue’s tenure produced the initial conditions that lead directly to a perfect education storm of financial deprivation and inequitable educational access. Examples of legislation detrimental to public education during Perdue’s tenure are the establishment of charter schools, the allowance for charter school flexibility (HB1190,/Act 449, 2004), and provision for tax credits and exemptions for private schools (HB1133/Act 773, 2008; HB1219/Act 618). Most detrimental and central to his educational plan were austerity cuts that from 2003 to 2010 stripped 4.5 billion dollars from public education (Croft 2013, 60; Henry and Pope 2010, A16). Whereas traditional public schools serving predominantly African American and low-income students were exposed to a political onslaught of financial deprivations that led to reductions in staff, resources, professional development funds, and furloughed days, charter and private schools and the students they served were sheltered by legislative maneuvers and financial appropriations (Croft 2013). These legislated actions, coupled with the perceived school failure exposed by NCLB’s accountability system, fostered the perception that public education was foundering and that the only remedy lay in promoting accountability through high-stakes testing and teacher evaluation. High Pressure Front: The Testing Industrial Complex The testing industrial complex (TIC), an attempted system of education reform catalyzed by standardized testing that emerged with NCLB, is a high-pressure front that creates ideal storm/reform conditions for education at the state and national levels. Over 10 years of NCLB policies yielded insignificant gains (if any) in student achievement, and the federal government began to realize the mathematical impossibility of expecting all children to reach a standardized proficiency level. Yet, despite the colossal failure of the policy, in 2009 the Obama administration attempted to salvage it with the creation of RT3, a program that created opportunities for states to apply for NCLB waivers. The granting of a waiver was attached to a state’s willingness to implement neoliberal policies such as establishment of charter schools and increased teacher accountability through standardized testing. Hence, RT3’s funding, waivers, and neoliberal policies have been integral to the advancement and institutionalization of the TIC. Here we define the TIC and describe the warm and cold fronts that bring it to bear. The Testing Industrial Complex The testing industrial complex directly relates to (and emulates) foundational elements of the prison industrial complex, such as: (a) the use of surveillance and unwarranted policing to feed punitive reform measures used to solve what are in reality economic, social, and political problems; (b) a confluence of bureaucratic, political, economic, and racialized interests with the underlying purpose of diverting profit from public entities to private corporations; (c) increases in high-stakes outcomes and curricular coopting, even though neither has shown to improve outcomes; and (d) a perception that the complex is practically impossible to dismantle (see Roberts in press). Here, we will focus on three major interconnected factors that make up the TIC: - Excessive high-stakes testing; - False political narratives about improving education; and - Transfer of curricular and financial governance from individual to local, local to state, and state to national/private entities. Excessive high-stakes testing. Never before in the history of the United States have we based so many key education policy decisions on test score outcomes. Across the United States, high-stakes testing policies have caused a trickle-down effect in which politicians put pressure to increase standardized test scores on school boards and superintendents, superintendents put pressure on principals, principals on teachers, and teachers on students—all to little or no avail. Meanwhile, the psychological and academic stakes for failing these tests have become far too high. The examples are rampant: children’s loss of sleep and illnesses during test season, students’ academic disengagement, school closures in marginalized communities, and teacher/principal job losses are just a few of the outcomes of the current testing system (Ahlquist, Gorski, and Montaño 2011; Au and Tempel 2012; Farley 2009; Kohn 2000a, 2000b; Lipman 2004; Swope and Miner 2000). Ironically, although over 12 years of evidence tell us that focusing exclusively on measurement, accountability, and standardized testing has produced outcomes contrary to those stated, we forge ever onward in the effort (Ravitch 2010; Sacks 2001). For example, the state of Georgia announced its intention to pull out of Common Core–regulated standardized testing; yet it has done so not because of the testing’s shortcomings, but only to save money. In the same announcement, the Georgia Department of Education stated its intent to continue the testing onslaught by creating its “own standardized assessments aligned to GA’s current academic standards” (GADOE 2013). The test, Georgia Milestones, is being administered to Georgia’s 1,702,750 students in 2014–2015. False political narratives about improving education. Educational institutions—e.g., the US Department of Education (DOE), the Georgia Department of Education, the Georgia Professional Standards Commission, legislative bodies such as the American Legislative Exchange Council, and corporate entities such as the Bill & Melinda Gates Foundation, the Broad Foundation, and the National Council for Teacher Quality—insist that raising educational standards, improving school systems, and closing the education gap for students of the global majority are their only concerns. However, the actual existence of such needs, the diagnosis of the reasons behinds these needs, and the ways these so-called needs should be addressed are all based on a neoliberal ideology promulgated through the TIC (Giroux 2012; Roberts in press). The aforementioned entities use print, digital, and social media to discredit teachers, teacher preparation programs, and schools in order to make the general populace believe that “something must be done about education.” Even if we choose to believe that US public education is inadequate, there are areas in the country and the world that have had great success in their educational endeavors, usually by providing increased social services for students and their caretakers or rich professional development opportunities for teachers (Berliner, Glass, and Associates 2014; Ravitch 2010; Ripley 2013; Sahlberg 2011). Notwithstanding this evidence, participants in the TIC rely on false narratives of failure that provide the rationale for excessive high-stakes testing and neoliberal reforms (Berliner, Glass and Associates 2014; Fair Test 2014; Paalberg 2012) US Secretary of Education Arne Duncan often espouses a politically correct narrative in which he lauds teachers and teaching; yet, his true understanding of the source of the problem with public schooling is revealed by his support of policies that evaluate teachers through high-stakes testing of students, and in quotations such as the following. During an interview with Rolland Martin for the show Washington Watch, Duncan stated: I spent a lot of time in New Orleans, and this is a tough thing to say, but let me be really honest. I think the best thing that happened to the education system in New Orleans was Hurricane Katrina. That education system was a disaster, and it took Hurricane Katrina to wake up the community to say that “we have to do better.” (Ravitch 2014a) Duncan (2011) also showed his disdain for public educators and espoused a false narrative of failure when he described the transformation of Englewood High School in Chicago during the Teach for America 20th Anniversary Summit: Same children, same community, same poverty, same violence. Actually went to school in the same building with different adults, different expectations, different sense of what’s possible. Guess what? That made all the difference in the world. Although there are multiple problems with Duncan’s statements, a large one is that they clearly overlook the causes of the poverty and violence he mentions and imply that those ills can be fixed by changing a school and its faculty. Further, the transformation of the school to which Duncan refers did not really include the same children, because the new charter school forced a number of them out (Rubenstein 2011). Duncan’s verbal jabs and use of false political narratives throughout his tenure demonstrate a belief that educators and public schools are inadequate at least, and usually disastrous. In Georgia, the false narrative of failure recurs in the words of government officials who ignore structural inequities, such as the huge influence of systemic poverty, and instead blame teachers for student underachievement and then create legislation to “get rid of those bad teachers” (Arnold n.d.). Its most evident manifestation is often found in the front-page headlines of The Atlanta Journal-Constitution, a premier Georgia newspaper. Headlines have included: “Georgia scores low grade for content preparation of elementary teachers,” “Is anyone surprised at a critical review of how we train teachers? Are teachers?”, “Teachers to be graded on student test scores: Controversial new ratings,” “No four-star teacher prep programs in Georgia,” “Learning curve: Teachers too often MIA,” and “Middling marks for teacher training in Georgia. Why can’t we improve it?” (AJC.com). Transfer of governance. Standardized testing demands a standardized curriculum to ensure the attainment of testing goals. The financial “encouragement” by the DOE toward reforms like the Common Core and value-added models (VAMs) of teacher evaluation through RT3 has resulted in a direct transfer of curricular and financial decision-making power from individual to local, local to state, and state to national/private entities. Although it denies it, through RT3 federal reforms and acquiescence from partner states such as Georgia the DOE has created a national curriculum (Strauss 2013). High-pressure front. High-pressure fronts frequently manifest as a warm front (precipitation and fog) followed by a cold front (narrow) bands of thunderstorms and severe weather. The TIC warm front rains down neoliberal education polices under the guise of improving education while obscuring the free-market ideology of corporatization, standardization, and privatization as well as the reforms’ real intent—financial gain. For example, corporate CEOs have created educational foundations and brought forward unqualified educational spokespeople supported by corporate money. Espousing the intent to improve education for students of the global majority, these foundations promulgate a large amount of TIC-informed education policies and spew a fog of money that makes it hard for the average individual to see the true value of public education or the record amounts of financial profit generated by such policies (Karp and Sokolower 2014; Ravitch 2010). After the warm front, a TIC cold front follows. This front manifests as the severe weather forcing local school systems to lay off teachers, close neighborhood schools, eliminate art and music programs, and dedicate more and more revenue to supporting standardized testing. Meanwhile, black, brown, and poor people are most grievously injured because the high-pressure front of the TIC weighs disproportionately on their backs and their communities (Fair Test 2010). The Mesoscale Evaluation System Riding on the crest of the TIC high-pressure front are national and local demands for accountability that provide justification for high-stakes evaluation tools and for what we call a mesoscale evaluation system. In nature, a mesoscale storm is comprised of individual storms that combine to form a larger persistent/perfect storm. Similarly, a mesoscale evaluation system is a combination of individual evaluation efforts spanning kindergarten through higher education that are meant to serve as mechanisms of accountability for educators and educator preparation. Just as a single drop of rain or gust of wind may not be inherently destructive, some tools of accountability proffered by education, legislative, or corporate entities may indeed be plausible and useful. In fact, such reform efforts claim to establish comprehensive standards aimed at professionalizing education and incentivizing the formation of career- and college-ready graduates who can better compete in a global market. Achieving such goals requires an interconnected system of high-stakes testing as the basis for determining the effectiveness and preparedness of teachers and teacher preparation programs. Here we argue that prior to the introduction of RT3, education, legislative, or corporate entities might have individually attempted to reform education on local, state, or national levels. Currently, however, these entities, galvanized by the discourses on the failure of public education described earlier, have aligned in an unprecedented manner to aggressively advance a new era of reform. The apparently distinct but actually interrelated reform measures, when combined, comprise an overarching mesoscale evaluation system that brings destruction to teacher preparation programs and K-12 public education. In addition, the reforms mostly affect students and teachers already marginalized on the basis of race, ethnicity, language, economic status, and ability. Continuing to use Georgia as a paradigmatic case, we discuss the tools that comprise the mesoscale evaluation system at the national, state, and local levels. Table 1 highlights the various components of the mesoscale system and illustrates how they manifest in K-12 education and higher education, specifically teacher education. National Neoliberal ideas have recently reemerged in education in an effort to remedy the perceived loss in US global economic competitiveness and education prominence. RT3 has served as a catalyst to promulgate market-driven ideals of standardization, corporatization, and privatization designed to comprehensively alter the delivery of public education. Constitutionally, the US government cannot mandate state adoption of education reform initiatives. However, federal dollars are often a powerful decision-making factor in states’ educational policy, and their allocation may be contingent on the state’s implementation of education reform. As Georgia’s Governor Nathan Deal noted in an April 1, 2011 press release after the state won its RT3 bid, “In any year, this grant [RT3] provides a great opportunity to pursue new ideas for improving education, but in tough budget times such as these, this grant is truly extraordinary.” Table 1: The Mesoscale Evaluation System \| Components of the Mesoscale System \| In K-12 Education \| In Higher Education \| \|-----------------------------------\|------------------\|--------------------\| \| Discourse of failure (used to justify need for increasing effectiveness and preparedness) \| Effectiveness \| Preparedness \| \| Evaluation methods (used to determine educator and preparation program effectiveness based on quantitative and qualitative measures) \| Teacher/Leader Keys Evaluation System (TLKES); Student Learning Objectives (SLOs) \| Teacher Preparation Program Effectiveness Measure (TPPEM) \| \| Assessment tools (used to assess in-service teacher effectiveness and pre-service teacher preparedness) \| Teacher Assessment of Performance (TAPS) \| ed Teacher Performance Assessment (edTPA) \| \| Standards (designed to encourage rigor, coherence, and consistency in curriculum and in educator preparation). \| Common Core State Standards (CCSS) \| The Interstate Teacher Assessment and Support Consortium (InTASC); Council for the Accreditation of Educator Preparation (CAEP) \| \| Consortia/corporations (hired via competitive bids to develop and disseminate evaluation tools as well as compile and analyze evaluation data) \| Partnership for Assessment of Readiness for College and Careers (PARCC); SMARTER Balanced Assessment Consortium (SBAC) \| Pearson Education \| \| Catalyst (used to connect the components of evaluation via federal and state funding) \| Race to the Top (RT3) \| Race to the Top (RT3) \| At the same time that the federal government started implementing RT3, higher education accreditation bodies were in the process of changing their national teacher preparation standards. Specifically, the Council for the Accreditation for Educator Preparation (CAEP)—the merger of two former accrediting agencies, the National Council for the Accreditation of Teacher Education (NCATE) and the Teacher Education Accreditation Council (TEAC)—produced the 2013 CAEP Accreditation Standards, designed to use accreditation to “leverage change in teacher preparation and [help] ensure that our students are prepared to compete in today’s global economy.”\textsuperscript{74} Even though RT3 and changes in higher education accreditation bodies occurred independently, they conveniently aligned with the aforementioned push for standardization, corporatization, and privatization. Jointly, NCATE and TEAC accredit programs in over 800 public and private institutions, which suggests that CAEP will have a comparable reach. The CAEP standards promote criteria to assess teacher education programs aimed at increasing teacher quality, student academic success, and recruitment of teachers of color. The tool to achieve such aims is a standardization of the teaching and teacher preparation process according to RT3 expectations, as evidenced by CAEP’s stated goal of determining “P-12 student learning and development using multiple measures, e.g., value-added measures, student-growth percentiles, and student learning and development objectives required by the state.” The use of accreditation criteria and other measures of accountability and the standardization of education are likely to undermine the articulated aims of reform. The proposed logic assumes that raising and standardizing quantitative criteria equates to creating a better teacher; yet this does not mitigate the problem of current reform trends that narrow curricula or endemic issues such as inadequate teacher salaries, limited attention to social inequalities, and deprofessionalization, discouraging prospects for curricular innovation that might meet the needs of students and educators (Crocco and Costigan 2007; Dilworth and Coleman 2014; Milner 2013). \textit{State} In exchange for a waiver from unmet NCLB requirements, states committed to altering the delivery of public education by implementing Common Core State Standards, and they revised teacher evaluation systems for K-12 teachers, statewide assessment systems for determining student career and college readiness [i.e., Partnership for Assessment of Readiness for College and Careers (PARCC), SMARTER Balanced Assessment Consortium (SBAC)], and comprehensive evaluation systems for teachers and leaders. All these tools were anchored to achievement measures, value-added models, and students’ standardized test scores. However, researchers, education scholars, and practitioners have questioned the proposed measures’ validity, plausibility, and ability to yield the stated goals of accountability (Baker, Barton, Darling-Hammond, et al. 2010; Cody 2012; Milner 2013). In Georgia, RT3 has manifested itself as a deluge of evaluations: teacher effectiveness evaluation (TKES), teacher preparedness evaluation (edTPA), and teacher preparation program evaluation (TPPEM). State-level K-12 teacher evaluation. The Teacher Keys Effectiveness System (TKES) categorizes K-12 teachers on four levels: ineffective, developing/needng improvement, proficient, or exemplary. A similar system, Leader Keys, is used for school leaders. Fifty percent of TKES is based on student growth and academic achievement, measured via growth percentiles/value-added models using students’ standardized test scores. Despite enduring concerns about this use of tests, the results of student growth percentiles determine a significant portion of a teacher’s effectiveness. The remaining portion includes results from administrators’ observations [Teacher Assessment on Performance (TAPS)], instructional artifacts, and student surveys on teachers’ instruction (grades 3–12). As a means of establishing performance-based salary increases (such as those found in corporate models), Georgia is also in the process of confirming a tiered certification system$^4$ that includes benchmarks such as passing scores on TKES and LKES. Tiered certification is presented as a way to provide educators and leaders with opportunities to grow in the profession; salary increases will no longer be based on higher education degrees but strictly on the results of the evaluation instruments. Not only have performance-based salary increases (i.e., merit pay) not been effective (Ravitch 2010), they also potentially minimize the significance of earning advanced degrees for education professionals. Instead of receiving quality salaries for their already high-stakes work, educators must rely on the acquisition of high student test scores as a narrow means for career advancement. State-level higher education teacher evaluation. In addition to the evaluation of in-service teachers, a growing concern is high-stakes evaluation of pre-service teachers. To address concerns of teacher preparedness to enter the profession, pre-service teachers in teacher education preparation programs will produce a Teacher Performance Assessment (TPA) portfolio, such as the edTPA adopted in Georgia and 34 other states. In this evaluation, pre-service teachers submit a teaching video and written reflections on their lesson design and implementation. As a part of Georgia’s tiered certification, pre-service teachers will be required to have a passing score for initial licensure. edTPA portfolio scores, rather than the evaluation by the program’s faculty that is currently used, will determine whether pre-service teachers are eligible for certification and entry into the field. The Stanford Center for Assessment, Learning, and Equity (SCALE) is the lead developer for edTPA. Evaluation Systems, a unit of the Pearson Corporation, will administer the edTPA. Pre-service teachers are projected to pay $300 each for Pearson-trained scorers within the education profession; scorers are paid $75 per portfolio.$^6$ State-level teacher preparation program evaluation. Just as teacher evaluations (e.g., TKES) and teacher performance assessments (e.g., edTPA) allegedly measure the effectiveness of individual educators and leaders, the Teacher Preparation Performance Effectiveness Measure (TPPEM) in Georgia intends to evaluate the effectiveness of teacher education programs (also a condition of securing RT3 funding). Fifty percent of a program’s effectiveness will be determined based on how well its graduates score on TKES. TPPEM, like TKES, is a high-stakes evaluation tool guided by value-added models. As noted above, numerous researchers and test makers report an overreliance on standardized tests and value-added models and warn against using tests in this manner (e.g., Baker, Barton, Darling-Hammond, et al. 2010; Berliner 2013; Cody 2012; Darling-Hammond 2012; Papay 2011; Smagorinsky 2014). Additional state-level testing changes. Complicating matters, on June 4, 2014, Georgia announced that new tests were to replace the Criterion-Reference Competency Test (CRCT) for 4th–8th grade students and the End-of-Course Tests (EOCT) used to determine eligibility for graduation. The new system of tests, Georgia Milestones, has been recently developed and administered by CTB/McGraw Hill. The company has a five-year contract at $107.8 million beginning Fall 2014. The test will be aligned with Common Core Georgia State Standards (CCGSS). Revamping testing systems is not new for Georgia; however, the timing, in the midst of cumulating changes in current high-stakes reforms, seems ill timed, in part based on the Georgia’s State Superintendent’s acknowledgment that any new rollout brings the possibility of lower scores: The increased expectations for student learning reflected in Georgia Milestones may mean initially lower scores than the previous years’ CRCT or EOCT scores. That is to be expected and should bring Georgia’s tests in line with other indicators of how our students are performing.$^7$ This announcement introduces yet another variable in the education reform storm. Wide-scale distribution of these tests raises additional concerns about an evaluation system that estimates employability and effectiveness based on the results of tests that will necessarily need adjustments. Over reported concerns regarding cost, Georgia withdrew from the use of Partnership for Assessment of Readiness for College and Careers (PARCC), subsequently altering RT3 implementation (GADOE 2013). Therefore, as Georgia continues to navigate the costs, drawbacks, and benefits of RT3, local school districts must negotiate the processes and expectations created by the reform. Local At the local level, the districts’ implementation of education reform has raised many questions and garnered limited answers. In Georgia, legislative, corporate, and education institutions answer those questions by reiterating the failures of the educators and the woeful academic performances of the students, as well as their confidence in the eventual success of reform initiatives. As a proof, they cite research (often limited) conducted by the very entities that are advancing or benefitting from the reform initiatives (e.g., the Bill & Melinda Gates Foundation). Nevertheless, a rising tide of concern persists within the education community about the influence of these pervasive changes on local districts. In particular, we discuss here the implications of teacher evaluation system (TKES), Student Learning Objectives (SLOs), and Common Core State Standards (CCSS). Local K-12 Teacher Evaluation (TKES). In Georgia, the implementation of TKES occurred after a truncated piloting period (five months) with 26 districts followed by summer of data analysis, after which, that same fall, the entire state became subject to mandated evaluation systems and Common Core curriculum expectations. Given the high-stakes evaluative nature of TKES, educators across the state have raised questions about the process, protocols, and key decision makers involved. For example, at a recent education reform conference, Georgia teachers raised questions such as: - How will the student growth models affect the scores when the content areas compared are so different (e.g., US History in 9th grade vs. 10th-grade Economics)? - Can teachers fight the results of students who may have received bad scores on a standardized test but have been performing well otherwise? - How can teachers engage administrators in a discussion about their problems with the TKES evaluation system? Reflecting not just a local but also a national concern, teachers across the country are asking the same types of questions about their own state-imposed value-added model evaluations. The answers they commonly receive are “We don’t know yet,” or statements of unquestioned confidence in the unproven reform mandates. Local Student Learning Objectives (SLOs). For tested courses (as determined by the state), student growth is measured in percentiles based on state-level assessments (in Georgia, 4th–8th grade CRCT, based on Fall 2014 Georgia Milestones, and for high school EOCT). For non-tested subjects, local districts are held to developing Student Learning Objectives (SLOs) per each non-tested course, which are to be approved by the state’s Department of Education. Teachers administer pre- and post-assessments, the results of which are submitted to a district evaluator who will determine an end-of-year rating—exemplary, proficient, needs development, or ineffective—based on whether the SLO was met. Local Common Core State Standards (CCSS). The role of CCSS (and the Common Core Georgia Performance Standards) continues to be a point of contention at the state and local levels in Georgia (Bluestein and Washington 2013; Gillooly 2014; Neely 2014; Smagorinsky 2013). Local concerns regarding the perceived imposition of state standards by the federal government have resulted in ongoing political debate. According to the Georgia Department of Education, “assessment is not supposed to drive curriculum” (at http://www.gadoe.org/); however, in order to standardize the assessment process, state standards have formed the basis for the tests, benchmarking educational attainment goals and determining subject-matter emphases. For instance, CCSS’ main thrust, to advance literacy across the curriculum, has invited concerns that emphasizing literacy and mathematics (the two areas that have received the most attention) will significantly marginalize other significant subjects such as science, social studies, the arts, and physical education. The Drawbacks of Converging Reform Efforts An issue worth of attention is the consequence of concurrently introducing multiple education reforms such as those discussed. Although designed to be complementary, the plethora of elements from RT3, state-level initiatives, and local implementations might obfuscate which variables are leading to the desired outcomes or, to the contrary, which measures have a negative effect on curriculum, evaluation, and student outcomes. The alignment of various evaluation efforts within the mesoscale evaluation system is very appealing, as it seems to minimize the time and energy educators need to expend on executing the provisions. Yet, it is of key importance to note that the emphasis undergirding the alignment is not supported by research. In fact, despite minimal research proclaiming the viability of reform aspects such as value-added models and standardized testing (Berliner 2014), a large amount of research by scholars within and external to the field of education points to the contrary (Berliner 2013, 2014; Milner 2013; see also fairest.org). Hence, as Ravitch (2014b, 154) asserts, they are actually hoaxes, “a mandate, a legislative mandate, or a program that you must obey but has no evidence behind it,” which is fundamentally undermining rather than enhancing the educational experiences of students, families, and teachers. The Perfect Storm: Alignment or Assault? The perfect storm arrived in full in 2015 when many of the theorized and piloted efforts previously described became official and in many instances required by law. Proponents of recent education reform measures claim that their efforts are purposefully aligned to improve educational outcomes for public school students. Although we agree that the education reforms are aligned, we argue that the alignment to date has not and will not improve public education. Instead, the alignment amounts to a direct assault on the bedrock of public education that has been building over time and has accelerated under the guise of accountability. If education outcomes are the determining factors as to whether educational reforms have been successful, then account after account tells us about the actual, rather than the proposed, results of educational reform since NCLB. Stories of school curricula narrowing (i.e., “teaching to the test”), inadequate funding and depleted human resources, and psychological costs to students and educators have been the telltale results from high-stakes testing and education reform. The perfect storm has become tantamount to an assault on three major groups: K-12 public schools, public schools of higher education, and the educators and the students they serve. Narrowed Curricula The pressure of high-stakes testing influences school systems in general, but particularly those in racially, economically, and linguistically marginalized communities, which have attempted to raise test scores through measures such as curriculum narrowing, the elimination of enrichment courses, an increase in skill and drill instruction, and/or rampant cheating (Roberts 2010; Wellstone 2002/2003). Many “low-performing” schools allocate more than a quarter of the year’s instruction to test prep, often resulting in a narrowing of curricula (Crocco and Costigan 2007). This over-emphasis on testing has trickled down to the youngest students, causing some educators to replace much needed playtime with testing lessons. As the Alliance for Childhood reports, “time for play in most public kindergartens has dwindled to the vanishing point, replaced by lengthy lessons and standardized testing.”8 The phenomenon of teaching to the test has been amply reported in K-12 to the detriment of students and educators, who are pressured to focus curriculum content on test preparation and further exposed to sentiments of de-professionalization. Milner (2013, 5) suggests that [w]hen news and other media report about the effectiveness and ineffectiveness of teachers and teaching based on the rise or fall of test scores and without other necessary information to make well-rounded judgments, the field of teaching is subject to unwarranted public criticism and consequently de-professionalization. In higher education, the teacher education equivalent of teaching to the test in K-12 is the teacher performance assessment “test” (i.e., edTPA). Au (2013, 25) expresses a rising concern among teacher educators: The edTPA is shaping our program in some not-so-healthy ways. Instead of focusing on good teaching, our conversations are quickly turning to how to prepare our students for the edTPA. Our student teaching seminars increasingly emphasize the test’s logistics, choosing the right kind of video segment for the test, choosing the right kind of unit for the test, making sure everyone is using the same language as the test. Education reform initiatives have caused K-12 schools and colleges of education to reevaluate curricular content, not toward expanding multidimensional learning opportunities, but rather toward adapting to the singular dimension of test expectations. However, school systems across the country are recognizing that less does not equate to more: Milwaukee Public Schools is one of several school systems across the country—including Los Angeles, San Diego and Nashville, Tenn.—that are re-investing in subjects like art and physical education. The Milwaukee school district is hiring new specialty teachers with the hope of attracting more families and boosting academic achievement. (Toner 2014, para. 3) Anarrowed curriculum emphasizing test preparation has had an additional effect on survivors of NCLB who have been socialized to perform and seek the “right” answer. NCLB-affected curricula have produced students with lower capacities for creativity, problem-solving, effective communication, and critical thinking (all skills reportedly desired by corporations) (Wernert 2013). Funding Priorities As a result of high-stakes testing pressures, school systems have adjusted their funding priorities to support testing and testing materials rather than enrichment, recess, and resources for all students. Standardized testing seems to be funded carte blanche; yet student educational outcomes have been either inconclusive or unimproved (Berliner, Glass, and Associates 2014; Fair Test 2014). The outcomes of that failure have frequently been punitive, resulting in school closings, firing of teachers/administrators, and decreased school funding (see CReATE 2013; Fisher 2013). Furthermore, states like Georgia that claim a lack of available funding, and therefore furlough teachers, cut instructional days, and reduce instructional material, do not seem to hesitate to implement education reform requirements that demand additional personnel, time, resources, and development (likely paid via RT3 provisions that will no longer be available after 2015). Education in Georgia, like in many other states, is underfunded except when it comes to money to support neoliberal reforms (Strauss 2014; Suggs 2014). Psychological Costs Most discouraging is the reality that education reform has led to negative physical and emotional consequences for students and educators. According to researcher Gregory J. Cizek (2001), anecdotes abound “illustrating how testing … produces gripping anxiety in even the brightest students, and makes young children vomit or cry, or both.” On March 14, 2002, the Sacramento Bee reported that “test-related jitters, especially among young students, are so common that the Stanford-9 exam comes with instructions on what to do with a test booklet in case a student vomits on it.” A three-year study completed in October 2010 by the Gesell Institute of Human Development showed that increased emphasis on testing makes “children feel like failures now as early as PreK” (at [http://www.gesellinstitute.org/](http://www.gesellinstitute.org/)). Georgia parent Stephanie Jones (2014) states: I am well aware of many Georgia families being sick and tired of the hyper-focus on the tests, recess being taken away, Saturday school being mandatory, after-school being mandatory, and summer school being mandatory all in the name of passing some test. Kids are stressed out and anxious, and learning that school is a place where anxiety is normal, and that the only real reason to “learn” something in school is so that you can pass a test at the end of the year. Student academic engagement and academic outcomes have also experienced serious damage. As pointed out by Senator Wellstone (2002/2003), “the effects of high-stakes testing have [had] a deadening effect on learning.” Wellstone’s words are illustrated by the skyrocketing numbers of students who have given up and dropped out of school because of the inability to pass a gateway test or a feeling of disengagement (Tyler and Loftstrom 2009). In conjunction with students’ stress and disengagement, K-12 teachers and teacher educators have expressed sentiments of profound demoralization (Santoro 2011). Educators experiencing high anxiety, frustration, and hopelessness have published open letters of resignation (e.g., see Downey 2012), brought lawsuits against the state (e.g., Florida; see http://feaweb.org/teachers-file-federal-736-lawsuit), and have been fired for expressing dissent (Hayes and Sokolower 2012–2013; Madeloni and Gorlewski 2013). Sarah Wiles, a science teacher in Charlotte, North Carolina, as cited by Megan (2014), clearly illustrates teacher demoralization when she says: I am so tired of being lied to about how important I am and how valuable I am…. I am also sick and tired of politicians making my profession the center of attention and paying it lip-service by visiting a school, kneeling next to a child, shaking my hand and thanking me, telling the nightly news that I deserve a raise, and then proceeding to speak through the budget that I am not worth it. If you aren’t going to do anything, and you know nothing will change, just leave me alone. I would rather be ignored than disrespected. In Georgia, teachers and teacher educators have written multiple editorials and left numerous comments in local media blogs in which they “speak of the tremendous pain that they feel in being part of a profession that is continually battered by [inaccurate] public commentary from education officials, taxpayers, and other stakeholders from outside the system” (Smagorinsky 2011). Conclusion and Implications In the face of the perfect storm we have described, our clarion call is not to endure or weather the storm, as educators have done with education reforms of the past. Previous survival techniques of battening down the hatches and waiting for the waves of reform to pass are insufficient to withstand this convergence of storm elements. Meteorologically, perfect storms are almost impossible to avoid; however, the repercussions may be so severe that, if we simply wait for this storm to pass, when we finally emerge from our hiding places we will find only remnants and fragments of our public schools. Neoliberal policy making (i.e., privatization, corporatization, and standardization) has dictated current iterations of education policy in the hope that “this time, things will be different.” Yet, historically, we have seen that no matter how idyllic current education reform initiatives appear on paper, they are most likely to leave educators and students adrift, feeling consumed, overwhelmed, and subjected to political finger-pointing, disappointment, disengagement, and shame. In order to secure our best chances that indeed things will be different, we advocate that K-12 educators and teacher educators: $(a)$ escalate actions to stop the eventual and present negative consequences of current education activities, laws, and reforms; and $(b)$ demand the provision of the financial, physical, emotional, and psychological infrastructure that must accompany education reform to achieve authentic, healthy, and sustainable success. Indeed, just as reforms have been growing nationwide, so have national, state, and local resistance efforts by educators, students, and parents/caretakers. Of many, we share selected exemplars of resistance to indicate how a rising number of individuals and collectives are striving to turn the tides (see Table 2; see also Strauss 2012). At stake is the education of all children: not just the ones who deserve it, not just the ones who do well on tests, not just ours, and not just the ones we like. Table 2: Exemplars of Resistance to Current Education Reforms \| National \| Georgia \| \|----------\|---------\| \| National Center for Fair & Open Testing www.fairtest.org National Resolution on High Stakes Testing http://timeoutfromtesting.org/nationalresolution/ Network for Public Education www.networkforpubliceducation.org Occupy the DOE http://www.occupythedoae.com/ Opt Out of the State Test http://optoutofstandardizedtests.wikispaces.com Save Our Schools www.saveourschools.org \| Georgia-United Opt Out http://unitedoptout.com/state-by-state-opt-out-2/georgia/ GREATER (Georgia Researchers, Educators, and Advocates for Teacher Evaluation Reform) http://greater2012.blogspot.com/ \| Corporately privatized winds of change have gathered their forces in ways that are deeply disturbing and unprecedented. Yet, there is still time to deflect total destruction. To do so, however, those who are authentic stakeholders must answer enduring questions about education and education reform: What kind of education do we want and need? For whom, for what aims, and at whose expense? Whether the edifice of public education is completely destroyed, rebuilt in the image of corporations in the United States, or saved will be determined by how hard we fight to salvage what is left. NOTES 1. The term “global majority” is used to represent many populations variously characterized in the United States as minority, at risk, underserved, non-white, of color, urban, of low socioeconomic status, and poor—all terms that are used to mask the hegemony of European American populations and the numeric and political reality of black, brown, and lower-income people worldwide. We use the term “global majority” to reflect a more affirming and accurate sense of the vast diversity of individuals represented in the United States. 2. Although presenting the two governors as political binaries may be a simplification, their tenures differed in significant ways. Barnes’s educational package mirrored the growing trend toward accountability that had been mounting since the 1983 report “A Nation at Risk,” and he served just prior to the full implementation of NCLB. Perhaps indicative of his political acumen, he was able to push through a largely Republican educational agenda, but with equity built in through funding. In fact, one source indicated that many of the ideas were Republican in origin (Brooks 2011). Notwithstanding a heavily swayed Republican agenda, Barnes’s educational platform built in safety nets from K through 12, all of which he funded (Cumming 1999, H8). In essence, even though his educational program reflected a growing concern for accountability, he counterbalanced this demand with built-in equity through comprehensive funding. Ironically, however, despite his equitable distribution of funding, provision of teacher raises, establishment of a career ladder for teachers, and increase in pay for National Board Certified teachers, he is more often remembered as the governor who was opposed to teachers because of his revocation of teacher tenure. In a personal interview, Governor Barnes lamented that he never opposed teachers; he just wanted to make it easier to replace ineffective teachers (R. Barnes personal interview, November 15, 2012). In contrast, Governor Perdue ended his tenure just prior to the full implementation of RT3. In fact, the US Department of Education awarded Georgia the Race to the Top Grant in August 2010 (http://gosa.georgia.gov/race-top), even though implementation did not begin until 2011 under Governor Deal’s tenure (http://gov.georgia.gov/00/press_print/). As much as Barnes’s educational package represented bipartisan ideology (R. Barnes personal interview, November 15, 2012), Perdue’s educational platform was dominated and supported by a majority Republican legislature. Hence, from 2003 through 2010, a series of measures (including austerity cuts and tax credits) were passed that undermined public schools rather than supporting them. Also, although one of Perdue’s first acts was to overturn the revocation of teacher tenure, during his term classes were increased, school days were shortened, funding for national board certification was reduced, and furloughed days were instituted. In retrospect, both governors worked in a climate of testing and accountability. One used legislation to support public education; the other used legislation to undermine it. Whereas one governor supported teachers in all but seemingly the most significant way, the other undermined teachers in more subtle ways. One left office shrouded in a legacy of disdain for teachers; the other left office with educators realizing that public education had been significantly weakened. In conclusion, and notwithstanding Barnes’s stance on teacher tenure, his efforts still reflected a desire to level the playing field (Croft 2013; Cumming 1999, H8). 3. At https://gov.georgia.gov/press-releases/2011-04-01/deal-announces-race-top-grant. 4. At http://caepnet.org. 5. See Georgia Professional Standards Commission, at www.gapsc.org. 6. For details, see https://sites.google.com/a/pearson.com/score-edtpa/. 7. At www.gadoe.org/External-Affairs-and-Policy/communications/Pages/PressReleaseDetails.aspx?PressView=default&pid=192. 8. At http://www.allianceforchildhood.org/restoring_play. REFERENCES Ahlquist, Roberta, Paul Gorski, and Theresa Montaño 2011 Assault on Kids: How Hyper-Accountability, Corporatization, Deficit Ideologies, and Ruby Payne Are Destroying Our Schools. New York: Peter Lang. 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Papay, John 2011 “Different Tests, Different Answers: The Stability of Teacher Value-Added Estimates across Outcome Measures.” American Educational Research Journal 48(1): 163–93. At Race to the Top, [http://gosa.georgia.gov/race-top](http://gosa.georgia.gov/race-top). Ravitch, Diane 2014a “My Favorite Line from Arne Duncan: What Is Yours?” At [http://dianeravitch.net/2014/04/05/my-favorite-line-from-arne-duncan-what-is-yours/](http://dianeravitch.net/2014/04/05/my-favorite-line-from-arne-duncan-what-is-yours/). 2014b “Hoaxes in Educational Policy.” The Teacher Educator 49(3): 153–65. 2010 The Death and Life of the Great American School System: How Testing and Choice Are Undermining Education. New York, NY: Basic Books. Ripley, Amanda 2013 The Smartest Kids in the World: And How They Got That Way. New York, NY: Simon and Schuster. Roberts, Mari A. In press “The Testing Industrial Complex: Incarcerating Education since 2001.” In School against Neoliberal Rule: Educational Fronts for Local and Global Justice: A Reader, edited by Mark Abendroth and Brad Porfilio. Charlotte, NC: Information Age Publishing. 2010 “Toward a Theory of Culturally Relevant Critical Teacher Care: African American Teachers’ Definitions and Perceptions of Care for African American Students.” Journal of Moral Education 39(4): 449–67 Rochford, J.A. 2007 P-16: The Last Education Reform. Book 2: Emerging Local, Regional, and State Efforts. Canton, OH: Stark Education Partnerships. Rubenstein, Gary 2011 “Same Kids, Same Building, Same Lies.” At http://garyrubinstein.wordpress.com/2011/03/06/same-kids-same-building-same-lies/. Paarlberg, Michael 2012 “The Chicago Strike Is Typical of American Politicians’ War on Teachers.” The Guardian, July 29. At www.theguardian.com/commentisfree/2012/sep/11/chicago-strike-union-teachers. Sacks, P. 2001 Standardized Minds: The High Price of America’s Testing Culture and What We Can Do to Change It. Boston, MA: Da Capo Press. Sahlberg, Pasi 2011 Finnish Lessons: What Can the World Learn from Educational Change in Finland? New York: Teachers College Press. Santoro, Doris A. 2011 “Good Teaching in Difficult Times: Demoralization in the Pursuit of Good Work.” American Journal of Education 118(1): 1–23. Smagorinsky, Peter 2014 “Authentic Teacher Evaluation: A Two-Tiered Proposal for Formative and Summative Assessment.” English Education 46(2): 165–85. 2013 “Common Core State Standards: A Lesson in Shrewd Marketing.” The Atlanta Journal Constitution (blog). At www.ajc.com/weblogs/get-schooled/2013/jul/08/common-core-lesson-shrewd-marketing/. 2011 “Want Reform? Ask GA Teachers.” AJC.com, January 10. At http://m.ajc.com/news/news/opinion/want-reform-ask-georgia-teachers/nQpYn/. Strauss, Valerie 2014 “Better Ways to Use Millions of Dollars Now Spent on Testing.” (blog). At www.washingtonpost.com/blogs/answer-sheet/wp/2014/06/24/better-ways-to-use-millions-of-dollars-now-spent-on-testing/. 2013 “Arne Duncan Tells Newspaper Editors How to Report on Common Core.” The Washington Post Answer Sheet (blog). At www.washingtonpost.com/blogs/answer-sheet/wp/2013/06/25/arne-duncan-tells-newspaper-editors-how-to-report-on-common-core/. 2012 “High-stakes Testing Protests Spreading.” The Washington Post (blog). At http://www.washingtonpost.com/blogs/answer-sheet/post/high-stakes-testing-protests-spreading/2012/05/30/gJQA6OQXOU_blog.html. Suggs, C. 2014 “The New Normal Does Not Work for Georgia’s Students.” Beyond the Numbers: The Georgia Budget & Policy Institute Blog, November 5. At [http://gbpi.org/the-new-normal-does-not-work-for-georgias-students](http://gbpi.org/the-new-normal-does-not-work-for-georgias-students). Swope, Kathy and Barbara Miner 2000 Failing Our Kids: Why the Testing Craze Won’t Fix Our Schools. Milwaukee, WI: Rethinking Schools. Toner, Erin 2014 “To Boost Attendance, Milwaukee Schools Revive Art, Music, and Gym.” (blog). At [www.npr.org/blogs/ed/2014/06/23/323033486/to-boost-attendance-milwaukee-schools-revive-art-music-and-gym?utm_source=npr_email_a_friend&utm_medium=email&utm_content=20140719&utm_campaign=storyshare&utm_term=](http://www.npr.org/blogs/ed/2014/06/23/323033486/to-boost-attendance-milwaukee-schools-revive-art-music-and-gym?utm_source=npr_email_a_friend&utm_medium=email&utm_content=20140719&utm_campaign=storyshare&utm_term=). Tyler, J.H. and M. Lofstrom 2009 “Finishing High School: Alternative Pathways and Dropout Recovery.” The Future of Children 19(1): 77–103. Wellstone, P. 2002/2003 “Wellstone on Testing: A Harsh Agenda.” Rethinking Schools 17(2). At [http://www.rethinkingschools.org/archive/17_02/Hars172.shtml](http://www.rethinkingschools.org/archive/17_02/Hars172.shtml). Wernert, Sean 2013 “No Child Left Behind Comes to College: The Implication of Limiting Early Age Play on Incoming College Students.” Academic Advising Today: Voices of the Global Community. At [www.nacada.ksu.edu/Resources/Academic-Advising-Today/View-Articles/No-Child-Left-Behind-Comes-to-College-The-Implications-of-Limiting-Early-Age-Play-on-Incoming-College-Students.aspx](http://www.nacada.ksu.edu/Resources/Academic-Advising-Today/View-Articles/No-Child-Left-Behind-Comes-to-College-The-Implications-of-Limiting-Early-Age-Play-on-Incoming-College-Students.aspx). Acts A+ Education Reform Act of 2000, O.C.G.A. §20–2–281 (2000). Act 394, 2008 Ga. L. 82, § 1/HB 1209 Act 449, 2004 Ga. L. 107. Act 618, 2006 Ga. L. 524, §§ 2/HB 1219. Act 773, 2008 Ga. 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About Saama's Data Hub is the most powerful data ingestion solution in the clinical research industry, centralizing and standardizing high volumes of data from any source. Eliminate manual data aggregation and reconciliation processes, allowing your team to generate insights from your data, not manage it. Benefits Centralize Data from Any Source * Ingest data from any source, with 40+ pre-built connectors and file-based ingestion * Apply common standards to all your data — and even assign different data standards by study * Centrally manage blinded / masked data; users can even blind parts of a dataset and restrict access Improve Access to Your Data Highly Scalable * With your clinical, operational, and financial data in a single location, it's easier to access and pull insights from your data Move Resources to Higher Value Activities * Allow data management teams to spend their time analyzing study data instead of organizing and reconciling it http://www.saama.com \| USA: 1.408.371.1900 \| firstname.lastname@example.org * AI-driven data mapping allows for each new study to be configured in just a few clicks * Easily scalable across your entire portfolio Accelerate Time to Market * Monitor study progress in real-time to identify and mitigate potential roadblocks \| \| 1 One Place for All Your Data \| \| Features Saama's Data Hub has the features you need to centralize, standardize, and utilize your study data quickly and easily. Secure, Role-Based Access Organizations can ensure data access to critical business functions while maintaining data security and privacy. Data Ingestion Ingest structured and unstructured data, including flat-files, in real time. Data Standardization Data is mapped into a standard data review model using 30+ out-of-the-box functions. Data Export Standardized data is available for export to any system. Automated Quality Checks Automatically checks that data is in the correct field or format and alerts users when data is missing or incomplete. Central Administration Manage data standards centrally and apply them across your entire study portfolio. Roles and user access are controlled from a single log-in. Metadata Management Allows for source and target metadata to be ingested and managed within the application. Data Blinding Users can upload blinded datasets, and even mask parts of a dataset and restrict access. AI-Driven Data Mapping Traceability AI algorithms can help predict the correct mapping between the source data and the target standard. Complete audit trail of all data transformations. View the original data source and see where, when, and how it was transformed. The Saama Difference Only Saama allows you to centralize and standardize your clinical, operational, and financial data in a single location. Our intuitive, scalable analytics platform is source-agnostic. This gives you the ultimate flexibility to choose data capture solutions that are right for your organization and trial. It's your data - use it as you want. Contact us at email@example.com to schedule a personalized demonstration.	<urn:uuid:b8491ff5-1f3c-4a2c-b7b2-6fbd18a375df>	CC-MAIN-2025-08	https://www.saama.com/wp-content/uploads/Data-Hub_Fact-Sheet_Jan-2025.pdf	2025-02-16T14:45:21+00:00	crawl-data/CC-MAIN-2025-08/segments/1738831952586.5/warc/CC-MAIN-20250216135951-20250216165951-00582.warc.gz	886,310,625	621	eng_Latn	eng_Latn	0.992519	eng_Latn	0.993203	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 1319, 3103 ]	[ 0.4765625 ]	[ 1.0234375 ]	[ 1.21875 ]	[ 1.6328125 ]	2	0	HuggingFaceFW/finepdfs
Nouns: 눈썹 = eyebrow 교사 = teacher 반 = class of students in school 직장 = location of work 벽 = wall 털 = hair (not on head)/fur 머리카락 = hair (on head) 저녁식사 = dinner 저녁시간 = evening time 점심식사 = lunch 점심시간 = lunch time (It is also common to omit the word "식사" and use 아침, 점심 and 저녁 to refer to the respective meals). Verbs: 찾다 = search for 공부하다 = study 가르치다 = teach 일하다 = work 짓다 = build 가지다 = own/possess 잠그다 = to lock something 잊다 = forget 돕다 = help 주다 = give Adjectives: 쉽다 = easy 덥다 = hot 그립다 = to miss (a thing) 귀엽다 = cute 춥다 = cold 어렵다 = difficult 더럽다 = dirty 바쁘다 = busy 같다 = same 안전하다 = safe 딱딱하다 = hard 부드럽다 = soft 가능하다 = possible 불가능하다 = impossible 맞다 = correct Adverbs and Other Words: 지각 = late 일찍 = early 오전 = morning 오후 = afternoon 매일 = everyday 여름 = summer 가을 = fall 겨울 = winter 봄= spring Irregulars As with all languages, there are some irregular conjugations that you need to know. Irregulars are applied to certain verbs or adjectives when adding something to the stem of the word. Korean grammar is based on these "additions" that are added to stems. I mentioned this in Lesson 5, but I want to reiterate it here. There are hundreds of additions that you can add to the stem of a verb or adjective. Some of these are conjugations and some of them are grammatical principles that have meaning in a sentence. You have learned about some of these additions now. For example: ~ㄴ/는다 to conjugate to the plain form ~아/어요 to conjugate to the informal high respect form ~ㅂ/습니다 to conjugate to the formal high respect form ~았/었어 to conjugate to the informal low respect form in the past tense ~ㄴ/은 added to an adjective to describe an upcoming noun In future lessons, you will learn about many more of these additions. For example, some of them are: ``` ~ㄴ/은 후에 to mean "after" ~기 전에 to mean "before" ~기 때문에 to mean "because" ~아/어서 to mean "because" ~(으)면 to mean "when" ~아/어야 하다 to mean "one must" ~아/어서는 안 되다 to mean "one should not" ``` Notice that some of these additions start with a vowel, and some of them start with a consonant. Most of the irregulars are applied when adding a vowel to a stem. The ㄹ irregular that is introduced at the end of the lesson is the only irregular that applies when adding a consonant to a stem. Let's look at one example before I introduce each irregular one by one. Let's say we want to conjugate the word "어렵다" into the past tense using the informal low respect form. The following would happen: Here, you can see that the actual stem of the word changed. This is referred to as the "ㅂ irregular" because the same phenomenon happens with many (but not all) words whose stem ends in "ㅂ". As I mentioned previously, most of these irregulars are applied when adding a vowel to a stem. Although there are many additions that start with a vowel, the only ones that you have learned about to this point are the conjugations taught in Lessons 5 and 6: ``` ~아/어 ~아/어요 ~았/었어 ~았/었어요 ~았/었습니다 ~았/었다 ``` As such, this lesson will present the Korean irregulars and how they change as a result of adding these conjugations. In later lessons when you learn about other additions, you can apply what you learned in this lesson to those concepts. For now, let's get started. ㅅ Irregular If the last letter of a word stem ends in ㅅ (for example: 짓다 = to build), the ㅅ gets removed when adding a vowel. For example, when conjugating: ``` 짓다 = to make/build 짓 + 어 = 지어 나는 집을 지어 = I build a house 짓 + 었어요 = 지었어요 저는 집을 지었어요 = I built a house ``` Notice that this only happens when adding a vowel. When conjugating to the plain form, for example, you only add "~는다" to the stem and thus ㅅ does not get removed: ``` 집을 짓는다 = to build a house ``` The reason this irregular is done is to avoid changing the sound of a word completely after conjugating it. ``` Pronouncing 짓다 sounds like 'jit-da.' Pronouncing 지어 sounds like 'ji-uh' Pronouncing 짓어 sounds like 'jis-suh' ``` The third one (which is incorrect) completely changes the sound of the word stem when a vowel is added (from 'jit' to 'jis.' Whereas in the second one, the sound of the word stem only changes from 'jit' to 'ji,' which is much smaller of a difference (especially considering the 't' in the pronunciation of 짓 is not aspirated - which makes it barely audible). I know that is confusing, but if you can't understand why it is done, that's fine. Just know that it must be done. Some other examples of words that follow this irregular are (these words are too difficult for you right now, but I'm just showing you): ``` 낫다 = better (adjective) - You will learn more about this word in Lesson 19 잇다 = to continue (verb) ``` Common words that this does not apply to are: ``` 웃다 (to laugh) = 저는 웃었어요 = I laughed 벗다 (to take off clothes) = 저는 저의 옷을 벗었어요 = I took off my clothes 씻다 (to wash) = 저는 저의 손을 씻었어요 = I washed my hands ``` Here is a table with the word "짓다 (to build)" being conjugated using all the honorific forms you have learned. The irregular conjugations are in bold. Notice that this only occurs when ~아/어 (or one of its derivatives like ~았/었어요) is added to the verb stem. Note that when a word stem has ㅅ as the fourth consonant, this irregular does not apply. For example, this does not apply to 없다, which you will learn about in the next lesson. ㄷ irregular If the last letter of a word stem ends in ㄷ (걷다 = to walk), the ㄷ gets changed to ㄹ when adding a vowel. This is only done with verbs. For example: I don't mean to confuse you, but I will: 걷다 means "to walk." When conjugating, by adding a vowel it changes to 걸어 Another meaning of 걷다 is "to tuck." But this meaning of 걷다 does not follow the irregular rule. So, when conjugating, by adding a vowel is simply stays as 걷어. In addition, 걸다 means "to hang." When conjugating, by adding a vowel it stays as 걸어 Confusing enough? Let's look at all three: Honestly, though, the whole 걷다/걷다/걸다 thing is probably the most confusing part of this conjugation, and don't worry too much about it. "Walk" is a word that is used much more frequently than "tuck," so it is not something that comes up a lot. The reason this conjugation is done is simply because the sounds flows off your tongue better. It is similar to pronouncing the word "butter" in English. When pronouncing "butter" we don't say "butt-tter," we just say "bud-er." Like the ㄷ irregular, it is simply to avoid saying a hard consonant. This is done to most stems ending in ㄷ, common words that this does not apply to (like 걷다 = to tuck) are: ``` 받다 (to get/receive) = 저는 돈을 받았어요 = I received money 묻다 = 묻어요 (to bury) = 저는 저의 강아지를 묻었어요 = I buried my dog 닫다 = 닫아요 (to close) = 저는 문을 닫았어요 = I closed the door ``` Here is a table with the word "걷다 (to walk)" being conjugated using all the honorific forms you have learned so far. The irregular conjugations are in bold. Notice that this only occurs when ~아/어 (or one of its derivatives like ~았/었어요) is added to the verb stem. ㅂ Irregular If the last letter of a word stem ends in ㅂ (쉽다 = easy), the ㅂ changes to 우 when adding a vowel. 우 then gets added to the next syllable in the conjugated word. This is mostly done with adjectives. Many verbs end with ㅂ but this rule is rarely applied to verbs (some of the few verbs where this rule applies are: 줍다 (to pick up), 눕다 (to lie down)). For example: ``` 쉽다 = to be easy 쉽 + 어 = 쉬 + 우 + 어 = 쉬워 그 것은 쉬워 = That thing is easy 어렵다 = to be difficult 어렵 + 어요 = 어려 + 우 + 어요 = 어려워요 그 것은 어려워요 = That was difficult 귀엽다 = cute 귀엽 + 어요 = 귀여 + 우 + 어요 = 귀여워요 그 여자는 귀여워요 That girl is cute ``` In the words "돕다" (to help) and "곱다" (an uncommon way to say "beautiful") ㅂ changes to 오 instead of 우. For example: ``` 돕다 = to help 돕 + 았어요 = 도 + 오 + 았어요 = 도왔어요 저는 저의 어머니를 도왔어요 = I helped my mother ``` Because this irregular is found in adjectives, you will be conjugating it not only at the end of a sentence, but also in the middle of a sentence (before a noun). Remember the difference between these two sentences. ``` 사과는 크다 = Apples are big 나는 큰 사과를 좋아한다 = I like big apples ``` In the first sentence, 'big' is an adjective that describes the noun (apple) at the end of the sentence. In the second, 'big' describes the apple (as 'a big apple') and then "like" acts on the noun. In Lesson 4, you learned how to describe a noun by placing an adjective with ~ㄴ/은 before it. Adding ~ㄴ/은 to adjectives where the stem ends in "ㅂ" causes this irregular to come into play. When placing an adjective (who's stem ends in "ㅂ") before a noun to describe it, you add ~ㄴ to the newly formed 우/오 syllable: More examples: Note that in most irregulars, the word changes differently if the last vowel in the stem is ㅗ OR ㅏ. However, in the ㅂ irregular, except for 돕다 and 곱다, all applicable words are changed by adding 우. ``` 아름답다 = beautiful: 아름답 + 어요 = 아름다 + 우 + 어요 = 아름다워요 그 여자는 아름다워요 = That girl is beautiful 새롭다 = new 새롭 + 어요 = 새로 + 우 + 어요 = 새로워요 그 학교는 새로워요 = That school is new 그 것은 새로운 학교예요 = That (thing) is a new school ``` Probably the most confusing of all irregulars, mainly because it seems strange that ㅂ can change to 우/오. The reason this happens is similar to the ㅅ irregular. As you know, when pronouncing a syllable with the last letter ㅂ, you don't really pronounce the 'B' sound. But, if you add a vowel after ㅂ the sound of 'B' would be pronounced. The purpose of the irregular is to eliminate the 'B' sound which isn't actually in the word. This is done to some words ending in ㅂ. Some common words where this does not apply: ``` 좁다 (narrow) = 이 방은 좁아요 = This room is narrow 넓다 (wide) = 이 방은 넓어요 = This room is wide (Korean people often describe a room/place being "big" by saying it is "wide" 잡다 (to catch/grab) = 저는 공을 잡았어요 = I caught the ball ``` Here is a table with the word "춥다 (cold)" being conjugated using all the honorific forms you have learned so far. The irregular conjugations are in bold. Notice that this only occurs when ~아/어 (or one of its derivatives like ~았/었어요) is added to the verb stem. ㅡ Irregular If the final vowel in a stem is ㅡ (for example: 잠그다 = to lock), when adding ~아/어, you can not determine whether you need to add ~어 or ~아 to the stem by looking at ㅡ. Instead, you must look at the vowel in the second last syllable. For example, in the word "잠그다", the second last syllable in the stem is "잠", and the vowel here is ㅏ. Therefore, as usual, we add ~아 to 잠그. For example: In cases like this where a word ends in "ㅡ" (that is, there is no final consonant after "ㅡ") and is followed by ~아/어 (or any of its derivatives), the ~아/어~ the "ㅡ" is eliminated and the addition of ~아/어~ merges to the stem. For example: 잠그다 = to lock The last vowel in the stem is ㅡ. The vowel in the second last syllable is ㅏ, so we add 아. For example: 잠그 + 아 Because there is no final consonant after " ㅡ ", ~ 아 replaces ㅡ 잠그 + 아 = 잠가 This would be the same in the past tense as well, for example: ``` 잠그 + 았어요 = 잠갔어요 저는 문을 잠갔어요 = I locked the door ``` Let's look at another example: 바쁘다 = to be busy The last vowel in stem is ㅡ. The vowel in the second last syllable is ㅏ, so we add 아. For example: 바쁘 + 아 Because there is no final consonant after " ㅡ ", ~ 아 바쁘 + 아요 = 바빠요저는 바빠요 = I am busy Let's look at another example: 예쁘다 = pretty The last vowel in the stem is ㅡ. The vowel in the second last syllable is not ㅏ or ㅗ, so we add 어. ``` For example: 예쁘 + 어 ``` ``` Because there is no final consonant after "ㅡ", ~어 replaces 예쁘 + 어요 = 예뻐 그 여자는 예뻐요 = That girl is pretty ``` ㅡ. If the word ends in a consonant (for example: 긁다 = to scratch), you just add the ~아/어 as you would to a normal word and nothing needs to merge. For example: 저는 머리를 긁었어요 = I scratched my head replaces ㅡ. . Another example where we find a single-syllable word with "ㅡ" as the only vowel is "듣다 (to hear)" 듣다 = to hear Last vowel in stem is ㅡ. There is no syllable preceding 듣, so we must add 어. 듣 ends in a consonant, so 어 does not get added directly to the syllable. But! Don't forget the ㄷ irregular. In this example, both ㅡ and ㄷ irregulars are used: 듣 + 었다 = 들었다 저는 쥐를 들었어요 = I heard a mouse This same rule applies when adding ~아/어 to words where, not only is the last vowel in the stem ㅡ, but all the vowels in the stem are ㅡ. For example, in the word "슬프다". An irregular to this already irregular rule is "만들다 (to make)." Even though the second last syllable in the stem has the vowel "ㅏ", ~어~ is added instead of ~아~. For example: Here is a table with the word "잠그다 (to lock – which is a verb)" being conjugated using all the honorific forms you have learned so far. The irregular conjugations are in bold. Notice that this only occurs when ~아/어 (or one of its derivatives like ~았/었어요) is added to the verb stem. And here is a table with the word "예쁘다 (pretty – which is an adjective)" being conjugated using all the honorific forms you have learned so far. The irregular conjugations are in bold. Notice that this only occurs when ~아/어 (or one of its derivatives like ~았/었어요) is added to the verb stem. Finally, here is a table with the word "만들다 (to make – which is a verb)" being conjugated using all the honorific forms you have learned so far. You will learn how 만든다 and 만듭니다 are formed later in the lesson when you learn about the ㄹ irregular. 르 Irregular If the final syllable in a stem is 르 (마르다), it is conjugated differently when adding ~아/어. This irregular only applies when adding ~아/어(or any of its derivatives) to a stem and not when adding any other grammatical principles that starts with a vowel or consonant. Up until now, you haven't learned about any of these other grammatical principles, that can start with anything other than ~아/어~, so don't worry about this distinction too much. When adding ~아/어 to these words, an additional ㄹ is created and placed in the syllable preceding 르 as the last consonant. The 르 also gets changed to either 러 or 라 (depending on if you are adding 어 or 아). This is done to both verbs and adjectives (the only exception is 따르다 = to follow/to pour). For example: ``` 다르다 = different 다르 + 아요 = 다 + ㄹ + 라요 = 달라요 그 것은 달라요 = That thing is different 빠르다 = to be fast 빠르 + 아요 = 빠 + ㄹ + 라요 = 빨라요 그 남자는 빨라요 = That man is fast 부르다 = to call somebody's name 부르 + 었어요 = 부 + ㄹ + 렀어요 = 불렀어요 저는 저의 누나를 불렀어요 = I called my sister ``` ) Here is a table with the word "고르다 (to choose – which is a verb)" being conjugated using all the honorific forms you have learned so far. The irregular conjugations are in bold. Notice that this only occurs when ~아/어 (or one of its derivatives like ~았/었어요 is added to the verb stem. And here is a table with the word "빠르다 (fast/quick – which is an adjective)" being conjugated using all the honorific forms you have learned so far. The irregular conjugations are in bold. Notice that this only occurs when ~아/어 (or one of its derivatives like ~았/었어요) is added to the verb stem. ㄹ Irregular If the final letter of a stem is ㄹ AND you add ~ ㄴ/~ㅂ to that stem, the ㄹ is removed and the ㄴ /ㅂ get added on directly to the stem. However, if you are adding '는' or something starting with ㅅ to the stem – the ㄹ is removed and ~는/~ㅅ is added directly after the stem. In addition, when adding ㄹ/을 to a stem that ends in ㄹ, you actually eliminate the ㄹ/을. That is a lot, so let's look at each in more detail: ㄹ Irregular – Adding ㄴ to words You have learned about adding ㄴ/은 to adjective stems when modifying nouns: 크다 = 큰 남자 When adding ~ㄴ/은 to a stem that ends in ㄹ,ㄹ is removed and ㄴ is added to the stem: 길다 = long 길 + ㄴ = 긴 저는 긴 거리를 건넜어요 = I crossed the long street 멀다 = far away ``` 멀 + ㄴ = 먼 저는 먼 병원에 갔어요 = I went to a far away hospital (a hospital that is far away) ``` You have also learned about adding ㄴ/는다 to verbs when conjugating to the plain form: ``` 나는 집에 간다 = I go home 나는 잔다 = I sleep ``` But when adding ㄴ/는다 to a verb stem that ends in ㄹ, you must remove ㄹ and add ㄴ다 to the verb stem: ``` 나는 문을 연다 = I open the door 나는 케이크를 만든다 = I make a cake ``` ㄹ Irregular – Adding ㅂ to words You have also learned about adding ㅂ to verb and adjective stems when conjugating in the Formal high respect form: Verbs: ``` 저는 집에 갑니다 = I go home 저는 잡니다 = I sleep ``` Adjectives: ``` 그 여자는 예쁩니다 = That girl is beautiful 그 것은 불가능합니다 = That thing is impossible ``` But when adding ㅂ니다 to verbs or adjectives whose stems end in ㄹ, you must remove ㄹ and add ㅂ directly to the stem: Verbs: ``` 저는 문을 엽니다 = I open the door 저는 케이크를 만듭니다 = I make a cake ``` Adjectives: ``` 그 병원은 멉니다 = That hospital is far 그 여자의 머리는 깁니다 = That girls hair is long ``` 머리 can mean 'head' or 'hair' depending on the context. If you want to specifically mention your hair, you can say "머리카락" always means the hair on one's head. 머리 or 머리카락 does not refer to the hair on an animal, or the body hair of a human. This hair is referred to as "털" and extends to most of the hair that can be found on animals (fur, the wool on a sheep, etc) Here is a table with the word "열다 (to open – which is a verb)" being conjugated using all the honorific forms you have learned so far. The irregular conjugations are in bold. Notice that this only occurs when ~ㄴ or ~ㅂ is added to the verb stem. And here is a table with the word "길다 (long – which is an adjective)" being conjugated using all the honorific forms you have learned so far. Notice that this only occurs when ~ㄴ or ~ㅂ is added to the verb stem (it would happen when ~ㄴ is added, but you don't add ~ㄴ/는 to an adjective when you conjugate it like this. There are times, however, when this would happen, but you haven't even gotten close to learning about them yet. For example, in Lesson 76, we talk about the addition of ~ㄴ/는데 to clauses. This would make 길다 turn into 긴데. Please don't even think about looking ahead until Lesson 76 until you've finished with this lesson, and the 69 lessons in between. I don't want to confuse you too much more because I am sure you are already really confused. Just the amount of content on this page alone is enough to make somebody cry. That being said, I think it is a very good exercise to try to compare how the words 듣다 and 들다 differ in their conjugations. Don't worry about the meaning of 들다 yet (it is a very complex word that has many meanings), but just assume it is a verb in this case. For now, let's just focus on how they are conjugated. Notice that when conjugating 듣다, you need to consider the following irregular patterns: - ㄷ irregular (because it ends in ㄷ) - ㅡ irregular (because the final vowel is ㅡ) The following table shows how 듣다 should be conjugated across the honorifics and tenses you have learned so far: Notice when conjugating 들다, you need to consider the following irregular patterns: - ㄹ irregular (because it ends in ㄹ) - ㅡ irregular (because the final vowel is ㅡ) The following table shows how 들다 should be conjugated across the honorifics and tenses you have learned so far: I feel that comparing these two is a very good exercise because you can see that sometimes, because of the irregular conjugations, 듣다 might look exactly like 들다. For example, in all of the past tense conjugations, there is no way to distinguish between the two based on sound, and the only way to distinguish them is by context in a sentence. There is no easy way around memorizing stuff like this. The only words of encouragement I can give you is that – as you become more and more familiar with the language, and as you expose yourself to it more and more, it does become second nature. I know you can't believe that now, but it does. ㄹ Irregular – Adding Anything that Starts with a "Solid" ㄴ or ㅅ As of now, you have not yet learned about adding anything that starts with a solid ㄴ or ㅅ to a stem, so don't worry about this too much now. What I mean by "solid ㄴ" is that – any addition where you add ㄴ, but there is no choice of having to add ~ㄴ or something else. For example, even though the plain form conjugation "~ㄴ/는다" starts with "~ㄴ", there is a choice of having to add "ㄴ" OR "는". This irregular only applies to grammar additions that start with "ㄴ", and there is no alternate addition. For example, as you will learn later, a grammatical addition to form a question is ~니. There is no alternate addition to this. For example, it is not ~ㄴ/니. I will show you the examples of how this works, but you won't be able to understand them. Just try to see how the irregular works within these examples, and I will re-present these again when you learn how to deal with adding a solid ~ㄴ and ~ㅅ. When you add a solid ~ㄴ or ~ㅅ to a stem of a word that ends in ㄹ, you must drop the ㄹ from the stem, and add the solid ~ㄴ or ~ㅅ after the stem: For example: ``` 열다 + ~나(요) = 여나요 열다 + ~니 = 여니 열다 + ~는 = 여는 열다 + ~냐 = 여냐 열다 + ~세요 = 여세요 ``` Again, that is just for your reference. I will teach you more about those irregulars when I teach you about the specific grammar within them. Specifically, you will learn about adding ~니 and ~나 to stems in Lesson 22; you will learn about ~는 in Lessons 26, 27 and 28; and will learn about~세요 in Lesson 40. Make sure that you realize that you have not learned any grammatical principle where "~는" is added. The addition of "~는" is not the diary form conjugation that you learned in Lesson 5. That conjugation is ~ㄴ/는다 - where, depending on the stem of the verb, you might need add ~ㄴ다 or ~는다. The "~는" addition is not the same, and will be talked about in Lessons 26, 27 and 28, but try not to worry about it now. Just to make my point clear - the diary form present tense conjugation of "열다" is "연다" (based on the information earlier). It is not 여는다. ㄹ Irregular – Adding ~ㄹ/을 to words Just like the above (는/ㅅ) example, you have not learned about adding ~ㄹ/을 to a stem, so don't worry about this too much now either. I will show you the examples, but you won't be able to understand them. Just try to see how the irregular works within these examples, and I will re-present these again when you learn how to deal with adding ~ㄹ/을. When you add ~ㄹ/을 to a stem of a word that ends in ㄹ, you actually drop the ㄹ/을 altogether: Again, that is just for your reference. I will teach you more about this irregular when I teach you about the specific grammar within it in Lesson 9. Adding ~ㄴ/은 to Adjectives I mentioned this in some of the sections above, but I would like to organize it all here. In Lesson 4, you learned how to add ~ㄴ/은 to adjectives to describe an upcoming noun. Some irregulars will come into play when adding doing this because of the possibility of adding a vowel to a stem. Let's look at the word "어렵다" as an example. 어렵다 has a consonant as its final letter, which means that ~은 must be added (instead of ~ㄴ). Therefore, we end up with: 어렵은 Because of this, now we now have the final consonant "ㅂ" followed by a vowel, which causes the ㅂ irregular to be applied. The correct conjugation of 어렵다 + ~ㄴ/은 is therefore "어려운." Below is a table that shows how irregular adjectives can change because of adding ~ㄴ/은: That's it! Wow that is a lot of irregulars. Note that these irregulars do not apply to word stems ending with a four-letter syllable. For example, the ㅅ irregular does not apply to 없다, which you will learn about in the next lesson. Check out our Irregular Guide (which is included next) if you are confused (I'm sure you are!). Everybody is confused when they learn these irregulars. Eventually you will reach a point where all of these will come natural to you. Whenever you learn a new word where the stem ends in ㅅ/ㄹ/ㅂ/ㄷ/르/ㅡ just make a mental note about how you should conjugate that word in the futureI don't even have to think about these irregulars anymore because they just flow out naturally. If you can't memorize them all right now, just try to understand them, which will allow you to recognize them later. 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Neonatal neurocritical care – finding and filling the gaps Workshop facilitated by the Institute for Manufacturing, Education and Consultancy Services, Cambridge, 24 May 2016 1 Brain Injury Healthcare Technology Co-operative Contents 2 1. Workshop summary This half-day workshop was designed to explore ways to improve outcomes across the patient journey, create outline ideas for future research and service-development projects, and encourage wider collaboration between brain injury professionals and service providers in these projects. Led by the University of Cambridge Institute for Manufacturing Education and Consultancy Services (IfM ECS), the workshop employed a 'fast-pass' version of the IfM landscaping methodology. Delegates identified targets for reducing costs and achieving earlier diagnosis as key drivers. To provide the evidence-base required to support the introduction of novel solutions and approaches to meet these targets, the establishment of a neonatal early-stage research network to enable access to data on rare conditions was discussed and agreed as an important primary step. The patient pathway experience is characterised by extensive monitoring but limited real-time analysis (e.g. no comprehensive big data analysis or machine learning technology). A notable challenge is the absence of automated early diagnosis of seizures. A key enabler/resource identified is an ongoing trial focussed on the automatic detection of seizures in term babies. A further challenge is that research is not seen as an essential part of the patient pathway. Delegates' vision for neonatal neurocritical care envisages a new set of drivers and trends: * Wearable technology * 3D printing * Creation of well-annotated multi-centre database of high-fidelity monitoring data * Automated sleep analysis on ICU to improve neurodevelopment In this vision, the patient pathway experience is characterised by individualised bedside monitoring and information management as well as efficient use of repurposed drugs for rare neurological disorders. Associated enablers and resources include wearable imaging technologies for continuous monitoring of optical, ultrasound electroencephalography (EEG), (MRI eventually) and ultimately artificial intelligence and computer vision (3D) for continuous monitoring. Five potential projects were proposed for further development: * Real-time video monitoring for parents * Individualised management of preterm infants in neonatal neurocritical care based on real-time multimodal monitoring * Continuous EEG monitoring for early seizure diagnosis * Neuroprotection * Sleep measurement Table 1 (page 4) summarises key details of the selected opportunities. Delegates found the workshop stimulating, enjoyable and insightful. Next steps are review and development of the five potential project opportunities in order to apply for grant funding. The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge \| Title \| \| Opportunity \| Benefits \| \|---\|---\|---\|---\| \| \| \| offers… \| \| \| Real-time video monitoring for parents \| Deeper parental involvement in neonatal care \| \| The need to promote parental well-being and family bonding. Addresses: • increased parental anxiety • physical barriers (travel, family commitments, disability/ health) At the same time enables neurodevelopmental care (newborn behaviours and communication, sleep) and teaching and research and clinical management \| \| Individualised management of preterm infants in neonatal neurocritical care based on real-time multimodal monitoring \| A methodology for integrating, interpreting and exploiting (in real time) multimodal neuro-monitoring data for preterm infants \| \| • Improved outcome using individualised strategy based on real-time multimodal monitoring • Decreased burden of preterm birth on individual, families, society, economy \| \| Continuous EEG monitoring for early seizure diagnosis \| Objectively detect seizures, predict their onset and improve neurodevelopmen- tal outcomes \| \| A cumulative effect across the life- span of individual • Create evidence base for best treatment \| \| Neuroprotection \| Reduce the number of children with brain damage \| \| • We can identify some types of injury at a time when it can be treated • Improve outcomes and reduce suffering \| Table 1 Key details of selected opportunities for further development Neonatal neurocritical care workshop, NIHR Brain Injury Healthcare Technology Co-operative, 24 May 2016 The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge 2. Aims, objectives and approach 2.1 Aims and objectives This event was designed to enable the NIHR Brain Injury Healthcare Technology Co-operative (HTC) to explore gaps in the area of neonatal neurocritical care, and identify opportunities for enabling projects to address those gaps. Its objectives were to: * Determine if healthcare technologies can help improve outcomes across the patient journey in the neuro neonatal intensive-care unit ('neuroNICU') * Create outline ideas for future research and service development projects * Encourage wider collaboration between HTC, brain-injury professionals and service providers in these projects 2.2 Approach Preparation and participation The workshop on 24 May 2016 brought together 16 delegates representing a cross-section of those involved in the patient pathway, for an interactive five-hour programme. A list of delegates is shown in appendix 1 (page 21). Developing the landscape In the first part of the workshop, delegates developed a 'neonatal neurocritical care landscape', building on individual preparatory work. The landscape development enabled identification of key topics, out of which potential opportunities for research and enabling projects were explored. The landscaping process was based on the following questions: * Why do we need to take action (particularly as regards developing needs)? * How can the patient pathway experience be developed to respond to those needs? * What enabling projects and resources are required to deliver that pathway experience? IfM's landscaping process employs individual reflection, group discussion and voting to generate information and ideas, captures and develops these on a large wallchart (the visual format highlighting potential gaps, links, opportunities and challenges), then ranks by voting. The three layers of the landscape are aggregated to identify linkages and clusters (on a 'linkage chart') and hence possible priorities for action. In this 'fast-pass' version of the process delegates, having prepared their individual narratives, presented their key perspectives directly onto all three layers of the landscape in a series of 2–3 minute 'pitches'. Prioritising the findings Delegates collectively reviewed the importance of the items identified then voted on priorities for each layer. The facilitator and client-lead then proposed which themes to investigate. The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge 5 Having identified a number of priority opportunities by this method, delegates formed syndicate groups, each to develop one outline research or enabling project, using a 'project proposal exploration' template. In the final session, syndicates presented their findings for whole-group review. Overview of approach Figure 1 illustrates the workshop approach. Subsequent sections of this report outline the main outputs from the process. Figure 1 Process employed, Neonatal neurocritical care workshop, NIHR Brain Injury Healthcare Technology Co-operative, 24 May 2016, showing templates for individual reflection, whole-group landscape development and syndicate work for topic development. 3. Landscape development The figures below summarise the key elements of the landscape (figure 2) and associated linkage chart (figure 3). Current 2016 Short term 2016 – 17 Medium term 2018 – 20 Long term 2020 – 25 Vision 2025+ Biomarkers Signal processing/neurophysiology Novel/multimodal imaging Other Cambridge Brain Injury Healthcare Technology Co-operative: Neonatal neurocritical care landscape Trenda and drivers STEEPL Social, Technological, Economic, Environmental, Political, Legal developments Strategic healthcare context NHS Patient pathway experience and unmet needs Identification of the vulnerable/at risk infant Condition diagnosis Neuroprotection interventions Family communications Other Enabling projects and resources Enabling projects Technologies Wearable technology 3D printing Targets for reducing costs and achieving earler diagnosis Complex cases require a synthesis of complex data in real time Neonatal early stage research network to enable access to rare conditions Early detection of degree of injury/earlier prediction of prognosis Creation of well-annotated multi-centre database of high-fidelity monitoring data Automated sleep analysis on ICU will improve neurodevelopment Continuous EEG monitoring of infants at risk Extensive monitoring but limited real time analysis (no comprehensive big data analysis or machine learning) Better identification of preterms at risk Automated early diagnosis of seizures is absent Individualised bedside monitoring and information management Enable efficient use of repurposed drugs for rare neurological disorders Research not seen as essential part of patient pathway Real-time video monitoring of infant for parents No robust method to determine how damaged the newborn injured brain Use of blood samples to determine the brain injury NIRS technology/signal processing Multi-modal data collection to review whether brain metabolism can predict outcome early at cotside Develop novel early diagnosis technologies for PAIS Molecular understanding of tertiary damage Wearable imaging technologies for continuous monitoring of optical, ultrasound EEG, (MRI eventually) Artificial intellegence and computer vision (3D) for continuous monitoring Ongoing trial in progress on automatic detection of seizures in term babies Set up trial in which sleep is promoted to see if it improves outcome \| Cambridge Brain Injury Healthcare Technology Co-operative: Neonatal neurocritical care landscape \| \| \| Current 2016 \| Short term 2016–17 \| Medium term 2018–20 \| \| Long term 2020–25 \| \| \| \|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\| \| Trenda and drivers \| STEEPL Social, Technological, Economic, Environmental, Political, Legal developments \| \| \| \| \| \| Wearable technology \| \| \| \| \| \| \| \| \| \| \| 3D printing \| \| \| \| \| Strategic healthcare context \| \| Targets for reducing costs and \| achieving earler diagnosis \| Complex cases require a synthesis of complex data in real time \| Complex cases require a synthesis of complex data in real time \| \| \| \| \| \| NHS \| \| \| Neonatal early stage research network to enable access to rare conditions \| \| \| Creation of well-annotated multi-centre database of high-fidelity monitori \| \| ng data \| \| \| \| \| \| \| \| \| Automated sleep analysis on ICU will improve neurodevelopment \| \| \| \| \| \| \| \| \| \| \| Early detection of degree of injury/earlier prediction of prognosis \| \| \| \| Patient pathway experience and unmet needs \| Identification of the vulnerable/at risk infant \| \| \| \| Continuous EEG monitoring of infants at risk \| \| \| Individualised bedside monitori \| ng and information management \| \| \| \| \| \| \| \| \| Better identification of preterms at risk \| \| \| \| \| Condition diagnosis \| \| Extensive monitoring but limited rea \| l time analysis (no comprehensive big data analysis or machine learning) \| \| \| \| \| \| \| \| \| \| Automated early diagnosis of seiz \| ures is absent \| \| \| \| \| \| \| \| Neuroprotection interventions \| \| \| \| \| \| Enable efficient use of repurposed drugs for rare neurological disorde \| \| rs \| \| \| Family communications \| \| Research not seen as essential pa \| rt of patient pathway \| Real-time video monitoring of infant for parents \| Real-time video monitoring of infant for parents \| \| \| \| \| \| Other \| \| \| \| \| \| \| \| \| \| Enabling projects and resources \| Enabling projects \| \| Ongoing trial in prog \| ress on automatic detection of seizures in term babies \| Set up trial in which sleep is promoted to see if it improves outcome \| Set up trial in which sleep is promoted to see if it improves outcome \| \| \| \| \| \| Technologies \| Biomarkers \| No robust method to deter \| mine how damaged the newborn injured brain \| Use of blood samples to determine the brain injury \| Use of blood samples to determine the brain injury \| \| \| \| \| \| \| Signal processing/neurophysiology \| \| NIRS technology/signal processing \| \| \| \| \| \| \| \| \| Novel/multimodal imaging \| \| Multi-modal data collection to review whether brain metabolism can predict out \| come early at cotside \| \| Develop novel early diagnosis technologies for PAIS \| \| \| \| \| \| Other \| \| \| \| \| Molecular understanding of tertiary damage \| \| \| \| \| \| \| \| \| \| \| Wearable imaging technologies for continuous monitoring of optical, ultrasound EE \| \| G, (MRI eventually) \| \| \| \| \| \| \| \| \| Artificial intellegence and computer vision (3D) for continuous monito \| \| ring \| Figure 3 Neonatal neurocritical care linkage chart, NIHR Brain Injury Healthcare Technology Co-operative workshop, 24 May 2016 The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge 8 The linkage chart visualises relationships between patient pathway experiences/unmet needs and a) trends and drivers and b) enabling projects and resources. It is largely derived from information and ideas contributed by delegates (shown as dark-blue squares), but also includes linkages added retrospectively by IfM (light-blue squares). Appendix 2 (page 22) lists the full output relating to 1. Trends and drivers, 2. Patient pathway experience and unmet needs, and 3. Enabling projects and resources, showing delegate views of the importance and timeframe attached to each item. 4. Selected topic development Tables 2–6 below show the topic development outputs as explored by delegates in syndicate groups: * Real-time video monitoring for parents * Individualised management of preterm infants in neonatal neurocritical care based on real-time multimodal monitoring * Continuous EEG monitoring for early seizure diagnosis * Neuroprotection * Sleep measurement 9 4.1 Real-time video monitoring for parents \| Proposed project: What problem are we going to solve? \| Parental involvement in neonatal care \| \| Team members: Kelly Spike, Ping Yip and Maria Chalia \| \|---\|---\|---\|---\| \| Why should we do this? \| • Parents are sometime unable to visit their babies (because of distance, siblings, twins) • Increased maternal depression in the NICU (and dads!) • Enable bonding, attachment and closeness (reduce anxiety?) • Help clinical diagnosis in certain infants • Neurodevelopmental teaching/care; NIDCAP; newborn behaviour and communication; sleep • For research and teaching purposes \| \| We have a need/opportunity for: Deeper parental involvement in neonatal care \| \| What is the scale of the problem? \| Every neonate; neonatal networks \| \| \| \| Required outcome and timing to complete \| Ethics; allow parental option (facetime instead); NHS computing facilities \| \| \| \| Staged deliverables and dates \| \| Now \| Because: • The need to promote parental well-being and family bonding • Increased parental anxiety • Physical barriers (travel, family commitments, disability/ health) • At the same time enable neurodevelopmental care (newborn behaviours and communication, sleep) and teaching and research and clinical management \| \| What is missing today, for example information? \| No video monitoring \| \| \| \| Current relevant research and other activities \| • Chip subcutaneous implant (motion detection and temperature) for 24-hour monitoring • Infrared 24-hour monitoring (esp. during night) \| \| \| The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge \| Key actions (including proposed team to address) \| Actions: Ethical approval to video for parental, clinical, legal and research; Data protection (pass- worded and encrypted?). Education of staff and parents on how to use equipment (password protected) \| Team members: Consultant in charge of managing monitoring neuroimaging devices with IT support & neurodevelopmental care sister \| \|---\|---\|---\| \| Resource requirements (financial and manpower) \| Equipment/finance – video recorders per cot; online system \| \| \| Other enablers and barriers \| Audio capture? Output might be used for legal proceedings; acute scenarios or procedures (time delay?, witness or not to witness?); could increase parental anxiety; on-going data storage (1hr of recording is ~ 9,000,000MB) \| \| Table 2 Topic development Real-time video monitoring for parents. Neonatal neurocritical care workshop, NIHR Brain Injury Healthcare Technology Co-operative, 24 May 2016 11 * 4.2 Individualised management of preterm infants in neonatal neurocritical care based on real-time multimodal monitoring \| Proposed project: What problem are we going to solve? \| Early warning system based on multimodal neuro-monitoring system in preterm infants for improved outcome Problem: inability to utilise the multimodal monitoring for improving preterm neuro-critical care \| \|---\|---\| \| Why should we do this? \| • Preterm birth in association with significant morbidities, mortalities and neuro-developmental outcome • Increasing prevalence of preterm birth • Huge economic and social cost \| \| What is the scale of the problem? \| £4 billion a year \| \| Required outcome and timing to complete \| • Multicentre research programme with centralised data analysis • Large multimodal longitudinal dataset with clinical annotation • Expert systems of annotated identification and clarification of injury severity and secondary insults \| \| Staged deliverables and dates \| • Unified local data collection system (hardware and software) • Centralised data collection infrastructure; clinical annotation paradigm; data collection phase • Data analysis; data validation (new hardware) \| \| What is missing today, for example information \| • Active involvement of clinicians with real-time annotation • Standardisation \| \| Current relevant research and other activities \| • EEG & seizure (Cork) • Adult TBI data collection analysis projects; Centre-TBI; Track-RBI • Paediatric ADAPT data collection study \| The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge \| Key actions (including proposed team to address) \| Actions: Establishing care team Training/standardisation \| Team members: \| Actions to deliver: • Data collection network with centralised database of high- resolution, high-fidelity data • Established clinical annotation paradigm • Expert system(s) for real-time classification of severity of injury, early warning indicators • New hardware if required \| \|---\|---\|---\|---\| \| Resource requirements (financial and manpower) \| • Significant resource requirement • Funding for data collection systems ; data collection investigators; centralised database • integration & management; data analysis; rolling out expert system for validation; and prototypes \| \| \| \| Other enablers and barriers \| Ethics; reliable annotation (standardised); cannot pilot!; objective reliable outcomes \| \| \| Table 3 Topic development Individualised management of preterm infants in neonatal neurocritical care based on real-time multimodal monitoring. Neonatal neurocritical care workshop, NIHR Brain Injury Healthcare Technology Co-operative, 24 May 2016 4.3 Continuous EEG monitoring for early seizure diagnosis \| Proposed project: What problem are we going to solve? \| Continuous monitoring EEG for early seizure diagnosis \| Team members: Gene Dempsey, John Suckling and Heike Rabe \| \|---\|---\|---\| \| Why should we do this? \| • Prevalence – high impact of intervention; seizures are bad for patients • Opportunity to test a new intervention; dissociation between clinical and electrical seizures • Interference or withdrawal of case/ decision to continue \| We have a need/opportunity for: • Objectively detect seizures • Predict their onset • Improve neurodevelopmental outcomes \| \| What is the scale of the problem? \| Disability long-term outcome \| \| \| Required outcome and timing to complete \| • Seizure burden reduction • Improve neurodevelopmental outcome \| \| \| Staged deliverables and dates \| • CE/quality of EEG caps/ other technology; wireless • Trials of various measurement of seizure detection • Trials benchmark performance algorithm/ expert – different credentials/ age group; disease specific • Trial introduce intervention (which one, when?) \| \| \| What is missing today, for example information \| • Analysis of published animal work – uniform human studies? • Meta-analysis; existing publication on seizure burden and neurodevelopmental outcome; wireless technology • EEG caps to put on easily as standard; • Development of ‘brain health’ index; algorithm for seizure detection; literature reviews on current treatments and their outcomes; integration of risk factors for seizures into decision pathways \| \| The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge \| Key actions (including proposed team to address) \| Actions: Engage with manufacturers (CE) – regulating approvals; engage with groups developing algorithm \| Team members: \| Actions to deliver: • Identify networks • Identify mature technologies • Fluid funding for consortium \| \|---\|---\|---\|---\| \| Resource requirements (financial and manpower) \| • Funding – HTA/, William Trust, EC; steering groups • Patient or parent involvement \| \| \| \| Other enablers and barriers \| • Collaboration with… • Treatment existing; mechanical materials; EUBC; learned societies; WC seizure group \| \| \| Table 4 Topic development Continuous EEG monitoring for early seizure diagnosis. Neonatal neurocritical care workshop, NIHR Brain Injury Healthcare Technology Cooperative, 24 May 2016 4.4 Neuroprotection \| Proposed project: What problem are we going to solve? \| • Rare/genetic regenerative in NICU • Preterm; term – (HIE/stroke) \| \|---\|---\| \| Why should we do this? \| • Improve outcome; economic; reduce suffering \| \| What is the scale of the problem? \| Collectively, large \| \| Required outcome and timing to complete \| \| \| Staged deliverables and dates \| • Inflammatory: Reduce BBB leak; reactive astrocytes; microglia-nano particles • Genomics: injury pathways; extreme phenotype; rare disorders • Follow up: EMR; clinic for severe outcome (CP, IDD) • Delivery: convention; IV-BBB; direct (cells) • Small molecule; ERT; gene; cells; gas \| \| What is missing today, for example information \| All of the above \| \| Current relevant research and other activities \| • Diagnostic imaging • Animal models; human neuropathology • Human cell-based models \| \| Key actions (including proposed team to address) \| Actions: Lead compounds; injury – SAG, EPO; rare – MPS7, Tay Sachs - identify cohorts across regions \| Team members: \| Actions to deliver: • Add therapy to hypothermia e.g. EPO • Possible therapy for preterm e.g. SMA • Personalised medicine for rare genetic disorders • Images, genetics, delivery, trials, laboratory investigation \| \|---\|---\|---\|---\| \| Resource requirements (financial and manpower) \| Full assessment required, but significant resource likely \| \| \| \| Other enablers and barriers \| Patient advocates/engagement \| \| \| Table 5 Topic development Neuro protection. Neonatal neurocritical care workshop, NIHR Brain Injury Healthcare Technology Co-operative, 24 May 2016 4.5 Sleep measurement \| Proposed project: What problem are we going to solve? \| Improved quality of sleep in infants on NICU; lack of/interrupted sleep – poor brain development \| Team members: Jeroem Dudnick, Jeremy Hebden and Topun Austin \| \|---\|---\|---\| \| Why should we do this? \| Problem affects all patients in the ICU (of any age!) \| We have a need/opportunity for: Improve infants’ sleep on the NICU: ‘Chronomedicine is the future’ \| \| What is the scale of the problem? \| Problem affects all patients in the ICU (of any age!) \| \| \| Required outcome and timing to complete \| Technologies to monitor motion – motion sensors, infrared sensors, EMG sensor 1. Bring in all the monitoring technologies (identify the optimal way of measuring sleep) 2. Develop a wearable device, integrating the technologies identified in (1.) \| \| \| Staged deliverables and dates \| Technologies to measure sleep – circadian rhythm, EEG/ a EEG, melatonin?, cortisol? \| Because: • Poor quality sleep is associated with adverse outcomes at all ages • This is particularly true for the developing brain, making millions of neuronal connections (or not) on the NICU \| \| What is missing today, for example information \| • Tailor care and management according to sleep e.g. feeding, drugs (n.b. caffeine) • Technology - wearable, cameras, integrated data analysis • Undertake meaningful research into sleep quality outcome \| \| \| Current relevant research and other activities \| • Research impact of sleep on developing brain • Improved sleep • Improved outcomes \| \| The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge \| Key actions (including proposed team to address) \| Actions: Develop the required technologies \| Team members: \| Actions to deliver: • Develop multimodal wearable technologies Study the impact of sleep (or lack of) in infants on the NICU • Provide a robust evidence base to commercialise this technology across NICU and beyond \| \|---\|---\|---\|---\| \| Resource requirements (financial and manpower) \| A large grant is likely to be required \| \| \| \| Other enablers and barriers \| Challenge of undertaking meaningful research given what is perceived to be an inherent bias among nursing staff \| \| \| Table 6 Topic development Sleep measurement. Neonatal neurocritical care workshop, NIHR Brain Injury Healthcare Technology Co-operative, 24 May 2016 5. Feedback and next steps Delegate feedback as given via the end-of-workshop questionnaire is summarised in appendix 3 (page 26). All delegates felt they were able to contribute, found the workshop stimulating, enjoyable and worthwhile and thought that it provided useful insights. The workshop process and structure were judged as good. Some delegates felt that broadening workshop participation to include, if possible, education and patient/parent representatives would have been beneficial. There were some concerns about temperature control in the venue. This report of the workshop is a draft for circulation, to invite comments from delegates before finalisation. Following finalisation of the report delegates will be invited to contribute to further development of the identified opportunities in order to support application for grant funding. Appendices Appendix 1: Workshop delegates Delegates: 1. Dr Topun Austin, Consultant Neonatologist, Cambridge University Hospitals 2. Dr Rob Cooper, Department of Medical Physics and Biomedical Engineering, University College London 3. Professor Gene Dempsey, Professor of Neonatology, University College Cork 4. Dr Jeroem Dudnick, Neonatologist, Sophia Children's Hospital, Rotterdam 5. Professor David Edwards, Professor of Neonatology, King's College London 6. Professor Jeremy Hebden, Head of Department of Medical Physics and Biomedical Engineering, University College London 7. Maria Chalia, Clinical Research Fellow, Cambridge University Hospitals 8. Professor Heike Rabe, Professor of Neonatology, Brighton and Sussex Medical School 9. Subha Mitra, Clinical Research Fellow, University College London 10. Dr Rob Ross-Russell, Consultant Paediatrician, Cambridge University Hospitals (a.m. only) 11. Professor David Rowitch, Head of the Department of Paediatrics, University of Cambridge 12. Dr Divyen Shah, Consultant Neonatologist, Royal London Hospital 13. Dr Peter Smielewski, Senior Research Associate, Department of Clinical Neurosciences, University of Cambridge 14. Ms Kelly Spike, Neonatal Neurocritical Care Nurse Specialist, Cambridge University Hospitals 15. Professor John Suckling, Director of Research, Department of Psychiatry, University of Cambridge 16. Dr Ping Yip, Lecturer in Neurotrauama, Queen Mary, University of London Facilitators: Andrew Gill, Principal Industrial Fellow, IfM Education and Consultancy Services, Cambridge Steve Chicken, Principal Industrial Fellow, IfM Education and Consultancy Services, Cambridge Also supporting: Peter Jarrett, Deputy Director of the Brain Injury HTC Mita Brahmbhat, Programme Manager of the Brain Injury HTC Talissa Gasser, Programme Coordinator of the Brain Injury HTC Appendix 2: Workshop outputs showing delegate votes A2.1 Trends and drivers \| \| \| \| Timing \| \|---\|---\|---\|---\| \| Swim lane \| Description \| Votes \| \| \| STEEPL Social, Technological, Economic, Environmental, Political, Legal developments \| Wearable technology \| 7 \| long term \| \| \| 3D printing \| 5 \| long term \| \| \| Autonomous technologies \| 2 \| vision \| \| Strategic healthcare context \| Targets for reducing costs and achieving earlier diagnosis \| 6 \| short term \| \| \| Complex cases require a synthesis of complex data in real time \| 6 \| medium term \| \| NHS \| Issues of specialty and research silos/poor access to cardiorespiratory data \| 2 \| current \| \| \| Fewer children with severe neurocognitive or neuropsychological impairment after term asphyxia \| 2 \| vision \| \| Neonatal networks \| Telemedicine for regional and district NICUs \| 3 \| short term \| \| \| Neonatal early-stage research network to enable better access to data on rare conditions \| 5 \| short term \| \| \| Creation of well-annotated multi centre database of high-fidelity monitoring data \| 6 \| long term \| \| \| Automated sleep analysis on ICU will improve neurodevelopment \| 7 \| long term \| The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge \| \| Early detection of degree of injury/earlier prediction of prognosis \| 4 \| long term \| \|---\|---\|---\|---\| \| Targets and strategic outcomes and intentions for patient pathway \| Need for richer clinical information around preterm brain injury \| 2 \| current \| \| \| Improved long-term outcomes for preterm infants \| 3 \| vision \| \| Swim lane \| Description \| Votes \| Timing \| Date \| \|---\|---\|---\|---\|---\| \| Identification of the vulnerable/at-risk infant \| Continuous EEG monitoring of infants at risk \| 6 \| medium term \| \| \| \| Identify high-risk patients \| 3 \| long term \| \| \| \| Better identification of preterm at risk \| 4 \| long term \| \| \| \| Individualised bedside monitoring and information management \| 7 \| vision \| \| \| Condition diagnosis \| Extensive monitoring but limited real-time analysis (no comprehensive big-data analysis or machine- learning technology) \| 4 \| current \| \| \| \| Need for early diagnosis to enable potential therapies to be developed \| 3 \| short term \| \| \| \| Automated early diagnosis of seizures is absent \| 4 \| short term \| \| \| \| Measurement of real-time brain metabolism at cot side leading to a novel neuroimaging technique \| 3 \| medium term \| \| \| Neuroprotection interventions \| Efficient use of repurposed drugs for rare neurological disorders \| 5 \| long term \| \| \| Family communications \| Research not seen as essential part of patient pathway \| 4 \| current \| \| \| \| Real time video monitoring of infant for parents \| 7 \| medium term \| \| A2.2 Patient pathway experience and unmet needs The NIHR Brain Injury Healthcare Technology Co-operative is delivered in partnership between Cambridge University Hospitals NHS Foundation Trust and University of Cambridge A2.3 Enabling projects and resources \| Swim lane \| \| Description \| Votes \| Timing \| Date \| \|---\|---\|---\|---\|---\|---\| \| Enabling projects \| \| Ongoing trial in progress on automatic detection of seizures in term babies \| 4 \| short term \| end of 2016 \| \| Technologies \| Biomarkers \| No robust method to determine how damaged the newborn injured brain \| 3 \| current \| n/a \| \| \| \| Use of blood samples to determine the brain injury \| 3 \| medium term \| 2018 \| \| \| Signal processing/neurophysiology \| NIRS technology/signal processing \| 3 \| short term \| n/a \| \| \| Novel/multimodal imaging \| Multi-modal data collection to review whether brain metabolism can predict outcome early at cot-side \| 3 \| short term \| n/a \| \| \| \| Develop novel early diagnosis technologies for PAIS \| 3 \| long term \| 2020 \| \| \| Other \| Molecular understanding of tertiary damage \| 3 \| long term \| n/a \| \| \| \| Wearable imaging technologies for continuous monitoring of optical, ultrasound EEG, (MRI eventually) \| 11 \| long term \| 2018 \| \| \| \| Artificial intelligence and computer vision (3D) for continuous monitoring \| 7 \| vision \| 2025 \| \| Organisation, processes, people and culture \| \| Set-up trial in which sleep is promoted to see if it improves outcome \| 3 \| medium term \| n/a \| The NIHR 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Summary The findings of the Audience Outlook Monitor in Victoria broadly follow the national results, which point to a positive long-term outlook for re-engagement of audiences. However, right now Victorian audiences are more cautious about attending events relative to those in other States/Territories. 19% of Victorian audiences say they are ready to attend arts and culture events as soon as it's permitted, relative to 22% nationally. Meanwhile, Victorian audiences are highly engaged online, with 79% having participated in digital arts and culture activities, compared with the national average (75%). Victorians are slightly more likely to have paid for an online experience compared to other Australian audiences (34%) but not to be spending more, suggesting there may be room to develop more paid offers for the Victorian market. Introduction This Victoria Snapshot Report identifies insights from 5,869 survey respondents connected with Victorian organisations participating in the Audience Outlook Monitor. The Audience Outlook Monitor is tracking how audiences feel about attending arts and culture events in the context of the COVID-19 pandemic. Baseline data was collected in May 2020 in a cross-sector collaborative survey process involving 44 Victorian arts and culture organisations, including museums, galleries, performing arts organisations and festivals. These organisations (totalling 159 nationally) simultaneously sent a survey to a random sample of their audiences, who had attended a cultural event since January 2018. Read more about the methodology and the types of events that are included. Data from over 23,000 respondents nationally have been aggregated in a freely available dashboard, to assist artists and cultural organisations of all kinds to understand how audiences feel about attending events again. By aggregating the data from all participating organisations, this study provides a detailed resource with insights about all different artforms, types of events and demographic groups in all parts of Australia. Find out how to use the dashboard to access results relevant to you, or read below for the key findings about audiences in Victoria. Returning to events 84% of attendees plan to return to cultural events in Victoria } Overwhelmingly, Victorian audiences plan to return to arts and culture events in future (84%), with 76% planning to attend just as they did in the past and 8% even more often. } On average, 19% of audiences are comfortable attending as soon as restrictions are lifted, which is slightly fewer than the national average (22%). 69% will attend when they deem the risk of transmission to be minimal, while 12% won't be back until there is no risk at all. } The results show that the pandemic will affect who comes back when, the types of events they attend, and the size of events that they feel comfortable with, but few say that they want to choose more light-hearted programs, or works that help make sense of the pandemic, when venues re-open. } The vast majority agree they will be most interested in the same types of events they used to attend (91%). Read on for more information about who will be back and when. Frequent attendees will be back sooner than others } Some groups in Victoria are more likely to attend as soon as restrictions are lifted. This includes: o People who previously attended the performing arts more than once a week (33%, compared to the Victorian average of 19%) o People who feel strongly committed to supporting arts and culture organisations (25%) o Subscribers to performing arts organisations (22%). } In contrast, the groups that are more likely to stay away until there is no risk at all include: o People with a disability (20%, compared to the national average of 11%) o Those who attend the arts a couple of times per year or less (13%) o Those aged over 65 (18%) and over 75 (19%). o People who are self-employed (20%), unemployed (19%) or not in the labour force (19%). Safety measures like hand-sanitiser will make a difference for some attendees } There are a wide range of views about public health measures, and whether safety measures are essential or excessive. } Most Victorian audiences would generally feel encouraged by safety measures like disinfecting public areas (87%) and providing hand sanitiser (87%). There is also general support for social distancing measures, and most performing arts subscribers would be encouraged to attend if patrons were seated apart according to social distancing guidelines (83%). } However, some measures may be polarising with a proportion (25%) saying they would actually be discouraged if they had to wear a face mask compared to those who would be encouraged (39%) by this measure. A proportion would also be discouraged by mandatory temperature checks at entry (11%). } Generally, audience views about venue safety are consistent with, or slightly more cautious, than the national average. 96% of Victorian audiences say these types of safety measures will positively influence their decision to attend, with 33% influenced 'a little' and 63% 'a lot'. } In Victoria, like in other parts of Australia, over 55s are more likely to say that safety measures would positively influence them 'a lot' (67%). However over 65s with a disability are less likely to be influenced by safety measures 'a lot' (57%), with some preferring to simply stay away. Shows and performances Audiences are not yet ready to return to large performance venues } Looking more closely at performance venues, audiences' comfort-levels depend on the size of the venue, and Victorian audiences are among the most cautious nationally right now. } Even if they were open, and following recommended safety guidelines, 12% of Victorian audiences say they would be 'very comfortable' attending a venue seating 100 people today, and 28% say they would be 'somewhat comfortable'. } Just 7% would be 'very comfortable' at venues seating 1,000 or more, which is consistent with the national average, and similar to the proportion that would be very comfortable flying domestically on a commercial airline (9%) right now. } Smaller venues of 50 people or less are the most likely to attract audiences in the near future, with 58% of audiences saying they would be at least somewhat comfortable attending today, if they were open and following relevant guidelines (compared with 62% nationally). } Outdoor programming may be viable sooner than indoor programming, with a greater proportion of audiences feeling comfortable attending an outdoor festival or event at present (64% in Victoria and nationally). } As is shown in the national data, only small numbers of Victorian audiences are actively making plans to attend live shows or performances in future (14%), and among those that are buying tickets, the largest proportion are doing so for events in January 2021 or thereafter (43%). Exhibitions Victorian audiences would largely be comfortable visiting museums and galleries, but not using interactive exhibits } The outlook for museums and galleries is looking more positive and most Victorian audiences say they would be at least somewhat comfortable walking around a museum or gallery (84%) or visiting a community art space (76%) today, if they were open and following recommended safety procedures. } Among frequent museum-goers and those aged between 55 and 64 the numbers that feel comfortable visiting msueums are even higher (88% and 89% respectively). } However, few Victorian audiences, of any age, would feel comfortable using hands-on exhibits at a museum (20%), confirming the need to rethink visitor experience design while health risks remain. Creativity at home Many Victorians have taken up creative hobbies in isolation and most plan to continue after the pandemic } A high proportion of Victorian respondents (50% compared with 46% nationally) are being creative at home more frequently than before the pandemic, and most of those being more creative are planning to continue doing so after the pandemic (88%). } Even among those who rarely attend arts events, a sizeable proportion (47%) are doing creative activities more frequently. One person shares that it has helped them navigate the period: 'Painting has provided me with an artistic outlet that has been calming in these stressful times'. } On average, 7% say they are doing creative activities less frequently, and one person explains, 'I have a busy household with children so haven't had time for my own creative pursuits. If I didn't have children, I would have certainly used the time practising musical instruments and writing music.' } Reading for pleasure and listening to music are common ways people are engaging with art and culture at home, but many audiences are also doing things like making art or craft (44%), making music (27%), making videos or doing photography (26%) and creative writing (19%). } When asked to share an example, many say that they've had a chance to resume long-forgotten hobbies, or finally had time to progress a creative project. One person said, 'I started editing a long-finished draft of a novel that has sat untouched for a couple of years.' } Others shared examples of how their creative interests extend to online and offline environments, 'I've done a bit painting during this time at home… I've been learning more about Melbourne's visual art scene, going on journeys through artists Instagram accounts.' Online engagement 4 in 5 Victorian respondents are participating in arts and culture online } Victorian audiences are highly engaged online, with 79% having participated in digital arts and culture activities compared with the national average (75%). } Victorian audiences are commonly watching arts video content (55%), watching live-streamed events (47%), or doing online classes or tutorials (38%). } Online participation is occurring in all age groups in Victoria: 55% of audiences aged over 75 have watched a pre-recorded performance in the past fortnight, similar to the proportion of under 35s (58%). } In giving examples of what they're doing online, people shared that digital participation has helped with their wellbeing, for example, 'I took online dance classes and learnt routines. The movement and creative output was really mood lifting.' } Many audience members (39%) say they are doing online arts and culture activities more frequently than before the pandemic. Among those who frequently attend the performing arts, this rate is even higher (54%). Online participation is allowing audiences to discover new works } Interestingly, one-third say they are motivated to engage online to support an organisation they feel is important (40%), while others say they are engaging online for their own wellbeing (35%), or to see things that they wouldn't normally be able to see (30%), which is similar to the national picture. } Confirming the audience development potential of this time, a sizeable proportion (32%) have discovered a new artist, artwork or performance online, or they know someone who has (14%). Online discovery is particularly high in frequent attendees who usually attend weekly or more (51%) and under 35s in Victoria (42%). } Several Victorian respondents shared examples of exploring new works with their children, for example, 'my son did an online class with Complete Works Theatre Co and it led us both to explore some spoken word poetry via youtube.' Another shared, 'My daughter has taken an interest in beatboxing and we are going to have an online lesson.' } There are signs that digital participation could translate to attendance at live events after the pandemic. For instance, one person said, 'Pre-recorded content has made me revisit arts organisations (ie The Australian Ballet) which I hadn't engaged with in years. It would make me more likely to attend a performance of the Australian Ballet in the future when I'm able to.' } Streamed performances are also fuelling discussion and interpretation of works. For instance, one Victorian respondent said, 'My friends have been suggesting theatre shows that are now online. We have an email group and send links and then talk about the shows in a chat room. We are loving the opportunity to see National Theatre productions from London.' Digital distribution will continue to play a role for Victorian audiences after the pandemic } Among those Victorians who are participating online more frequently than they used to, most (68%) think they will continue doing so when the pandemic is over, suggesting there will be a long-term role for digital distribution of cultural content. } The intention to continue participating online is higher among some groups, such as people with a disability (75%), those who are caregivers to older adults (70%) and parents of children aged under six (68%). It is weaker among those who usually attend performing arts events once a week (64%), suggesting that frequent attendees may return to their usual patterns, at least to an extent. } One Victorian respondent said, 'I like the increased connectivity and accessibility of many different types of visual and performance culture and online workshops', while another shared that, 'Online participation is increasingly the only way that I will be able to enjoy these activities.' } Some Victorian respondents say that after the pandemic, they would like a choice of attending in-person or watching a livestream (36%). Again, people in Victoria who live with a disability are more likely to want this option available (46%), confirming the role for digital in expanding access to the arts. The Victorian market for digital work could be developed further } In Victoria, most audiences engaging online say they have not paid for any online arts or culture experiences in the past fortnight (64%), though a significant minority have (36%). } Victorians are slightly more likely to have paid for an experience compared to the national average (34%) but not to be spending more. } Among those that have paid for an online arts experience nationally, 36% has spent more than $50 in the past fortnight (34% in Victoria). Nationally, older audiences over 75 years have spent the most (49% have spent over $50), while under 35s have spent the least (19% have spent over $50). } Over two-thirds say they are at least somewhat likely to pay a small amount for access to digital programs in future (70% relative to 68% nationally). } At this point, the most common form of payment has been via donation, with smaller proportions paying for a single online pay-per-view event or purchasing an ongoing subscription for an arts platform. However, these rates could change as the pandemic goes on, and will be measures to watch closely in future data collection phases of this study, planned for July and September 2020. } People are experiencing a variety of barriers to engaging online, but most commonly Victorian respondents report that they either have other priorities for their time (33%) or generally don't know what is on offer (34%), suggesting there could be a role for greater investment in content discovery and digital marketing. } With high rates of online engagement, and a suggested willingness to pay, there may be opportunity to develop more paid offers for the Victorian market. One Victorian respondent gave an example: 'I discovered a new Australian artist on Instagram and bought one of her paintings.' Support Victorian audiences want to support arts and culture through the pandemic, but not everyone feels able to financially } Most audiences surveyed in this study (who are recent attendees of cultural organisations) say they are moderately (53%) or strongly (37%) committed to supporting arts and culture organisations, though some people note that they feel like they are not in a position to do so financially right now. } One respondent in Victoria shared, 'Now more than ever our community will look towards this sector to relieve them of the stresses associated with the pandemic. Whilst our business has been impacted, we will continue to support the industry in some way.' } Many respondents note a connection to the sector in some way, through friends, family, or their work. It's perhaps then unsurprising that respondents say they are more likely to donate to a specific artist or organisation that is important to them (67%), rather than a general sector support fund (50%). } There is a segment who would be willing to participate in other forms of support, like buying vouchers that can be redeemed for future programs (67%) or purchasing a subscription or membership, even if some of the events might be cancelled (55%). } Artists and cultural organisations can use the dashboard to see what demographic groups are most likely to participate in different forms of support, and identify audience segments to develop new offers for. } In terms of organisations' communications with audiences, Victorian respondents are most interested to hear about upcoming online events and digital offerings (58%), and plans for future live events, post pandemic (49%). These tend to rank higher than general communications about how organisations are faring. What's next To explore the data in more detail and find out how audiences for your work are responding, visit the dashboard. Instructions and tips for using the dashboard are available in a short video. In the coming weeks, more Fact Sheets will be released, to provide you with insights about key regions, artforms and topics. You can also expect tips and practical steps to apply the findings in your work. To receive future snapshots, fact sheets and resources in your inbox, as soon as they are available, you can opt in to receive Audience Outlook Monitor news directly from the researchers here. 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Highland Redemption A Duncurra Legacy Novel 100 Shades of Sin... In The Billionaires, Calista Fox delivers a sexy and sensuous friends-to-lovers tale with a delicious love triangle twist. Jewel Catalano, Rogen Angelini, and Vin D'Angelo had been childhood best friends, spending every possible moment with one another. Rogen became her first love, the first one to show her what pleasure could be. Until a volatile feud erupted between their powerful California wine country families and she and Rogen were torn apart from each other. What she didn't expect was to find comfort and passion like she had never known in Vin's arms and bed. But when that too ended in disaster, Jewel moved to San Francisco to work for the Catalano empire. Years later, a series of daring acquisitions brings Jewel back to River Cross, the hometown where Rogen and Vin have recently returned as well. Jewel has the curves, the smarts, and the success to bring any man to his knees—especially the two men who remained best friends and still burn to possess her. Mixing family business with erotic pleasure ignites a smoldering love triangle. But in order to pull off the bold deal that will build the trios' own legacy and to stay in their heady, sensual paradise, they must discover what true love really is—or lose everything their hearts' desire, in The Billionaires by Calista Fox. Princess Sophia has helped her twin sister Lily save the duchy of Marin. But now Sophie faces a greater threat when she sets out to free Palinar from its beastly prince. In this reimagining of Beauty and the Beast, Beauty will have to use all of her strength and intelligence if she is to outwit her enemies, break a curse and find true love. The spy who sought refuge… When injured spy Sir Roger Danby comes asking for shelter at her inn, Lucy Carew is wary. He may be strikingly handsome, but the disgraced single mother has learned the hard way with men like him. Against her better judgment, she gives him refuge. Sir Roger has never been at the mercy of a woman before, and he's never met one as mysterious and bewitching as Lucy. He hasn't come looking for redemption, but Lucy is a woman who could reach in and touch his closely guarded heart… Her parents want a betrothal, but Mairead MacKenzie can't get married without revealing her secret and no man will wed her once he knows. Plain in comparison to her siblings and extremely reserved, Mairead has been called "MacKenzie's Mouse" since she was a child. No one knows the reason for her timidity and she would just as soon keep it that way. When her parents arrange a betrothal to Laird Tadhg Matheson she is horrified. She only sees one way to prevent an old secret from becoming a new scandal. Tadhg Matheson admires and respects the MacKenzies. While an alliance with them through marriage to Mairead would be in his clan's best interest, he knows Laird MacKenzie seeks a closer alliance with another clan. When Tadhg learns of her terrible shyness and her youngest brother's fears about her, Tadhg offers for her anyway. Secrets always have a way of revealing themselves. With Tadhg's unconditional love, can Mairead find the strength and courage she needs to handle the consequences when they do? Elsie thought she had found love.The handsome young minstrel awoke her desire and his music fed her soul. But just as love was blossoming, the inconceivable happened--Elsie awoke more than seven hundred years in the future, in someone else's body.Gabriel Soldani thought he had found love several times, only to have it slip from his grasp. In medical school he had fallen hard for Elizabeth Quinn but their careers led them in different directions. When their paths cross again, he hopes they've been given another chance. There's only one problem...the woman he's never forgotten doesn't remember him.Once love is found...and then lost...can it be found again? Highland RedemptionA Duncurra Legacy Novel Sequel to Sing to Me of Dreams What happens when a single mom falls for the best friend of the brother who doesn't know she exists? An unexpectedly delightful cowboy holiday romance. ????? "Absolutely spectacular." ~Bella (Five-star Amazon Review) When Sheriff Dane Wilson rescues a sassy, single mom and her daughter on a runaway Christmas hayride, he falls hard for the irreverent duo. But when Dane discovers the spunky school teacher has a secret connection to his best friend, his protective nature kicks in. After a wintry first kiss raises the stakes, Dane has to decide whose side he's on. Only a deathbed promise would send Jaimi Hamilton to Rogue Valley for Christmas to track down her brothers, the nine Stockton cowboys who don't know about her. She has no intention of actually introducing herself to them…but her irreverent daughter and a too-sexy-for-his-own-good sheriff have other plans. Sometimes it takes family to help two broken hearts discover the true meaning of Christmas and love that lasts forever. Tropes: Holiday romance. Cowboys. Secret baby (who is all grown up now)! A "his best friend's sister" romance. Small-town sheriff. Humor. Lots of feels. The meaning of family. ????? "Where do I even start with how much I enjoyed this book? It was funny and sexy and I couldn't stop reading it once I started!!!! …a BEAUTIFUL love story." ~Janet W. (Five-star Amazon Review) ????? "This book was AMAZING! Such a cute and sweet story." ~Five Star Amazon Review ????? "It's a family of misfits that's full of love." ~Bonnie (Five-star Amazon Review) ????? "It makes me wish I had family like this." ~Barbara (Five-star Amazon Review) ????? "I just wanted to wrap my arms around him and never let go." ~Dee (Fivestar Amazon Review) ????? "Oh these Stockton men, and that includes extended family like Dane, are totally irresistible! Absolutely swoon worthy, lovable and emotionally driven. Family is everything." ~Madison (Five-star Amazon Review) ????? "That is what family is truly about! Loved every bit of it!" ~S. Kelly (Five-star Amazon Review) ????? "A BEAUTIFUL love story." ~Janet (Five-star Amazon Review) ????? "An absolutely spectacular addition. Written beautifully, with all the characters we know and love from previous books. I laughed aloud so many times, and even shed a few tears. An absolute must read." ~Bella (Five-star Amazon Review) ????? "Sheriff Dane would definitely be my first choice as a Christmas gift with his charm, good looks, and protective nature for those he loves." ~Five-star Amazon Review ????? "A true holiday romance." ~Tina (Fivestar Amazon Review) Books in the Wyoming Rebels series (all books are standalone and can be read in any order): A Real Cowboy Never Says No A Real Cowboy Knows How to Kiss A Real Cowboy Rides a Motorcycle A Real Cowboy Never Walks Away A Real Cowboy Loves Forever A Real Cowboy for Christmas A Real Cowboy Always Trusts His Heart A Real Cowboy Always Protects A Real Cowboy for the Holidays A Real Cowboy Always Comes Home ABOUT THE AUTHOR: New York Times and USA Today bestselling author Stephanie Rowe is "contemporary romance at its best" (Bex 'N' Books). She's author of more than fifty novels, and she's a 2021 Vivian® Award nominee, and a RITA® Award winner and five-time nominee, the highest awards in romance fiction. As an award-winning author, Stephanie has been touching readers' hearts and keeping them spellbound for more than a decade with her contemporary romances, romantic suspense, and paranormal romances. For more information on Stephanie and her books, visit her on the web at www.stephanierowe.com. ????? "Stephanie Rowe infuses her characters with a passion that I have rarely seen matched in any romance novelist I have ever come across." ~ Five-star Amazon Review on Darkness Awakened ????? "What I love about Stephanie's writing is her ability to immerse you in her characters and their world. It is a connection that sticks with you long after the last page." ~Five-star Amazon Review on Burn ????? "It's a gift to tell a story and convey emotion to the reader that really drives their reading experience. Rowe has that gift in spades." ~Kwolff (Five-star Amazon Review on Burn) Finding yourself the girlfriend to a king can be daunting! Victoria Phillips is young and innocent and a breath of fresh air in the world of mercenary and conniving politics in which Dharr Hokum lives as King of Ashir. Dharr has decided that the delicate beauty will be his future bride, although she doesn't really know who he is. But when he finds another man coming out of her apartment, he assumes the worst. Five years later, he finds that he still can't get the innocent looking beauty out of his mind. When his niece and nephew need help, he blackmails Victoria to do the job, intending to have what he denied himself in their previous relationship - namely: her body. Victoria was devastated the last time Dharr walked out of her life. Can she survive it the next time? She has to - for Dharr has threatened her friend and family and she'll do anything to protect them from his harsh punishments. She'll just have to be stronger this time around - and not let him into her heart like she did the last time he swooped into her life. When Maggie Mitchell, is transported to the thirteenth century Highlands will Laird Logan Carr help mend her broken heart or put it in more danger than before? Generous, kind, and loving, Maggie nearly always puts the needs of others first. So when a mysterious elderly woman gives her an extraordinary pocket watch, telling her it's a conduit to the past, Maggie agrees to give the watch a try, if only to disprove the woman's delusion. But it works. Maggie finds herself in the thirteenth century Scottish Highlands, with a handsome warrior who clearly despises her. Her tender soul is caught between her own desire and the disaster she could cause for others. A collection of seven novellas by seven bestselling authors of Scottish historical romance, spanning five hundred years. Will she find a way to resolve the trouble and return home within the allotted sixty days? Or will someone worthy earn her heart forever? One week with the man I never got over. One week where I pose as his fiancée. One week where I act like I'm madly in love with him. I can survive that. Maddie Morland. My shining star.She's the only woman I've ever loved.The only woman I can't get out of my mind.Now, nine years later, she's back.She needs money. I need a fiancée.I tell myself that all I want is closure.But things have never been that simple where Maddie's concerned...* Cameron Drake.He was always too good for me.My mother was a drunk. My father was in jail.Cameron was my refuge. My escape. Until his father drove me away.But now?Cameron's a billionaire. Sexier than ever.He wants to pretend we're engaged. Wants me to pretend I'm still in love with him.Except I won't be pretending...Fake Fiancé is a standalone romance with a guaranteed HEA and no cheating. It was previously released in a boxed set. Returning home to Willow Park, Illinois to care for her ailing father, Lucy Flint, who is now sober, wiser and ready to make amends to the very long list of those she wronged in her wild younger days, hopes for a second chance at love with Dr. Richard Hunter, the ex-boyfriend she left behind years ago. Original. The Golden Couple is the next electrifying novel from Greer Hendricks and Sarah Pekkanen, the #1 New York Times bestselling author duo behind You Are Not Alone, An Anonymous Girl, and The Wife Between Us. If Avery Chambers can't fix you in 10 sessions, she won't take you on as a client. Her successes are phenomenal--she helps people overcome everything from domineering parents to assault--and almost absorb the emptiness she sometimes feels since her husband's death. Marissa and Mathew Bishop seem like the golden couple--until Marissa cheats. She wants to repair things, both because she loves her husband and for the sake of their 8-year-old son. After a friend forwards an article about Avery, Marissa takes a chance on this maverick therapist, who lost her license due to controversial methods. When the Bishops glide through Avery's door and Marissa reveals her infidelity, all three are set on a collision course. Because the biggest secrets in the room are still hidden, and it's no longer simply a marriage that's in danger. A Macmillan Audio production from St. Martin's Press "THE GOLDEN COUPLE is my favorite kind of thriller: a guessing game filled with characters you care about and twists you don't see coming. THE GOLDEN COUPLE takes a deep dive into a marriage, where what you see on the surface is not necessarily the truth, and the results are mesmerizing. Add to this a therapist who doesn't play by the rules and you have an utterly compelling, spellbinding read." -- Lisa Jewell, Author of THEN SHE WAS GONE and INVISIBLE GIRL "THE GOLDEN COUPLE is a propulsive, twisty, unputdownable thriller - with two heroines you won't be able to get enough of... and a twist you'll never see coming. Greer Hendricks and Sarah Pekkanen have outdone themselves!" -- Laura Dave, Author of THE LAST THING HE TOLD ME "THE GOLDEN COUPLE is propulsive and thrilling. It grabbed me from the first page and didn't let go. A page-turner that will keep you keep you guessing until the very end." -- Taylor Jenkins Reid, author of MALIBU RISING and DAISY JONES AND THE SIX Gennie MacDonnell grew up surrounded by love. Even so, she doesn't expect her marriage to be marked by all-consuming passion. She was betrothed to Aedan Munro when she was but a lass of twelve. Still, she does hope for companionship¿and perhaps a bit more. But she learns quickly learns both wishes are in vain.Aedan Munro was taught the importance of honor, duty, and respect¿but never love. Unbeknownst to him, his entire life has been shaped by a tragedy that happened long before he was born. But, to his surprise, the sweet lass he marries stirs both his heart and his desire. It flies in the face of everything he's been taught, but it makes him yearn for more¿for something he believes he can't have.In spite of the demons of the past, will they be strong enough to listen to their hearts and claim the love of a lifetime? Electra Crippen has fallen in love with Frenchman Roger Marchand's old-world ways. She doesn't know Roger and the Englishman he battled were caught in a time warp centuries earlier. When Electra and her sister disappear clues show they'd been caught in the same time warp. Roger knows he must go back to save them-back to enemy land and war. Laird Niall MacIan needs Lady Katherine Ruthven's dowry to relieve his clan's crushing debt but he has no intention of giving her his heart in the bargain. Niall MacIan, a Highland laird, desperately needs funds to save his impoverished clan. Lady Katherine Ruthven, a lowland heiress, is rumored to be "unmarriageable" and her uncle hopes to be granted her title and lands when the king sends her to a convent. King David II anxious to strengthen his alliances sees a solution that will give Ruthven the title he wants, and MacIan the money he needs. Laird MacIan will receive Lady Katherine's hand along with her substantial dowry and her uncle will receive her lands and title. Lady Katherine must forfeit everything in exchange for a husband who does not want to be married and believes all women to be self-centered and deceitful. Can the lovely and gentle Katherine mend his heart and build a life with him or will he allow the treachery of others to destroy them? Married for six years, and still a virgin! Sasha had fallen in love with Damon at first sight, only to live for the next six years in almost complete isolation from him. She had tried desperately to turn herself into the perfect wife for his infrequent visits, but no more! She was through trying to become someone she wasn't. And she was finished reading about his mistresses in the tabloids. She'd had enough! So why did her heart race when he walked through the door? And how did she end up in his bed? Damon Galanos had been forced to marry Sasha to retain ownership of his ancestral home, but he never intending to stay married to the innocent girl. However, after destroying her grandfather for his blackmail, Damon found that he couldn't get Sasha out of his mind. So he returned to his "wife", realizing she had become a beautiful woman – one he planned to explore further. Imagine his surprise when his docile wife demanded a divorce! Lady Gillian MacLennan's clan needs a leader, but the last person on earth she wants as their laird is Fingal Maclan. She can neither forgive nor forget that his mother killed her father, and, by doing so, created Clan MacLennan's current desperate circumstances. King David knows a weak clan, without a laird, can change quickly from a simple annoyance to a dangerous liability, and he cannot ignore the turmoil. The MacIan's owe him a great debt, so when he makes Fingal MacIan laird of clan MacLennan and requires that he marry Lady Gillian, Fingal is in no position to refuse. In spite of the challenge, Fingal is confident he can rebuild her clan, ease her heartache and win her affection. However, just as love awakens, the power struggle takes a deadly turn. Can he protect her from the unknown long enough to uncover the plot against them? Or will all be lost, destroying the happiness they seek in each other's arms? Sometimes a bad boy can be a good man.Lucas Grant¿s brother is going to be New York Times and USA Today bestselling author Ruth Cardello returns with an irresistible series about sexy billionaires and the strong-willed women who tame them. Brett Westerly is his father's golden child, but it's come at a cost. As head of the family corporation, he throws himself into his work—hiding in his office is easier than confronting the reality of his broken family. After a bitter divorce that split the family and divided loyalties, the wealthy Westerly matriarch offers an early inheritance to any grandchild who marries and invites the entire family to the wedding. Brett's brother Spencer rashly gets engaged, and Brett knows it's his duty to intervene. But he never imagined the unwelcome desire Spencer's fiery fiance would spark in him. Now the man who's used to getting everything he could want has met the one woman he can't have. Ever since she was a girl, Alisha Coventry considered Spencer and his sister Rachelle the family she didn't have. When Spencer asks for her help, Alisha has no problem becoming his fake fiance—until she meets Spencer's sexy older brother Brett. The chemistry between them is undeniable—forbidden—but as their relationship deepens, Brett is determined to have her. Alisha only wanted to help the family make amends. Now she's falling for the wrong Westerly. Page 12/24 furious. Lucas was supposed to secure a betrothal with a wealthy heiress to save his clan from financial ruin. After meeting her, he cannot marry the detestable woman.As he flees Edinburgh to escape her, he happens upon six men who are holding a lovely Highland lass captive. He can¿t just leave her to whatever fate awaits, so he rescues her. Well, perhaps rescue isn¿t the right word¿When he learns the feisty lass he stumbled upon is Ailsa MacLennan, he sees another way to help his clan. He¿s going to hold her for ransom.But when she steals his heart, what will the ransom be? When Lady Alyse de Courcy is betrothed to Sir Geoffrey Longford, she has no choice but to make the best of a bad bargain. The hulking knight is far from her ideal man, and although he does possess some wit and charm, he is no match for the sinfully sensual man she secretly admires, Thomas, Earl of Braeton, her betrothed's best friend. From the first, Sir Geoffrey finds himself smitten by Lady Alyse, and, despite her infatuation with his friend, vows to win her love. When Geoffrey puts his mind to wooing Alyse, he is delighted to find her succumbing to his seduction. But when cruel circumstances separate them, Geoffrey must watch helplessly as Thomas steps in to protect Alyse-and falls in love with her himself. As the three courtiers accompany Princess Joanna to her wedding in Spain, they run headlong into the Black Plague. With her world plunged into chaos, Alyse struggles with her feelings for both the men she loves. But which love will survive? comply. ...At least in appearance. Katherine Gordon wants nothing to do with the Katherine, Alexander vows to move heaven and earth to save her. Zach Hayden was an ordinary guy until an accident in Gavin Stanton's research lab left him howling at the moon. Turned into a werewolf by the same serum he helped to create, biochemist Zach is now seven inches taller, has seventy pounds of new muscle, and, well -- everything got bigger. Sophia Stanton is a Cruelly betrayed by the woman he loves, Alexander MacGregor vows it will be a cold day in hell before he gives his heart again. But as next in line to become laird, he is given an ultimatum; wed a mysterious lass within five days or forfeit his lands and his birthright to become the next laird. Distrust and dark secrets urge him to refuse, but the duty he has trained for all his life compels him to arrogant Highlander to whom she suddenly finds herself betrothed. His handsome looks, intelligence and great strength mean naught. Another man had seemed just as appealing, once. That was before she learned the treachery of a heart of stone hidden behind a handsome smile. She would not let her heart be broken again. Forced together by fate, Alexander and Katherine agree on only one thing. Love is not to be trusted. Yet when nameless danger threatens confident billionaire bear shifter who enjoys the finer things in life -- especially fine men. Unlike her older brother Gavin, she has no plans to settle down with just one mate. Why limit yourself to a single taste when you can have a little lick of everything? Unconvinced that Zach has adjusted to his transformation, Sophia's brothers confine Zach to their family compound in Montana, where Zach and Sophia both hear the Beat, an old shifter legend that guarantees they are made for each other, is falling in love their fate—or is it just wishful thinking? family. International Bestselling Author Ava Miles presents the much-anticipated installment of the bestselling Dare Valley series about two people coming home and fighting for a second chance at love. J.T. Merriam has a bottle of champagne on ice for the moment his soul-sucking divorce is final—and he plans to share it with the woman who has made him believe in happily ever after again. Not only is Caroline Hale his partner in opening the new Merriam Art Museum in Dare Valley, but she's helping him heal, showing him that love isn't a four-letter word. The only problem: his ex is determined to destroy every thing he has—including Sophia offers to teach him how to manage his new powers—and libido. But when When her powerful family questions his motives and powers, can Zach rise to the occasion— And become Sophia's true alpha? Millions of readers have fallen in love with Ava's bestselling books...come join the his relationship with Caroline. J.T. tries to cut her off, but it seems she's always Page 16/24 one step ahead. When she shows up in Dare Valley with all her furs and ferocity, everyone is worried, especially J.T.'s rough-and-tumble twin brother and Arthur Hale, his adopted uncle and newspaper giant. One brief mistake isn't going to determine his life, and it's certainly not going to stop J.T. from wooing the woman he loves. Between the clown (don't ask) and the gelato (yes, please), he's doing his best to keep both of their spirits up. But then his ex goes after Caroline, and all bets are off… PRAISE: "Ava's story is witty and charming." Barbara Freethy #1 New York Times Bestselling Author on Nora Roberts Land "On par with Nicholas Sparks' love stories." Jennifer's Corner Blog "The constant love, and the tasteful sexual interludes, bring a sensual, dynamic tension to this appealing story." Publisher's Weekly "I am adding Ava Miles to my list of always reads like Susan Mallery, Jill Shalvis, Kristen Ashley, and NORA ROBERTS." Marjay's Reading Blog "Miles' story savvy, sense of humor, respect for her readers and empathy for her characters shine through..." USA Today on The Gate to Everything Submit to desire...Surrender controlCome play at Hidden Gem, an elite, highly discreet adult club on Florida's west coast.Cassandra Hastings, is new to the lifestyle, but has grown to trust club owner, Tristan Cabot, implicitly. In fact, she is hoping for more...hoping for his heart. Tristan, who agreed to take Cassandra on as a trainee is finding it harder and harder to maintain a professional distance. He too wants more. The foundation of any good relationship is trust but between a Dominant and a submissive it is absolutely vital. When it's challenged, will they go their separate ways?A full-length, billionaire romance with no cheating and a guaranteed HEA. It includes consensual explicit content.Previously published as Trust and Betrayal, under the pen-name Lexi Hawthorne. Two souls in need of healing. Two hearts destined to beat as one. Lady Constance de Bret was determined to be a nun, until shadows from the past eclipsed her present. Marriage is the safest option, but she insists on a spiritual union, in which physical intimacy is forbidden. Not so easy with a bridegroom who wields unparalleled charm! But a long-buried secret could taint his affection and cloak her in shadow forever. Back from the Crusades, Sir Robert le Donjon craves a home of his own and children to inherit it. From the moment he meets Constance, he feels a mysterious bond between them. When she's threatened, he vows to protect her and agrees to the spiritual marriage, with the hope of one day persuading her to enjoy a "real" one. She captivates him but opens old wounds and challenges everything he thought he believed. Billionaire Ian Shaw can have everything he wants--except a happy ending. Or at least that's what it feels like with his fortune recently liquidated, his niece, Esme, still missing, and the woman he loves refusing to speak to him. In fact, he doubts she would date him even if they were stranded on a deserted island. Despite her love for Ian, Sierra Rose knows he has no room in his life for her as long as the mystery of his missing niece goes unsolved. The only problem is, Sierra has solved it, but a promise to Esme to keep her whereabouts secret has made it impossible to be around Ian. When the PEAK chopper is damaged and Sierra lacks the funds to repair it, Ian offers a fundraising junket for large donors on his yacht in the Caribbean. But the three-day excursion turns into a nightmare when a rogue wave cripples the yacht and sends the passengers overboard. Shaken up and soaked to the bone, Ian finally has a chance to test his theory when he and Sierra do indeed find themselves washed up on a strange, empty shore. It will take guts and gumption for the PEAK team to rescue the duo. But it will take a miracle to rescue Ian and Sierra's relationship. What if I Fall was originally released as one of two full-length novels included in, The Choice. Sixty days in another life, another time¿it¿s tempting. Sara Wells is in Venice, preparing to leave on a fourteen day cruise to Greece, when Gertrude offers her the pocket watch. But Sara is a romance author and worries she¿ll fall in love. The problem is, she¿s already in love with Mark. She suspects he¿s ready to propose to her. She doesn¿t want to have to make that kind of choice.But the universe unfolds as it should, and when humans close doors, fate often opens a window. And fate, with a little help from Gertrude, ensures that Sara encounters a traveler from the past as well as more intrigue than she can pack into the books she writes. A knight to protect her—this Yuletide By order of the English king, Alice of Swaffham searches London nobility for the traitor dealing information to the Scots. Little does she know that the mysterious spy she seeks is the man she once loved and thought she'd lost forever… If Hugh of Shoebury felt unworthy of Alice before, as the Half-Thistle spy he can never claim her heart. Now he must Tomas's life changed forever when at the age of seven he was adopted by Laird and Lady Maclan ending the abuse he'd suffered at Ambrose Ruthven's hand. He'd never looked back and never intended to But fate had other plans... Now, nineteen years later, he runs headlong into his past. The Ruthvens are in trouble and Tomas is in a position to help them. But can he set aside his hatred for Laird Ruthven for the good of the clan into which he was born? Fate always adds a twist... Laird Ruthven's daughter is not what Tomas expected. Vida Ruthven is sweet, smart, and utterly irresistible. Now, Tomas must choose between being the savior or taking the ultimate revenge. fight to keep not only his dark secrets—and Alice—safe from a vengeful king…but also his burning longing for her at bay! Grace Breive is strong and independent because she has to be. She has a wee daughter to care for and, having lost her parents and husband, has no one else on whom she can rely. Driven from the only home she has ever known, she travels to Castle Sutherland to find a grandmother she never knew she had. As Laird Sutherland's heir, Bram Sutherland understands his obligation to enter into a political marriage for the good of the clan, but he is captivated by the beautiful Calder MacGerry, laird of an impoverished clan, has resolved to end the bitter feud between the MacGerrys and Sinclairs. He jumps at Laird Sinclair's offer of marriage to his only daughter, Katja, to seal the agreement between their clansonly to get more than he bargained for.Katja's chance to escape her father's harsh treatment appears to be too good to be true. But becoming Lady of a clan that despises her because she's a Sinclair, doesn't make her life any easier. When the attacks turn deadly, she fights her way out, making a dangerous passage to the Shetland Isles for refuge with her mother's Viking family.Calder and Katja's marriage, built on mistrust, rushes quickly into disaster. As Calder seeks to repair the damage, Katja discovers not another enemy, but a husband who pledges a new beginning. and resilient young mother. Will Bram and Grace follow the dictates of their hearts, or will echoes from the past force them apart? Does he hate her clan enough to visit his vengeance on her? Or will he listen to her secret and his own heart's yearning? Hatred lives and breathes between medieval clans who often don't remember why feuds began in the shadowed past. But Eoin MacKay remembers. He will never forget how he was treated by Bhaltair MacNicol-the acting head of Clan MacNicol. He was lucky to escape alive, and vows to have revenge. Years later, as laird of Clan MacKay, he gets his chance when he captures Lady Fiona MacNicol. His desire for revenge is strong but he is beguiled by his captive. Can he forget his stubborn hatred long enough to listen to the secret she has kept for so long? And once he knows the Anna MacKay fears the MacLeods. Andrew MacLeod fears love.Anna, angry with her brother, took a walk to cool her temper. She had no intention of venturing so close to MacLeod territory--until she saw a wee lad fall through the ice.Andrew becomes enraged when it appears the MacKay lass has abducted his son, his last precious connection to the wife he lost--until he learns the truth. Anna, risked her life to save his beloved child. Now there is a chance to end the generations old hate and fear between their clans.Fate connects them. The desire for peace binds them. Will a rival tear them apart? truth, can he show her she is not alone and forsaken? In the end, is he strong enough to fight the combined hostilities and age-old grudges that demand he give her up? The electronic version of Highland Revenge can be found in the collection Highland Winds - The Scrolls of Cridhe Volume 1. Collects four paranormal romances that star shape-shifting men. After losing her soulmate, Cassie Calloway was heartbroken and didn¿t know how she was going to move on. Then Gertrude, an immortal spirit, offered her an opportunity to spend sixty days in another time, as another person. Sixty days to step away from her sorrow. Sixty days to begin healing. How could she refuse that? So with the aid of a remarkable pocket watch, Cassie finds herself in fourteenth century Scotland on the adventure of a lifetime.The situation seemed perfect.But with the pocket watch, things are never as simple as they first appear¿ Darek Christiansen is wounded and angry since the tragic death of his wife, Felicity. New assistant county attorney Ivy Madison simply doesntt know any better when she bids on Darek at the charity auction. Nor does she know that when she crafted a plea bargain three years ago to keep Jensen Atwood out of jail and in Deep Haven fulfilling community service, she was releasing the man responsible for Felicity's death. Can they work through their prayers when caught between new love and old grudges? Can a twenty-first century independent woman find her true destiny, in thirteenth century Scotland? At his father's bidding, Cade MacKenzie begs a favor from Laird Macrae--Lady MacKenzie desperately needs the renowned Macrae midwife. Laird Macrae has no intention of sending his clan's best, instead he passes off Elsie, a young woman with little experience, as the midwife they seek.But fate--in the form of a mysterious older woman and an extraordinary pocket watch--steps in. Elizabeth Quinn, a disillusioned obstetrician, is transported to the thirteenth century. She switched souls with Elsie as the old woman said she would but other things don't go quite as expected. Perhaps most unexpected was falling in love with Cade MacKenzie. The third book in the Larson Brothers series from New York Times bestselling author Cherrie Lynn is the sexiest installment yet! Youngest Larson brother Damien has the luck of the devil. Fast talking and faster thinking, he owns a successful nightclub in Houston and runs an illegal poker room upstairs. After a troubled childhood, now nothing is out of Damien's reach—except his accountant, Emma Haskell. Emma has always been drawn to Damien's dark intensity and the gleam in his eyes that promises more than she can possibly handle. But when her brother's gambling threatens to destroy her family, Damien makes her an offer she'd be crazy to accept—but can't refuse: her brother's debts will be forgiven, and Emma belongs to him for thirty days. In Damien's world, he shows his angelic bookkeeper what it's like to live with the devil. But Emma brings out a side in Damien he thought didn't exist. Will the flames of lust Copyright : www.treca.org Get Free Highland Redemption A Duncurra Legacy Novel scorch them both, or will this beauty tame the beast and give him something to fight for? Raw Heat scorches with emotional intensity and smoldering passion that will leave readers spellbound! Copyright: 2357757dcaa882ae138ea458b8e50a54 Torn from his Romany mother's arms as a small boy, Viscount Emilian St. Xavier has spent a lifetime ignoring the whispers of gypsy that follow him everywhere. A nobleman with wealth, power and privilege, he does not care what the gadjos think. But when the Romany come to Derbyshire with news of his mother's murder at the hands of a mob, his world implodes. And Ariella de Warenne is the perfect object for his lust and revenge…. Ariella de Warenne's heritage assures her a place in proper society, though as a radical and independent thinker she scorns her peers' frivolous pursuits in the Ton, fashion and marriage. Until a Roma camp arrives at Rose Hill, and she finds herself drawn to their charismatic leader, Emilian. Even when he warns her away, threatening that he intends to seduce and destroy her, she cannot refuse him. 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*Mini-grant and Website Launch Announcement* Posting Date: November 10, 2016 Funding Activity: Child Passenger Safety Intervention Activity Funding Funding Purpose: The overall goal is to support existing or create new child passenger safety efforts in tribal communities. Application Deadline: December 12th, 2016 Dear Sir or Madam: Motor vehicle injuries are the leading cause of death among Native American and Alaska Native children. Administered by the Northwest Portland Area Indian Health Board and funded by the National Institute for Minority Health and Health Disparity, the Native CARS Study is dedicated to improving the use of child safety seats in tribal communities and keeping children safe. Enclosed, please find information about mini-grant opportunities from Native CARS that will be available with the launch of the Native CARS Atlas website, a community guided resource from Tribes for Tribes. Mini grants will cover a selection of activities available to your community related to child passenger safety. To receive intervention activity funding, you will be required to attend & complete a 3-day workshop in Portland, OR (all travel expenses paid) from January 10-12, 2017. While some documentation is required before this workshop, we will provide instruction on data collection and provide assistance with activity plans and evaluation measures at this workshop. Only seven Tribes or tribal organizations will be awarded funding. Feel free to contact me at firstname.lastname@example.org or 503-228-4185 with questions. Thank you for supporting child passenger safety in your community. We look forward to working with you to improve child passenger restraint use in your community. Sincerely, Tam Lutz, MPH, MHA Native CARS Project Director Mini-Grant Application Checklist As you go through the steps of completing your mini-grant application, please use this checklist to ensure the application is completed correctly. ☐ Signed Application Form (part 1) ☐ Selected Data Collection Method (part 3) ☐ Selected Community Intervention Activity (part 4) ☐ Attach Tribe or Tribal organization documentation (at the discretion of the Tribe or Tribal organization) that indicates Tribe or Tribal organization supports mini-grant application (e.g., letter of support, Tribal resolution). ☐ Return application to email@example.com or send by COB 12/12/16 to: Tam Lutz Native CARS Project Northwest Portland Area Indian Health Board 2121 SW Broadway, Ste 300 Portland, OR 97201 Native CARS Mini-Grant Application CFDA: 93.307 Part One: Applicant Information Tribal Organization: EIN: Address: Phone: Email: Contact Name for Proposal: Lead (if different than contact above), the person who will lead the scope of the work described in this application and attend workshop: Name: Phone: Email: Total Award Amount: $7,000 ($1,000 for coalition building; $1,000 for data collection; $5,000 for intervention) Facilities and Administration (F&A) costs or indirect rate: Transportation/Hotel Accommodations: All travel expenses – lodging at Marriott Residence Inn Riverside in Portland Oregon, per diem, air travel and/or mileage – will be provided by NPAIHB. Statement of Intent/Terms of Reimbursement: By signing this application, I agree to attend all three days of the Native CARS mini-grant workshop. Upon successful completion of the workshop, I will be awarded the full grant amount to be spent only on coalition building, data collection activities and the selected community activity intervention plan. Signature: ___________________________ Date: ________________________ The Child Safety Coalition functions as advocates for appropriate child passenger safety in the community. Creating a Child Safety Coalition of individuals who have knowledge about or interest in child passenger safety can help you with the planning and execution of your proposed activities. Further information about building your Child Safety Coalition will be provided at the Native CARS Atlas workshop. Prior to application, please begin investigating potential collaborators and list below. Potential collaborators may include a Head Start staff member, Police Chief, Tribal Attorney etc. Note: you may finalize this during the workshop. The Coalition can expect to meet four times during the year to be determined by the members. Coalition members may attend a Safe Native American Passenger (SNAP) training provided by a Child Passenger Safety Technician within their community. Collaborators: (This may be a tentative list that you finalize during workshop) Budget: We anticipate the following expenses will be incurred to form your Coalition. \| Expense \| Amount \| \|----------------------------------------------\|--------\| \| SNAP Training Expenses \| \| \| • Trainer \| 100 \| \| • Food \| 90 \| \| • Materials (for Binders/Printing SNAP materials) \| 30 \| \| Team Vests ($30 x 6 vests) \| 180 \| \| Honorarium ($100 x 6) \| 600 \| \| Total \| $1,000 \| Data collection is a necessary component in any successful community intervention. To ensure sustainable interventions, it is important to understand current child safety seat usage in the community as well as community beliefs about child safety seat usage. For those communities who already have car seat data, you may consider expanding on existing data with a focus group. NOTE: we will provide data collection training to applicants during the workshop. Below are two choices of data collection: vehicle observation or focus group. Please review and select one of the following data collection methods, by checking the box next to the data collection method you prefer. ☐ VEHICLE OBSERVATION (e.g. current car seat usage, # observed vehicles) The tribal organization above will use the Native CARS vehicle observation protocol to collect data on how community children ride in motor vehicles. This will allow us to determine the proportion of children who are properly restrained, assess risk factors for improper restraint, and focus our intervention efforts accordingly. Each survey takes 1-2 minutes to complete. The driver will receive a token of appreciation for their time. Objectives: Objective 1: Collect data on 100 vehicles with child passengers age 8 & younger traveling on or near tribal communities Objective 2: Enter the data into a database for automatic analysis Objective 3: Review the data report to understand the percent of children who are properly restrained, incorrectly restrained, and unrestrained and identify which children are at increased risk for riding incorrectly restrained or unrestrained. Use of computer with Microsoft Excel will be needed. Evaluation Measures: - Number of vehicles observed - Number of children observed - Data was entered into database (Yes, No) Budget: \| Expense \| Amount \| \|----------------------------------------------\|---------\| \| Incentive items for participating drivers ($5 per observation/interview) \| $500 \| \| Clipboard with storage (2 at $15 each) \| $30 \| \| Printing of survey forms \| $70 \| \| Interviewer honorarium \| $400 \| \| Total \| $1,000 \| Time Line: To be completed at workshop Date Due: TBD ☐ FOCUS GROUP (e.g. community knowledge, attitudes, beliefs, barriers, facilitators) The tribal organization above will use the Native CARS focus group protocol to obtain a community context about child passenger restraint usage; community members will share what they know about child passenger restraints, their observations of restraint use in their community, as well as “their stories” to illuminate any common attitudes or beliefs about child passenger restraints. This will allow the Tribe to identify barriers that may prevent drivers from properly restraining their child passenger and facilitators of proper restraint of child passengers. The focus group should take no more than one hour. Objectives: Objective 1: construct no more than 10 focus group questions Objective 2: recruit 8-12 focus group participants Objective 3: Hold 1 focus group Objective 4: Review the transcripts or written notes to understand the common themes discussed, barriers and facilitators Evaluation Measures: - Number of participants in attendance - Completion of focus group (Yes, No) - Focus group data were transcribed, organized and reviewed (Yes, No) Budget: \| Expense \| Amount \| \|----------------------------------------------\|---------\| \| Incentive items for participating participants ($25 per observation/interview) \| $300 \| \| Dictation recorder \| $400 \| \| Printing \| $70 \| \| Focus group facilitator honorarium \| $100 \| \| Transcription of 60 minute focus group \| $130 \| \| Total \| $1000 \| Time Line: To be completed at workshop Date Due: TBD Part Four: Intervention Activity Plans $5,000 Creating intervention activity plans will allow you to design effective, community-based interventions and develop strategies to improve car safety seat use in your community. Attached are six intervention activity plans that other northwest Tribes have designed and implemented successfully. Please review and select one of the intervention activity plans below. ☐ Child Passenger Safety Technician/Car Seat Clinic (Total Cost: $5,000) ☐ Child Passenger Law (Total Cost: $5,000) ☐ Law Enforcement Training* (Total Cost: $5,000) ☐ Distribution of Child Safety Seats/RPMS Patch** (Total Cost: $5,000) ☐ Media Campaign (Total Cost: $5,000) ☐ Community Education & Outreach (Total Cost: $5,000) Must work with a CPS Tech (local or Native CARS) for Law Enforcement Training Must have CPS Tech locally available for Child Safety Seats/RPMS Patch Enclosed, please find the community intervention proposals. Intervention Activity Plan Lead: Tribe: Date: \| Title of Intervention Activity: \| Child Passenger Safety Technician Training and Car Seat Clinic \| \|---------------------------------\|-------------------------------------------------------------\| \| Approach* \| Health and Safety Education; Public Health and Safety Practice \| \| Issues Addressed \| - Lack of experienced CPS technicians in the community; - Lack of or inappropriate use of child safety seats in the community; - Instruction on proper installation of proper child safety seats needed \| \| Collaborators \| \| Audience: - Staff and/or volunteers who serve families with children age 12 and under - Non-parent caregivers, parents of children 12 and under - Children 12 and under - Potential CPS Tech Candidates Description: Part 1: CPS Technician Training Tribe will recruit tribal staff and volunteers who serve families with children age 12 and under to attend a Child Passenger Safety Technician (CPST) Certification course. The locations of these courses vary within each state and are available throughout the year. Three identified candidates will travel to take the 3-day course. The course requires candidates finish all three consecutive days and must pass a certification written and practical test. Upon completion of the course and receipt of certification, CPS Techs will provide community members with car seat installation and education support. CPS Techs will provide a minimum of four hours of community car seat education training to community members, complete five individual car seat checks observed by a certified CPS Tech Instructor (instructor in nearby town), and six continuing education credits (in-person or online). Objectives: 1. Promote proper use of child car seats via community-based CPS technicians at local clinics, schools and/or car safety events. 2. Increase the number of certified CPS technicians serving the families of children 12 and under within the reservation community. 3. Provide opportunities for CPS technicians to maintain their certification. Potential Evaluation Measures: - Total count of individuals registered for CPST course - Total count of attendees who complete CPST course - Total count of individuals who receive CPST certification - Number of CPS technician opportunities reported that fulfill recertification (car seat clinics with certified instructors, integrated car seat education classes) Part 2: Car Seat Clinic The three certified community-based CPS Technicians will organize 2-3 community car seat clinics in 2017. The purpose of this clinic is to ensure the proper installation and usage of appropriate child safety seats in the community. CPS techs will provide one-on-one checks of installed child safety seats and educate driver about proper installation/usage of these seats in their vehicles. Drivers will be encouraged to bring their child passengers to the car seat clinic. Consultations will last roughly 20 minutes. We plan on a total of 5 consultations per CPS Techs per car seat clinic. During the car seat clinic, CPS Technicians will: - Record the type/number of car seat(s), location of seat(s) in the vehicle and observations of misuse or damage; - Ensure that the seat(s) is appropriate for the child’s age and size; - Review seat instructions and vehicle owner’s manual with the caregiver; - Ensure appropriate position in vehicle; - Check current seat safety, e.g., seat recalls, expiration date and damage/defects to the seat; - Observe the caregiver install the seat(s) on their own and provide education when needed; - Educate caregivers as to the importance of car safety for all passengers, especially children; - Educate the caregiver about the transition to the next type of car seat for their child/children; - Answer any questions the caregiver may have. Objectives: 1. Ensure proper selection and installation/use of safety seats in vehicles 2. Educate drivers about proper selection installation and positioning of child safety seats 3. Provide 3 car seat clinics Potential Evaluation Measures: - Total number of car seat clinics held - Total number of each type of child safety seats (e.g., infant, forward facing, combination, convertible, booster) checked at car seat clinics - Total number of drivers who were able to properly installed child safety seats - Total number of seats identified that need to replaced (e.g., recalled, damaged, not proper for child’s age or size, not compatible for vehicle) Time Line: To be completed at workshop Due Date: TBD ## Budget \| Expense \| Cost \| \|----------------------------------------------\|-------\| \| CPST training Tuition \| \| \| CPST certification course fee (3x$85) \| $255 \| \| Travel to course \| \| \| Per diem (includes 3 attendees) (230 x3) \| $690 \| \| Mileage/rental/gas (includes all 3 attendees)\| $200 \| \| Lodging (includes 3 attendees) (420 x3) \| $1260 \| \| Car Seat Clinic \| \| \| Mileage for CPT Techs \| $305 \| \| Snacks (200 x 3) \| $600 \| \| Promotion materials \| $600 \| \| Supplies (Clip boards, cones, promotional materials, demo dolls) \| $970 \| \| CPS Vests (3 X $40) \| $120 \| \| Total Cost \| $5000 \| With approval from Native CARS, line items in the above budget may be altered to meet the needs of community specific costs projected for the intervention activities described above but total cost of intervention plan activity may not exceed $5,000. Title of Intervention Activity: Child Passenger Law \| Approach: (Awareness, Behavior Change, Public Health Practice, Environment, Policy) \| Environment, Policy \| \|---\|---\| \| Issue Addressed \| Revise or create a seat belt law that meets current National Highway Traffic Safety Administration (NHTSA) recommendations; Update or create a fee schedule and fine process that encourages police to enforce the law \| \| Collaborators \| Police, Courts, Tribal Attorney, Business Council, General Membership; Media \| Audience: Reservation Residents, Tribal and Non Tribal member drivers, parents and guardians of children 12 and under. Description: The tribe will review current (if existing) tribal child safety seat law and order code, fee schedule and fine process and compare to current NHTSA recommendations. Following this review, the tribe will propose changes to the code so that all children are in appropriate seats and/or safety restraints while riding in vehicles. The Lead will also consult with the Tribal attorney’s office (1) to determine proper channels for submission to council, law and justice committee and the public and (2) to review proposed changes. Objectives: 1. To review current child passenger safety law 2. To compare current child passenger law (if any) to NHTSA recommendations 3. To review fee schedule and fine process 4. Propose changes to law and fine process 5. To ratify new child passenger safety law or change 6. Mount media campaign to notify community of law change Potential Evaluation Measures: - Title/Number of new law or proposed law change - Changes to fine process as proposed to Law and Justice committee - Number of community review meetings - Count of attendees at review meetings Time Line: To be completed at workshop Date Due: TBD Budget \| Expense \| Amount \| \|----------------------------------------------\|--------\| \| Consultant (code development, code draft review, final code) \| $3500 \| \| Printing Costs for Public Review (documents, code change brochures) \| $600 \| \| Meeting Expenses (refreshments or dinners) \| $400 \| \| Site Rental for Public Review Meetings \| $400 \| \| Mileage to travel to Public Meetings \| $100 \| Total Cost $5000 With approval form Native CARS, line items in the above budget may be altered to meet the needs of community specific costs projected for the intervention activities described above but total cost of intervention plan activity may not exceed $5,000. Title of Intervention Activity: Law Enforcement Training Approach: (Awareness, Behavior Change, Public Health Practice, Environment, Policy) - Awareness; Public Safety Practice Issue Addressed - Lack of knowledge of current tribal passenger safety law; - Inadequate enforcement of current tribal child passenger safety law Collaborators - Tribal Police Officers, Tribal Police Chief, Tribal Court, CPS Techs, Pre-requisite: Must have a CPS Technician available to provide instruction or utilize the CPS Technicians we have available to refer. Audience: - Tribal Police on the Reservation Description: The Lead will review law and order practices including traffic data collection (e.g. how traffic data is collected, number of safety citations, citations per officer, and frequency of data review) in order to educate police officers on current child passenger safety law. This intervention proposes to train tribal police about consistent and proper enforcement of current tribal child passenger safety law. CPS Technicians will lead two training sessions. Focus areas will address specific needs discovered in data collection phase, e.g. better defining gross misuse of car seat. As part of this training, law enforcement officers will receive a certificate of participation. Upon completion, officers will also receive a bag (to be stored in their car) of educational swag and other incentive items for distribution to drivers and passengers during initial warning stops. These will serve as child safety educational tools. The lead will contract a graphic artist to design print media to support the vision of police officers enforcing the child passenger restraint law and providing guidance to drivers on proper child passenger restraint use. Objectives: 1. Educate tribal law enforcement on specifics of child passenger safety law (e.g. difference between gross misuse of car seat laws and incorrect seat for child). 2. Engage local tribal police department to consistently enforce child passenger safety laws. 3. Emphasize the role of law enforcement as “Educator” about child passenger safety in the community. 4. Develop print media to support vision of police officers as child passenger restraint enforcers and educators. Potential Evaluation Measures: - Number and type of media developed - Number of posters developed and locations posted - Count or schedule of radio PSA airing - Count or schedule of video PSA airing - Number of articles published in [tribal newspaper] - Count of social media hits Time Line: To be completed at workshop Date Due: TBD ## Budget \| Description \| Expenses \| \|--------------------------------------------------\|----------\| \| CPS Tech to lead training \| $400 \| \| Training Expenses (room rental, food etc) \| $400 \| \| 10 Officer Educational Swag Bags \| $2000 \| \| Print Training Materials, binders, forms \| $200 \| \| Promotional print materials (e.g., posters brochures) \| \| \| Graphics contractor \| $800 \| \| Printing \| $1200 \| \| Total \| $5000\| With approval from Native CARS, line items in the above budget may be altered to meet the needs of community specific costs projected for the intervention activities described above but total cost of intervention plan activity may not exceed $5,000. Title of Intervention Activity: Child Safety Seat RPMS/EHR Patch and Child Safety Seat Distribution \| Approach: (Awareness, Behavior Change, Public Health Practice, Environment, Policy) \| Public Safety Practice, Health Education. \| \|---\|---\| \| Issue Addressed \| - Lack or inadequate knowledge of appropriate child safety seat recommendations and referrals for the right type of seat among parent and non-parent caregivers; - Inadequate access to car seats (particularly booster seats) for all children 12 and under; - Lack of education regarding car safety best practices for children \| \| Collaborators \| Community Health, Medical (All Providers), IT, Maternal/Child Health \| Pre-requisite: Must have a local CPS Technician available to provide consultation to parents or guardians of children in need of a car seat and car seat installation support. Part 1: Electronic Health Record Patch Audience: - Health care providers and parent/caregivers utilizing clinic who have a child or children of safety seat age and size (12 and under) - Parents and caregivers of children 12 and under. Description: The tribal organization listed above will use the Native CARS RPMS/EHR patch to increase use of appropriate child car seats among parents/caregivers. A tribal Child Passenger Safety Technician (CPST) will train all providers in the medical department to (1) consistently and systematically counsel parents/caregivers on child safety seat recommendations and (2) help families access child safety seats (CSS) through the tribal distribution program. Specifically, the patch will: - Set up a reminder in the electronic health record (EHR) for provider to discuss and document if appropriate car seat is currently being used. - Set up a reminder for provider to counsel parent/caregiver when next child safety seat transition is and discuss best practices for age and size. - Offer the provider the option to issue a referral (or prescription) for child safety seat via CSS Referral/Prescription. - Give access to CPS Tech for referral review and parent follow-up. - Give access to CPS Tech to document distribution of CSS and expiration date of distributed seat in EHR. Objectives: 1. Create a seamless system to track car seat referrals and distribution. 2. Utilize medical providers to emphasize the importance of implementing child safety seat recommendations. 3. Increase knowledge and compliance of parent/caregiver on appropriate seats for a child’s age/size. 4. Encourage providers to talk to parents/caregivers and children about the transition to the next stage of child safety seats. Potential Evaluation Measures: - Count of CSS distributed/ CSS referrals via patch reports - Number of providers utilizing the CAR RPMS patch via patch user report - Number of child medical visits in which CSS education was provided and documented on RPMS - Provider feedback of the CSS patch, e.g. whether the new CSS patch helped them to talk to parents about car seats Part 2: Distribution of Child Safety Seats Based on children identified by providers and documented in CARS RPMS patch, we plan to increase access to car seats that are right for children’s age and size. We will purchase car seats for distribution to parents or guardian of children who have been provided a consult via the Native CARS patch. A CPS Technician will be identified to coordinate car seat distribution. The car seat distribution processes will be agreed upon in conjunction with the CAR RPMS patch implementation planning. The CPS Technician will distribute the car seat so parents or guardians of the children receive instruction as to the appropriate car seat for their child/children as well as proper installation of the seat. The CPS technician will be available to guide parents or guardian as they install car seats into their vehicles. Communities that do not wish to give car seats free of charge can choose to establish a reimbursement system for parents or guardians who purchase their own seats. For example, the Tribe awards $100 for convertible car seats and $20 for booster seats. Objectives: 1. Educate parent or guardian about child seat safety, particularly the importance of age/size-appropriate car seats for children 12 and under. 2. Increase the number of children in appropriate car seats when riding a vehicle 3. Provide access to a child safety seat distribution programs on reservation Potential Evaluation Measures: - Number of parents or guardians who access the distribution program - Number of seats distributed - Number of parents or guardians who came to distribution program as a result of a CARS RPMS Patch consult order by provider Time Line: To be completed at workshop Date Due: TBD Budget: \| CARS RPMS Patch \| Expense \| \|------------------------------------------------------\|---------\| \| Incentive items for providers who have the most referrals \| $300 \| \| Lunch provisions for patch training \| $250 \| \| Printing for CPS Tech cards, referral cards and training Materials \| $200 \| \| Snack provision to present progress at all staff meeting using patch \| $200 \| \| Car seat distribution \| \| \|------------------------------------------------------\|---------\| \| Purchase of car seats \| $4000 \| \| Purchase of CPS Tech materials (e.g., LATCH Manual, recall list notification) \| $50 \| Total Cost $5000 With approval from Native CARS, line items in the above budget may be altered to meet the needs of community specific costs projected for the intervention activities described above but total cost of intervention plan activity may not exceed $5,000. Intervention Activity Plan Lead: Tribe: Date: Title of Intervention Activity: Child Safety Seat (CSS) Media Campaign \| Approach: (Awareness, Behavior Change, Public Health Practice, Environment, Policy) \| Awareness \| \|---\|---\| \| Issue Addressed \| Will be determined after review of child safety seat data \| \| Collaborators \| Tribal Communications \| Audience: Drivers and passengers within the tribal community (may be focused on specific sub-group depending on review of data) Description: This intervention proposal builds off of data collection efforts. Issues addressed by the media campaign will depend on the themes discovered in the data, such as short car trips, on and off Reservation or trips with non-parent caregivers. The media campaign may promote child car safety and injury prevention on and off the Reservation. Messages may include tribal specific vehicular injury and mortality data, proper child car seat usage and qualitative data gathered from focus groups. Messages should be concise and brief and address the issues discovered in your data collection. Applicant can select one of the following four media campaign options below: - Option 1: Video and Radio PSA Develop one 30-second video public service announcement (PSA) for local TV station, IHS clinic or administrative building featuring tribal youth, Native CARS information and current CSS information. Develop two 30-second radio PSA spots. Option 2: DIY Billboard - Build three site-specific 8 x 6 ft plywood billboards to be placed at strategic locations. - Contract graphic artist to produce six vinyl banners to be placed on three billboards. Option 3: Professional Billboard - Contract with graphic artist to produce billboards - Contract with a commercial billboard company to advertise on a billboard (such as Lamar, Outdoor Billboard, Pattison) Option 4: Print Media - Develop print media (e.g., posters, displays, and/or brochures) to be placed in strategic locations including social media Objectives: 1. Develop tribe-specific, data-driven media campaign that emphasizes the importance of child safety seat use every trip, every time, including reservation and on short trips in 2017. 2. Implement media components and distribute messages at designated locations in 2017. 3. Have a visible presence throughout the community and various media channels to better promote the message of child passenger safety. Potential Evaluation Measures: - Number and type of media developed - Number of posters developed and locations posted - Count or schedule of radio PSA airing - Count or schedule of video PSA airing - Number of articles published in [tribal newspaper] - Count of social media hits Time Line: To be completed at workshop Date Due: TBD ## Budget \| Category \| Expense \| \|---------------------------------\|------------------\| \| Video and Radio PSA \| \| \| Consultant to draft scripts, story boards, contact stations, scout locations, recruit cast, organize schedule \| $4000 \| \| Incentives \| $240 \| \| Mileage \| $260 \| \| Supplies \| $500 \| \| Total \| $5000 \| \| Category \| Expense \| \|---------------------------------\|------------------\| \| Billboards – Professional Rental \| \| \| Photographer/Graphic Designer \| $610 \| \| Professional Billboards 2 (2195 each) full scale billboard for 4 months \| $4390 \| \| Total \| $5000 \| \| Category \| Expense \| \|---------------------------------\|------------------\| \| Billboards - DIY \| \| \| Construct and erect 3 8’ x 6’ plywood billboard (3x$1200) \| $3600 \| \| Printing of vinyl billboard banners (6x$100) \| $600 \| \| Photographer/Graphic Design \| $800 \| \| Total \| $5000 \| \| Category \| Expense \| \|---------------------------------\|------------------\| \| Video and Radio PSA \| \| \| Consultant to draft scripts, story boards, contact stations, scout locations, recruit cast, organize schedule \| $4000 \| \| Incentives \| $240 \| \| Mileage \| $260 \| \| Supplies \| $500 \| \| Total \| $5000 \| \| Category \| Expense \| \|---------------------------------\|------------------\| \| Print Media \| \| \| Photographer \| $1620 \| \| Graphic Designer \| $1670 \| \| Model Incentives (10 x $40) \| $400 \| \| Printing (posters, brochures, displays, inserts) \| $1110 \| \| Snacks/water bottles \| $200 \| \| Total \| $5000 \| With approval from Native CARS, line items in the above budget may be altered to meet the needs of community specific costs projected for the intervention activities described above but total cost of intervention plan activity may not exceed $5,000. Title of Intervention Activity: Community Education and Outreach \| Approach: (Awareness, Behavior Change, Public Health Practice, Environment, Policy) \| Health Education, Awareness \| \| --- \| --- \| \| Issue Addressed \| Low knowledge and awareness of child safety seat recommendations \| \| Collaborators \| Community Action Partnership, Head Start, Elementary Schools, WIC, Health Clinics \| Audience: Staff and personnel at tribal and non-tribal entities who interface with tribal children in need of proper child passenger restraints Description: The tribal organization listed above will increase awareness of available child safety seat resources in the community via education and information sessions held at child-focused organizations, e.g. Head Start, Elementary schools, WIC, local health clinics etc. At these locations, community members will receive the necessary information they need to educate parents and caregivers about child passenger safety and/or direct them to the proper resource for additional information. For instance, children may be weighed and measured to determine the appropriate child safety seat for them. Objectives: 1. Mobilize community partners to be advocates of child passenger safety and informational resources for the parents/caregivers. 2. Increase awareness of child passenger safety among organizations throughout the community that serve young children who require safety seats. Potential Evaluation Measures: - Count of and contact information for all organizations approached to educate about car safety - Number of families/children consulted regarding car seat safety Time Line: To be completed at workshop Date Due: TBD Budget \| Item \| Expense \| \|----------------------------------------------------------------------\|----------\| \| Table cloth with Tribal & Native CARS logos \| $100 \| \| Canopy \| $200 \| \| Small Equipment (scales, portable stadiometer, demonstration dolls) \| $700 \| \| Child Passenger Safety Video tapes \| $500 \| \| Education materials (e.g., charts, handouts, window clings, \| $2000 \| \| Sample child safety seats, restraints, webbing and latchplate for \| $1500 \| \| demonstration \| \| \| Total Cost \| $5,000\| With approval from Native CARS, line items in the above budget may be altered to meet the needs of community specific costs projected for the intervention activities described above but total cost of intervention plan activity may not exceed $5,000.	<urn:uuid:609dc60b-f4d2-463f-8ecd-05e5031e495f>	CC-MAIN-2024-38	https://www.npaihb.org/wp-content/uploads/2023/07/2016-Native-CARS-Mini-Grant-Application.pdf	2024-09-15T19:58:00+00:00	crawl-data/CC-MAIN-2024-38/segments/1725700651647.78/warc/CC-MAIN-20240915184230-20240915214230-00150.warc.gz	837,858,609	7,001	eng_Latn	eng_Latn	0.979595	eng_Latn	0.993662	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "unknown", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	rolmOCR	[ 1772, 2532, 3644, 5239, 7055, 8739, 9320, 10282, 11245, 13514, 15030, 16168, 17362, 18701, 19888, 21331, 22239, 23097, 24845, 26649, 27970, 29415, 30736, 33346, 34510, 36145 ]	[ 1.0078125, 1.4921875 ]	[ 1.9140625, 2.75 ]	[ 1.8359375, 1.75 ]	[ 2.875, 1.8984375 ]	2	0	HuggingFaceFW/finepdfs
Regina Exhibition Association Limited (REAL) Appointment of Directors RECOMMENDATION Executive Committee recommends that City Council: 1. Authorize the Executive Director, Financial Strategy & Sustainability, as the City's proxy, to exercise the City's voting rights at the upcoming Regina Exhibition Association Limited (REAL) membership meeting to elect the following individuals to the Board of Directors for a three-year term, ending April 2023: * Kyle Addison – (new candidate) * Jim Hopson – (new candidate) * Ken Budzak – (re-appointment) * Patricia Thomson – (new candidate) 2. Approve this report at its May 27, 2020 meeting. ISSUE Administration requires delegated authority from City Council in order to exercise the City's voting rights at REAL's annual general meeting in accordance with the direction provided by City Council. IMPACTS The Governance and Nominating Committee has identified the four individuals listed below as desirable appointees to the volunteer Board of Directors. Each will be appointed to threeyear terms. OTHER OPTIONS None with respect to this report. COMMUNICATIONS After all Board appointments are finalized, REAL will notify the successful appointees. DISCUSSION Effective January 1, 2014, Regina Exhibition Association Limited (REAL) was continued under The Non-profit Corporations Act, 1995 (Saskatchewan), with the City becoming its sole voting member. This change in structure made REAL a "municipal corporation" of the City. As the sole voting membership holder of REAL, the City must exercise its voting rights at the REAL annual general meeting. Pursuant to the Unanimous Members Agreement (UMA) between the City of Regina (COR) and the Regina Exhibition Association Limited (REAL), and specifically Sections 4.3 and 6.2.b.i., appointments to REAL's Board of Directors requires the approval of the City. In the Articles of Continuance, UMA, and REAL Bylaws, REAL can have a Board of no less than seven (7) and no more than thirteen (13) voting-appointed directors. There are also the two (2) ex-officio directors that are outside of these numbers and appointed by the Ministry of Agriculture (appointee Kevin France) and by the COR Council (appointee Chris Holden), which would see the maximum number of Board Directors at fifteen (15). The Board of REAL is currently comprised of the following eleven directors: In the fall of 2019, the REAL Board of Directors completed a skills self-assessment against an approved list of sixteen (16) skillsets with refined definitions and a weighting system. The skillsets include board experience, strategic planning, stakeholder management, safety, human resources, finance, legal, business technology, operations, branding, infrastructure development, tourism and economic development, sport, entertainment and recreation, fund development and sponsorship, food and beverage, and agriculture. Once the Board of Directors completed their skills self-assessment, the Governance and Nominating Committee (GNC) completed a gaps analysis and recommended that the top priority skills for recruitment included: * Food and beverage * Legal * Infrastructure development * Fund development and sponsorship To identify additional desired director skillsets for the 2020/2021 recruitment, the GNC requested directors to identify what skill gaps on the Board given REAL's strategic direction, should be the priority skills for recruitment. The GNC recommended, and the Board of Directors endorsed the following: * Stakeholder management * Board experience * Strategic planning The 2020/2021 REAL Board of Directors recruitment opened on October 22, 2019 and closed at midnight (12:00 a.m.) on January 26, 2020. The recruitment was advertised in the Leader Post, the Evraz Place website, and through a social media campaign. The recruitment resulted in: * 21 expressions of interest (before the January 26, 2020 closing) * 5 expressions of interest (after the closing and at the time of submitting this letter) * 5 withdrawn interest * 2 did not complete and did not respond to two (2) reminder emails * 14 completed applications o 11 new candidates o 3 current board directors seeking re-appointment, one who resigned during the competition process The GNC reviewed all applications and reached consensus on six (6) new candidates for the short-list that went through the interview process on March 4 and March 5, 2020.The GNC met on March 5, 2020, following the last interview and reached consensus on the candidates that would be recommended for the 2020/2021 slate. The GNC is a subcommittee of the REAL Board of Directors. In summary, the GNC has identified the four individuals listed below as desirable appointees to the Board of Directors. The appointments to the REAL Board would be for three-year terms. Based on these appointments, the thirteen members on the new REAL's Board of Directors will comprise of the following: This report is seeking delegated authority to exercise the City's voting rights to fill the four positions on the Board of Directors. DECISION HISTORY The recommendation contained in this report requires City Council approval. Respectfully Submitted, Respectfully Submitted, Prepared by: Abiodun Akindele, Financial Management Analyst	<urn:uuid:e1bf4ac4-cb53-4e20-bffe-bb3d4e462f81>	CC-MAIN-2021-04	http://reginask.iqm2.com/Citizens/FileOpen.aspx?Type=4&ID=8385&MeetingID=4858	2021-01-27T09:53:50+00:00	crawl-data/CC-MAIN-2021-04/segments/1610704821381.83/warc/CC-MAIN-20210127090152-20210127120152-00192.warc.gz	82,276,262	1,089	eng_Latn	eng_Latn	0.976249	eng_Latn	0.993625	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 845, 2374, 4030, 5068, 5274 ]	[ 0.392578125 ]	[ 1.796875 ]	[ 2.03125 ]	[ 2.5 ]	1	0	HuggingFaceFW/finepdfs
#1 Stories of stress and coping A few of the people we spoke to talked about experiencing high levels of stress in their lives, through school, work or due to their personal circumstances. The sense of feeling under pressure, and of that pressure not being understood by key people around them – family, friends and teachers – was palpable in some of the stories we heard. Some of the young people we spoke to explained that they had felt pressure to take subjects at school that they did not enjoy, or that they were pushed to take exams or study at university before they felt ready. Others were attempting to manage multiple stressful situations at the same time. The story of one young woman characterises the kind of journey some of our younger storytellers had been through. Throughout her early life this storyteller had a difficult home situation. Her mother was at times unwell with a mental health problem and, consequently, she lived with her grandmother from an early age. Her mother did not always respond well to this situation, which led to a complicated situation at home and with local authorities. [Storyteller's mother] was calling the police and making accusations about me being locked up in the house by my nan and granddad and she would [say I was locked in] the basement sometimes. Obviously the police would come by and I would get annoyed by police now whenever I see them because they were like, "Are you alright? We have just got to check. We are just doing a job." At the end of the day, from however many years ago from then to now, I have tried to contact the police [from the local area] just to say, "If my mum calls or makes allegations saying that I am missing…" She used to say I am missing as well. I said, "Don't take it on. Try and block it if you can. Put a note on your system to say call me." I wanted them to check. [Storyteller 2] 26 Throughout her narrative she describes a complicated family situation, involving a history of mental health difficulties on both sides of the family. At times, we felt a sense of her feeling quite alone both within her family and at school, and of needing to take responsibility for herself at a young age. In her early school years our storyteller spoke about feeling clever and doing well. She felt supported in her school environment and did well on assignments and in exams. This situation began to deteriorate as she approached her GCSE and A-level exams, and this sense of being left alone to cope with difficult things was again present in her story. In primary school, my teachers knew that I was a young carer, so they looked out for me. In secondary school, my teachers knew that I was smart, so they pushed me. In sixth form, they didn't give a shit – sorry for the language, but they really didn't. Around this time she also found herself distracted by pursuing relationships with men, which she describes as contributing to a loss of interest in her education. […] All of those hormones really made me focus on men and I wasn't really thinking about my education. Because I was naturally smart, I just thought I would ace the maths and I did ace the maths. I didn't even do any revision and I still got an A. I thought I would be able to do that in all of my subjects, me being big-headed. Plus, I had just won Student of the Year for Key Stage 3. […] I wanted to put that in. That is an achievement. […] Yes. I decided to do it again thinking I could get A* and then get A in every other subject. I was predicted at least three As, apart from maths. […] Yes. I got a B in my physics. I got a B in all of my exams but I got an E in my coursework and at the time, when I was doing my physics coursework I was in a relationship and he was very controlling. She felt support was not provided to her through the later stages of her education, potentially due to a lack of understanding on the part of her teachers. This had an impact on her ability to succeed in the subjects she was studying. …my teachers weren't really helpful – they didn't really understand or, maybe because I wasn't diagnosed or had a learning disability, or learning difficulty should I say, sorry, they didn't see anything. They thought "you know, this girl got twelve/eleven A-C grades; she is capable of doing A-levels, we don't need to help her, let her do the work". So, that is what I'm thinking, so that must be what they're thinking as well. At the end, when I finished the first year of sixth form, I didn't – because I failed the whole year, I thought "no, I have put all my time, all my effort into it. I don't bunk". I started bunking near the end, because I was just like, "no, they're not helpful and it's like no-one understands". So, because no-one understood what I was going through, I didn't even understand what I was going through, so I didn't have any help like that, so I guess I definitely developed the psychosis, and they diagnosed me with anxiety and severe depression as well. 27 Our storyteller described how cannabis had been present in her life from a very early age, which may have resulted in drugs feeling like a familiar coping strategy to reach for. She had this in common with a number of storytellers who spoke of using drugs as a way to manage or escape from stress. She pinpointed a particular moment when she felt that stress resulted in her turning to "weed": I tried to do maths at A-level and my sixth form didn't help me. […] I just wanted to do science and maths and that would have equated to three or four A-levels but they said I had to do Health and Social Care as well which was a BTEC so that is like an extra two A-levels. That would have been me doing six A-levels and everyone else was doing four. They wouldn't allow me to just do the three. […] I didn't really understand Health and Social Care and I [wasn't] interested. I should have moved school but I liked the head teacher of the sixth form, who was my ex-sociology teacher and I got on with her. Most of my friends were staying there as well and I hadn't been to a lot of schools. I was a bit timid and shy as well and wasn't ready to meet new friends yet. I was just a bit in my own world really. […] Yes. I think that's where it got stressful. I was getting really agitated. I started smoking weed when I started Health and Social Care. Like several other storytellers who had used recreational drugs, or who had cared for someone who did, this storyteller explained how her experiences of using drugs had happened around the same time as she felt her mental health was deteriorating and she received a diagnosis of psychosis. 28 So, yes, I thought I was going mad, but I didn't think it was anything to be brought up about, so I kept it to myself. Obviously, my friends saw because they had me on the Messenger, but I started smoking, after that, when I left school, after my GCSEs, and I lost my concentration in my work, in everything, really, and I guess it was just like a big decrease. Rather than me being elevated and being like, "yeah, I'm studying A-levels now, I'm doing this, I'm doing that", it was just like neutral, and I felt like I was still in school, just having to do what I have to do, but I didn't really think "this is Perspectives on stress AND pressure Gary I could identify with the experiences of stress and pressure our storytellers talked with us about. Leaving a job which offered little hope for the future gave me hours of unstructured time and I was struggling to survive on benefits. I couldn't afford to feed myself properly and lost a lot of weight. It was around this time that my voices became more frequent. Dolly I can personally relate to the school pressure scenario. I started to hear voices at 14 when both my school and my home life were difficult. The school did not know how to handle it, which added to the pressure, saying things like 'pull your socks up' and 'you are not concentrating hard enough'. You don't get a complimentary pair of socks when you enter the mental health system. another big step, I need to focus on it". I just took it for granted, and I think that is – the smoking as well; the smoking makes me lazy. […] Yes, so I started smoking weed between when the GCSEs finished and my A-levels started, and I think that whole gap was where it kind of escalated, the whole poor mental health – that got poorer. She explained to us that she had been unaware of the connection between cannabis and psychosis and that she needed more support to understand the link than was on offer. I think that, if I knew that it was the weed that made me into that state, in the first place, I wouldn't have picked it up. If I had someone telling me, assuring me, "don't smoke the weed; it's not good for you, it's bad for you, that's why you had this episode, it will do it again", but I got – someone said 'psychosis' and I got a print-out, that had some symptoms on it. At the time, my concentration was very, very, very poor. Immediately after her diagnosis she was cared for at home by her grandmother, and the home treatment team. She had a relatively good experience with the home treatment team, who helped her adjust her medication. The home treatment team came to do a referred review and they asked me how I was feeling. They always ask that. The first time they came I said, "I am not feeling well." I felt so much better because I was actually able to talk without stuttering. I said I was having hallucinations and didn't know what was going on and they said maybe it was the medication. They changed the medication and it got better. The hallucinations stopped and I am on the same medication now. It's quite good. However, during this time she was encouraged to move out of her home to live independently. The process through which this happened remains unclear to her and has left her with feelings of rejection. I had my own room and stuff, so it wasn't like I was in the front room or – I was living there for twelve years, maybe, then my Nan asked me if I wanted to leave and I didn't know what I said, but I must have said yes, because she – I don't know, whatever happened, my care-coordinator was telling me that if I wanted to go to the housing, or something – something happened, I don't know, but, anyway, I went in housing and they put me in emergency accommodation and, reflecting on it – not thinking, at the time, but reflecting on it, I thought that my family didn't want me, but I've talked to them and stuff and that's not the case, but the fact that they asked me to leave, I thought "what's wrong with me? Am I turning into my mum?", because my mum has severe mental difficulties; she is severely mentally challenged, and I think that's where I get it from, from that gene or that inheritance of DNA or whatever. There was also a sense of further 'aloneness' and isolation in her narrative as she talked about her new housing situation, which felt unfriendly, and at times unsafe. I have just been looking after myself. I have got other problems, like rent arrears and my neighbours chatting, saying that I'm – complaining about me, but they are false allegations. So, they are all males, in my block, in my flat, and two of them have – one said that – there are three people, A, B and C, and I'm C – so, A, B, D, should I say. 29 A said that B likes me, then A said that A likes me, and then D had his friend over that tried to do something to me, and I told the police about it – a bit late though. I only told them this year and it happened like a year and a half ago, but I didn't think anything of it. So, now that I have told my housing officer and she started getting on to me about people saying that they're complaining, or whatever, it's like everyone is trying to make up stuff against me now. So, some underneath me are saying that I'm stamping on the floor every night and banging and I broke his ceiling light, by stamping on the floor, so I don't understand how that is possible. This situation was compounded by a breach of confidentiality by her housing officer, who disclosed something that she had told them to one of her neighbours. This disclosure had negative consequences for her relationship with that person. She also described difficulty in securing further support, which may have been partly due to a lack of understanding on the part of the housing authorities of the impact of her mental health on her. My Nan came with me to see my carecoordinator, to book an appointment. My Nan told my care-coordinator what was happening, and that breach of confidentiality and stuff, so she – I don't remember, now. […] She said she was going to make an appointment and then she was going to call my Nan. She still hasn't called my Nan, and we're supposed to go – I want to book an appointment, so that she can come and we can go to book a housing appointment, so they can talk, because they are supposed to know that I am under mental health and stuff, the housing, but they don't take that into 30 consideration, because if they knew I had psychosis, they would understand that I might do things that – like hallucinate or shout, at one point, and not realise that I'm shouting, or just, if I'm depressed, I'll start screaming – not screaming, but shouting or crying loudly, or whatever. It's just that I'm trying to calm myself down, you know? So, it's not anyone killing me in the property, it's just me, by myself, but then again, I know that I have to take neighbours into consideration, and stuff, but all the things that I'm being accused of, it's not even me that's doing it, it's the other neighbours. Under these stressful housing conditions, it is perhaps not surprising that at the time of the interview, the storyteller was still smoking cannabis, despite wanting to stop. Yeah, because it's like – not like you're taking oxygen, but like you're meditating, kind of, when you smoke, like you're taking deep breaths and you can see it coming out and it's like – I think that is what got me hooked onto smoking, as well, was me feeling it going in and out of my lungs and thinking "this is a nice feeling". Not nice effects, long-term effects, but it's a nice feeling, at the time. I don't know. Yeah, so I should be recovered soon, hopefully. This storyteller described to us her determination to stop smoking and move on. She said that she had taken an active role in researching services that might support her. This suggests a resourcefulness that she shares with many of the storytellers we spoke to. When we met here, she was about to start with a new service that supports people to stop taking drugs. Yes, so there is a group on Wednesdays. I'm going to go tomorrow. I signed up last week, when I had my assessment, and I passed it because I had high THC levels and, yes, that was the only thing present, which should have been the right thing. Yes, I'm going to go tomorrow and see what they say, because it's like a support group and stuff, where they talk and stuff, so I thought, "yeah, why not", I might go there and let out some feelings. That's what they're for, you know? […] I was googling and I was looking for – because, recently, I've been looking for detox clinic and things like that, because I really want to stop the smoking, but I go to my GP and they're not really very helpful. So, I don't know, I called the – I self-referred myself, came in for an assessment and they gave me a leaflet with a timetable of all the groups, for the whole week, and the woman circled the cannabis stuff and they have yoga, as well. So, yes, that was like self-referral and I'm going to go there tomorrow and see how it goes. Despite all the challenges this storyteller was facing at the time of the interview, she remained positive and had clear plans for the future, even if it was still a struggle to remain motivated at times. Yes, so I'm starting college again in September. […] Doing ICT, or IT. Yes, that's like a foundation year, so I'm going to do that and then go to university, but university is where I want to be and what I want to do, specialising in cyber security, mobile forensics, digital forensics, because I've actually got a forensic science level three, but just half of it, but it's still classed as a pass-pass. Yes, it's the equivalent to one and half A-levels, that's it. So, I want to use that because I know that it's not a waste of my life, so use that forensics, go into IT and make my dream and lots of money. […] I think that's why I'm depressed, because money doesn't solve all problems, but it solves many problems and I know that there are so many problems that affect me directly and indirectly, that could be solved with money. So, I'm just trying to say that I have this mindset, where I think, "if I'm doing this, to get to here, to get to there, to be this", so that is my motivation, but it's not always motivational, because I'm just thinking "it's another day, I'm still here". Perspectives on cannabis Gary In my own experience, weed made me 'come back to life' when the medication I was taking was numbing me completely and I saw no point in living. It became a survival tactic. However, the marijuana that was available when I was a user was nowhere near as potent as the Class B skunk that is around now. Any user, for whatever reason, can always become psychologically addicted. Dolly My personal experience of marijuana was instant paranoia so I didn't pursue it. I had had the experience of psychosis beforehand but smoking made it immediately worse. 31	<urn:uuid:fe305a9c-6358-4495-8031-df07cd56c8ae>	CC-MAIN-2022-27	https://mcpin.org/wp-content/uploads/2020/11/1.-Stories-of-stress-and-coping.pdf	2022-06-26T11:46:53+00:00	crawl-data/CC-MAIN-2022-27/segments/1656103205617.12/warc/CC-MAIN-20220626101442-20220626131442-00172.warc.gz	445,392,814	3,935	eng_Latn	eng_Latn	0.999502	eng_Latn	0.999598	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 1883, 4983, 8036, 11324, 14640, 17554 ]	[ 1.96875 ]	[ 4.28125 ]	[ 2.46875 ]	[ 2.296875 ]	1	0	HuggingFaceFW/finepdfs
TO: Investment Partners FROM: Emeth Value Capital \| emethvaluecapital.com DATE: 01/25/2021 RE: 2020 H2 Letter Foreword I intend to share the updated results at the outset of each letter. It is worth reiterating that I ascribe little significance to short term results. I look out many years when making investments for the partnership and believe our results are best weighed using a similar time horizon. On Empathy The real trouble with this world of ours is not that it is an unreasonable world, nor even that it is a reasonable one. The commonest kind of trouble is that it is nearly reasonable, but not quite. Life is not an illogicality; yet it is a trap for logicians. It looks just a little more mathematical and regular than it is; its exactitude is obvious, but its inexactitude is hidden; its wildness lies in wait. (GK Chesterton) While building a successful long term track record in public markets is challenging, it is monumentally challenging to build a successful long term track record by identifying fund managers attempting to do the former. For most, the principal hurdle that comes to mind is fees. Pedigreed, blue-chip fund managers often come with a hefty price tag, and while Howard Marks popularized the saying, "You can't eat IRR," the same could be said of gross return. Indeed, when considering the math behind a diversified portfolio of high cost fund managers, the significance of the burden becomes clear. For example, consider a hedge fund with a traditional two and twenty fee structure. This fund manager would need to generate nearly four percentage points of annual alpha to breakeven with the long term equity market return of seven percent on a net basis. As a result, limited partners who wish to construct a diversified portfolio of such managers, while also generating long term outperformance, must be able to structurally identify investment managers who outperform the market by a factor of 1.6x per annum. In public markets where the playing field is level, this is a heroic undertaking. However, the task is further complicated by an additional variable, which is that many of the determinants of success for a public markets fund manager are not directly observable. No model or depth of research can obviate the need to think critically. And while a fund manager's research process, or the way in which information is assembled, is tangible, the context in which that information is processed is not. The ability to identify a winning proposition in the absence of data, handicap risk that is fundamentally qualitative, and process an unbounded non-static set of competitive outcomes requires intuition of the business variety. Likewise, while traditional value investing texts would have you believe that success requires an investor to check all emotions at the door, research has shown that it is, in fact, this exact toolkit which serves as the foundation for sound decision making. In his 1994 book Descartes' Error, acclaimed neuroscientist and University of Iowa professor Dr. Antonio Damasio established that although the notion of rationalism appears sensible, it is at odds with the biological mechanics of decision making. Damasio recounts the case study of "Elliot", a model patient whose ventromedial prefrontal cortex (vmPFC) was damaged during an operation required to remove a brain tumor. Following the surgery, Elliot's intellectual capacity – IQ, memory, and language processing – remained fully intact. However, it became evident that he now struggled to complete even rudimentary tasks. Faced with an organizational chore, he'd deliberate for an entire afternoon about how to approach the problem. Projects at work were either left incomplete or had to be corrected. And despite repeatedly being shown his flaws, he could not course correct. Further testing soon revealed Elliot's true deficit. Elliot's capacity for empathy, or his ability to process emotionally charged situations, was severely impaired. Damasio and his colleagues later studied numerous patients with similar damage to the vmPFC, who, like Elliot, showed a consistent inability to make decisions. In a famous set of trials known as the Iowa Gambling Task, Damasio constructed an experiment to measure decision-making impairment through the simulation of real-life uncertainty, reward, and punishment. Players were asked to maximize their profits by selecting cards from four separate card decks – A, B, C, or D – which, unbeknownst to the player, had predetermined payoff profiles. Cards selected from decks A or B resulted in a cumulative $250 loss for every ten cards, while cards selected from decks C or D resulted in a cumulative $250 gain for every ten cards. Findings revealed that as the task progressed, normal control subjects gradually made more selections from the good decks (C or D) and less selections from the bad decks (A or B). And after approximately fifty selections, control subjects could explain what was amiss in the trial. On the other hand, patients with damage to the vmPFC behaved like normal subjects only on the first few selections. After an initial sampling of cards, they continued to draw from the bad decks (A or B) for the duration of the experiment. In fact, perplexingly, many patients with damage to the vmPFC continued to select cards from the bad decks (A or B) even after they consciously recognized that these decks were rigged against them. Finally, when re-tested six months after the initial trial the performance of patients with damage to the vmPFC did not improve, whereas the normal control subjects improved significantly. What is brought into question is the assumption of directionality. While scientists have traditionally considered emotion to be a discrete response to the processing of external or internal events, Damasio's findings suggest that the relationship is more accurately described as interdependent. Therefore, while it may appear an illogicality, it happens that the ideal disposition for any investor is one that is both highly rational and emotional. Logic tempers emotion in the same fashion that empathy aids in the processing of highly complex situations. While the examples explored above are extreme, the ability to effectively tap into empathy, for conditions both obvious and nuanced, is central to an investor's judgement. DP Eurasia NV Overview DP Eurasia is the exclusive master franchisee of Domino's Pizza in Turkey, Russia, Azerbaijan and Georgia. The group opened its first store in Istanbul in 1996 and was founded by Aslan Saranga, one of the most respected operators within the Domino's ecosystem, at the age of twenty-seven. Aslan maintains a significant ownership stake in the company and is a member of the Domino's Pizza General Management Council, which is comprised of the CEOs of the top ten countries in the global Domino's Pizza network. DP Eurasia is the fifth largest master franchisee within the global Domino's system and is consistently recognized as one of the best performing international master franchisees. In Turkey, DP Eurasia is the dominant operator with a store base that is five times larger than its nearest competitor, PizzaPizza. In Russia, DP Eurasia is the second largest operator behind local champion Dodo Pizza. The group has increased its store network more than tenfold in the last fifteen years and has whitespace to more than triple its existing store count. The Domino's Business Model Domino's Pizza is one of the most successful fast food brands worldwide with seventeen percent global market share in QSR pizza, 17,250 store locations across ninety countries, $14 billion in annual sales, and over one hundred consecutive quarters of positive like-for-like growth internationally. The strength of their business model is widely recognized. In short, scale advantages allow Domino's to deliver great tasting pizza, at a cheaper price, and faster than the highly fragmented universe of competitors. These scale advantages manifest themselves in numerous ways. For example: - Corporate marketing spend per pizza - Rent per pizza - Central SG&A per pizza - Hourly wages per pizza - Store Density improved delivery times more repeat orders more scale - Bulk purchases raw ingredient savings per pizza - R&D per pizza improved app experience more repeat orders more scale - R&D per pizza improved pizza taste more repeat orders more scale - Increased sales improved franchisee economics more franchisees more scale - … you get the idea. In addition, these scale advantages are turbocharged by a company culture that is entrepreneurial, meritocratic, and highly focused on franchisee economics. It has been said that the best way to make a lot of money, is not to figure out how to make money for yourself but figure out how to make money for others. This dynamic has worked wonders for Domino's over the last twenty years. DP Eurasia Operations DP Eurasia has 754 system stores in Turkey, Russia, Azerbaijan, and Georgia. In Turkey, the group has 542 stores that are located throughout the country; whereas, in Russia the group has 199 stores that are highly concentrated in the city of Moscow. In Azerbaijan and Georgia, DP Eurasia only has stores in the capital cities of Baku and Tbilisi. Domino's has a strong focus on efficiency. Their stores do not require large preparation and eat-in areas and, as a result, the average store size is only 1,200 square feet – approximately two-thirds smaller than the QSR average. In addition, Domino's delivery centric model allows the group to operate in lower footfall areas, which provides significant flexibility in choosing a location and results in lower rent per square foot. DP Eurasia utilizes a disciplined, time-tested store location selection process that is referred to as mapping. Proper mapping is critical to ensuring sub-franchisee success and maintaining a commitment to Domino's thirty minute delivery guarantee (ninety-five percent on time deliveries in Turkey and ninety percent on time deliveries in Russia). Furthermore, DP Eurasia retains a strategic balance between corporate and franchised stores, with sixty-eight percent of locations being franchised. Corporate locations allow DP Eurasia to establish a network of owned stores in its most densely populated areas, thus maximizing profitability, while they also provide an important platform to develop operational best practices and innovate on food offerings. On the other hand, franchised locations are the lifeblood to scaling the Domino's network, which in turn allow DP Eurasia to grow with minimal capital requirements and create a highly profitable recurring revenue stream. To achieve consistent quality of its products, competitive supplier prices, and timely delivery of items to its system stores, DP Eurasia centralizes its supply and procurement function. The group owns and operates seven commissaries that manufacture the pizza dough and supply system stores in Turkey and Russia with all ingredients and materials required. Notably, one hundred percent of ingredients and materials are sourced domestically for both Turkey and Russia system stores, leaving DP Eurasia operationally unexposed to currency divergences. The group's four commissaries in Turkey have an 850 store capacity (300+ remaining), and the three Russian commissaries have a 330 store capacity (130+ remaining). DP Eurasia incurs capital expenditure primarily in relation to corporate store openings and centralized investments in technology. Consequently, with most new store openings coming from its sub-franchisees, DP Eurasia can grow its network in a capital efficient manner. The continued growth of the group's network is further supported by strong underlying franchisee economics. In Turkey, franchisee new store builds have three to four year payback rates, and in Russia franchisee new store builds have a three year payback rate. This has allowed DP Eurasia to grow its store count while maintaining considerable diversification among its franchisee base (no single franchisee has more than fifteen locations). DP Eurasia's financial model consists of four income streams: profit on corporate owned stores, net royalty spread, food gross margin, and franchisee opening fees. The group's corporate stores operate at an average mid-twenties percent store level margin, while it earns a five to six percent net royalty spread on subfranchisee system sales. In addition, DP Eurasia earns a thirty-five percent gross margin on food sales to sub-franchisees in Turkey and a mid-teens gross margin on food sales to sub-franchisees in Russia. Finally, first time franchisees are charged $50 thousand for opening a new location ($20 thousand for "homegrown" Domino's employee units which are one-third of all new builds), and $20 thousand for each additional location opened thereafter. In other words, each newly opened sub-franchisee location pays for approximately one year of maintenance expenditure for a corporate owned location. Russian Margin Convergence In the years immediately preceding the 2017 initial public offering, DP Eurasia's Turkish adjusted EBITDA margins hockey-sticked from the low single digits to the low teens as it began to fully leverage centralized costs and benefit from scale purchases, higher network density, and an increasingly mature store base. In recent years, DP Eurasia's Russian adjusted EBITDA margins have been in the mid-single digits but are expected to increase non-linearly in the coming years to converge with the core Turkish market. There are a few important levers to this margin inflection. First, DP Eurasia has 160 corporate employees in Russia to support 199 system stores, compared with 200 corporate employees in Turkey to support 542 system stores. Central SG&A expenses are more than forty percent of total gross profit, which provide a meaningful foundation for operational leverage. Second, approximately half of all Russian locations have been opened in the last three years, compared with ten percent in Turkey, and store units require eighteen to twenty-four months to fully mature. Finally, commissary food sales represent a substantial portion of franchisee revenue, and DP Eurasia earns half the margins on food sales in Russia as it does in Turkey. This difference is primarily attributable to economies of scale, and, as such, the group expects its food margins to increase in Russia as the store network grows. Management at DP Eurasia has reiterated every year its confidence in margin convergence, which it expects to manifest rapidly around the 350-400 store mark in Russia. Digital Sales Penetration DP Eurasia has a strategic focus on increasing its digital sales penetration to levels generally observed across global Domino's master franchisees (or approximately seventy to eighty percent of system sales). Orders placed using the group's online platforms have a higher customer ordering frequency, promote direct customer interaction at the corporate level, allow demand push marketing, and result in a better customer experience. Furthermore, this technology centric platform allows franchisees to become less reliant on their own marketing initiatives, which enables them to divert more focus to operational aspects. The group's digital sales penetration has more than doubled over the last five years, now accounting for more than fifty percent of system sales, and is a strong driver of like-for-like growth. In addition, in many ways DP Eurasia is a frontrunner on the technology curve compared to global peers. By 2019, DP Eurasia successfully rolled out its GPS order tracking system, which displays the location of delivery drivers to customers in real time and allows the group to capture and monitor driving routes, across every store in Turkey. This has improved the customer ordering experience, and DP Eurasia is already witnessing improved labor efficiency with an increase in deliveries per driver of twelve percent. This technology is being rolled out across the US but is still not widely available. Fortressing for Growth DP Eurasia and other successful master franchisees, like Domino's Pizza Enterprises, grow through employing a strategy called fortressing. In effect, Domino's continues to infill stores within a defined mapping area which serves to enhance its delivery position, increase customer satisfaction, and build a strong local brand presence. This tactic of splitting stores is counterintuitive, but it allows Domino's to leverage the benefits of network density to increase market share. On the surface, it would appear that the bigger the market per location, the better one would do – stores with more households would receive more orders. However, in a delivery centric model, not all orders are created equal. Within a large store territory, many orders earn substantially less profit due to delivery distance, which also results in customers receiving less fresh pizza, which then results in fewer recurring customer orders. In addition, physical store presence is a form of brand marketing, and without density the marketing burden per household increases. The bottom line is that faster delivery speed, which also results in fresher pizza, leads to happier customers who order more and increase total sales. There is, however, an optimum density and the global Domino's network has done a substantial amount of market research to figure out where this optimum exists – a data advantage that would be difficult for regional competitors to replicate. Below are a few slides from Domino's Pizza Enterprises' Investor Day, which highlights the fortressing strategy using the Netherlands region as a case study. The Role of Aggregators A common question for all operators in the QSR space, particularly Domino's, is what impact the rise of second generation aggregators will have on business. The higher quality Domino's Master Franchisees, like Domino's Pizza Enterprises and DP Eurasia, have taken a different outlook on the role of these intermediaries – viewing the platforms as digital advertising channels, rather than competitors. Domino's has advertised for many years on Google and Facebook and has witnessed strong ROI on platform spend. Today, after years of experience across several geographies, spend through aggregator platforms has proven to result in similarly compelling rates of return. In fact, Domino's believes that they are able to effectively segment the market and add less price sensitive incremental business via the aggregators. Pizza fanatics are offered a level of customization through the Domino's app that does not exist over an aggregator platform, and Domino's regular promotions and discounts are only offered through their own app. Thus, aggregators allow the group to capture customers who value the convenience of online ordering but are otherwise less interested in price and customization. It is also important to note that both DP Eurasia and Domino's Pizza Enterprises interact with all of their aggregator relationships under a first generation model wherein they complete the physical delivery themselves. This is essential to controlling the customer experience and ensuring a commitment to their thirty minute delivery guarantee. Finally, the interplay between aggregators and brands needs to be assessed at the local level, and I would posit that DP Eurasia is exceptionally well positioned in this regard. In Turkey, there is one aggregator, Yemeksepeti, that has ninety-nine percent of the market share. The company is a first generation aggregator (meaning they do not offer physical delivery themselves), and DP Eurasia has worked with them since the early 2000's. More than half of DP Eurasia's digital sales in Turkey come from Yemeksepeti, and the margins per order are the same as the group's own digital platform. In Russia, the landscape is entirely different. Until five years ago, there was no real presence of aggregators. Today, both Yandex.Eats and Delivery Club are competing aggressively to establish market share as second generation aggregators. Notably, the former head of DP Eurasia's Russian division, Guvenc Donmez, left the company in 2019 to become the CEO of Delivery Club. After many years on the sidelines, DP Eurasia began a fifty store test on Delivery Club's platform at the beginning of 2020, only three months after the arrival of their former employee. They were able to negotiate favorable economics and secure the right to operate under a first generation model where the group delivers all its own orders. The initial results were impressive, and DP Eurasia announced in March their intention to roll out all stores on the platform, which was completed in early June. This is particularly important because Domino's largest competitor in Russia, Dodo Pizza, has been outspoken against aggregators for some time and will almost certainly cede market share to DP Eurasia with this transaction. Management Talent In addition to benefiting from Aslan Saranga's experience, DP Eurasia has been able to attract key talent to its operations. Guvenc Donmez was essential in turning around the Domino's Russia segment after being acquired by DP Eurasia in 2013, and being named the CEO of Delivery Club is a testament to his caliber. The former CFO, Mustafa Ozgul, has replaced Guvenc as the CEO of the Russia division, and to complement his skillset Aslan recruited Tarun Bhasin, a twenty year veteran of Domino's, to join as COO. Tarun last served as the President and COO of Domino's India and was responsible for successfully scaling the business from one hundred to one thousand units. Tarun started in February 2020 and will prove to be a tremendous asset to DP Eurasia. In addition, Anna Masalova, who most recently served as finance director of McDonald's Russia, was appointed as the CFO of the group's Russian segment. Finally, in September 2020, DP Eurasia announced that Andrew Rennie, a twenty-five year executive of Domino's, will be joining the board as a strategic director. Andrew last served as the CEO of European operations of Domino's Pizza Enterprises and increased sales ten fold over his thirteen year career there. Intriguingly, the largest shareholder of DP Eurasia, Turkven, granted Andrew a four million share call option with a strike price of £1.05 and an expiration date of September 30, 2022 as an incentive. As a minority shareholder, one is able to participate in the value creation without dilution. COVID-19 While Domino's has broadly been a beneficiary amidst the global upheaval of the restaurant industry, DP Eurasia has not been without its own short term headwinds. Both Russia and Turkey issued strict national lockdown measures with seventy-two straight days of curfew in Russia and twenty-six straight days of curfew in Turkey. Moreover, the group entered the pandemic with a higher than average sales mix favoring dine-in and takeaway, which was severely disrupted. In the first months of the spring lockdown, DP Eurasia's Turkish division experienced meager like-for-like sales, while the Russian division suffered negative thirty percent like-for-like results. This performance was markedly worse than the broad Domino's network. However, DP Eurasia was able to operate at cash flow neutral throughout this trying time, and by October store level results had improved significantly. For example, in Turkey September and October likefor-like sales grew forty-four percent, bringing the Turkish year to date like-for-like figures to positive twenty-three percent. In addition, Russia improved dramatically as DP Eurasia rolled out an improved pizza offering with a new dough formulation as well as key toppings all backed by a greater Moscow TV campaign. Though it is early days, Russia witnessed slightly positive like-for-like results by the last weeks of October. Finally, while it is an unfortunate circumstance, it looks highly probable that DP Eurasia will exit this pandemic with materially less competition from the fragmented universe of restaurant operators. Valuation Over the past ten years, the four largest international Domino's master franchisees have created 2,942 percent total shareholder value in US dollar terms. DP Eurasia is a relative newcomer to the public markets but trades at a substantial discount to these comparable operators of scale. For example, DP Eurasia is currently valued at 7.4x enterprise value to EBITDA versus an average 28.9x enterprise value to EBITDA for the listed peer group. On a multiple of system sales basis, the discount appears equally as steep. Domino's master franchisees globally follow different business models ranging from one hundred percent corporate owned (Jubilant Foodworks) to ninety-seven percent franchised (Domino's Pizza Group Plc). One would expect networks with a higher percentage of corporate owned locations to trade at a higher multiple of system sales, given that they capture a higher percentage of profit for every dollar spent. However, even with a network that is sixty-eight percent franchised, DP Eurasia trades at a fifty-seven percent discount on a multiple of system sales basis to Domino's Pizza Group Plc and a seventy-five percent discount to Domino's Pizza Enterprises, which are ninety-seven percent and seventy-eight percent franchised networks, respectively. Jubilant Foodworks, which owns all of its locations, trades at a multiple of system sales that is 16.5x higher than DP Eurasia. Meanwhile, the group has grown its store network at a faster rate than all international master franchisees with the exception of Domino's Pizza Enterprises, and its store level economics are among the highest in the global Domino's network. Finally, DP Eurasia has whitespace to grow to 2,400 units in its core markets, which makes the group the least penetrated network among the international master franchises. On a forward looking basis, one can also consider the incremental value accretion of each cohort of new store openings. DP Eurasia expects to open sixty-five to ninety new stores per year over the next several years. These new store builds are weighted approximately one-third to Turkey, where the group expects to grow primarily through franchised openings, and two-thirds to Russia, where openings will be balanced between corporate and sub-franchisee locations. DP Eurasia earns approximately ten percent margins on sub-franchisee system sales, and its own corporate stores operate at a mid-twenties percent contribution margin. In addition, new corporate store builds cost roughly ₺1.2 million, while the group receives ₺140 thousand net for each sub-franchisee opening. Therefore, each annual store cohort will require ₺18 million to ₺27 million in upfront net CAPEX but will go on to produce ₺17 million to ₺25 million in recurring annual free cash flow (the average U.S. Domino's franchisee has operated for over eighteen years). In other terms, based on the year end price of £0.45 per share, each new store cohort will accrete two to four percentage points to DP Eurasia's free cash flow yield per annum. It is also worth noting that while the group is conservatively financed, its business model provides several levers to expedite debt paydown while continuing to grow system sales. For example, if DP Eurasia opted to lean on sub-franchisee openings for all new builds in a given year, it could generate an additional ₺21 million to ₺32 million in immediate cash flow without sacrificing system sales growth. Furthermore, because there is robust demand for units from new and existing sub-franchisees, the group's network of 241 corporate owned stores are highly liquid assets. While it would be almost certainly detrimental to long term shareholder value, DP Eurasia could repay all existing debt by transferring its corporate owned locations to sub-franchisees at the cost of a new build. This transaction would significantly lessen the capital intensity of the business and position DP Eurasia for a long runway of growth from a base five to seven percent free cash flow yield. Finally, we can estimate a range of values for DP Eurasia by projecting unit growth by country, like-for-like growth, system profitability, capital intensity, and other key inputs. The table below highlights the base case scenario for DP Eurasia, which equates to £0.92 per share, or roughly double the December 31 st , 2020 share price. Elephant(s) in the Room As a US dollar denominated investor, currency devaluation poses a significant risk to shareholders of DP Eurasia. For example, over the last ten years the Turkish Lira has devalued against the dollar by over seventy-five percent, while the Russian Ruble has devalued against the dollar by over fifty percent. These macro drivers of return can quickly transform excellent local operating performance into abysmal investment outcomes for foreign owners. Moreover, forecasting the direction of currencies is complex, highly dependent on geopolitical considerations and sentiment, and lies firmly beyond my circle of competence. However, there remain several elements that give me confidence in the prospective real returns of DP Eurasia. First, as mentioned previously, DP Eurasia purchases all of its raw ingredients in local currencies, leaving its profit structure unexposed to currency fluctuations. Second, in 2018 the group refinanced all of its euro denominated debt with ruble and lira denominated debt to match the underlying revenues of the business. Third, DP Eurasia's Russian operations are becoming an increasingly significant proportion of total system sales, and Russia's economy is far less reliant on foreign flows than Turkey. Recall that the 2014 financial crisis in Russia generated the lion's share of ruble devaluation over the last decade, which was instigated by a collapse in oil price. In 2014, Russia required $100 /bbl oil to balance its fiscal budget, but today that figure stands at less than $40/bbl. Fourth, while by no means a predictive measure, goods and services in Turkey and Russia in real terms are some of the most affordable globally. For instance, consider the infamous Big Mac index. The Big Mac index was invented in 1986 as a lighthearted guide to assess whether currencies are at their "correct" level. It is based on the theory of purchasing power parity (PPP), the notion that in the long run exchange rates should move towards the rate that would equalize the prices of an identical basket of goods and services (in this case, a burger) in any two countries. According to The Economist, the Turkish Lira and Russian Ruble rank 54 th and 55 th , respectively, of fifty-six total countries surveyed, with an implied sixty-four and sixty-eight percent fair value discount to the US dollar. Fifth, DP Eurasia's scale and brand recognition allows the group to manage raw input inflation better than competitors and pass on heightened costs to consumers in the form of price increases. Sixth, in the event of currency collapse induced recession, Domino's Pizza has proven to be a globally resilient business as consumers trade-down into lower price food offerings during a recession. Finally, I use a twenty percent discount rate to calculate the net present value of cash flows for DP Eurasia in our financial model. In addition to a standard eight percent discount rate, this allows for a sixty-five percent local currency devaluation over a ten year period. Conclusion At a time where the investment community eagerly confers revenue multiples of 10x, 30x, or even 100x upon collectively agreed champions, our partnership is comfortable opting for different battlegrounds. We cannot control the prices others are willing to pay for assets, and, thankfully, those prices similarly have little bearing on the fundamental performance of our own portfolio. Our sandbox is large by design, and today our opportunity set of assets that are underappreciated, run by operators with high co-ownership, and available at attractive prices remains robust. As always, I am happy to speak with you at length about any of our companies, and I remain grateful for your trust and partnership. Appendix A: Realized Investments Table above reflects the IRR of realized portfolio investments (unannualized if < 1 Year), and the equivalent IRR that would have been achieved had each invested dollar been allocated to MSCI ACWI. Full Disclosure Available Upon Request Appendix B: Unrealized Investments Table above reflects the IRR of unrealized portfolio investments (unannualized if < 1 Year), and the equivalent IRR that would have been achieved to date had each invested dollar been allocated to MSCI ACWI. **Full Disclosure Available Upon Request Disclosures Investment in Emeth Value Capital are subject to risk, including the risk of permanent loss. Emeth Value Capital's strategy may experience greater volatility and drawdowns than market indexes. An investment in Emeth Value Capital is not intended to be a complete investment program and is not intended for short term investment. Before investing, potential clients should carefully evaluate their financial situation and their ability to tolerate volatility. Emeth Value Capital, LLC believes the figures, calculations and statistics included in this letter to be correct but provides no warranty against errors in calculation or transcription. Emeth Value Capital, LLC is a Registered Investment Advisor. This communication does not constitute a recommendation to buy, sell, or hold any investment securities. Performance Notes Net performance figures are for a typical client under the standard fee arrangement. Returns for clients' capital accounts may vary depending on individual fee arrangements. Net performance figures for Emeth Value Capital, LLC are reported net of all trading expenses, management fees, and performance incentive fees. Reported returns prior to January 1 st , 2021 reflect the personal account performance of Emeth Value Capital, LLC's sole managing member, and therefore represent related performance. All performance figures are unaudited and are subject to change. Contact Emeth Value Capital welcomes inquiries from clients and potential clients. 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COMPETITION COMMISSION OF INDIA (Combination Registration No. C-2020/12/804) 10 th February 2021 Notice under Section 6 (2) of the Competition Act, 2002 filed by Bank of India CORAM: Mr. Ashok Kumar Gupta Chairperson Ms. Sangeeta Verma Member Mr. Bhagwant Singh Bishnoi Member Order under Section 31(1) of the Competition Act, 2002 1. On 31 st December 2020, the Competition Commission of India ('Commission') received a notice under Section 6(2) of the Competition Act, 2002 ('Act'), filed by Bank of India ('BOI/Acquirer'). The notice was filed pursuant to the execution of Share Purchase Agreement dated 2 nd December 2020 amongst BOI, AXA Investment Managers, AXA Investment Managers Asia Holdings Pvt. Ltd. ('AXA IM Asia'), BOI AXA Investment Managers Private Limited ('BOI AXA IM'), and BOI AXA Trustee Services Private Limited ('BOI AXA TS'). 2. The Proposed Combination contemplates acquisition of BOI AXA IM and BOI AXA TS by BOI [Hereinafter, BOI AXA IM and BOI AXA TS are collectively referred to as 'Targets'] [Acquirer and Targets are collectively referred to as 'Parties'] 3. BOI and AXA Investment Managers through their investment company AXA IM Asia have a Joint Venture ('JV') in mutual fund business, viz. BOI AXA Mutual Fund ('BOI AXA'), in India. BOI AXA consists of two companies, viz. (i) BOI AXA IM, and (ii) BOI Page 1 of 3 Combination Registration No. C-2020/12/804 AXA TS. These provide asset management and trustee services to BOI AXA, respectively. 4. BOI presently holds 51% of the paid-up equity share capital of the Targets. The remaining 49% is held by AXA IM Asia. 5. In terms of Regulations 14(3) of the Competition Commission of India (Procedure in regard to the transaction of business relating to combinations) Regulations, 2011, vide communication dated 14 th January 2021, the Acquirer was required to furnish certain information and clarifications. In response, the Acquirer filed its written submission on 20 th January 2021. 6. The Proposed Combination relates to acquisition of 49% of the total share capital of BOI AXA IM and BOI AXA TS by BOI. Post the Proposed Combination, 100% of the share capital of both the said companies will be held by BOI resulting in the Acquirer becoming the sole owner of the Targets and the sole sponsor of BOI AXA. 7. The Acquirer is in the market of Mutual Fund through the Targets. Apart from this, the Acquirer does not hold equity stake in any other mutual fund. It is observed that market share of the parties in mutual fund business is not significant. Even if one were to segment mutual fund into equity oriented mutual funds, debt oriented mutual funds and hybrid mutual funds, the market shares of the Parties still remain insignificant. Mutual funds and their distribution are also characterised by presence of several other players such as HDFC Bank, State Bank of India, Axis Bank and ICICI Bank. 8. Considering the material on record including the details provided in the notice and the assessment of the Proposed Combination based on the factors stated in Section 20(4) of the Act, the Commission is of the opinion that the Proposed Combination is not likely to have any appreciable adverse effect on competition in India. Accordingly, the Commission approves the Proposed Combination under Section 31(1) of the Act. Page 2 of 3 Combination Registration No. C-2020/12/804 9. This order shall stand revoked if, at any time, the information provided by the Acquirer is found to be incorrect. 10. The information provided by the Acquirer shall be treated as confidential in terms of and subject to provisions of Section 57 of the Act. 11. The Secretary is directed to communicate to the Acquirer accordingly. Page 3 of 3	<urn:uuid:fe86e1d4-5d30-4f33-b26b-68e786da7174>	CC-MAIN-2021-49	http://cci.gov.in/sites/default/files/Notice_order_document/Final-Order-804-Wbupload.pdf	2021-11-29T21:09:26+00:00	crawl-data/CC-MAIN-2021-49/segments/1637964358842.4/warc/CC-MAIN-20211129194957-20211129224957-00080.warc.gz	14,605,090	894	eng_Latn	eng_Latn	0.847889	eng_Latn	0.96905	[ "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 1361, 3337, 3731 ]	[ 0.1298828125 ]	[ 1.9375 ]	[ 2.0625 ]	[ 2.203125 ]	1	0	HuggingFaceFW/finepdfs
Benefits of Public Relations Assessment Task Why public relations are important (Individual activity) (LO3 AS2) Read the article below about public relations and answer the questions that follow. Size doesn't matter when it comes to PR By: Marie Yossava Any company, no matter the size or capacity, can benefit from publicity, but it is commonly misunderstood in business that PR is something that only large corporations have the budget for and the brand to carry it. The power of PR for SMEs can assist in business growth and recognition. A great concept is only as good as the market's awareness of its need for your business offering. Many people do not know how to commercialise a concept and PR is one of the disciplines of marketing that help do just that. Publicity helps take the message to market and inform target markets that the product or service is now available, differentiates your company from competitors, advises of the compelling reason(s) as to why they should be doing business with you and finally builds brand awareness. Credibility Unless the public (target markets) know you exist, how can they transact with you? PR coverage lends credibility to you, your business and the products and services beyond what can be gained with paid advertising. Advertising can take your brand so far while PR complements it and the overall marketing strategy. Publicity also changes perceptions. Other organisations look up and start taking cognisance of the new kids on the block and realise they have a serious contender in the marketplace. Existing clients are assured that they are working with a recognised business that holds an opinion and is an authority within their field. Potential customers acknowledge that this company is no small fry (mickey mouse) outfit/operation and perhaps considers it as the preferred partner. (Source: http://www.bizcommunity.com/Article/196/18/38402.html) a) What does PR stand for? b) Name two benefits PR can bring to a small business. c) What is the misconception about PR that exists in small businesses? [1 mark] [2 marks] [1 mark] d) Do some research and find out what 'spin' means in public relations. [1 mark] e) In the run-up to the 2009 general elections, some political parties sent text messages to their electorate to encourage them to register to vote. Why is this considered public relations? [1 mark] f) Do some research to find out what skills and abilities people should have who work in public relations. Name two. [2 marks] g) Try to find out by what other two names public relations departments in companies are also known. [2 marks] [Total: 10 marks]	<urn:uuid:7dccdea4-2021-473c-9e1b-536c1f1bc23e>	CC-MAIN-2024-51	http://www.holycrosshigh.co.za/G9EMS_BANK/Grade%209%20Benefits%20of%20public%20relations%20Question.pdf	2024-12-10T17:22:19+00:00	crawl-data/CC-MAIN-2024-51/segments/1733066067282.2/warc/CC-MAIN-20241210163759-20241210193759-00378.warc.gz	40,381,240	545	eng_Latn	eng_Latn	0.998318	eng_Latn	0.998318	[ "eng_Latn" ]	false	docling	[ 2643 ]	[ 2.359375 ]	[ 3.421875 ]	[ 3.390625 ]	[ 2.390625 ]	1	0	HuggingFaceFW/finepdfs
Proceedings of the Colo City Council June 3, 2013 The Colo City Council met in regular session on Monday, June 3, 2013, at City Hall. Mayor John Wilson called the meeting to order at 7:00 p.m. The roll was called showing members present and absent as follows: Present: Peakin, Nichols, Patrick, Norgart, Conrad. Absent: None. Council member Peakin moved to approve the minutes of the May 6, 2013, meeting as presented. Council member Norgart seconded the motion and it passed all ayes. Receipts Summary: General Fund 35402.21, Road Use Tax Fund 3965.82, Water Utility Fund 10925.39, Sewer Utility Fund 8478.50, Solid Waste Fund 6337.74 Tax Increment Finance Fund 9002.20, Trust and Agency Fund 450.00, Local Option Sales Tax Fund 7246.63, Special Revenue Fund 1577.36. Council member Norgart moved to approve the following claims for payment. GENERAL FUND 51.00 Council member Patrick seconded the motion and it passed all ayes. The Council received reports from the Colo Public Library and the Colo Crossroads Committee. Council member Conrad moved to appoint Lee Matteson to the Colo Recreation Board with a term ending 12-31-17. Council member Norgart seconded the motion and it passed all ayes. Council member Norgart moved to approve a request by TJ's Hideaway for the closing of Main Street from the Community Center west to Fourth Street on July 13, 2013, from 4:00 p.m. until 2:00 a.m. July 14, 2013. Council member Nichols seconded the motion and it passed all ayes. Council member Conrad moved to approve an outdoor service application for TJ's Hideaway for July 13-14, 2013. Council member Nichols seconded the motion and it passed all ayes. Council member Peakin moved to approve the closing of Collins Street from the alley north of Warner Street to North Third Street on July 6, 2013, from 12:00 noon until 9:00 p.m. Council member Patrick seconded the motion and it passed all ayes. Council member Norgart moved to approve the following Street closings for the Colo Crossroads Festival: July 12, 2013, Voorhies Street between Fourth Street and Fifth Street from 4:00 p.m. until 7:00 p.m., July 13, 2013, Main Street from Second Street to Sixth Street, Sixth Street from Main Street to South Street, South Street from Sixth Street to Second Street, and Second Street from South Street to Main Street from 10:00 a.m. until 11:30 a.m. and Sixth Street from Bailey Street to Voorhies Street, Voorhies Street from Fourth Street to Sixth Street, Fifth Street from Bailey Street to Voorhies Street from 11:00 a.m. until 3:00 p.m. Council member Peakin seconded the motion and it passed all ayes. Council member Norgart introduced and moved the approval of a RESOLUTION SETTING THE SALARIES FOR APPOINTED OFFICERS AND EMPLOYEES OF THE CITY OF COLO, IOWA, EFECTIVE JULY 1, 2013. Council member Peakin seconded the motion and it passed with record vote as follows: Ayes: Peakin, Norgart, Nichols, Conrad, Patrick. Nays: None. Whereupon the Mayor declared the motion carried and the resolution approved and he gave it No. 13-6-1 for the record. Council member Conrad introduced and moved the approval of A RESOLUTION TO TRANSFER FUNDS FOR FISCAL YEAR ENDING 6-30-13. Council member Nichols seconded the motion and it passed with record vote as follows: Ayes: Norgart, Nichols, Conrad, Patrick, Peakin, Nays: None. Whereupon the Mayor declared the motion carried and the resolution approved and he gave it No. 13-6-2 for the record. Council member Nichols introduced and moved the approval of A RESOLUTION TO TRANSFER FUNDS FOR FISCAL YEAR 2013-14. Council member Peakin seconded the motion and it passed with record vote as follows: Ayes: Nichols, Conrad, Patrick, Peakin, Norgart. Nays: None. Whereupon the Mayor declared the motion carried and the resolution approved and he gave it No. 13-6-3 for the record. Council member Conrad moved to approve payment for the Sanitary Sewer Grout Sealing Project and the Standby Generator Project upon satisfactory completion of the projects. Council member Norgart seconded the motion and it passed all ayes. Council member Norgart move to authorize the city clerk to request proposals for an annual financial examination for the fiscal year ending 6-30-13 as required by the Iowa Code. Council member Nichols seconded the motion and it passed all ayes. The Council received an update from the Colo Community Visioning Committee. There being no further business to come before the meeting Council member Norgart moved to adjourn. Council member Peakin seconded the motion. The motion carried and the meeting adjourned. ______John C. Wilson_______ Mayor ATTEST: _______Scott V. Berka_____ City Clerk	<urn:uuid:2e005d07-7366-4c95-a430-b25cc4211f6d>	CC-MAIN-2017-39	http://showcase.netins.net/web/colo-iowa/cc_06-03-13_min.pdf	2017-09-25T02:26:05Z	crawl-data/CC-MAIN-2017-39/segments/1505818690307.45/warc/CC-MAIN-20170925021633-20170925041633-00064.warc.gz	315,976,332	1,175	eng_Latn	eng_Latn	0.990209	eng_Latn	0.994667	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 1035, 4702 ]	[ 0.73828125 ]	[ 1.5703125 ]	[ 1.9765625 ]	[ 2.375 ]	2	0	HuggingFaceFW/finepdfs
Lorrie Payne February 1, 1964 - October 8, 2020 Lorrie Hollis Payne, age 56 of Joelton, Tennessee died Thursday, October 8, 2020 at Centennial Medical Center in Nashville. Her remains will be cremated and a memorial service will be held Saturday, October 17th, at 1PM at Cheatham Dam in Ashland City. It will be under the right bank pavilion. Lorrie was born on February 1, 1964 in Nashville, Tennessee to the late G.W. and Geraldine Goolsby Hollis. She had worked in accounts receivables at Bridgestone, Methodist Publishing House, and recently at A.O. Smith. She loved to cook, especially meatloaf, loved to dance and was a good, big sister. She was a Christian. In addition to her parents, she is preceded in death by a brother, Ricky David Hollis. She is survived by her brother, Randall Wayne Hollis; and her sister, Tammy Michelle (Bruce) Walker. If so desired, memorial contributions may be made to one's choice of their favorite animal foundation. AUSTIN & BELL FUNERAL HOME in Pleasant View is in charge of these arrangements. 6316 Highway 41A, Pleasant View, Tennessee 37146 (615) 746-4433 www.austinandbell.com Comments Watching movies on Sundays many years ago. I'll never forget Lorrie. Cynthia Walton - October 11, 2020 at 12:49 AM " Alice And Bobby Chandler lit a candle in memory of Lorrie Payne " Alice and Bobby Chandler - October 10, 2020 at 10:26 PM" Jamie Badders lit a candle in memory of Lorrie Payne Jamie Badders - October 10, 2020 at 10:11 PM" Anna Creek lit a candle in memory of Lorrie Payne Anna Creek - October 10, 2020 at 09:38 PM Lorrie was neighbor my on Thomasville Road. I will always treasure our friendship. Untill we meet again. " Marie Pickett - October 10, 2020 at 09:29 PM Hope Hollis lit a candle in memory of Lorrie Payne " Hope Hollis - October 10, 2020 at 09:27 PM Bridget Mabry lit a candle in memory of Lorrie Payne" Bridget Mabry - October 10, 2020 at 12:51 PM My sincere condolences to you all. Lorrie was always sweet to me and I'll forever remember her gorgeous smile. She loved her family fiercely, and her cats! " Jamie Badders - October 10, 2020 at 12:17 PM	<urn:uuid:d811b458-bf21-4eda-84fc-d33d3a6bae47>	CC-MAIN-2021-10	https://www.austinandbell.com/obituaries/Lorrie-Payne/Print/Wall	2021-02-25T07:18:54+00:00	crawl-data/CC-MAIN-2021-10/segments/1614178350846.9/warc/CC-MAIN-20210225065836-20210225095836-00397.warc.gz	685,212,632	588	eng_Latn	eng_Latn	0.988757	eng_Latn	0.994889	[ "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 1130, 1578, 2138 ]	[ 0.384765625 ]	[ 0.35546875 ]	[ 1.9765625 ]	[ 2.328125 ]	1	0	HuggingFaceFW/finepdfs
Club Code of Conduct 1. Please treat the Club as you would your own property and take responsibility to ensure its continued success. 2. Good manners should be practiced at all times. Members should behave with courtesy and consideration towards other players. 3. Please don't enter a court when a game is in progress if it is likely to cause interference or distraction. Only so do when play has temporarily stopped. 3. If you need to cross a court that is occupied to access yours, please only cross in between points. Access to courts 4, 5 & 6 should be made via the lower gate to ensure crossing courts is kept to a minimum. 4. During play, if a ball of yours strays onto or behind another court, do not attempt to retrieve the ball if there is a game in progress on that court. Wait until the point on the adjoining court is finished before you retrieve the ball. 5. While a game is in progress, please do not make excessive noise while in the vicinity of that court out of respect to the players. 6. Preference for court time/use will be given to members over non- members. 7. When tennis courts are booked but not occupied, a grace period of 15 minutes should be allowed after which the courts may be taken on a first come first served basis. 8. After 8.00 pm no singles play will be allowed if all courts are occupied and there are members waiting to play (doubles only). 10. Court time is to be restricted to 1 hour if all courts are in use and members are waiting to play (doubles). 11. Proper tennis shoes only to be worn on the courts. 12. Please don't leave rubbish on the courts. Stackallen Tennis and Pitch & Putt Club Pighill Slane Co Meath www.stackallensclub.com 0863802167	<urn:uuid:d2696878-127e-4b39-a27e-af1585c17dd8>	CC-MAIN-2024-30	https://stackallenclub.ie/wp-content/uploads/2021/11/Club-Code-of-Conduct.pdf	2024-07-20T15:02:42+00:00	crawl-data/CC-MAIN-2024-30/segments/1720763515300.51/warc/CC-MAIN-20240720144323-20240720174323-00850.warc.gz	472,064,892	383	eng_Latn	eng_Latn	0.9995	eng_Latn	0.9995	[ "eng_Latn" ]	false	docling	[ 1699 ]	[ 0.80859375 ]	[ 1.4140625 ]	[ 3.0625 ]	[ 1.5390625 ]	1	0	HuggingFaceFW/finepdfs
Constructing Correlation Coefficients from Similarity and Dissimilarity Functions Ildar Z. Batyrshin Centro de Investigacion en Computacion, CIC-IPN, Av. Juan de Dios Bátiz S/N, Nueva Industrial Vallejo, Gustavo A. Madero, 07738 Ciudad de México, CDMX, e-mail: email@example.com Abstract. Correlation coefficients (association measures) were introduced more than one hundred years ago as measures of relationship between variables that usually belong to one of the following basic types: continuous, ordinal, or categorical. Nowadays, it appears the growing demand for the development of new correlation coefficients for measuring associations between variables or objects with more sophisticated structures. The paper presents a non-statistical, functional approach to the study of correlation coefficients. It discusses the methods of construction of correlation coefficients using similarity and dissimilarity measures. Generally, all these measures are considered as functions defined on the underlying (universal) domain and satisfying some sets of properties. The methods of construction of correlation functions on the universal domain can be easily applied for constructing correlation coefficients for specific types of data. The paper introduces a new class of correlation functions, satisfying a weaker set of properties than the previously considered correlation functions (association measures) defined on a set with involution (negation) operation called here strong correlation functions. The methods of constructing both types of correlation functions are discussed. The one-to-one correspondence between the strong correlation functions and the bipolar similarity and dissimilarity functions is established. The theoretical results illustrated by examples of construction of classical Pearson's product-moment correlation coefficient, Spearman's and Kendall's rank correlation coefficients, etc. from similarity and dissimilarity functions. Keywords: similarity; dissimilarity; correlation; association; Spearman's and Kendall's rank correlations; Pearson's correlation; cosine similarity, and cosine correlation 1 Introduction Similarity and association measures actively studied more than one hundred years as measures of relationship between data initially in pattern classification and statistics and later in data mining and machine learning [1, 9-11, 13, 14, 16-20]. Correlation coefficients (association measures) were introduced in statistics as measures of the relationship between variables of one of the following types: continuous, ordinal, or categorical. Nowadays, we see the growing demand for measuring the relationship between data with diverse structures: sequences and time series, rating profiles, vectors with different attributes, fuzzy sets, matrices, images, texts with syntactic structures, etc. An application of classical correlation coefficients to new types of data often impossible or gives misleading results. For this reason, to have the correlation coefficients specific for the analyzed data type is of great interest. The paper considers the methods of construction of correlation coefficients using similarity and dissimilarity measures defined on an underlying set referred to as a universal domain. One can easily apply these methods to a specific type of data. The similarity, dissimilarity, and correlation measures are considered as functions satisfying some sets of properties [3, 4, 8]. This paper introduces a new class of correlation functions, satisfying a weaker set of properties than the previously considered correlation functions (association measures) [4, 8] called here strong correlation functions and defined on a set with involution (negation) operation. We discuss the methods of constructing both types of correlation functions using (dis)similarity functions. We establish the one-to-one correspondence between the strong correlation functions and "bipolar" (dis)similarity functions. The examples of the construction of correlation coefficients for specific domains illustrate the theoretical results. The paper has the following structure. Section 2 gives definitions of similarity and dissimilarity functions. Sections 3 and 4 consider the methods of construction of strong correlation functions (association measures) on the set with involution operation. In Section 5, we introduce generalized correlation functions that can be defined on a set without involution operation and study their relationships with (dis)similarity functions. In Section 6 we establish one-to-ome correspondence between strong correlation functions and bipolar (dis)similarity functions. Section 7 discusses related works and includes the conclusion. 2 Similarity and Dissimilarity Functions The paper considers similarity, dissimilarity, and correlation measures or coefficients as functions defined on some nonempty underlying set Ω [8]. As such set one can use, for example, any specific domain: the set of all real-valued ntuples, the set of binary vectors, the set of membership values, the set of images, etc. To emphasize that the underlying set Ω is not a specific domain but any domain this set will be referred to as a universal domain. Definition 1. A similarity function on a set Ω is a function S:Ω×Ω→[0,1] satisfying for all x, y in Ω the properties: ``` S(x,y) = S(y,x), (symmetry) S(x,x) = 1. (reflexivity) ``` If for some x, y in Ω it is fulfilled: S(x,y) = 0, then S is called (0)normal (in ( x,y )). Definition 2. A dissimilarity function on a set Ω is a function D:Ω×Ω→[0,1] satisfying for all x, y in Ω the properties: If for some x, y in Ω it is fulfilled: then D is called 1-normal (in (x,y)). Dissimilarity functions are dual to similarity functions. Definition 3. Similarity S and dissimilarity D functions are called complementary if for all x, y in Ω it is fulfilled: . One can obtain one of these functions from the corresponding complementary function for all x, y in Ω as follows: It is clear that a similarity function is 0-normal if and only if its complementary dissimilarity function is 1-normal. Example 1. Let Ω be a set of nonnegative real-valued n-tuples x = (x1,…,xn) such that x ≠ (0,…,0). Then for any x = (x1,…,xn) and y = (y1,…,yn) in Ω the following function: is the symmetric and reflexive similarity function called a cosine similarity measure and denoted as cos(x,y). It is 0-normal for orthogonal pairs of n-tuples x and y such that xiyi = 0 for all i=1,…,n. The similarity function cos(x,y) has the following complementary dissimilarity function [8]: Due to the duality of similarity and dissimilarity functions, one can consider only one of these functions, but they have different interpretations and methods of construction; hence, we consider them together. These functions studied in [8]. For short, we call them also (dis)similarity functions. 3 Strong Correlation Functions The correlation functions (association measures) were introduced in [3, 4, 8] on a universal domain Ω with an involutive operation N as functions satisfying several properties of Pearson's product-moment correlation coefficient. Here these correlation functions called strong correlation functions. The methods of construction of correlation functions using similarity functions have been proposed, and it was shown how the Pearson's correlation and Yule's Q association coefficient could be constructed using suitable similarity functions [2, 5, 8]. In the following sections, we will consider correlation functions satisfying a weaker set of properties. Definition 4. A function N:Ω→Ω satisfying for all x in Ω the property: N(N(x))=x, (involutivity) is called a reflection or a negation on Ω if it is not an identity function, i.e. if for some x in Ω it is fulfilled: N(x) ≠ x. An element x in Ω such that N(x) = x is called a fixed point and the set of all fixed points of the negation N in Ω is denoted as FP(N, Ω) or FP(Ω). Below Ω\FP(Ω) denotes the set of all elements in Ω, which are not fixed points. The set FP(Ω) can be empty. It is easy to show that the set Ω\FP(Ω) is closed under reflection operation. Proposition 1 [4]. Let N:V→V be a reflection on a set V, and R:V×V→R be a symmetric real-valued function, i.e.: R(x,y) = R(y,x), for all x,y in V . The function R satisfies for all x,y in V the property: R(N(x),N(y)) = R(x,y), if and only if it is fulfilled: R(x,N(y)) = R(N(x),y). Symmetric function R satisfying these properties will be called a co-symmetric function [8]. Further, we will consider co-symmetric similarity, dissimilarity, and correlation functions. A similarity function S:V×V→[0,1] satisfying for all x, y in V the property: S(x,N(x)) = 0, is called a consistent similarity function [8]. Dually, a dissimilarity function D:V×V→[0,1] will be called a consistent dissimilarity function if for all x, y in V it is fulfilled: D(x,N(x)) = 1. A similarity function S is consistent or co-symmetric if and only if its complementary dissimilarity function is consistent or co-symmetric, respectively. Definition 5 [4]. Let N be a reflection on Ω and V be a subset of Ω∖FP(Ω) closed under N. A strong correlation function (association measure) on V is a function A:V×V→[–1,1] satisfying for all x, y in V the properties: A(x,y) = A(y,x), (symmetry) A strong correlation function will be also referred to as an invertible correlation function. Proposition 2 [4]. A strong correlation function A on V satisfies for all x, y in V the following properties: A(x,N(x)) = –1, A(N(x),N(y)) = A(x,y). (co-symmetry) Example 2. Let Ω be the set of all real-valued n-tuples x = (x1,…,xn) with the reflection operation N(x) = –x = (–x1,…, –xn). Let V be a set of all non-constant ntuples from Ω such that x≠(q,…,q) for any real value q. It is clear that V is closed under N, and it has no fixed elements. It is easy to check that the Pearson's product-moment correlation coefficient: where 𝑥̅ = 1 𝑛 ∑ 𝑥𝑖 𝑛 𝑖=1 , 𝑦̅ = 1 𝑛 ∑ 𝑦𝑖 𝑛 𝑖=1 is the strong correlation function on V. Consider the methods of construction of strong correlation functions (association measures) [3, 4, 8]. Theorem 1. Let N be a reflection on Ω and V be a nonempty subset of Ω\FP(Ω) closed under N. Let S:V×V→[0,1] be a co-symmetric and consistent similarity function, then the function A:V×V→[–1,1] defined for all x, y in V by is a strong correlation function on V. The formula (3) has a simple interpretation: the correlation between x and y is positive if x is more similar to y than to its negation, and the correlation is negative in the opposite case. Replacing in (3) the similarity function S by the complementary dissimilarity function: D(x,y) = 1 – S(x,y) obtain the following formula for constructing a strong correlation function from a co-symmetric and consistent dissimilarity function: This formula can be more convenient than (3) for constructing strong correlation functions when we use distance-based dissimilarity functions [8]. Example 3 [2, 5, 8]. Consider the dissimilarity function on the set V of nonconstant n-tuples (see Example 2) that generates by (4) the Pearson's productmoment correlation coefficient (2): One can check that it is co-symmetric and consistent. Example 4. If the cosine function from Example 1 is defined on the set of all nonzero real-valued n-tuples with the negation operation N(x) = –x = (–x1,…, –xn), then it will satisfy the properties of the strong correlation function and can be generated by (4) using the following dissimilarity function [8]: This dissimilarity function is co-symmetric and consistent. As it follows from Examples 1 and 4, the cosine function will be the similarity function if it is defined on the set of nonzero, nonnegative real-valued n-tuples, and it will be the strong correlation function if it is defined on the set of nonzero real-valued n-tuples [8]. The cosine is often used as a similarity measure between the texts represented by vectors of attributes where xi equals to the frequency of appearing of the ith attribute in the text [18]. In this case, all vector components take nonnegative values. As a correlation function, the cosine used, for example, in measuring associations between time series presented by sequences of local trends that can have positive and negative values [2, 6]. Generally, the cosine correlation can be used instead of Pearson's correlation on the set of real-valued ntuples when the calculation of means used in Pearson's correlation has not much sense, for example, when the signs of the elements of n-tuples are important, or these elements contain the values of attributes measured in different scales. Pseudo-Differences in Constructing Strong 4 Correlation Functions Let TC:[0,1]×[0,1]→[0,1] be a t-conorm [15], i.e. commutative, associative, monotonic function satisfying boundary condition: TC ( a ,0) = 0, for all a in [0,1]. Usually, t -conorm is denoted by the letter S , but in this paper, the symbol S is used for similarity functions and similarity measures, for this reason, we denote t -conorm as TC . We will say that a t-conorm TC has no nilpotent elements if for all a, b in [0,1] it is fulfilled: TC(a,b) = 1 if and only if a = 1 or b = 1. Consider the examples of basic t-conorms defined for all a, b in [0,1] as follows [15]: TCM(a,b) = max(a,b), (maximum) TCP(a,b) = a+b-ab, (probabilistic sum) TCL(a,b) = min(a+b,1). (Lukasiewicz t-conorm) t-conorms TCM and TCP have no nilpotent elements but TCL has. Definition 6 [12]. Let TC be a t-conorm. A pseudo-difference operation ⊖TC associated to TC is defined for all a, b in [0,1] as follows: where 𝑎 𝑇𝐶 𝑏 is the TC-difference defined by: . Consider the pseudo-difference operations associated to basic t-conorms [12]: . be a nonempty subset of →[0,1] be a co-symmetric and consistent Theorem 2 [3,4]. Let N be a reflection on Ω and V Ω∖FP(Ω) closed under N. Let S:V×V similarity function then the function is a strong correlation function on V. Theorem 1 is a particular case of Theorem 2 when it is used the pseudo-difference operation ⊖TC = ⊖L associated to Lukasiewicz t-conorm. In some domains, it is difficult to construct consistent similarity functions. In such cases, the property of consistency S can be replaced by the property of weak consistency (weak similarity of reflections) of S defined for all x,y in V by: S(x,N(x)) < 1. Theorem 3 [3,4]. Let N be a refkection on Ω and V be a nonempty subset of Ω\FP(Ω) closed under N. Let S:V×V→[0,1] be a co-symmetric similarity function satisfying weak consistency, then the function is a correlation function on V if t-conorm TC has no nilpotent elements. From Theorem 3, it follows that if similarity function S is co-symmetric but only weakly consistent, then there is no reason to use in (5) pseudo-difference operation a⊖TCb= a – b but one can use pseudo-difference operations associated to maximum TCM and product TCP t-norms. Some examples one can find in [3, 4]. 5 Generalized Correlation Functions Here we introduce the correlation functions that can be not strong. In the definition of such correlation functions, we do not require that the underlying set Ω equipped with some negation operation. We will consider the methods of construction of such correlation functions and, further, we will show when these methods will define strong correlation functions. Finally, we establish the one-toone correspondence between "bipolar" similarity functions and strong correlation functions. Definition 7. A function A:Ω×Ω→[–1,1] on a nonempty set Ω is a correlation function if it is symmetric, reflexive and has negative value for some x, y in Ω: A(x,y) < 0. A correlation function A is called (–1)-normal (in (x,y)) if A(x,y) = –1 for some x, y in Ω. A non-strong correlation function will be called a weak o semi-correlation function. Proposition 3. Suppose S and D are similarity and dissimilarity functions on Ω such that for some x, y in Ω it is fulfilled: S(x,y) < D(x,y), then the function defined for all x,y in Ω by: is a correlation function. Proof. The similarity of A follows from the similarity S and D. The reflexivity of A follows from the reflexivity of S and irreflexivity of D. When for some x, y in Ω it is fulfilled S(x,y) < D(x,y), the value of A in (6) is negative. ■ If S is 0-normal and D is 1-normal in the same pair of elements (x,y) then A is (-1)normal. If similarity and dissimilarity functions in (6) are complementary, then the function (6) will be a correlation function if for some x, y in Ω it fulfills S(x,y) < 0.5. The formula (6) has a reasonable interpretation: the correlation between x and y is positive if the similarity between them is greater than the dissimilarity, and the correlation is negative in the opposite case. Definition 8. If the similarity S and dissimilarity D functions in (6) are complementary, then the correlation function A defined by (6) is called complementary to S and D, and (S,D,A) for such functions is called a complementary (or correlation) triplet. From Definitions 3 and 8 and from Proposition 3 it follows that the similarity, dissimilarity and correlation functions from the complementary triplet (S,D,A), can be obtained one from another for all x, y in Ω as follows: Example 5. The Spearman's rank correlation coefficient is equivalent to the Pearson's product-moment correlation coefficient applied to rankings of n objects [9, 14]. When each of rankings x = (x1,…,xn) and y = (y1,…,yn) contains n different integer ranks, 1 ≤ xi, yi ≤ n, i.e. there are no ties, the Spearman's rank correlation coefficient is calculated as follows: where di = xi - yi. Consider the function: It is irreflexive, symmetric and takes values in the interval [0,1], hence it is the dissimilarity function and Spearman's rank correlation coefficient defined by rS(x,y) = 1 – 2D(x,y), is a correlation function, compare with (9). Example 6. The Kendall rank correlation coefficient is defined for measurements without ties x= (x1,…,xn) and y= (y1,…,yn) of two variables for n objects as follows [11,14,17]: 𝜏= 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑐𝑜𝑛𝑐𝑜𝑟𝑑𝑎𝑛𝑡 𝑝𝑎𝑖𝑟𝑠 − 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑑𝑖𝑠𝑐𝑜𝑛𝑐𝑜𝑟𝑑𝑎𝑛𝑡 𝑝𝑎𝑖𝑟𝑠 , 𝑛(𝑛−1)/2 that can be represented as the difference between similarity S and dissimilarity D functions (6): defined as follows: where concordant and disconcordant pairs (i,j), i<j, defined by: The Kendall rank correlation coefficient uses the signs of differences between measurement values: (xi – xj) and (yi– yj), hence takes into account only the ordering (or ranking) of these values. Note that S is reflexive, D is irreflexive, and both functions are symmetric, take values in [0,1]; hence they are similarity and dissimilarity functions, respectively. Due to the measurements are without ties, i.e., all have different values, from sij + dij = 1 for all 1≤i<j≤n, it follows S(x,y)+D(x,y)= 1, i.e., S and D are complementary functions, and together with Kendall rank correlation coefficient compose complementary triplet (S,D, ), hence for S, D, and A= all relations (7)-(9) are fulfilled. 6 Relationship between Strong Correlation Functions and Similarity Functions The following theorem answers the question: when the correlation function from a complementary triplet will be strong. Theorem 4. Let N be a reflection on Ω and V be a nonempty subset of ) ( \ FP closed under N. The formulas (8) establish the one-to-one correspondence between the strong correlation functions and the similarity functions satisfying for all x, y in V the following property: Proof. Suppose (1) is fulfilled, then applying (8) we obtain from (12): 2S(x,y) – 1 + 2S(x,N(y)) – 1= 0, and 2S(x,y) + 2S(x,N(y))= 2, i.e. (11) is fulfilled. Similarly, from (11), (8) we can obtain (1) ■ A similarity function satisfying (11) for all x, y in V will be referred to as a bipolar similarity function, see [7], because the right side of (11) one can consider as a sum: 1 = 0 + 1, of "poles" 0 and 1 of the interval of similarity values [0,1]. Similarly, we can present the property (12) of the inverse relationship of correlation function (1) as bipolarity condition, where the right side equal to the sum: 0 = –1 + 1, of the "poles" of the interval of correlation function values [-1,1]. For this reason, a strong correlation function one can consider also as a bipolar correlation function, and Theorem 4 one can interpret as follows: there exists a one-to-one correspondence between bipolar correlation functions and bipolar similarity functions. From Theorem 4 it follows also that the formulas (9) establish a one-to-one correspondence between strong correlation functions and bipolar dissimilarity functions satisfying for all x, y in V the bipolarity condition: It is easy to see from (7) that for complementary similarity and dissimilarity functions the bipolarity relations (11) and (13) are equivalent to: Proposition 4. Let N be a reflection on Ω and V be a nonempty subset of ) ( \ FP closed under negation N. Let S be a bipolar similarity function on V then it is consistent and co-symmetric. Proof. From (11) replacing y by x and from the reflexivity of S obtain the consistency of S: S(x,N(x)) = 1 – S(x,x) = 1 – 1= 0. Replacing in (11) x by N(x) and y by N(y) obtain: S(N(x),N(y))+S(N(x),N(N(y)))= 1. Further, applying involutivity of N: N(N(y)) = y, and symmetry of S obtain: S(N(x),N(y)) = 1 – S(N(x),N(N(y)))= 1– S(N(x),y)= 1– S(y,N(x)). From (11) we have S(y,x) + S(y,N(x)) = 1, that together with symmetry of S gives: 1– S(y,N(x))= S(y,x)=S(x,y), and finally we obtain: S(N(x),N(y)) = S(x,y), i.e. co-symmetry of S ■ From Proposition 4 and Theorem 1 it follows that the bipolar similarity function can be used for constructing a strong correlation function by (3): A(x,y)=S(x,y) – S(x,N(y)), and from (14) it follows that this strong correlation function is complementary to S, i.e. (6) is fulfilled: A(x,y)= S(x,y) – D(x,y), hence the simplified formulas (8): A(x,y)= 2S(x,y) – 1, and (9): A(x,y)= 1 – 2D(x,y), can be used. From (8) and (9) it follows that the strong correlation function is the rescaling of bipolar similarity and dissimilarity functions. Example 7 (see Example 6). Let Ω be the set of real-valued n-tuples x = (x1,…,xn). Define the reflection on Ω as follows: N(x) = (M – x1,…, M – xn), where M is some constant, for example, M = 0 or M = max{x1,…,xn}. For similarity function S from Example 6 denote sij the addends that will be used for calculating S(x,N(y)): Hence, D(x,y) = S(x,N(y)), similarity function S is bipolar and the Kendall rank correlation coefficient is the strong correlation function. Example 8. It can be shown also that the dissimilarity functions considered in Examples 3, 4 and 5 are bipolar and give by A(x,y) = 1 – 2D(x,y), the following strong correlation functions, respectively: the Pearson's product-moment correlation coefficient, the cosine correlation coefficient, and the Spearman's rank correlation coefficient. In the last case, the reflection operation on the set of rankings reverses the rankings by N(xi)=n+1–xi. 7 Related Works and Conclusion Some of the relationships between similarity, dissimilarity, and correlation coefficients considered in Sections 5 and 6 have been mentioned in several works. The formulas like (6), (9) appear in [14] in the calculation of Kendall rank correlation coefficient, where instead of similarity and dissimilarity functions, the positive and negative scores are used. The formula (10) of Spearman rank correlation also given in this book. Kendall [14] proposed the "general correlation coefficient" using the values aij and bij defined for Spearman, Kendall and Pearson correlation as functions of differences xi – xj and yi – yj for all i,j = 1,…,n. How to define aij and bij in general case, it is not clear. It is only required that aij = -aji and bij = -bji. Also, the generalization of formulas like (6) and (9) on the universal domain not considered. The half of formulas from (7)-(9) used for constructing similarity and dissimilarity measures from correlation coefficients were considered in [1, 16]. The problem of the construction of correlation coefficients from similarity and dissimilarity measures not considered in these works. The properties like symmetry, inverse relationship and co-symmetry of a "good" relative measure of the association were also considered in [11] but the negation has been considered only for real numbers and the general methods of construction of such measures on the universal domain with involution were not proposed. Some formulas like (6), and from (7)-(9) for the probabilities of concordance and discordance are considered in [11]. Theorems 1-3 are considered in [3, 4, 8]. The methods of construction of correlation functions on universal domain Ω as difference between similarity and dissimilarity functions proposed in this paper in Section 5 and one-to-one correspondence between strong correlation functions and bipolar similarity functions formulated in Section 6 together with the methods of construction of strong correlation functions (association measures) proposed in [2, 3, 4, 8] have more straightforward interpretation of the correlations in terms of similarities and dissimilarities. These methods give a general and regular methodology for constructing correlation functions on different domains where one can introduce a reflection (negation) operation. The very surprising result has been obtained here in Theorem 4. It establishes deep relationships between correlation coefficients and similarity (dissimilarity) measures. The one-to-one correspondence between strong correlations and bipolar similarity functions together with (8) shows that there is no much difference between these two concepts. This result paves the way for the construction of new strong correlation functions on almost any domain where negation (reflection) operation and similarity or dissimilarity functions satisfying suitable properties can be defined. The methods of construction of similarity and dissimilarity functions suitable for the generation of correlation functions (association measures) can be based on the results obtained in [2, 8]. For example, one can construct dissimilarity functions using Minkowski distance and p-transformation of data, using the methods of co-symmetrization of similarity functions, etc. Acknowledgment This work was partially supported by project IPN SIP 20196374. The author also thanks Dr. Imre Rudas for his help in the publication of this work. References [1] H. T. Clifford, W. Stephenson: An introduction to numerical classification, Academic Press, New York, 1975 [2] I. Batyrshin: Constructing time series shape association measures: Minkowski distance and data standardization, BRICS CCI–2013, IEEE, 2013, pp. 204-212, https://arxiv.org/ftp/arxiv/ papers/1311/1311.1958.pdf [3] I. Batyrshin: Association measures and aggregation functions, Advances in soft computing and its applications. Lecture Notes in Computer Science, Vol. 8266, Springer, 2013, pp. 194-203 [4] I. Z. Batyrshin: On definition and construction of association measures, Journal of Intelligent & Fuzzy Systems, Vol. 29, 6, 2015, pp. 2319-2326 [5] I. Batyrshin, V. Kreinovich: One more geometric interpretation of Pearson's correlation, Thailand Statistician, Vol. 13, 2015, pp.125-126 [6] I. Batyrshin, V. Solovyev, V. Ivanov: Time series shape association measures and local trend association patterns, Neurocomputing, Vol. 175, 2016, pp. 924-934 [7] I. Batyrshin, F. Monroy-Tenorio, A. Gelbukh, L.A. Villa-Vargas, V. Solovyev, N. Kubysheva: Bipolar rating scales: a survey and novel correlation measures based on nonlinear bipolar scoring functions, Acta Polytechnica Hungarica, Vol. 14, 3, 2017, pp. 33-57 [8] I. Batyrshin: Towards a general theory of similarity and association measures: similarity, dissimilarity and correlation functions, Journal of Intelligent and Fuzzy Systems, Vol. 36, 4, 2019, pp. 2977-3004 [9] P. Y. Chen, P. M. Popovich: Correlation: Parametric and nonparametric measures, Sage, Thousand Oaks, CA, 2002 [10] J. D. Gibbons: Nonparametric measures of association, Sage Publications, Iowa, 1993 [11] J. D. Gibbons, S. Chakraborti: Nonparametric statistical inference, Dekker, New York, 2003, 4 th ed. [12] M. Grabisch, J. L. Marichal, R. Mesiar, E. Pap: Aggregation Functions, Cambridge Univ. Press, Cambridge, UK, 2009 [13] P. Jaccard: Nouvelles recherches sur la distribution florale, Bull. Soc. Vaud. Sci. Nat., Vol. 44, 1908, pp. 223-270 [14] M. G. Kendall: Rank correlation methods, Griffin, London, 1970, 4 th ed. [15] E. P. Klement, R. Mesiar, E. Pap: Triangular norms, Springer Science & Business Media, 2013 [16] M-J. Lesot, M. Rifqi, H. Benhadda: Similarity measures for binary and numerical data: a survey, Int. J. Knowledge Engineering and Soft Data Paradigms, Vol. 1, 2009, pp. 63-84 [17] A. M. Liebetrau: Measures of Association, Sage Publications, Iowa, 1983 [18] G. Salton: Automatic text processing: the transformation, analysis, and retrieval of information by computer, Addison-Wesley, Boston, MA, 1989 [19] P. N. Tan, V. Kumar, J. Srivastava: Selecting the right interestingness measure for association patterns, 8 th Proc. Eighth ACM SIGKDD Int. Conf. Knowledge Discovery and Data Mining, 2002, pp. 32-41 [20] G. U. Yule: On the association of attributes in statistics: with illustrations from the material of the childhood society, &c., Phil. Trans. Royal Soc. of London. Series A, Vol. 194, 1900, pp. 257-319	<urn:uuid:b258d373-c3e3-4a24-b222-49e9b158ec75>	CC-MAIN-2020-40	http://acta.uni-obuda.hu/Batyrshin_97.pdf	2020-09-20T06:36:56+00:00	crawl-data/CC-MAIN-2020-40/segments/1600400196999.30/warc/CC-MAIN-20200920062737-20200920092737-00257.warc.gz	4,685,387	7,406	eng_Latn	eng_Latn	0.925042	eng_Latn	0.979837	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 3075, 5406, 6593, 8621, 10405, 12668, 14032, 16111, 18204, 19775, 22496, 24734, 27365, 29540 ]	[ 0.7890625, 0.734375 ]	[ 4.78125, 4.875 ]	[ 3.65625, 4.625 ]	[ 1.9921875, 2.328125 ]	1	0	HuggingFaceFW/finepdfs
HEALTH TECHNOLOGY MICROSOFT WINDOWS 10 UPGRADE CHECKLIST Summary Upgrading to Windows 10 requires many important considerations for a clinic to plan for or be aware of to ensure a smooth transition and maintain privacy and security standards. Consider all of the general areas presented in the checklist below and review with IT support as needed to plan your upgrade to Windows 10. Microsoft Windows 10 Upgrade Checklist BACKUP Ensure all of your data is backed up before upgrading PCs Have a contingency plan in case you need to halt the upgrade and continue using the old operating system temporarily HARDWARE Ensure your PC hardware meets or exceeds the recommended specifications for your EMR and your Windows 10 Identify any new hardware that may be needed ahead of the transition, (eg. peripherals, workstations) PERFORMANCE Consider time and bandwidth needed for the initial upgrade of your PCs, plan to upgrade outside of business hours Upgrade using a hard-wired connection where possible, upgrades over wireless will take much longer Disable or remove any unnecessary software added automatically from the Windows 10 upgrade (eg. free trial software, browser add-ons, Microsoft OneDrive) Disable any unnecessary operating system features that became enabled during the upgrade PRIVACY & SECURITY Check settings that share your personal data with other resources and limit to appropriate resources only Review all settings of new features introduced in Windows 10 to ensure they meet the privacy expectations of your practice Ensure operating system and anti-virus are scheduled to update regularly HEALTH TECHNOLOGY SOFTWARE Choose the appropriate version of Windows 10; should be Windows 10 Professional or Enterprise for business use to support clinic security and privacy requirements Review any business-critical software requirements, including EMR, to ensure compatibility with Windows 10 Identify any software or software updates are needed ahead of the transition such as new drivers TRAINING Test out Windows 10 ahead of time on a single workstation to understand the impact of changes for business-critical software and processes Plan training for staff if required to adapt to visual and process changes in the new operating system or related software Frequently Asked Questions How do I know what new feature or settings are available in Windows 10? The best place to review all of the new features implemented in Windows 10 and related requirements are the official Microsoft website: Microsoft Windows 10 Specifications & System Requirements https://www.microsoft.com/en-ca/windows/windows-10-specifications Microsoft Windows 10 Features https://www.microsoft.com/en-ca/windows/features DISCLAIMER This document provides general guidelines and approaches only. We strongly recommend that you retain a knowledgeable and qualified professional to regularly assess and maintain your clinic's technology. For more information, guidance, or support contact: Doctors Technology Office 604 638-5841 email@example.com www.doctorsofbc.ca/doctors-technology-office Last Updated: July 2019	<urn:uuid:00b6407d-5ba8-4f46-8a72-3aefd2bbcf66>	CC-MAIN-2022-21	https://www.doctorsofbc.ca/sites/default/files/dto-checklist-microsoft_windows_10_upgrade.pdf	2022-05-22T10:38:23+00:00	crawl-data/CC-MAIN-2022-21/segments/1652662545326.51/warc/CC-MAIN-20220522094818-20220522124818-00083.warc.gz	830,731,649	656	eng_Latn	eng_Latn	0.991432	eng_Latn	0.992625	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 1638, 3165 ]	[ 0.46484375 ]	[ 3.046875 ]	[ 4.03125 ]	[ 2.640625 ]	1	0	HuggingFaceFW/finepdfs
EMPLOYMENT VERIFICATION (PLEASE EMAIL COMPLETED FORM TO firstname.lastname@example.org) Applicant's Name:_______________________________________ DOB:___________________ APPLICANT'S CONSENT & WAIVER I (the "Applicant") consent and give permission to Mark Downey & Associates, Inc. (the "Manager:), to request, inquire, access, obtain, verify, and otherwise use any of the information, regardless of and in what form, for the purposes of leasing property, including but no limited to documents regarding finances, wages and salary, work history and status, financial credit, criminal history and status, residency history and public records. Applicant gives consent to any 3 rd party to release such information to Manager upon Manager's written request. Applicant is responsible for any and all costs related to such requests or releases of information to Manager. Applicant agrees to indemnify, defend, and hold harmless Manager against any loss, damage, or other claims (including reasonable attorney's fees) arising from the request and release of Applicant's information, including loss, damage, or other claims (including reasonable attorney's fees) resulting from Manager's or Applicant's negligence. Applicant's signature:____________________________________ Date:________________________ EMPLOYER PLEASE COMPLETE: 1. Applicant's Employer:________________________________________________________ 2. Applicant's Job Title:_________________________________________________________ 3. Applicant's Date of Hire:______________________________________________________ 4. Has employee worked continuously since date of hire? _____Yes _____No 5. If no to question #4, please explain why: _________________________________________ __________________________________________________________________________ 6. Salary / Hourly pay amount:___________________________________________________ 7. Is employment full-time? ______Yes ______No…If no, how many hours per week? _____ 8. Any violations? ____Yes ____No…If yes, please explain:_____________________________ __________________________________________________________________________ 9. Additional Comments:________________________________________________________ Employer Signature________________________________ Employer Phone #: ________________ Employer Printed Name:_____________________________ Date: __________________________	<urn:uuid:073644a6-825c-4d77-97fb-d2b94ff16f09>	CC-MAIN-2023-14	https://www.markdowneyhomes.com/wp-content/uploads/2023/01/Employment-Verification.pdf	2023-03-29T19:31:00+00:00	crawl-data/CC-MAIN-2023-14/segments/1679296949025.18/warc/CC-MAIN-20230329182643-20230329212643-00717.warc.gz	967,033,916	419	eng_Latn	eng_Latn	0.985358	eng_Latn	0.985358	[ "eng_Latn" ]	false	docling	[ 2400 ]	[ 0.0238037109375 ]	[ 0.20703125 ]	[ 1.0546875 ]	[ 2.5 ]	3	0	HuggingFaceFW/finepdfs
Day surgery – helseatlas.no Tonsillectomy Tonsillectomy is one of the most commonly performed operations, particularly on children. The operation can be performed on patients with recurring sore throats for more than two years, recurring ear infections and, in children, enlarged tonsils that cause discomfort. Tonsillectomies, rates adjusted for gender and age per 100,000 population per hospital referral area, per year and as an average for the period 2011–2013 Tonsillectomies, rates adjusted for gender and age per 100,000 population per hospital referral area, broken down by public or private treatment providers, average for the period 2011–2013 Definitions The following combinations of codes define this patient group: Primary or secondary diagnosis (ICD-10) H65.2, H65.3 or in code block J35 in combination with the procedure codes (NCSP) EMB10, EMB12, EMB15, EMB20, EMB30 or EMB99 for hospitals with activity-based funding, and the same diagnosis code in combination with the tariff codes K02a, K02b, K02d, K02e, K02f or K02g for specialists in private practice under a funding contract with the regional health authorities. Private treatment providers include private hospitals and specialists under contracts with the public specialist health service. Procedures per year and average for the period 2011–2013 Comments Just under 14,000 tonsillectomies are carried out in Norway each year. The total number of operations increased in 2013, and the increase has taken place among private treatment providers. The proportion of operations performed by private treatment providers varies: In Oslo, 49% are performed by private providers, in Nordlandssykehuset's hospital referral area 1%. The rates do not vary much from year to year within each hospital referral area, but there is considerable variation between the areas. The population of Finnmark have tonsillectomies more than twice as often as the population in St. Olavs Hospital's catchment area. For more information: www.helseatlas.no	<urn:uuid:d33f9de9-7cd7-4c9a-bc44-d3e8357b584a>	CC-MAIN-2024-26	https://qa.skde.no/helseatlas/files/fact-sheet-tonsillectomy.pdf	2024-06-16T02:18:40+00:00	crawl-data/CC-MAIN-2024-26/segments/1718198861640.68/warc/CC-MAIN-20240616012706-20240616042706-00657.warc.gz	431,451,432	455	eng_Latn	eng_Latn	0.992859	eng_Latn	0.992859	[ "eng_Latn" ]	false	docling	[ 2018 ]	[ 0.73046875 ]	[ 2.6875 ]	[ 3.015625 ]	[ 2.390625 ]	1	1	HuggingFaceFW/finepdfs
STEM Publishing: The writings of C. H. Mackintosh Fifteenth Letter to a Friend. C. H. Mackintosh. (Extracted from Things New and Old, Vol. 18.) My Beloved Friend, The year 1848 was a testing time for all who professed to occupy the ground of Brethren. In the summer of that year, a question was raised as to whether we were really gathered on the ground of the unity of the body, or merely as independent or fragmentary congregations, having a measure of acquaintance and sympathy, but no common ground of responsibility in fellowship and testimony as those who were members one of another, united to the living Head in heaven, and to one another, by the Holy Ghost. It was at Bristol that this profoundly interesting question was raised; and from thence it extended to every place, on the face of the earth, where there happened to be an assembly of Brethren. As you are doubtless aware, there was a congregation of Baptists who met for worship at a chapel called "Bethesda," in Bristol. There was an associated body meeting at "Salem" chapel; but I shall speak of both under the one name of Bethesda, and further I shall do so as briefly as possible, inasmuch as my sole object is to bring out the great principle at stake, and not, by any means, to dwell on persons or places which can only possess an ephemeral interest. Well, then, some years previous to the time above referred to, this Baptist congregation was received into fellowship with Brethren — received as a body. The whole assembly, professedly and ostensibly, took the ground occupied by Brethren. I do not mention names or descend into minute details; I merely give the great leading fact, because it illustrates a most important principle. It has been my conviction, for many years, that this reception of a congregation was a fatal mistake on the part of Brethren. Even admitting, as I most heartily do, that all the members and ministers may have been most excellent people taken individually; yet I am persuaded that it is a mistake, in any case, to receive a whole body as such. There is no such thing as a corporate conscience. Conscience is an individual thing; and unless we act individually before God, there will be no stability in our course. A whole body of people, led by their teachers, may profess to take certain ground, and to adopt certain principles; but what security is there that each member of that body is acting in the energy of personal faith, by the power of the Holy Ghost, and on the authority of the word of God? It is of the very last importance that, in every step we take, we should act in simple faith, in communion with God, and with an exercised conscience. Indeed I cannot but believe that one special cause of weakness in the various assemblies of Brethren is that numbers have come on the ground who are not in the power of the truth in their own souls, and they act as a dead weight and a hindrance. But, most clearly, it is a grave mistake to receive a whole body of people into communion where there is no opportunity of testing the spiritual state of the individuals composing that body. We had a very striking illustration of this in London, in the year 1853. A congregation of Baptists desired to take the ground occupied by Brethren; and they did so. But hardly had they taken the step, when the brother who had built the chapel and gathered, by his preaching, the congregation, perceived the mistake. He immediately called the assembly together, and told them that both he and they must act on their individual responsibility before the Lord. In pursuance of this statement, on the following Lord's day, the chapel was locked, and the people were compelled individually to consider their ground and their proper course of action. : Fifteenth Letter to a Friend. Now, some would pronounce this a very bold step; but it was a noble step; and the sequel proved it to be a right step — the only right step. In the course of a few weeks — weeks, no doubt, of profound exercise of soul and deep painful searching of heart — that whole congregation — with two or three exceptions, and those, I believe, of a doubtful character — not in a body, but individually applied for fellowship, at the various assemblies of Brethren, and each case was taken up on its own merits, and tested by the word of God. Then the brother to whom the chapel belonged kindly lent it as a convenient meeting place for Brethren. Of course, he had, during the time the place was closed on Lord's day morning, carried on his individual work of preaching and teaching, as he does to this day; and, blessed be God, since that time, that dear spot has been made the birth-place of hundreds of souls, and a blessed feeding place for the lambs and sheep of the beloved flock of Christ. May it continue to be so till He comes! How very different was the case of Bethesda! A testing time came. Deadly error was taught at Plymouth — error touching the position and relations of our Lord Jesus Christ — error which placed Him (I shrink from penning the words) under the curse and wrath of God all His days and that not vicariously, but in virtue of His association with Israel and the human family. I cannot bear to go further into the terrible doctrine taught at Plymouth, or to transfer to this page the expressions in which that doctrine was presented. I have no desire to use strong or stern language in reference to individuals; but I must say to you, my beloved friend, that I consider the doctrine quite as bad as Socinianism itself; at least the former as well as the latter leaves us without the Christ of God. It is useless to talk of distinctions, for if we have not the Christ of the New Testament, we have no Christ, no Saviour at all. Arius or Socinus may deny the deity of our adorable Lord and Saviour; Irving may deny His pure and sinless humanity; a Plymouth teacher may present Him in a position and in a relationship which would make Him need a saviour for Himself — may God pardon the very penning of the lines! May He pardon the man who taught such horrible doctrine. They all deny the Christ of God. They blaspheme His person and His name. Their doctrines are to be held in utter abhorrence by every true lover of Jesus. Well, then, dearest A., this deadly error was taught at Plymouth; and, moreover, the holders and teachers of this error were received at Bethesda. A few faithful members remonstrated, protested, and entreated that such doctrines should be judged, and its teachers put out of communion. It was all in vain. Ten of the leaders wrote a letter — the well-known "Letter of the Ten" — well known, I mean, to those of us who were called to wade through those deep waters. In this letter, which was adopted by the great bulk of the congregation at Bethesda, they refused to judge the doctrine. They said, "What have we at Bristol to do with doctrines taught at Plymouth?" In a word, they committed themselves, plainly and palpably, to the ground of neutrality and indifference, as regards our blessed Head: and independency, as regards His beloved body. Such was the ground set forth in "The Letter of the Ten" — a document prepared by ten intelligent men, adopted by some hundreds of christian people, and which, I believe, remains to this day unrepealed and unrepented of. It is true that, after the sad mischief was done, and fifty or sixty of the Lord's people had left Bethesda rather than sanction such a wretched principle or ground of fellowship, the leaders held what they called seven church meetings for the purpose of examining the tracts in which the error was taught, and one of the leaders said that "according to that doctrine, Christ would need a saviour for Himself." But the "Letter" was never withdrawn — never repented of; and hence it remains to this day as the studied and deliberate statement of the real ground of Bethesda fellowship, which is, to my mind, simply indifference, as to Christ, and independency, as to His body the church. I purposely refrain from giving the names of persons and from entering into any details as to the conduct, manner, or spirit of individuals. As regards all these things, we can believe there were faults on all sides. I must confess I have no taste for dwelling upon such things. And further, I may assure you, my friend, that I am not conscious of a single atom of bitter feeling toward any individual. I am writing after an interval of 27 years, and I desire to confine myself to the great principle involved in the whole case of Plymouth and Bethesda. I have not depended upon hearsay in the matter. We all know how things may be coloured and exaggerated in the heat of discussion. But there can be no question of colouring, exaggeration or heated discussion, in reading the Plymouth tracts which contain what I must designate abominable doctrine or in reading the "Letter of the Ten" which sets forth the miserable principles of neutrality, indifference, and independency. The fact is, Bethesda ought never to have been acknowledged as an assembly gathered on divine ground; and this was proved by the fact that, when called to act on the truth of the unity of the body, it completely broke down. And not this only; but had the members of the congregation been more animated by true loyalty to Christ they would have risen as one man to expel from their borders every trace of the doctrine which blasphemed their Lord. I am quite prepared to believe that numbers were totally ignorant of what they were about; that they meant well and had no true apprehension of what was involved. But if an ignorant pilot is urging the vessel upon the rocks, it is poor consolation to those on board to be told that he is a most blameless well-meaning man. Such, then, dearest A., is a very brief and condensed statement of the real ground of what is called "The Bethesda question." Of course, Brethren everywhere had to face it. There was no getting out of it. It had to be looked at straight in the face. To many it proved a terrible stumbling-block. They never could see their way through it. For my own part, I felt I had just the one thing to do, namely, to take my eye off completely from persons and their influence, and fix it steadily upon Christ. Then all was as clear as a sunbeam and as simple as the very elements of truth itself. I have never had a shadow of a doubt or hesitation as to the course adopted in the main, or as to the great underlying principles; but I can quite understand and make allowance for the difficulties of souls just setting out on their course, when called upon to encounter the Bethesda question, particularly when I remember how hard it is, generally speaking, to get a thoroughly dispassionate and unprejudiced view of it. But this I must say, as the result of a good deal of experience and observation, I have invariably found that where a person was enabled to look at the matter simply in reference to Christ and His glory, all difficulty vanished. But, on the other hand, if personal feeling, affection for individuals, anything merely natural, be allowed to operate, the spiritual vision is sure to be clouded, and a divine conclusion will not be reached. There is one thing which seems to act as a terrible bugbear to many, and that is the cry of "Exclusivism" raised against those who, as I believe, seek to maintain the truth of God at all cost. A moment's calm reflection, in the light of scripture, will be sufficient to show that we must either go thoroughly in for the principle of exclusivism, or admit that, on no ground, for no reason whatsoever, should we ever exclude from the Lord's table one who may really be a member of the body of Christ. If any one will maintain this latter, he is plainly at issue with the apostle in 1 Corinthians 5. In that chapter, the assembly at Corinth was distinctly taught, by the inspired apostle, to be an "exclusive" assembly. They were commanded to exclude from their midst and from the table of their Lord, one who, notwithstanding his grievous sin, was a member of the body of Christ. Now, is not this the very heart's core of the principle of exclusivism? Unquestionably. And, further, my friend, let me ask, must not the assembly of God, of necessity, be exclusive? Is it not responsible — solemnly responsible to judge the doctrine and the morals of all who present themselves for communion? Is it not solemnly bound to put away anyone who, in doctrine or walk, dishonours the Lord and defiles the assembly? Will anyone question this? Well then, this is "exclusivism" — that terrific word! The fact is, very many confound two things which are quite distinct in scripture, the house of God and the body of Christ. Hence, if any one is refused a place at the table, or put away from it, they speak of "rending the body of Christ," or "cutting off members of Christ." Was the body rent, or a member cut off, when the sinning one was put away from the assembly at Corinth? Clearly not. Neither is it in any such case. Thanks be to God, no one can rend the body of Christ or cut off its very feeblest member. God has taken care that "there shall be no schism in the body." The strictest discipline of the house of God can never touch, in the most remote way, the unity of the body of Christ. That unity is absolutely indissoluble. A clear understanding of this would answer a thousand questions and solve a thousand difficulties. But then it is often said, when a person is put away or refused, "Do you not consider him a child of God?" I answer, No such question is raised. "The Lord knoweth them that are his; and let every one that nameth the name of Christ depart from iniquity." We are not called upon to pronounce as to a man's secret relations with God, but simply as to his public walk before men. If an assembly denies its responsibility to judge the doctrine and walk of those "within," it is not an assembly of God at all, and all who would be true to Christ should leave it, at once. Hence, therefore, my beloved and valued friend, we can see that "exclusivism," so far from being a dreaded bugbear, is the bounder duty of every assembly gathered on the ground of the church of God; and those who deny it prove themselves to be simply ignorant of the true character of the house of God, and of the immensely important distinction between the discipline of the house and the unity of the body. And here you will allow me just to answer a question which is not infrequently put; it is this, "Do the Brethren consider themselves the church of God?" They do nothing of the kind. They are not the church of God. There are thousands of the beloved members of Christ scattered throughout the various denominations of the day. I am prepared to recognize, in the person of a Roman Catholic priest, a member of the body of Christ, and a gifted vessel of the Holy Ghost. I may marvel how he can stay where he is, for I believe the Romish system to be a dark and dreadful apostasy. But then I do not believe in any one of the religious systems of Christendom. Not one of them can stand the test of Holy Scripture. Not one of them is the church of God. No; nor is one of them on the ground of the church of God. And here, my friend, is just the difference. I do not believe that the Brethren are the church of God; but they are on the ground of the church of God, else I should not be amongst them for one hour. They occupy a position which ought to command every saint of God in Christendom. What should prevent all Christians from coming together on the first day of the week to break bread, in the unity of the body of Christ, and in dependence upon the guidance and power of the Holy Ghost? Is not this what we find in the New Testament? And, if so, why should we not follow it? Do I want to see the church restored to its pentecostal glory? By no means. This was the delusion of poor Edward Irving. I never expect to see the church restored; but I long to see Christians departing from error and iniquity, and walking in obedience to the precious Word of God. Is this expecting too much? Nay, I can never be satisfied with anything less. And do not imagine, dearest A., that I want to puff up "The Brethren." Nothing is further from my thoughts. I believe the ground they occupy is divine, else I should not be on it. But as to our conduct on the ground, we can only put our faces in the dust. The position is divine; but as to our condition, we have ever to humble ourselves before our God. A friend once said to me, "Do you know that the Rev. Mr. is delivering a course of lectures against the Brethren?" "Tell him," I said, "with my kind regards, that I am doing the very same just now. But there is this immense difference between us, that he is lecturing against their principles, while I am lecturing against their practices. He is attacking the ground; I, the conduct on the ground." And yet, it is not that I consider the Brethren any worse than their neighbours; but, when I consider the high ground they take, the conduct and character ought to be correspondingly high. This, alas! is not the case. Our spiritual tone, both in private life and in our public reunions, is sorrowfully low. There is a sad lack of depth and power in our assemblies. There is excessive feebleness in worship and ministry. I cannot, nor do I want to, go into details in the way of proof or illustration. I content myself with the statement of the broad fact, in order that our souls may be exercised as to the real cause of all this. I fear there are many contributing causes. I believe the vast increase in our numbers, within the last twenty years, is, by no means, an index of an increase of power. Quite the reverse. No doubt, we have to be thankful for the increase — thankful for every soul brought into what we believe to be a right position. But then we need to be watchful. The enemy is vigilant, and he will seek to introduce spurious materials into our midst in order to bring discredit on the ground, and cast dishonour on the Lord. In the various denominations around us the inconsistencies of individuals are in a measure hidden behind the bulwarks of the system. But Brethren stand fully exposed, and their failures are used as an argument against their ground. The grand point for us all is to be humble and lowly, dependent and watchful. Let us remember those precious words to the church of Philadelphia, "Thou hast a little strength, and hast kept my word, and hast not denied my name." Yes, dear friend, this is it, "My word" — "My name." May we remember it! May we be kept very little in our own eyes, clinging to Christ, confessing His name, keeping His Word, serving His cause, waiting for His coming! Here I must close my letter, and my series of letters. I only hope I have not wearied you. I certainly have run on much further than I intended when I began. But then you never told me to stop, so that if I have overtaxed you, you must, in measure, blame yourself. The Lord bless you, beloved brother, most abundantly, and make you a blessing! So prays, Your deeply affectionate C. H. 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SCHREINER DÉNES DOKTORI TÉZISEK "A görög mitológia és művészet kapcsolata Schelling művészetfilozófiájában" című doktori disszertációhoz Doktori tézisek A disszertáció a görög mitológia és a görög művészet kapcsolatát vizsgálja Schelling művészetfilozófiájában. Ehhez elsősorban a szerző művészetfilozófiai előadásait veszi szemügyre, de adott esetben bevonja a vizsgálatba az életmű más darabjait is. Főképpen Schelling identitásfilozófiai korszakába eső írásai jönnek számításba, ám - főképp a mitológia problémája tekintetében - a korai és a késői szövegek tanítását is figyelembe veszi. Ezenkívül a schellingi gondolatokat számos ponton összeveti a kortárs szövegekkel, főként a német klasszika, romantika és idealizmus filozófiai és irodalmi alkotásaival. Témájából kifolyólag természetesen nem hagyható figyelmen kívül az antik görög hagyomány sem, így néhány esetben szembesíti a schellingi szöveget a görög filozófiai és művészeti hagyománnyal. E tágabb összefüggéseken belül tesz fel a dolgozat kérdéseket a szöveg kapcsán s törekszik végiggondolni a válaszokat, azok lehetséges következményeit. A dolgozat egyes fejezetei részben a schellingi előadások egyes részeit tárgyalják, ám a fő szempont a szövegben előkerülő témák több aspektusból való szemügyre vétele. Így ugyanazon problémák többször is szóba kerülnek, más-más oldalukat megvizsgálva. A bevezető részben olyan kérdések szerepelnek, melyek az egyes további fejezetekben kerültek részletesebb vizsgálat elé, s melyeket a dolgozat fő tematikája szempontjából a szöveg kapcsán relevánsnak gondoltunk. A kérdések mellett előzetes megfontolások és problémafelvetések is szerepelnek, abból a célból, hogy jelezzük a további vizsgálódás irányait. Ezekből a bevezető gondolatokból indultak ki a dolgozat későbbi megfontolásai. Az első fejezet alapvetően módszertani és rendszertani problémákat tárgyal. Egyrészt tisztázza a transzcendentális és az identitásrendszer közti kapcsolatot, ezek felépítését, másrészt szemügyre veszi a görög mitológia és művészet rendszertani helyét az előadások egészében. Nagy fontossággal bír a rendszer alapzata és a ráépülő részek egymáshoz való viszonyának a tisztázása. A második fejezet a művészetfilozófiai előadásokban található mitológiafelfogást vizsgálja általános értelemben. Ehhez kapcsolódik az ebből kibontakozó művészetfelfogás szintén általános értelmű vizsgálata. Ezután egy kitérő következik, melyben a schellingi mitológiafelfogást tekintettük át az életmű egészében. Erre azért volt szükség, mert ezáltal világosabbá vált az itt jelentkező elképzelés, illetve rá lehetett mutatni ennek segítségével azokra a pontokra, melyekből kiindulva Schelling pályafutása későbbi szakaszaiban változtatott korábbi nézetein. A harmadik fejezet ennek fényében az egyes mítoszelemzéseket tárgyalja, melyeket a második még csak általánosságban érintett. E konkrét elemzések művészetfilozófiai következményeinek felmérése szintén itt történik. A negyedik fejezet a művészeti ágak és a műfajok elméletét veszi szemügyre. Itt nemcsak a konkrétabb esztétikai kérdések tárgyalása megy végbe, hanem a korábban tárgyalt gondolatok új szemszögből való megvilágítása. Az ötödik fejezetben újabb aspektusváltás történik, mivel ebben a dolgozat során már érintett hermeneutikai kérdések kifejezett tematizálására tettünk kísérletet. Végül is itt a schellingi antikvitáskép belső magja volt a kérdés tárgya, természetesen összefüggésben a mitológia és a művészet összekapcsolásával. Mindez fényt vethet saját értelmezői helyzetünkre is. A hatodik fejezet módszertanilag és tematikusan is kapcsolódik az előzőhöz. A történelemfilozófiai szál ugyanis egyrészt ugyanúgy végighúzódik az előadások egész szövegén, mint a művészetmitológia koncepciója, másrészt itt újra szóba kerül az antikvitás és a modernitás viszonya, kiegészítve az új mitológia problémáival. Mint ebből a felsorolásból is kiderül, a dolgozat különböző módszerek és szempontok szerint vizsgálja Schelling elgondolásait, és különböző diszciplínák témáit érinti. Ami a metodikát illeti, az alapvetően filozófiai-esztétikai vizsgálat mellett és azon belül hangsúlyosan szerepelt a hermeneutikai és eszmetörténeti megközelítés, ám alkalomadtán kiegészítettük mindezt fenomenológiai jellegű megfontolásokkal is. Ezeken kívül a szoros szövegelemzés és az átfogóbb tárgyalásmód egyaránt megtalálható. A szöveg más szövegekkel való összevetése, illetve a szövegen belül felbukkanó gondolatok egymással ütköztetése szintén a módszertan részét képezték. A fejezetek elején szereplő mottók és a mellékelt képek, a disszertáció főszövegével és jegyzeteivel együtt, gondolatmenetünk különböző rétegeit hivatottak jelezni, illetve lehetővé teszik az értekező prózától eltérő médiumok bevonását is. Ami az érintett tudásterületeket illeti, a dolgozat a vizsgált művekből kifolyólag alapvetően művészetfilozófiai beállítottságú, ám ez összekapcsolódik konkrétabb jellegű esztétikai vizsgálódásokkal és műelemzésekkel egyaránt. Emellett nagy hangsúlyt fektettünk a mitológia- és vallásfilozófia kérdéseire is. A fenti elméleti megfontolások természetesen vallástörténeti és művészettörténeti problémákat is érintettek. Végül, de nem utolsósorban, a dolgozat hozzájárulni kíván az ókor recepciójának történetéhez is. A következőkben összefoglalnám kutatásaim eredményeit. Az első meglátásom az, hogy a schellingi művészetfilozófia több szinten olvasható, a rendszer egésze, a mitológia bevonására épülő fejtegetések és az egyes műalkotások értelmezése szintjén. Éppen ezért újszerűnek tartom ezt a megközelítést, mivel az idealista filozófia keretein részben túllépve kísérletet tesz egy alternatív művészetfilozófia feltárására a schellingi szövegen belül. Ezzel összefügg az a sajátos törekvés is, hogy a konkrét istenalakok és mítoszok Schelling által történő magyarázatát komolyan fontolóra vegye, és szembesítse az antik hagyománnyal. Ehhez kapcsolódik az a tézisem, miszerint a műalkotás időviszonya a szövegben legalább három szinten elemezhető, az időtlen, a mitikus és az empirikus idő szintjén. Meglátásom szerint tehát a schellingi művészetfilozófiában benne rejlik a műalkotás olyan ontológiai vázlatának lehetősége, mely az említett temporális struktúrákban gyökerezik. A következő tézisem az, hogy Schelling általános filozófiai konstrukciós elvei és a mitológia értelmezése közt nem egyirányú determináció van, hanem inkább kölcsönhatás, és az előadások esztétikai mítoszfelfogása általában befolyásolja a művészetértelmezést. Mindez azt jelenti, hogy nemcsak az áll, hogy a Schelling e művében lévő mitológiafelfogás esztétikai jellegű, hanem a fordítottja is, tudniillik, hogy ez a művészetfilozófia a mitológia meghatározott szemléletére, filozófiájára van alapozva. Mindezekhez kapcsolódó radikálisabb és újszerű nézetem az, hogy egyrészt Schelling saját filozófiájának abszolútum-fogalmát beépíti a mitológia világába, másrészt a homéroszi perspektívát teszi meg a művészet filozófiai tárgyalásának alapzatává. Ezáltal egyedülálló módon a mitológiai nézőpontját, illetve az eposzköltő látásmódját filozófiai konstrukciós elvvé változtatja. Ez olyképpen sikerülhetett, hogy művészet- és mitológiafilozófiai céljai érdekében Platón filozófiai világképét visszavetítette Homérosz mitológiai világába. Következő megállapításom erre alapozódik. E szerint a schellingi mitológiafelfogásban az istenek saját világának egybeköltése, a filozófiai-költői mitológia - a "poétikus teogónia" - elsőbbségre tesz szert istenvilág belső önszerveződéséhez, a tulajdonképpeni teogóniához képest. Mindez azt jelenti, hogy Schelling előbb konstruál istenalakokat, majd istenvilágot, mitológiát, ami a költői és filozófiai tevékenység prioritását mutatja a mitológia belső világához viszonyítva. Ugyanakkor - s ezt szintén fontos meglátásnak gondolom - Schelling az istenvilág költői konstrukciójának alapelvét, azaz a "poétikus teogónia" elvét, egyesítve a homéroszi "poétikus ontológia" elvével, mégiscsak beemeli magába az istenvilágba. Apollón alakjának jóvoltából ugyanis a költészet individualizáló, formát és alakot teremtő tevékenységének elve a mitológiai világon belülre kerül. A schellingi művészetfilozófia tehát legbensőbb magja szerint apollóni jellegű. Következő tézisem az, hogy a Schelling által szemügyre vett mitológiai világ, mind a mítoszvariációkat, mind az értelmezéseket tekintve túlságosan zárt rendszert mutat, és egyfajta erős kanonizációs igény munkál benne. Meglátásom szerint ennek oka a filozófiai rendszerépítkezésben rejlik. Fontosnak tartom a dolgozat azon vélekedését, miszerint Schelling a művészeti ágak és a műfajok elméletének kidolgozásakor tudatosan önreferenciális jellegű alkotásokat és mítoszokat választ ki. Ennek segítségével ugyanis az esztétikai kérdéskör kiindulópontja visszahelyeződik a vizsgálat tárgyába. Így például a képzőművészet paradigmájául választott antik szobor a mítosz mítoszának ábrázolását példázza. Következő meglátásom az, hogy az eposz és a tragédia összehasonlító elemzése Schellingnél eltérő mitológiafilozófiát von maga után. Ugyanis Schelling szerint az eposztól eltérően a tragédiában már megtalálható a sorstól való elkülönböződés, a vele való szembeszállás. Az emberi és az isteni világ elválása ezenkívül új antropológiát eredményez. Mindennek eredményeképpen Schelling a tragédia elemzése során átalakítja a kezdeti elgondolásait a mitológiáról, és beépíti a történetiség elvét, illetve művészetfilozófiai szemszögből e műfajban látja a kereszténység kialakulásának előzményét. Ebből kiindulva megállapítható, hogy a schellingi történelemfilozófia álláspontja azt szemlélteti, hogy a görög művészet önmaga és a mitológia elmúlásának elvét saját magában hordozta. Amiképpen tehát a kereszténység megjelenése is döntő módon művészetfilozófiailag értelmeződik, úgy az antikvitás hanyatlása is a művészet közegében lesz bemutatva. Ráadásul az antikvitás és a kereszténység/modernitás szembeállítása során Schelling történeti és szisztematikus ellentéteket vegyít, mely megbontja a művészetfilozófia eredeti alapzatát. A művészetfilozófia bázisául szolgáló azonosságfilozófia alapján ugyanakkor megállapítható, hogy Schelling művében az antikvitásból a kereszténységbe való átmenet egyúttal magának az abszolútumnak alakváltását is jelenti. E gondolat pedig nagy fontossággal bír Schelling kései szövegeinek megértésében is. A dolgozat lényeges következtetésének tartom azt, hogy az új mitológia programja több szempontból is ambivalens jellegű. Egyrészt esztétikai programról van szó, másrészt természetfilozófiai spekulációkat takar. Mindehhez hozzávehető még, hogy a program megvalósulásának ideje bizonytalan marad. És végül, az új mitológia akarása és a reá való várakozás a szövegben sajátos feszültséget eredményez. A régi és az új mitológia problematikája elvezet minket a schellingi művészetvallás és ókorfelfogás középpontjába. Tézisem az, hogy ez művészetvallás tulajdonképpen művészetmitológia, mely gondolat Schelling klasszicista eredetű esztétizáló szemléletéből ered. Ugyanis Schelling az antik mitológia és művészet konstrukciója során kiemeli ezeket vallási összefüggésükből, és tisztán esztétikai kontextusba illeszti őket. A kultusztól való elszakítás eredményeképpen jut el a mitológia és a művészet egybekapcsolásához. A kontextus megváltoztatásával biztosítja a szöveg az antik műalkotások sajátos mai befogadásának lehetőségét. Schellingnél ez egyszerre esztétikai szemlélet és spekulatív művészetfilozófiai megközelítés. Újszerűnek tartom mindezzel kapcsolatban annak a problémának a felvetését, miszerint a filozófia mellett az antik művészet kifejlődése is összekapcsolódott a mitológiai képzetekbe vetett bizalom megrendülésével. Schelling ezt a folyamatot nem veszi figyelembe, mivel ókorfelfogásában mitológia, művészet és filozófia átfedésbe kerül. A schellingi művészetfilozófia végső soron a filozófiai szemlélet közvetítésére bízza az antik istenek közvetlenségének tapasztalatát. Publikáció * Játék, kaland, káosz című könyvismertetés Paul Feyerabend A módszer ellen c. művéről (Népszabadság, 2002. szeptember 28.). * Társszerkesztés az Ész, természet, történelem című kötetben (Áron Kiadó, Budapest, 2002.) * A művészet szerepe Nietzsche kultúrkritikájában (in: Ész, természet, történelem, id. kiadás) DÉNES SCHREINER DOCTORAL THESES of the Doctoral Dissertation entitled "The Relation of Greek Mythology and Art in Schelling's Philosophy of Art" Doctoral Theses The present dissertation examines the relation of Greek mythology and Greek art in Schelling's philosophy of art. Primarily, it scrutinizes Schelling's lectures on the philosophy of art; however, in certain cases it extends its scope of investigation to other pieces of his oeuvre. Essentially, writings from his period of identity philosophy are taken into consideration; nevertheless, especially as far as the issue of mythology is concerned, the dissertation also takes into account the message of early and late texts. Moreover, in several cases it compares Schelling's thoughts with contemporary texts, particularly with philosophical and literary works of German classicism, romanticism and idealism. Due to its choice of topic, it cannot ignore ancient Greek philosophy, either; therefore, in certain cases it contrasts Schelling's text with traditional Greek philosophy and art. Within the framework of this wider context, the dissertation poses questions concerning the texts and makes an attempt to think over the answers and their possible implications. Each chapter contains a discussion of a given part of Schelling's lectures; however, the main focus is on the many-faceted examination of the issues coming up in the text. Consequently, the same problems occur several times, their various aspects being investigated. The introduction poses questions that are examined in detail in subsequent chapters and are considered as relevant in terms of the main topic of the dissertation. Besides, the introduction outlines preliminary thoughts and raises initial problems in order to indicate the direction of further investigation. The subsequent considerations of the dissertation are based on these introductory ideas. Essentially, the first chapter discusses problems related to methodics and taxonomy. On the one hand, it sheds slight on the relation between the transcendental and the identity system as well as on their structure. On the other hand, it examines the taxonomic place of Greek mythology and art in the lectures as a whole; the clarification of the mutual relation of the basis of the system and the elements based on it is of paramount importance. The second chapter contains a general investigation of the concept of myth as present in the lectures on the philosophy of art; then comes a general examination of the concept of art based on it. It is followed by an overview of Schelling's concept of mythology as present in his oeuvre. This "detour" was necessary to clarify the emerging ideas and to highlight those points which served as a basis for Schelling to change his earlier views in later periods of his career. The third chapter discusses the analysis of myth, which was but referred to in the second chapter. Also, it surveys the implications that these specific analyses entail on the level of the philosophy of art. The fourth chapter scrutinizes the theory of artistic forms and branches of art; moreover, it deals with more specific aesthetic issues and elucidates ideas already discussed from a different point of view. The fifth chapter brings yet another shift of aspect: an attempt is made to thematize hermeneutical issues already alluded to. Here, the subject of our inquiry is the inner core of Schelling's concept of antiquity, in relation to connecting mythology and art. All these may shed light on our position of interpretation. As far as methodics and topics are concerned, the sixth chapter is related to the previous one. That is, the element of the philosophy of history, along with the concept of the mythology of art, are present throughout the lectures; on the other hand, the relation of antiquity and modernism – complemented by issues concerning the new mythology – is touched upon again. As it is evident from the above specifications, my dissertation examines Schelling's concepts on the basis of various methods and from various points of views; also, it deals with the issue of various disciplines. As for methodics, along with (and within the framework of) a basically philosophical-aesthetic inquiry, an approach based on hermeneutics and the history of thought was of paramount importance; nevertheless, I occasionally complemented it with considerations of a phenomenological nature. Besides, text analysis proper and a more comprehensive treatment are employed. Comparing the texts with other texts and collating ideas that emerge in the text also form an organic part of methodics. The epigraphs at the beginning of each chapter and the annexed pictures, along the body text and footnotes of the dissertation, are to indicate the various levels of our sequence of ideas. At the same time, they render it possible for us to employ media other than scholarly discourse. As far as the referred fields of knowledge are concerned, the dissertation – due to the works it analyses – is essentially characterised by an orientation towards the philosophy of art. This orientation, however, is coupled with aesthetics-related speculations of a more factual nature and analyses of works of art. At the same time, I laid special emphasis on issues of the philosophy of mythology and the philosophy of religion. Obviously, the above theoretical considerations touched issues of the history of religion and the history of art as well. Last but not least, the dissertation intends to make contribution to the history of the reception of the antiquity. In the followings, let me summarize the results of my research. My first observation is that Schelling's philosophy of art is to be interpreted on various levels. These are as follows: (1) the system as a whole, (2) argumentation based on references to mythology and (3) the analysis of individual works of art. In my opinion, this approach is original as it partially transcends the framework of idealist philosophy and makes an attempt to disclose an alternative philosophy of art within Schelling's text. A related approach is the endeavour to consider Schelling's explanation on specific gods and myths and to contrast it with ancient traditions. My thesis is that the relation of time and a work of art can be interpreted on at least three levels (on the levels of the timeless, the mythical and the empirical time) is based on this. That is, in my opinion a possibility of an ontological outline of works of art that is rooted in the above-mentioned temporal structures lies latent in Schelling's philosophy of art. My next thesis is that the relation between Schelling's general philosophical principles of construction and his interpretation of mythology is characterised not by a unidirectional determination but by interplay, and that the aesthetic concept of myth as present in the lectures usually influences the interpretation of art. In other words, the conception of myth in this work of Schelling's is of aesthetic nature and, at the same time, this philosophy of art is based on a certain view and philosophy of myth. My more radical and original view is related to this. I think that Schelling, on the one hand, integrates his own concept of the absolute in the world of mythology and, on the other hand, takes the Homeric perspective as a foundation of a philosophical discussion of art. Doing so, he transforms his mythological point of view and the epic poet's way of seeing things into a philosophical principle of construction. In order to do so, he, in an attempt to achieve his objectives related to the philosophy of art and mythology, projected Plato's philosophical world concept to Homer's mythological world. My next statement is based on this. In Schelling's concept of mythology, the act of composing together myth and the gods' own world, that is, the philosophical-poetical mythology ('poetic theogony') takes priority over the inner self-organization of the gods' world (theogony proper). This implies that Schelling creates figures of gods before creating the gods' world and mythology, which indicates the priority of poetical and philosophical activity over the inner world of mythology. In my opinion, it is also an important consideration that Schelling lifts the principle of the poetic construction of the gods' world (that is the principle of 'poetic theogony') to the gods' world by combining it with the principle of the Homeric 'poetic ontology'. Due to Apollo's figure, the principle of poetry as an individualizing activity that creates form and shape falls within the realm of mythology. That is, the innermost core of Schelling's philosophy of art is of Apollonian character. My next thesis is that the mythological world examined by Schelling manifests an excessively closed system in terms of myth variations and interpretations alike; in addition, we can detect a strong demand for canonization in operation. In my view, this is a consequence of the construction of philosophical systems. I believe that it is important to point out the consideration that Schelling, when elaborating on the theory of branches of arts and artistic forms, consciously selects selfreferential works and myths. As a result, the starting point of aesthetic issues is shifted back to the object of investigation. For instance, the antique statue selected to be paradigm of fine arts exemplifies the representation of the myth of myth. My next observation is that for Schelling a comparative analysis of epic poetry and tragedy leads to differing philosophies of mythology, since in his opinion tragedy (unlike epic poetry) entails divergence from and opposition to destiny. Besides, the separation of the world of the humans and that of gods results in a new anthropology. Consequently, Schelling, when analysing tragedy, transforms his initial ideas on mythology; he incorporates the principle of history and, from the point of view of the philosophy of art, considers this artistic form as the antecedent of the evolution of Christianity. Using the above information as a starting point, we can establish that Schelling's standpoint in the philosophy of history demonstrates that Greek art carried the principle of its own cessation and the cessation of mythology. Therefore, just as the emergence of Christianity is basically interpreted in terms of the philosophy of art, so is the decline of antiquity demonstrated in the context of art. Furthermore, Schelling, while contrasting antiquity with Christianity/modernity, combines historical and systematic contrasts, which breaks up the original foundation of the philosophy of art. At the same time, on the basis of identity philosophy (the foundation of the philosophy of art) we can establish that in Schelling's work the transition from antiquity to Christianity implies the metamorphosis of the absolute itself. When attempting to understand Schelling's later texts, this idea is of major importance. A key conclusion of my dissertation is that the programme of this new mythology is ambivalent in several respects. On the one hand, it is an aesthetic programme; on the other hand, it incorporates speculations on natural philosophy. It can be also added that the time of the realization of the programme is uncertain. Finally, the aspiration for and the expectation of the new mythology generates a peculiar tension in the text. The issue of the old and new mythology takes us to the very core of Schelling's religion of art and concept of antiquity. My thesis, then, is that this religion of art is a mythology of art; I build this idea on Schelling's aesthetic attitude rooted in classicism. When constructing the ancient mythology and art, he lifts them out of their religious context and places them into a purely aesthetic context. He arrives at connecting mythology and art as a result of separating them from the cult. Changing the context, he renders a peculiar, modern reception of ancient works of art possible. In Schelling's works, this is an aesthetic point of view and a speculative approach related to the philosophy of art. I am convinced that it is an original idea to pose the problem that the evolution of ancient art (along with philosophy) is intertwined with the shaking of trust in mythological notions. Schelling ignores this process as in his concept of antiquity mythology, art and philosophy overlap. 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You as a teacher are requested to give your sincere comment against each of the statements by putting a tick (√) mark on appropriate gradecolumn. Your sincere evaluation will be helpful for meaningful assessment of the program so that next improvement plan may be undertaken Name of the entity (Faculty/Department/Discipline/Institute):_________________________ University: _____________________________ 1. Evaluate the following aspects of the program in terms capacity to provide quality education by marking "√" in the box of corresponding column according to the scale given: 5–Strongly agree; 4–Agree; 3–Undecided; 2–Disagree; 1–Strongly disagree; (Note: The figures in the parentheses indicate standards under the assessment criteria) A. Governance B. Curriculum Design and Review C. Student Entry qualifications, Admission procedure, Progress and Achievements D. Structure and Facilities E. Teaching learning and assessment E.1: Teaching Learning E.2: Learning Assessment F. Students Support Services G. Staff and Facilities: Recruitment and staff development H. Research & Extension Services I. Process Control Internal (Quality Assurance and Continuous quality Improvement) Other Aspects: 1. Major weaknesses you have observed in the quality of graduates ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ 2. 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Harnett County Sheriff’s Office Felony Arrests November 15, 2021 ## Arrest Report ### Event \| Arrest Date and Time \| 11/14/2021 21:31:36 \| \|----------------------\|---------------------\| \| Arrest Track \| Z8 \| \| Date Confined \| 11/14/2021 \| \| Fingerprint Check Digit No. \| 8359NBC \| \| NCIC Checked? \| YES \| \| Were Photos and Prints Taken? \| Photo: Yes Prints: Yes \| Address of Arrest Red Hill Church Rd Dunn NC 28334 Arrest Type TAKEN INTO CUSTODY Arrest Disposition ARREST/NO INVESTIGATION Arresting Agency Jurisdiction ### Booking \| Juvenile Record No \| Booking Search Conducted \| Special Needs / Risks \| Committing Magistrate \| \|--------------------\|---------------------------\|-----------------------\|-----------------------\| \| \| \| \| T. SMITH \| Bond Type SECURED Bond Amount 6000 Assisting Officer Name ### Offense(s) \| Charge \| Felony / Misdemeanor \| Count \| Domestic Related \| \|--------\|----------------------\|-------\|------------------\| \| 15A-543(B) FAILURE TO APPEAR ON FELONY \| FELONY \| 1 \| No \| Warrant Date 07/13/21 Court Date 11/30/2021 09:00:00 Court Type DISTRICT COURT Offense Jurisdiction (If not arresting agency) ### Arrestee \| Name (Last, First Middle) \| D.O.B. \| Age \| Race \| Ethnicity \| Sex \| Place of Birth \| Citizenship \| \|---------------------------\|--------\|-----\|------\|-----------\|-----\|---------------\|-------------\| \| PURSLEY, ERIC TYLER \| \| 31 \| W \| N \| M \| NORTH CAROLINA\| \| Physical Address IEW PATH RD DUNN NC 28334 Email Phone Occupation Organization Name Business Address Business Phone Moniker Height 508 Weight 160 Hair BROWN Eye Skin Oddities Social Security Number License No. / Licence State NC FBI Number SBI Number Armed No Scars / Marks / Tattoos Description Location Nearest Relative Name (Last, First Middle) Address Phone Physical Condition / Health Risk Consumed EtOH? Consumed Drugs? ### Transport / Custody \| Patrol Vehicle Searched Prior To Transport \| Vehicle Searched Prior To Shift \| Contraband Found \| Handcuffs Double-locked \| \|-------------------------------------------\|---------------------------------\|------------------\|-------------------------\| \| \| \| \| \| ### Narrative ARREST REPORT NARRATIVE ON 11/14/2021 I (CORPORAL J.A. EDWAWRDS) ARRESTED ERIC PURSLEY FOR A ORDER FOR ARREST OUT HARNETT COUNTY FOR OBTAINING PROPERTY BY FALSE PRETENSE AND MISDEMEANOR LARCENY. ### Involvement Type \| Reporting \| Officer \| Date \| Signature \| \|-----------\|---------\|------\|-----------\| \| \| Edwards, Johnathan Andrew 2231 \| \| \| ## Arrest Report ### Event \| Arrest Date and Time \| 11/14/2021 21:09:06 \| \|----------------------\|---------------------\| \| Arrest Track \| Z4 \| \| Date Confined \| 11/14/2021 \| \| Fingerprint Check Digit No. \| 8358NBG \| \| NCIC Checked? \| YES \| \| Were Photos and Prints Taken? \| Yes Photo: Yes Prints: Yes \| ### Address of Arrest Crest Cir Spring Lake NC 28390 ### Arrest Type TAKEN INTO CUSTODY ### Arrest Disposition CLEARED BY ARREST ### Arresting Agency Jurisdiction HARNETT COUNTY SHERIFFS OFFICE ### Booking \| Juvenile Record No \| Booking Search Conducted Patdown \| \|--------------------\|----------------------------------\| \| Bond Type \| SECURED \| \| Bond Amount \| 20500 \| ### Offense(s) \| Charge \| 14-208.11 FAIL REGISTER SEX OFFENDER \| \|--------------------\|--------------------------------------\| \| Felony / Misdemeanor \| FELONY \| \| Count \| 1 \| \| Domestic Related \| No \| ### Warrant Date 09/25/20 ### Court Date 11/15/2021 09:00:00 ### Court Type DISTRICT COURT ### Offense Jurisdiction (If not arresting agency) ### Arrestee \| Name (Last, First Middle) \| MORRIS, CHARLES JUNIOR \| \|---------------------------\|------------------------\| \| D.O.B. \| \| \| Age \| 56 \| \| Race \| B \| \| Ethnicity \| N \| \| Sex \| M \| \| Place of Birth \| NORTH CAROLINA \| \| Citizenship \| \| ### Physical Address HOMELESS SPRING LAKE NC ### Occupation Organization Name Business Address ### Moniker Height 6'01 Weight 155 Hair BLACK Eye BROWN Skin DARK BROWN Oddities ### Social Security Number License No. / Licence State NC FBI Number SBI Number Armed No ### Scars / Marks / Tattoos \| Description \| Location \| \|-------------\|----------\| \| TATTOO \| INITIALS (MMG) ABDOMEN \| ### Nearest Relative Name (Last, First Middle) MORRIS, MARY Address MATTHEWS RD Phone ### Physical Condition / Health Risk Apparently Normal Consumed ETOH? No Consumed Drugs? NO ### Transport / Custody Patrol Vehicle Searched Prior To Transport Vehicle Searched Prior To Shift Contraband Found Handcuffs Double-locked Page 1 of 2 Date and Time Printed 11/14/2021 11:00:42 PM On 11/14/2021 I went to Crest Cir, Spring Lake in reference to Charles Morris having outstanding warrants. I came in-contact with Charles and brought him into custody, I transported Charles to the Harnett County Detention Center. I then transferred custody to the Harnett County Detention Staff. Charles has been removed from NCIC. No Further \| Involvement Type \| Officer \| Date \| Signature \| \|------------------\|--------------------------\|------\|-----------\| \| Reporting \| Tortolani, Matthew Rocco \| \| \| ## Arrest Report ### Event \| Arrest Date and Time \| 11/09/2021 12:11:48 \| \|----------------------\|---------------------\| \| Arrest Track \| Z3 \| \| Date Confined \| 11/15/2021 \| \| Fingerprint Check Digit No. \| 8361NBG \| \| NCIC Checked? \| YES \| \| Were Photos and Prints Taken? \| Yes Yes \| Address of Arrest 220 CLASSIC COVE CT FUQUAY-VARINANC 27526 Arrest Type TAKEN INTO CUSTODY Arrest Disposition CLEARED BY ARREST Arresting Agency Jurisdiction ### Booking \| Juvenile Record No \| Booking Search Conducted Patdown \| \|--------------------\|----------------------------------\| \| \| \| Special Needs / Risks Committing Magistrate T. SMITH Bond Type NO BOND Bond Amount 0 Assisting Officer Name ### Offense(s) \| Charge \| Felony / Misdemeanor \| Count \| Domestic Related \| \|--------\|----------------------\|-------\|------------------\| \| 14-277.3(A)(C) FELONY STALKING \| FELONY \| 1 \| Yes \| Warrant Date 11/13/21 Court Date 11/16/2021 09:00:00 Court Type DISTRICT COURT Offense Jurisdiction (If not arresting agency) \| Charge \| Felony / Misdemeanor \| Count \| Domestic Related \| \|--------\|----------------------\|-------\|------------------\| \| 50B-4.1(A) DV PROTECTIVE ORDER VIOL (M) \| MISDEMEANOR \| 1 \| Yes \| Warrant Date 11/13/21 Court Date 12/10/2021 09:00:00 Court Type DISTRICT COURT Offense Jurisdiction (If not arresting agency) ### Arrestee \| Name (Last, First Middle) \| D.O.B. \| Age \| Race \| Ethnicity \| Sex \| Place of Birth \| Citizenship \| \|---------------------------\|--------\|-----\|------\|-----------\|-----\|---------------\|-------------\| \| WILLIAMSON, GREGORY THORNTON \| 1 \| 43 \| W \| N \| M \| HENDERSON, NC \| USA \| Physical Address CLASSIC COVE CT FUQUAY VARINANC 27526 Occupation Organization Name Business Address Email Phone Moniker Height 5'11 Weight 223 Hair RED Eye BLUE Skin FAIR SKIN Oddities Social Security Number License No. / Licence State NC FBI Number SBI Number Armed No Scars / Marks / Tattoos Description Location Tattoos GREEN TATTOO TRIBAL UPPER LEFT SHOULDER Nearest Relative Name (Last, First Middle) HASTY, KATHY Address Phone Physical Condition / Health Risk Consumed EtOH? Consumed Drugs? ### Transport / Custody \| Patrol Vehicle Searched Prior To Transport \| Vehicle Searched Prior To Shift \| Contraband Found \| Handcuffs Double-locked \| \|--------------------------------------------\|---------------------------------\|------------------\|-------------------------\| \| ☑ \| ☑ \| □ \| ☑ \| ### Narrative ARREST REPORT NARRATIVE ON 11/15/2021 I (CORPORAL J.A. EDWARDS) ARRESTED GREGORY THORNTON WILLIAMSON FOR TWO WARRANTS OUT OF HARNETT COUNTY FOR FELONY STALKING AND DV PROTECTIVE ORDER VIOLATION. Date and Time Printed 11/15/2021 12:38:35 AM \| Involvement Type \| Officer \| Date \| Signature \| \|------------------\|--------------------------\|------\|-----------\| \| Reporting \| Edwards, Johnathan Andrew 2231 \| \| \| Date and Time Printed: 11/15/2021 12:38:35 AM ## Event \| Arrest Date and Time \| 11/12/2021 12:27:00 \| \|----------------------\|---------------------\| \| Arrest Track \| Z1 \| \| Date Confined \| 11/12/2021 \| \| Fingerprint Check Digit No. \| 8341NBQ \| \| NCIC Checked? \| YES \| \| Were Photos and Prints Taken? \| Yes, Yes \| Address of Arrest 175 Bain St Lillington NC 27546 Arrest Type TAKEN INTO CUSTODY Arrest Disposition CLEARED BY ARREST Arresting Agency Jurisdiction HARNETT COUNTY SHERIFFS OFFICE ### Booking \| Juvenile Record No \| Booking Search Conducted \| \|--------------------\|---------------------------\| \| \| Patdown \| \| Special Needs / Risks \| Committing Magistrate \| \|-----------------------\|------------------------\| \| \| D. McLean \| \| Bond Type \| Bond Amount \| \|-----------\|-------------\| \| SECURED \| 250000 \| \| Assisting Officer Name \| Court Date \| \|------------------------\|------------\| \| \| 11/09/21 \| ### Offense(s) \| Charge \| Felony / Misdemeanor \| Count \| Domestic Related \| \|-------------------------\|----------------------\|-------\|------------------\| \| 14-27.4 STATUTORY SEXUAL OFFENSE \| FELONY \| 1 \| No \| \| Warrant Date \| Court Date \| Court Type \| Offense Jurisdiction (if not arresting agency) \| \|--------------\|------------\|------------\|-----------------------------------------------\| \| 11/09/21 \| \| DISTRICT COURT \| \| \| Charge \| Felony / Misdemeanor \| Count \| Domestic Related \| \|-------------------------\|----------------------\|-------\|------------------\| \| 14-202.1 INDECENT LIBERTIES WITH CHILD \| FELONY \| 1 \| No \| \| Warrant Date \| Court Date \| Court Type \| Offense Jurisdiction (if not arresting agency) \| \|--------------\|------------\|------------\|-----------------------------------------------\| \| 11/09/21 \| \| DISTRICT COURT \| \| ### Arrestee \| Name (Last, First Middle) \| D.O.B. \| Age \| Race \| Ethnicity \| Sex \| Place of Birth \| Citizenship \| \|---------------------------\|--------\|-----\|------\|-----------\|-----\|---------------\|-------------\| \| Spears, Willie Lee Sr \| \| 69 \| B \| N \| M \| NC \| US \| \| Physical Address \| Email \| Phone \| \|------------------\|-------\|-------\| \| Clayhole Rd Dunn NC 28334 \| \| \| \| Occupation Organization Name \| Business Address \| Business Phone \| \|------------------------------\|------------------\|----------------\| \| Retired \| \| / \| \| Moniker \| Height \| Weight \| Hair \| Eye \| Skin \| Oddities \| \|---------\|--------\|--------\|------\|-----\|------\|----------\| \| \| 603 \| 215 \| BLACK\| BROWN\| MEDIUM BROWN \| \| \| Social Security Number \| License No. / Licence State \| FBI Number \| SBI Number \| Armed \| \|------------------------\|-----------------------------\|------------\|------------\|-------\| \| \| \| \| \| No \| \| Scars / Marks / Tattoos \| Description \| Location \| \|-------------------------\|-------------\|----------\| \| \| \| \| \| Nearest Relative Name (Last, First Middle) \| Address \| Phone \| \|--------------------------------------------\|---------\|-------\| \| Spears, Gertrude \| Clayhole Rd \| \| \| Physical Condition / Health Risk \| Consumed EtOH? \| Consumed Drugs? \| \|----------------------------------\|----------------\|-----------------\| \| \| \| \| ### Transport / Custody \| Patrol Vehicle Searched Prior To Transport \| Vehicle Searched Prior To Shift \| Contraband Found \| Handcuffs Double-locked \| \|--------------------------------------------\|---------------------------------\|------------------\|------------------------\| \| \| \| \| \| ARREST REPORT NARRATIVE On Friday November 12th of 2021, Willie Lee Spears Sr was taken into custody at the Harnett County Courthouse for an outstanding Warrant for Arrest for one count of Statutory Sexual Offense with a Child and one count of Indecent Liberties with a Child. These charges stem from an investigation, whereby Willie Lee Spears Sr was found to have engaged in a sexual act and committed a lewd and lascivious act with (N.K.B. DOB: 1/25/06). The outstanding Warrant for Arrest was served and Willie Lee Spears Sr was given a $250,000 secured bond with a first appearance set for 11/15/2021 in Harnett County District Court in Lillington. Willie Lee Spears Sr was entered into NCIC as a wanted person and will now be removed. \| Involvement Type \| Officer \| Date \| Signature \| \|------------------\|------------------\|------\|-----------\| \| Reporting \| Gardner, Jacob Ryan 2327 \| \| \|	2b6afb82-93a8-4ecb-a57b-40a818aac4bf	CC-MAIN-2022-05	http://www.harnettsheriff.com/downloads/felony-arrests-november-15,-2021.pdf	2022-01-17T22:22:17+00:00	crawl-data/CC-MAIN-2022-05/segments/1642320300624.10/warc/CC-MAIN-20220117212242-20220118002242-00275.warc.gz	99,926,975	3,484	eng_Latn	eng_Latn	0.619195	eng_Latn	0.828044	[ "unknown", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "unknown", "eng_Latn", "eng_Latn" ]	true	rolmOCR	[ 65, 3006, 5617, 6165, 9327, 9582, 13818, 14748 ]	[ 0.55078125 ]	[ 0.89453125 ]	[ 1.1796875 ]	[ 1.9375 ]	1	0	HuggingFaceFW/finepdfs
Table of Contents Statement of financial position As at 31 December (Currency: Turkish Lira ("TL") unless otherwise restated) Statement of Comprehensive Income For the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) The notes on pages 5 to 36 are an integral part of these financial statements. Statement of Cash Flows For the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 1 Reporting entity Fiba Faktoring Hizmetleri Anonim Şirketi ("Fiba Faktoring" or the "Company") was established in 1992 to provide factoring services to industrial and commercial firms, and is registered in Turkey. The address of the registered office of Fiba Faktoring is as follows: 1. Levent Plaza A Blok Kat: 2, 7 Büyükdere Caddesi No: 173 1. Levent 34330 İstanbul-Turkey. The number of employees of the Company as at 31 December 2009 is 117 (31 December 2008: 111). The Company's principal activity is to provide factoring services substantially in one geographical segment (Turkey). 2 Basis of preparation (a) Statement of compliance The Company maintains its books of account and prepares its statutory financial statements in Turkish Lira ("TL") in accordance with the Turkish Uniform Chart of Accounts, the Turkish Commercial Code (the "TCC"), and Tax Legislation. The accompanying financial statements have been prepared in accordance with International Financial Reporting Standards ("IFRS") and are based on the statutory records with adjustments and reclassifications for the purpose of fair presentation in accordance with IFRS as issued by International Accounting Standards Board (IASB). (b) Basis of measurement The financial statements have been prepared on the historical cost basis, as adjusted for the effects of inflation that ended at 31 December 2005 except for the derivative financial instruments and financial assets at fair value through profit or loss which are measured at fair value. The methods used to measure fair values are discussed further in note 4. (c) Functional and presentation currency These financial statements are presented in TL, which is the Company's functional currency. Except as otherwise indicated, all financial information presented in TL is rounded to the nearest digit. (d) Use of estimates and judgments The preparation of the financial statements requires management to make judgements, estimates and assumptions that affect the application of accounting policies and the reported amounts of assets, liabilities, income and expenses. Actual results may differ from these estimates. Estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the year in which the estimate is revised and in any future years affected. In particular, information about significant areas of estimation uncertainty and critical judgments in applying accounting policies that have the most significant effect on the amount recognised in the financial statements are described in the following notes: * Note 3(d) – Useful life of assets * Note 4 – Determination of fair values * Note 8 – Taxation * Note 11 – Factoring receivables – Allowance for doubtful receivables * Note 20 – Employee benefits * Note 19 – Derivative financial instruments Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 2 Basis of preparation (continued) (e) Changes in accounting policies Presentation of financial statements The Company applies revised IAS 1 "Presentation of Financial Statements (2007)", which became effective as of 1 January 2009. As a result, the Company presents in the statement of changes in equity all owner changes in equity, whereas all non-owner changes in equity are presented in the statement of comprehensive income. Comparative information has been re-presented so that it is also in conformity with the revised standard. Since the change in accounting policy only impacts presentation aspects, there is no impact on earnings. (f) Other accounting developments Disclosures pertaining to fair values and liquidity risk for financial instruments The Company has applied Improving Disclosures about Financial Instruments (Amendments to IFRS 7), issued in March 2009. The amendments require that fair value measurement disclosures use a three-level fair value hierarchy that reflects the significance of the inputs used in measuring fair values of financial instruments. The amendments require disclosure of a maturity analysis for non-derivative and derivative financial liabilities, but contractual maturities are essential for an understanding of the timing of cash flows. For issued financial guarantee contracts, the amendments require the maximum amount of the guarantee to be disclosed in the earliest period in which the guarantee could be called. Since IFRS 7 only impacts disclosure aspects, there is no impact on earnings. 3 Significant accounting policies The accounting policies set out below have been applied consistently to all years presented in these financial statements. (a) Accounting in hyperinflationary economies International Accounting Standard ("IAS") No. 29, which deals with the effects of inflation in the financial statements, requires that financial statements prepared in the currency of a hyperinflationary economy to be stated in terms of the measuring unit current at the reporting date and the corresponding figures for previous years be restated in the same terms. One characteristic that necessitates the application of IAS 29 is a cumulative three year inflation rate approaching or exceeding 100%. The cumulative three-year inflation rate in Turkey has been 35.61% as at 31 December 2005, based on the Turkish nation-wide wholesale price indices announced by Turkish Statistical Institute. This, together with the sustained positive trend in the quantitative factors such as financial and economical stabilization, decrease in the interest rates and the appreciation of TL against the US Dollars ("USD"), have been taken into consideration to categorise Turkey as a nonhyperinflationary economy under IAS 29 effective from 1 January 2006. Therefore, IAS 29 has not been applied to the financial statements as at and for the year ended 31 December 2009 and 2008. (b) Foreign currency transactions Transactions in foreign currencies are translated to TL at the foreign exchange rates ruling at the dates of the transactions. Monetary assets and liabilities denominated in foreign currencies are translated to TL at the exchange rates ruling at the reporting date announced by Central Bank of Turkey (CBT). Gains and losses arising from foreign currency transactions are recognised to the statement of comprehensive income. Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 3 Significant accounting policies (continued) (b) Foreign currency transaction (continued) Foreign currency translation rates used by the Company as at 31 December are as follows: 2009 2008 (c) Financial instruments Non-derivative financial instruments Non-derivative financial instruments comprise cash and cash equivalents, factoring receivables, investments, other assets, factoring payables, loans and borrowings and other liabilities. Non-derivative financial instruments are recognised initially at fair value plus any directly attributable transaction costs. Subsequent to initial recognition non-derivative financial instruments are measured as described below. A financial instrument is recognised if the Company becomes a party to the contractual provisions of the instrument. Financial assets are derecognised if the Company's contractual rights to the cash flows from the financial assets expire or if the Company transfers the financial asset to another party without retaining control or substantially all risks and rewards of the asset. Regular way purchases and sales of financial assets are accounted for at trade date, i.e., the date that the Company commits itself to purchase or sell the asset. Financial liabilities are derecognised if the Company's obligations specified in the contract expire or are discharged or cancelled. Cash and cash equivalents Cash and cash equivalents comprise cash balances, demand deposits and time deposits at banks having original maturity less than 3 months and readily to be used by the Company or not blocked for any other purpose. Time deposits are measured at amortised cost using the effective interest method, less any impairment losses. Demand deposits are measured at cost. Accounting for interest income and expense is discussed in note 3 (l). Factoring receivables and other assets Factoring receivables are measured at amortised cost less specific allowances for uncollectibility and unearned interest income. Specific allowances are made against the carrying amount of factoring receivables and that are identified as being impaired based on regular reviews of outstanding balances to reduce factoring receivables to their recoverable amounts. When a factoring receivable is known to be uncollectible, all the necessary legal procedures have been completed, and the final loss has been determined, receivable is written off immediately. Loans and borrowings Loans and borrowings are recognised initially at fair value, net of any transaction costs incurred. Subsequent to initial recognition, loans and borrowings are stated at amortised cost with any difference between cost and redemption value being recognised in the statement of comprehensive income over the period of the borrowings. Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 3 Significant accounting policies (continued) (c) Financial instruments (continued) Investments Investment in debt securities are classified as financial asset at fair value through profit or loss and are measured at fair value, and changes therein are recognised in profit or loss. Investments in equity securities are classified as available-for-sale assets. Available-for-sale assets are financial assets that are not held for trading purposes, or held to maturity. Investments in equity securities are measured at cost less impairment losses as their fair values cannot be estimated reasonably. When equity investments are disposed of, any resulting gain or loss is recognised in the statement of comprehensive income as the difference between the sales price and the carrying amount of the investment. Other Other assets and payables are measured at cost. Derivatives held for risk management purposes The Company holds derivative financial instruments for risk management purposes. In accordance with its treasury policy, the Company engages in currency swap, forward and option contracts. However, these derivatives do not qualify for hedge accounting and are accounted for as trading instruments. Derivatives held for risk management purposes are recognised initially at fair value; attributable transaction costs are recognised in profit and loss when incurred. Subsequent to initial recognition, derivatives are measured at fair value, and changes therein are accounted for as described below. Other non-trading derivatives When a derivative financial instrument is not held for trading and is not designated in a qualifying hedge relationship, all changes in its fair value are recognised immediately in profit or loss. Share capital Ordinary shares Incremental costs directly attributable to issue of ordinary shares and share options are recognised as a deduction from equity, net of ant tax effect. Share capital increased pro-rata to existing shareholders is accounted for at par value as approved at the annual meeting of shareholders. (d) Property and equipment Recognition and measurement Items of property and equipment acquired before 1 January 2006 are measured at cost restated for the effects of inflation in TL units current at 31 December 2005 pursuant to IAS 29 less accumulated depreciation and impairment losses. Property and equipment acquired after 1 January 2006 are measured at cost, less accumulated depreciation, and impairment losses. Cost includes expenditures that are directly attributable to the acquisition of the asset. When parts of an item of property and equipment have different useful lives, they are accounted for as separate items (major components) of property and equipment. Gains and losses on disposal of an item at property and equipment are determined by comparing the proceeds from disposal with the carrying amount of property and equipment and are recognized net within "other income" in the statement of comprehensive income. Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 3 Significant accounting policies (continued) (c) Property and equipment (continued) Subsequent costs The cost of replacing part of an item of property and equipment is recognised in the carrying amount of the item if it is probable that the future economic benefits embodied within the part will flow to the Company and its cost can be measured reliably. The costs of the day-to-day servicing of property and equipment are recognised in the statement of comprehensive income as incurred. Depreciation Depreciation is recognised in the statement of comprehensive income on a straight-line basis over the estimated useful lives of each part of an item of property and equipment. The estimated useful lives for the current and comparative years are as follows: Buildings 50 years Leasehold improvements are amortised over the periods of the respective leases on a straight-line basis. Depreciation methods, useful lives and residual values are reviewed at each financial year-end and adjusted if appropriate. (e) Intangible assets Intangible assets represent computer software licenses and rights. Intangible assets acquired before 1 January 2006 are measured at cost restated for the effects of inflation in TL units current at 31 December 2005 pursuant to IAS 29, less accumulated amortisation, and impairment losses. Intangible assets acquired after 1 January 2006 are measured at cost, less accumulated amortisation, and impairment losses. Amortisation is charged to comprehensive income on a straight-line basis over the estimated useful lives of intangible assets. The estimated useful lives for the current and comparative years are between 3 and 15 years. (f) Leased assets Leases in terms of which the Company assumes substantially all the risks and rewards of ownership are classified as finance leases. Upon initial recognition the leased asset is measured at an amount equal to the lower of its fair value and the present value of the minimum lease payments. Subsequent to initial recognition, the asset is accounted for in accordance with the accounting policy applicable to that asset. Other leases are operating leases and are not recognised on the Company's statement of financial position. (g) Impairment Financial assets A financial asset is considered to be impaired if objective evidence indicates that one or more events have had a negative effect on the estimated future cash flows of that asset. An impairment loss in respect of a financial asset measured at amortised cost is calculated as the difference between its carrying amount, and the present value of the estimated future cash flows discounted at the original effective interest rate. An impairment loss in respect of available-for-sale financial assets is calculated by reference to its current fair value. Financial assets are tested for impairment on an individual basis. Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 3 Significant accounting policies (continued) (g) Impairment (continued) Financial assets (continued) All impairment losses are recognised in profit or loss. An impairment loss is reversed if the reversal can be related objectively to an event occurring after the impairment loss was recognised. For financial assets measured at amortised cost, the reversal is recognised in comprehensive income. For available-for-sale financial assets that are equity securities and whose fair value is reliably measured, the reversal is recognised directly in other comprehensive income. Non-financial assets The carrying amounts of the Company's non-financial assets other than deferred tax assets are reviewed at each reporting date to determine whether there is any indication of impairment. If any such indication exists then the asset's recoverable amount is estimated. For intangible assets that have indefinite lives or that are not yet available for use, recoverable amount is estimated at each reporting date. An impairment loss is recognised if the carrying amount of an asset or its cash-generating unit exceeds its recoverable amount. A cash-generating unit is the smallest identifiable asset group that generates cash flows that largely are independent from other assets and groups. Impairment losses are recognised in comprehensive income. The recoverable amount of an asset or cash-generating unit is the greater of its value in use and its fair value less costs to sell. In assessing value in use, the estimated future cash flows are discounted to their present value using a pre-tax discount rate that reflects current market assessments of the time value of money and the risks specific to the asset. An impairment loss in respect of goodwill is not reversed. In respect of other assets, impairment losses recognised in prior years are assessed at each reporting date for any indications that the loss has decreased or no longer exists. An impairment loss is reversed if there has been a change in the estimates used to determine the recoverable amount. An impairment loss is reversed only to the extent that the asset's carrying amount does not exceed the carrying amount that would have been determined, net of depreciation or amortisation, if no impairment loss had been recognised. (h) Employee benefits Reserve for employee severance payments In accordance with the existing social legislation in Turkey, the Company is required to make certain lump-sum payments to employees whose employment is terminated due to retirement or for reasons other than resignation or misconduct. Such payments are calculated on the basis of an agreed formula, are subject to certain upper limits and are recognised in the accompanying financial statements as accrued. The reserve has been calculated by estimating the present value of the future obligation of the Company that may arise from the retirement of the employees. As at 31 December, the assumptions used in the calculation are as follows: Short-term benefits Short-term employee benefit obligations are measured on an undiscounted basis and are expensed as the related service is provided. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 3 Significant accounting policies (continued) (i) Provisions A provision is recognised if, as a result of a past event, the Company has a present legal or constructive obligation that can be estimated reliably, and it is probable that an outflow of economic benefits will be required to settle the obligation. Provisions are determined by discounting the expected future cash flows at a pre-tax rate that reflects current market assessments of the time value of money and the risks specific to the liability. (j) Offsetting Financial assets and liabilities are offset and the net amount is reported in the statement of financial position when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis, or to realise the asset and settle the liability simultaneously. (k) Related parties For the purpose of accompanying financial statements, the shareholders, key management personnel and the Board members, and in each case, together with their families and companies controlled by/affiliated with them; and investments are considered and referred to as the related parties. (l) Interest income and expense recognition Interest income and expense are recognised in comprehensive income using the effective interest method. The effective interest rate is the rate that exactly discounts the estimated future cash payments and receipts through the expected life of the financial asset or liability (or, where appropriate, a shorter period) to the carrying amount of the financial asset or liability. The effective interest rate is established on initial recognition of the financial asset and liability and is not revised subsequently. The calculation of the effective interest rate includes all fees and points paid or received, transaction costs, and discounts or premiums that are an integral part of the effective interest rate. Transaction costs are incremental costs that are directly attributable to the acquisition, issue or disposal of a financial asset or liability. Interest income and expense presented in the statement of comprehensive income include interest on financial assets and liabilities at amortised cost on an effective interest rate basis. (m) Fees and commission Fees and commission income and expenses that are integral to the effective interest rate on a financial asset or liability are included in the measurement of the effective interest rate. Other fees and commission income are recognised as the related services are performed. Other fees and commission expense are expensed as the services are received. (n) Dividends Dividend income is recognised when the right to receive income is established. (o) Net trading loss Net trading loss comprises gains less losses related to trading assets and liabilities, and includes all realised and unrealised fair value changes and foreign exchange differences. Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 3 Significant accounting policies (continued) (p) Income tax Income tax comprises current tax and deferred tax. Income tax is recognised in profit and loss, except to the extent that it relates to items recognised directly in equity, in which case it is recognised in equity. Current tax is the expected tax payable on the taxable income for the year, using tax rates enacted or substantially enacted at the reporting date, and any adjustment to tax payable in respect of previous years. Deferred income tax is provided, using the balance sheet method, on all taxable temporary differences arising between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for taxation purposes. Deferred tax liabilities and assets are recognised when it is probable that the future economic benefits resulting from the reversal of taxable temporary differences will flow to or from the Company. Deferred tax assets are recognised to the extent that it is probable that future taxable profit will be available against which the deferred tax asset can be utilised. Deferred tax assets are reduced to the extent that it is no longer probable that the related tax benefit will be realised. Currently enacted tax rates are used to determine deferred taxes on income. (r) Subsequent events Subsequent events are events that occur between reporting date and the authorization date for the issuance of the financial statements and may impact the company positively or negatively. If there is evidence of such events as at reporting date or if such events occur after reporting date and if adjustments are necessary, Company's financial statements are adjusted according to the new situation. The Company discloses the post-reporting date events that are not adjusting events but material. (s) New standards and interpretations not yet adopted A number of new standards, amendments to standards and interpretations which are not effective as of 31 December 2009 have not been applied in preparing these financial statements and not expected to have any impact on the financial statements of the Company except for IFRS 9. IFRS 9 – Financial Instruments, is published by International Accounting Standards Board in October 2009 as a part of a broad project that aims to bring new regulations to replace IAS 39 – Financial Instruments: Recognition and Measurement. Developing a new standard for financial reporting for financial assets that is principle-based and less complex is aimed by this project. The objective of IFRS 9, being the first phase of the project, is to establish principles for the financial reporting of financial assets that will present relevant and useful information to users of financial statements for their assessment of amounts, timing and uncertainty of the entity's future cash flows. With IFRS 9 an entity shall classify financial assets as subsequently measured at either amortised cost or fair value on the basis of both the entity's business model for managing the financial assets and the contractual cash flow characteristic of the financial asset. It is stated that IAS 39 standards related to impairment of financial asset and hedge accounting will continue to be effective. An entity shall apply IFRS 9 for annually periods beginning on or after 1 January 2013. An earlier application is permitted. If an entity applies this IFRS in its financial statements for a period beginning before 1 January 2013, it shall disclose this fact and shall apply this IFRS to its prior period financial statements. Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 4 Determination of fair values Accounting classification and fair values A number of the Company's accounting policies and disclosures require the determination of fair value, for both financial and non-financial assets and liabilities. Fair values have been determined for measurement and / or disclosure purposes based on the following methods. Where applicable, further information about the assumptions made in determining fair values is disclosed in the notes specific to that asset or liability. Fair value is the amount at which a financial instrument could be exchanged in a current transaction between willing parties, other than in a forced sale or liquidation, and is best evidenced by a quoted market price. The estimated fair values of financial instruments have been determined using available market information by the Company, and where it exists, appropriate valuation methodologies. However, judgment is necessary required to interpret market data to determine the estimated fair value. While management has used available market information in estimating the fair values of financial instruments, the market information may not be fully reflective of the value that could be realised in the current circumstances. Management has estimated that the fair value of certain statement of financial position instruments is not materially different than their recorded values due to their short-term nature except for long term receivables and loans and borrowings. The investments that are classified as available-for-sale do not have a quoted market price in an active market and other methods of reasonably estimating their market values would be inappropriate and unworkable, accordingly they are stated at cost, including the restatement for the effects of inflation till 31 December 2005, less impairment losses. Financial assets at fair value through profit or loss are measured based on quoted market prices at the reporting date. As at 31 December , the carrying amounts and fair values of financial instruments are as follows: Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 4 Financial assets and liabilities (continued) Fair value hierarchy The table below analyses financial instruments carried at fair value, by valuation method. The different levels have been defined as follows: Level 1: Quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2: Inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly (i.e., as prices) or indirectly (i.e., derived from prices). Level 3: Inputs for the asset or liability that are not based on observable market data (unobservable inputs). 5 Personnel expenses For the years ended 31 December, personnel expenses comprised the following: Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 6 Administrative expenses For the years ended 31 December, administrative expenses comprised the following: 7 Other expenses For the years ended 31 December, other expenses comprised the following: As at 31 December 2009, donations include expenditures made to "Kızılay-Şükrü-Nurten Topçuoğlu Rehabilitation Center" amounting to TL 2,976,696, to "AÇEV" amounting TL 805,200 (31 December 2008: 703,600 TL), to "Hüsnü Özyeğin Foundation" amounting TL 978,220 (31 December 2008: 25,000 TL) and to other various donations by TL 155,864 (31 December 2008: "Özyeğin University" amounting to TL 5,000,000, Sabancı University amounting to TL 121,820, to other various donations TL 1,047,294 and progress payments of donated school constructions in progress amounting to TL 27,490,033). Notes to the Financial Statements (Currency: Turkish Lira ("TL") unless otherwise stated) As at and for the Year Ended 31 December 8 Taxation As at 31 December 2009, corporate income tax is 20% (31 December 2008: 20%) on the statutory corporate income tax base, which is determined by modifying accounting income for certain exclusions and allowances for tax purposes. There is also a withholding tax levied at a certain rate on the dividends paid and is accrued only at the time of such payments. Some of the deduction rates included in the 15 th and 30 th articles of the Law no. 5520 on the Corporate Tax, has been redefined according to the cabinet decision numbered 2006/10731, which has been announced at Trade Registry Gazette of 23 July 2006-26237. In this context, withholding tax rate on dividend payments which are made to the companies except those are settled in Turkey or generate income in Turkey via a business or a regular agent has been increased to 15% from 10%. Under the Turkish taxation system, tax losses can be carried forward to be offset against future taxable income for up to five years. Tax losses cannot be carried back to offset profits from previous years. In Turkey, there is no procedure for a final and definitive agreement on tax assessments. Companies file their tax returns within four months following the close of the accounting year to which they relate. Tax returns are open for five years from the beginning of the year that follows the date of filing during which time the tax authorities have the right to audit tax returns, and the related accounting records on which they are based, and may issue re-assessments based on their findings. In Turkey, the transfer pricing provisions have been stated under the Article 13 of Corporate Tax Law with the heading of "disguised profit distribution via transfer pricing". The General Communiqué on disguised profit distribution via Transfer Pricing, dated 18 November 2007 sets details about implementation. If a taxpayer enters into transactions regarding sale or purchase of goods and services with related parties, where the prices are not set in accordance with arm's length principle, then related profits are considered to be distributed in a disguised manner through transfer pricing. Such disguised profit distributions through transfer pricing are not accepted as tax deductible for corporate income tax purposes. The income tax expense for the years ended 31 December comprised the following items: () Adjustment to prior years includes the tax penalty for the years 2002 and 2003. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 8 Taxation (continued) The reported income tax for the years ended 31 December are different than the amounts computed by applying the statutory tax rate to profit before tax as shown in the following reconciliation: In accordance with the related regulation for prepaid taxes on income, advance payments during the year are being deducted from the final tax liability computed over current year operations. Accordingly, the income tax expense is not equal to the final tax liability appearing on the statement of financial position. The current tax liabilities as at 31 December comprised the following: () As at 31 December 2008, the Company has not any taxable profit. TL 4,427,892 of prepaid taxes paid during the year was included in Note 15 "Other assets". This amount is not netted-off with the tax liabilities payable resulting from the tax penalty for the years 2002 and 2003. In 2009, the amount is received as cash from tax office. Deferred tax is provided, using the balance sheet method, on all taxable temporary differences arising between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for taxation purposes, except for the initial recognition of assets and liabilities which effect neither accounting nor taxable profit. At 31 December, deferred tax assets and liabilities were attributable to the items detailed in the table below: Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 8 Taxation (continued) Deferred tax assets and liabilities are offset when there is a legally enforceable right to set off current tax assets against current tax liabilities and when the deferred income taxes relate to the same fiscal authority. The movement of deferred assets and (liabilities) for the years ended 31 December are as follows: 9 10 Cash and cash equivalents As at 31 December, cash and cash equivalents comprised the following: As at 31 December 2009 and 2008, cash and cash equivalents include cash balances on hand, demand deposits and time deposits with original maturity periods of less than three month and over-night time deposits. As at 31 December 2009, TL denominated time deposits are amounting to TL 290,000 have a maturity of 4 January 2010 with interest rates of 7.50% (31 December 2008: TL 213,900,000 with a maturity of ranges between 2 January 2009 and 16 January 2009 with interest rates of 15.75% and 21.10%). As at 31 December 2009, foreign currency time deposits (original amount of USD 58,290,000, GBP 378,000) has maturities on 4 January 2010 within a range of interest rates of 0.37% to 4.10% (31 December 2008: original amount of USD 86,801,000, Euro 30,228,000, GBP 196,000 with a maturity of 2 January and 16 January 2009 and within interest rates of 1.75% to 5.75%). For the years ended 31 December, there is no restriction on cash at banks. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 11 Factoring receivables As at 31 December, factoring receivables comprised the following: As at 31 December 2009 and 2008, all factoring receivables, except restructured factoring receivables mature within one year. Restructured factoring receivables amounting to 72,944,394 TL matures between 2011 and 2019. Movements in the allowance for doubtful receivables for the years ended 31 December was as follows: Balance at 31 December 16,987,096 20,255,428 ()As at 31 December 2009, the Company sold its fully impaired factoring receivables portfolio amounting to TL 16,858,924 to Girişim Varlık Yönetimi AŞ at amount of TL 105,000. As at 31 December, the ageing analysis of the impaired factoring receivables are as follows: Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 12 Investment securities 12.1 Investments in debt securities carried at fair value through profit or loss As at 31 December 2009, investments in debt securities carried at fair value through profit or loss are as follows: As at 31 December 2009, investments in debt securities carried at fair value through profit or loss comprised of Irish government bonds with a total carrying value of TL 49,590,959 (31 December 2008: None). The Company disposed the bond on 4 January 2010 at EUR 23,028,773, which has a cost amounting to EUR 23,005,011. 12.2 Investments in equity securities available for sale For the years ended 31 December, the Company holds equity securities in the following companies: As at 31 December, the investments above are classified as available-for-sale do not have a quoted market price in an active market and other methods of reasonably estimating their market values would be inappropriate and unworkable, accordingly investments acquired before 1 January 2006 are measured at cost restated for the effects of inflation in TL units current at 31 December 2005 pursuant to IAS 29, less impairment losses. According to the Board of Directors' decision dated 9 March 2009 and numbered 12, the Company sold its 28.32% shares at Fiba Gayrimenkul Gel. İnş. ve Yat. AŞ which has a cost amount of TL 7,049,702 at TL 6,814,233 to Fina Holding AŞ. According to the Board of Directors' decision dated 23 December 2008 and numbered 199, the Company acquired 49.00% of Girişim Varlık Yönetimi AŞ at TL 40,000,400. Since the Company does not have significant influence on the management of Girişim Varlık Yönetimi AŞ, its investment at Girişim Varlık Yönetimi AŞ is classified as available-for-sale. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 13 Property and equipment (1) Others comprised of paintings which are not amortised. (2) As at 31 December 2009, TL 2,344,213 (31 December 2008: TL 2,396,123) of net book value of building is acquired under finance lease contracts. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 14 Intangible assets 15 Other assets As at 31 December, other assets comprised the following: Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 16 Loans and borrowings As at 31 December, loans and borrowings comprised the following: 2008 () These rates represent the average nominal interest rates of outstanding borrowings with fixed and floating rates as at 31 December. As at 31 December 2009, loans and borrowings amounting to TL 417,840,000, USD 128,000,000 and Euro 21,500,000 are secured by Fiba Holding AŞ (31 December 2008: USD 285,500,000 and Euro 22,000,000). 17 Factoring payables As at 31 December, factoring payables are as follows: Factoring payables represent the amounts collected on behalf of customers but not yet paid as of the reporting date. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 18 Other liabilities As at 31 December, other liabilities comprised the following: 19 Derivative financial instruments The Company uses the currency swap, forward and option derivative instruments. "Currency swaps" are commitments to exchange one set of cash flows for another. Swaps result in an economic exchange of currencies. Options are derivative financial instruments that give the buyer, in exchange for a premium payment, the right, but not the obligation, to either purchase from (call option) or sell (put option) to the writer a specified underlying at a specified price on or before a specified date. Forward contracts are commitments to either purchase or sell a designated financial instrument, currency, commodity or an index at a specified future date for a specified price and may be settled in cash or another financial asset. The Company uses these derivative financial instruments, not designated in a qualifying hedge relationship, to manage its exposure to foreign currency risk. The notional amounts of certain types of financial instruments provide a basis for comparison with instruments recognised on the statement of financial position but do not necessarily indicate the amounts of future cash flows involved or the current fair value of the instruments and, therefore, do not indicate the Company's exposure to credit or price risks. The derivative instruments become favorable (assets) or unfavorable (liabilities) as a result of fluctuations in foreign exchange rates and interest rates relative to their terms. The aggregate contractual or notional amount of derivative financial instruments on hand, the extent to which instruments are favorable or unfavorable and, thus the aggregate fair values of derivative financial assets and liabilities can fluctuate significantly from time to time. The fair values of derivative instruments held as at 31 December, which represent the carrying values are as follows: As at 31 December 2009, currency swaps mature in one month, currency options mature between 2 June 2010 and 7 September 2010 and accumlative boosted forward transactions mature on December 2010. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 20 Employee benefits As at 31 December, employee benefits comprised the following: 20.1 Reserve for employee severance payments In accordance with existing social legislation in Turkey, the Company is required to make lumpsum payments to employees whose employment is terminated due to retirement or for reasons other than resignation or misconduct. Such payments are calculated on the basis of 30 days' pay, maximum of TL 2,365 at 31 December 2009 (31 December 2008: TL 2,173) per year of employment at the rate of pay applicable at the date of retirement or termination. The principal assumption used in the calculation of the total liability is that the maximum liability for each year of service will increase in line with inflation semi-annually. As at and for the years ended 31 December, movements in the reserve for employee severance payments were as follows: 20.2 Vacation pay liability For the years ended 31 December, movements in the vacation pay liability were as follows: Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 21 Equity 21.1 Paid-in capital At 31 December 2009 and 2008, the paid-in capital amounted to TL 44,378,194 as restated in terms of TL units current at 31 December 2005 pursuant to IAS 29 in the accompanying financial statements. At 31 December 2009 and 2008, the nominal paid-in capital of the Company comprises 14.000.000 shares of TL 1 each. For the years ended 31 December, the composition of the authorised and paid-in share capital was as follows: 21.2 Legal reserves The legal reserves, which are included in retained earnings, are established by annual appropriations amounting to 5% of income disclosed in the Company's statutory accounts until it reaches 20% of paid-in share capital (first legal reserve). Without limit, a further 10% of dividend distributions in excess of 5% of paid-in capital is to be appropriated to increase legal reserves (second legal reserve). The first legal reserve is restricted and is not available for distribution as dividend unless it exceeds 50% of share capital. In the accompanying financial statements, the total of the legal reserves amounted to TL 10,625,548 as at 31 December 2009 (31 December 2008: TL 10,625,548). 21.3 Fair value reserve The fair value reserve comprises the cumulative net change in the fair value of available-for- sale financial assets until the investment is derecognised. For the years ended 31 December, the movements in the fair value reserve are as follows: 21.4 Retained earnings 75% of gains on disposal of equity shares and immovables which were held for at least 2 years within the assets of acquired entities after acquisition, are exempt from taxation if such gains are added to paid-in capital or kept under equity as restricted funds for at least 5 years. As of 31 December 2009, retained earnings balance is comprised of restricted funds amounting to TL 154,902,418 (31 December 2008: TL 88,342,398). Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 22 Financial risk management Counter party credit risk The Company is subject to credit risk through its factoring operations. Risk Management and Analysis Department is responsible to manage the credit risk. The Company requires a certain amount of collateral in respect of its financial assets. Management has a credit policy in place and the exposure to credit risk is monitored on an ongoing basis. Credit evaluations are performed on all customers requiring credit. A special software program has been developed to monitor the credit risk of the Company. At reporting date, there were no significant concentrations of credit risk. The maximum exposure to credit risk is represented by the carrying amount of each financial asset in the statement of financial position. Since the Company operates only in Turkey, geographic concentration of the maximum exposure to credit risk for factoring receivables at the reporting date is mainly domestic. At 31 December, the detail of the breakdown of the net factoring receivables by industrial groups is as follows: Investments in debt securities are preferred to be in liquid securities and easily convertible to cash. Transactions involving derivatives are mainly with related parties. The Company establishes an allowance for doubtful receivables that represents its estimate of incurred losses in respect of factoring receivables. This allowance includes the specific loss component that relates to individual customer exposures. The Company has obtained the following collaterals for its receivables at 31 December: Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 22 Financial risk management (continued) Liquidity risk Liquidity risk is the risk that the Company will encounter difficulty in meeting obligations from its financial liabilities. The Company's approach to managing liquidity is to ensure, as far as possible, that it will always have sufficient liquidity to meet its liabilities when due, under both normal and stressed conditions, without incurring unacceptable losses or risking damage to the Company's reputation. The Company monitors its liquidity position on a periodic basis, which assists it in monitoring cash flow requirements and optimizing its cash return on investments. Typically the Company ensures that it has sufficient liquid assets to meet expected operational expenses including the servicing of financial obligations; this excludes the potential impact of extreme circumstances that cannot reasonably be predicted. To manage liquidity risk arising from financial liabilities, the Company holds liquid assets mainly comprising cash and cash equivalents and investments in debt securities for which there is an active market. These assets can be readily sold to meet liquidity requirements. The following are the contractual maturities of financial liabilities, including interest payments and excluding the impact of netting agreements. () Other liabilities exclude withholding taxes and duties payable. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 22 Financial risk management (continued) Liquidity risk (continued) The table below shows the notional amounts of derivative instruments analyzed by the term to maturity. The notional amount is the amount of a derivative's underlying asset, reference rate or index and is the basis upon which changes in the value of derivatives are measured. The notional amounts indicate the volume of transactions outstanding at year-end and are neither indicative of the market risk nor credit risk. () The minimum notional amounts are presented in the table and the maximum notional amount can be maximum three times of the presented balances. Market risk Market risk is the risk that changes in market prices, such as foreign exchange rates and interest rates will affect the Company's income or the value of its holdings of financial instruments. The objective of market risk management is to manage and control market risk exposures within acceptable parameters, while optimizing the return on risk. Interest rate risk The principal risk to which non-trading portfolios are exposed is the risk of loss from fluctuations in the future cash flows of fair values of financial instruments because of a change in market interest rates. All the financial instruments have fixed interest rates except for the loans which have floating interest rate. The Company's operations are subject to the risk of interest rate fluctuations to the extent that interest-earning assets and interest-bearing liabilities mature or reprice at different times or in differing amounts. In the case of floating rate assets and liabilities, the Company is also exposed to basis risk which is the difference in repricing characteristics of the various floating rate indices, such as year end libor and different types of interest. Risk management activities are aimed at optimizing net interest income, given market interest rate levels consistent with the Company's business strategies. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 22 Financial risk management (continued) Market risk (continued) The tables below summarise average effective interest rates by major currencies for monetary financial instruments at 31 December: Interest rate profile At 31 December, the interest rate profile of the interest-bearing financial instruments was: Fair value sensitivity analysis for fixed rate instruments The Company does not account for any fixed rate financial assets and liabilities at fair value through profit or loss, and the Company does not designate derivatives as hedging instruments under a fair value hedge accounting model. Therefore a change in interest rates at the reporting date would not affect profit or loss. Additionally, the Company does not account for any fixed rate financial assets and liabilities as available-for-sale. Therefore a change in interest rates at the reporting date would not directly affect equity. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 22 Financial risk management (continued) Market risk (continued) Cash flow sensitivity analysis for variable rate instruments A change of 100 basis points in interest rates at the reporting date would have increased (decreased) equity and profit or loss before tax by the amounts shown below. This analysis assumes that all other variables, in particular foreign currency rates, remain constant. The analysis is performed on the same basis for 31 December 2008. Foreign currency risk The Company is exposed to currency risk through transactions (such as factoring operations and borrowings) in foreign currencies. As the currency in which the Company presents its financial statements is TL, the financial statements are affected by movements in the exchange rates against TL. At 31 December, the currency risk exposures were as follows (TL equivalents): () Accumulated boosted forward transactions are presented with minimum notional amounts. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 22 Financial risk management (continued) Market risk (continued) Foreign currency risk (continued) Foreign currency sensitivity analysis A 10 percent weakening of TL against the foreign currencies at 31 December would have increased (decreased) equity and profit or loss by the amounts shown below. This analysis assumes that all other variables, in particular interest rates, remain constant. The analysis is performed on the same basis for 31 December 2008. A 10 percent strengthening of the TL against the foreign currencies at 31 December 2009 and 31 December 2008 would have had the equal but opposite effect on the above currencies to the amounts shown above, on the basis that all other variables remain constant. Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 22 Financial risk management (continued) Market risk (continued) Capital management The Company's policy is to maintain a strong capital base so as to maintain investor, creditor and market confidence and to meet local regulatory requirements. The minimum share capital requirement of the Company is TL 5,000,000 as at 31 December 2009. 23 Commitments and contingencies Commitments and contingent liabilities arising in the ordinary course of business comprised the following items for the years ended 31 December: 24 Related party disclosures For the purpose of accompanying financial statements, the shareholders, key management personnel and the Board members, and in each case, together with their families and companies controlled by/affiliated with them; and investments are considered and referred to as the related parties. A number of transactions are entered into with the related parties in the normal course of business. These transactions were carried out on an arms-length basis during the normal course of business. As at 31 December, the Company had the following balances outstanding from its related parties: () Time deposits at Credit Europe Bank Suisse is the fiduciary account of the Company. Credit Europe Bank Suisse make placements of the funds to third parties on behalf of the Company. Other assets Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 24 Related party disclosures (continued) As at 31 December 2009, derivative transactions with related parties are as follows: (*)Accumulative boosted forward transactions are presented with minimum notional amounts. For the years ended 31 December, the transactions with the related parties are summarised below: Notes to the Financial Statements As at and for the Year Ended 31 December (Currency: Turkish Lira ("TL") unless otherwise stated) 24 Related party disclosures (continued) Total benefit of key management for the years ended 31 December 2009 and 2008, amounted to TL 996,497 and TL 1,529,431, respectively. 25 Subsequent event The Company disposed the Irish bond classifed as investments in debt securities at fair value through profit or loss on 4 January 2010 at EUR 23,028,773, which has a cost amounting to EUR 23,005,011.	<urn:uuid:8258288f-f91c-4669-bddf-656a21a71fb9>	CC-MAIN-2018-30	http://fibafaktoring.com.tr/files/faaliyet-raporlari/IFRS31122009.pdf	2018-07-18T06:56:08Z	crawl-data/CC-MAIN-2018-30/segments/1531676590069.15/warc/CC-MAIN-20180718060927-20180718080927-00345.warc.gz	135,101,817	10,944	eng_Latn	eng_Latn	0.960891	eng_Latn	0.994469	[ "unknown", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 19, 130, 334, 446, 3453, 6971, 9878, 13019, 16030, 19321, 22369, 26079, 28270, 29112, 30029, 32621, 34166, 35694, 36562, 38415, 38784, 39015, 39778, 42057, 43185, 45216, 46925, 48441, 50535, 51582, 52669, 53530, 55001, 55452, 55985 ]	[ 0.484375, 0.359375 ]	[ 2.765625, 3.140625 ]	[ 2.015625, 2.3125 ]	[ 2.296875, 2.703125 ]	3	2	HuggingFaceFW/finepdfs
C0-04DA-1 Cut Sheet Technical Specifications Agency Approvals 1-800-633-0405 Page 1 of 1 www.automationdirect.com CLICK analog output module, 4‑channel, current, 12‑bit, output current signal range(s) of 4-20 mA, external 24 VDC required. For complete product information, please see this item on our store at the following link: https://www.automationdirect.com/pn/C0-04DA-1 Document generated April 26, 2024	<urn:uuid:42bd9e71-91a6-4a34-8a4e-9c6d3f92149f>	CC-MAIN-2024-22	https://cdn.automationdirect.com/static/specs/cutsheet/C0-04DA-1_cutsheet.pdf	2024-05-21T23:29:04+00:00	crawl-data/CC-MAIN-2024-22/segments/1715971058522.2/warc/CC-MAIN-20240521214515-20240522004515-00644.warc.gz	137,006,007	120	eng_Latn	eng_Latn	0.545599	eng_Latn	0.545599	[ "eng_Latn" ]	false	docling	[ 418 ]	[ 0.173828125 ]	[ 1.1875 ]	[ 1.1328125 ]	[ 2.40625 ]	1	0	HuggingFaceFW/finepdfs
UNION SCOREBOARD PETITIONS ELECTIONS STRIKES December 1-‐31, 2012 January 1, 2012 – December 31, 2012 Total Petitions For Representation 106 Includes 0 petitions for which the union name is unknown at this time A Year Ago Dec. '11 Petitions 114 Most Active Region Philadelphia 10 Most Active Unions Hall of Shame: Top Decerts Elections Nationally RC Elections Decertifications* All Elections *Includes all RDs&RMs January 1, 2012 – December 31, 2012 Top 10 Unions on Strike New Strikes / Avg. Days Out 163/29 New Workers Affected 112,242 Total Days Lost 2,615,473 Longest Continuing Strikes Reported as continuing on 2-27-13	<urn:uuid:d4831a01-edf2-42b6-8494-cbcbcb67f936>	CC-MAIN-2017-17	http://www.lrionline.com/wp-content/uploads/INK_Scoreboard_Feb_13.pdf	2017-04-30T16:35:29Z	crawl-data/CC-MAIN-2017-17/segments/1492917125719.13/warc/CC-MAIN-20170423031205-00076-ip-10-145-167-34.ec2.internal.warc.gz	591,121,797	246	eng_Latn	eng_Latn	0.825405	eng_Latn	0.825405	[ "eng_Latn" ]	false	docling	[ 655 ]	[ 0.921875 ]	[ 1.2890625 ]	[ 1.0234375 ]	[ 0.25 ]	1	2	HuggingFaceFW/finepdfs
REPORT ON A STUDY OF THE ATTITUDES OF POTENTIAL PARTICIPANTS FROM THE PRIORITY SECTOR OF TOURISM IN THE BORDER REGIONS OF SMOLYAN, BLAGOEVGRAD, HASKOVO AND KARDZHALI TOWARDS THE POSSIBILITY OF SETTING UP AND JOINING A BUSINESS COUNCIL Contents 1. Explanatory Notes This report on the study of the attitudes of potential participants from the priority sector of Tourism in the border regions of Smolyan, Blagoevgrad, Haskovo and Kardzhali towards the possibility of setting up and joining a Business Council is prepared in implementation of Activity 2 and Activity 3 of the Business Council Project – 6275_BC, financed under Subsidy Contact No. B6.3a.18/13.04.2021, Territorial Cooperation Program Interreg V-A Greece – Bulgaria 2014-2020. In the implementation of Activity 2 and Activity 3, all the requirements of the Contracting Authority (Beneficiary) have been met, as we have strictly adhered to the requirements set out in the technical specification and the technical proposal. Due to the interrelatedness between the implementation of Activity 2 and the implementation of Activity 3, a survey of attitudes was carried out at the same time, and the results were combined in this document referred to as Report on a Survey of the Attitudes of Potential Participants from the sector of Tourism in the Border Regions of Smolyan, Blagoevgrad, Haskovo and Kardzhali to the Possibility of Setting up and Joining a Business Council. 2. Introduction In connection with the implementation of Contract No. 3/17.11.2021 and in accordance with the technical specification for the implementation of the public procurement, a selection by public invitation for the following purpose - providing services for the implementation of the Business Council Project – 6275_BC, financed under Subsidy Contact No. B6.3a.18/13.04.2021, a survey was conducted regarding the attitudes of target groups for the setting up and joining a business council. The purpose of the survey was to establish the specific needs, opinions and recommendations of the business representatives in the border areas in order to solve the problems and challenges they face, as well as for the purpose of partnership, which will help the consolidation of the factors influencing entrepreneurial success, stimulate survival of businesses and promote an entrepreneurial culture. As a result, the Contractor has prepared this report, which graphically presents the results of the conducted survey. Based on them, a thorough analysis of the needs and problems of the representatives of the sector of Tourism in the border areas has been made, whilst the main conclusions have been drawn. They should serve as the basis for the work of newly established business councils in the project mentioned above. The target group of the survey, conducted for the needs of the project and used as the basis of this report, are the representatives of the sector of Tourism in the border regions of Blagoevgrad, Smolyan, Haskovo and Kardzhali. It is important to point out that in connection with the implementation of the project, all the business representatives from the various priority sectors were asked the same survey questions, and therefore the same methodology was used. In this respect, the reports have a common methodology part but they differ in their analytical parts. 3. Methodology The study of these attitudes was carried out using the following methods: * A telephone survey; * Filling out a questionnaire in a web-based form; * Organizing individual and group sessions; The survey included representatives of the sector of Tourism in the regions of Smolyan, Blagoevgrad, Haskovo and Kardzhali and the respondents were divided proportionally according to the representatives of the sector in the towns and villages in each region. The questions developed for the purpose of the study were anonymous as they usually have an advantage as the survey participants feel better about sending their personal information to "third parties". Also, anonymous surveys ensure more trust and thus more feedback, and the goal of the survey was to make respondents feel comfortable and secure while providing open and honest feedback. The survey card has been prepared in such a way that it takes as little time as possible to fill in, but gives a realistic idea of the opinions and attitudes of the representatives of the target group. The survey cards contain both specific questions tailored to the target groups and general questions focused on common problems faced by the business representatives. The survey also included questions related to the sector's developmental potential after setting up a business council. The content of the questionnaires includes several types of questions aimed at studying the attitudes towards setting up a business council participation of the target groups in it. They aim to bring more clarity in the following areas: Survey of attitudes towards setting up a business council and its benefits for the business of the representatives; Self-determination of business representatives (to which of the priority sectors they fall) and number of employees; Studying the attitudes of target groups towards their participation in cross-border projects and their cooperation with cross-border partners; What are the main difficulties and problems they often face, including finding manpower; What are their attitudes towards membership in a business council and its functions, role and benefits for the specific priority sector; The questions included in the survey card for the representatives of the sector of Tourism are: of a closed type, those allowing the expression of opinions and those with the option of more than one answer. Having in mind that often in surveys, respondents instinctively mark the first possible answers that are brought to the fore, and to prevent such a possibility, the possible answers are not short and require the respondent to think. This guarantees awareness when the respondents mark the answers and makes the results accurate and reliable. When applying the methodology for the analysis of the collected data, a standard logically determined process was used, which includes the following three main stages: * Collection of initial information and data (the survey); * Analysis of the collected information; * Formulation of evaluation conclusions, comments and recommendations (the preparation of a report); 4. Results and Analysis of the Survey of the Attitudes of Representatives of the sector of Tourism towards Setting up and Participation in a Business Council The respondents from this target group are 156, a group bigger than the other target groups, therefore, the validity of the survey is bigger as the number of representatives is bigger. The comparison of the results will be done on the basis of the number of respondents or distributed in percentages. For the needs of this project, we did a survey with the following questions and received the following answers: As far as question No. 1 is concerned 97.4 % of the representatives in the sector believe that setting up a business council will improve the relationship between businesses and the institutions. Only 2.6% responded negatively as they had already established systematic ways of dealing with the institutions. The results of the first question make it clear that it is difficult for the representatives of the sector to communicate with the representatives of the institutions, therefore, a business council should make the task to improve the communication between the two a priority in order to improve the business climate in the cross-border areas. This question provides a strong and clear approval by the representatives of this target sector that setting up a business council is beneficial and of key importance for its development and will support it. A business council will be a fundamental link between business representatives and institutions. In addition, the business council will potentially improve the business environment in the sector, as it will proactively solve problems. With the help of question No. 2 of the survey, which is an identifying question, we can figure out a representative of which of the project priority sectors has filled out the web-based survey. As we have mentioned above, there are 156 representatives of the sector of Tourism. По отношение на отговорите на въпрос № 3 е видно, че масово в сектор Туризъм са заети от 1 до 10 души, като 92,7 % от анкетираните са потвърдили тези данни. Други 6.2 % имат наети от 11 до 50 служители. Над 50 наети служители имат само 1.1% от представителите на сектора. Това се дължи на факта, че в фирмите работещи в сектора са предимно малки или средни предприятия. Regarding the answers to question No. 3, it is evident that 1 to 10 people are mostly employed in the sector of Tourism as 92,7 % have confirmed these data. Other 6.2 % employ from 11 to 50 people. Those who have more than 50 employees are 1.1%. This is because the companies in this sector are mainly small or medium-sized ones. The respondents run mainly fast food restaurants, restaurants, cafes, guest houses, small hotels, etc. It is important to note that the surveys were sent proportionally to representatives of the sector from all priority areas, and according to the answers to question #4 it is clear that the largest share of the surveyed representatives of the sector of Tourism falls on the district of Blagoevgrad with 38.7%, due to the fact that with a web-based survey, the observance of an exact proportion is impossible since the recipients of the survey have also shared it with other representatives of this branch. The region of Smolyan comes close second with 32.3 %, followed by the region of Haskovo with 17.7% and the region of Kardzhali with 11.3%. The responses to question No. 5 77.4% of the representatives of the sector of Tourism gave a negative answer regarding their participation in cross-border projects, and only 22.6% gave a positive answer. The reason for these responses can be found in the lack of training and information. This is unequivocal evidence that one of the issues that the business council should consider is providing an awareness environment and training for the participation in projects under various operational programs and European funds, as well as looking for partners in cross-border areas from the same management sector. It is important to note that there is a possibility that the representatives of the sector have not participated in cross-border projects, since in Bulgaria there have been purposeful efforts to support small and medium-sized businesses, through programs of the Agriculture Fund, including funding local initiative groups and private projects of the representatives of the sector and/or other financial donors. Therefore, it is necessary for the newly formed business council to set clear boundaries and activate and direct its members to get involved in those programs from which the development of these businesses would benefit. This should include disseminating information through various information channels and/or brochures about the benefits of cross-border projects, which are particularly important for the development of border areas. Regarding question No. 6, which aims at measuring the attitudes of the representatives of the sector of Tourism towards cooperating with foreign partners. It is evident that a large number of these representatives are open to partnerships and cooperation with foreign representatives in their sphere of management, i.e. 61 representatives of this target group. In the second place 55 of the respondents have indicated that they do not need foreign partnerships and lastly, 40 people replied that they already work with foreign business representatives and are also open to new work with new partners. The representatives who are not willing to engage in partnerships outline a priority activity of a business council, i.e. focusing their efforts on building partnerships, both witesh business councils in Greece and as well as expanding partnerships within the European Union. A functional business council could work to create the right business environment in which business representatives seek and find partner organizations from their sphere of management and, accordingly, help to create partner relationships and joint work. According to the conducted survey 61 representatives of the sector of Tourism think that the main difficulties for them are the slow administrative service, the lack of awareness of the problems facing businesses and the lack of consultation with the businesses when formulating the policies that affect their development. In the second position 45 representatives view high local taxes and fees as a difficulty, followed by lack of specific expertise on specific business matters (29). Other 28 consider the lack of electronic management as a difficulty. The last two positions are taken by the difficult access to executives in the institutions (20) and unfriendly administration (15). The results obtained from this question should be the starting point for one of the main priorities of the business council, namely, to improve the behavior of the administration by giving feedback and recommendations, thus increasing the trust of businesses towards the administration. Another major problem in the joint work between businesses and the administration is the lack of trust in the representatives of the executive and local authorities. This hinders the companies' initiative and demotivates them to take an active part in the process. On the other hand, this contributes to the buildup of attitudes of the type "there is no point in such cooperation". This, combined with lobbying practices and the lack of invitations to participate in the decision-making process, completes the picture of the most common obstacles to good cooperation between businesses and administration. A business council should aim at changing precisely these attitudes of business representatives. Therefore, a business council could require the district administrations to include business representatives in the discussions at the earliest possible stage, when their participation would have the greatest effect on the policies made and the management decisions made, and, in addition, require feedback about the progress made on the topics and issues discussed. Day-to-day communication, coordination and management of the partnership will ensure the necessary smoothing of differences and the achievement of better mutual understanding between the participating organizations. Clear and transparent mechanisms of interaction with the administration are the key to more active involvement of businesses in the process of articulating public policies. Receiving information from the administration about the measures taken in response to certain proposals is also an important element that influences the commitment of the representatives of the sector. It is also necessary to create a form of permanent partnership between businesses and the administration in order to have visible results in terms of the development of the sector. Question No. 8 also provided the possibility of marking more than one answer. T he results of the survey place two responses with the same frequency (61) in the first place namely entering new markets and offering new products. 50 representatives of the sector of Tourism plan to participate in projects with European and/or national funding, followed by investment in innovations and brands (30), loans and leasings (16), increasing the number of job positions (14), raising wages (12) and lastly increasing the volume of production (10). In the context of the survey results described above, a business council will be a developmental tool that provides the framework for dialogue and activation of stakeholders around an economic or social problem, working towards its solution. We might be able to explain reasonable the large number of those willing to raise the wages of their emploees or increase the volume of their work as a result of crisis caused by the corona virus infection. Unfortunately, the tourist industry was one the first sectors that had to close down in managing the pandemic crisis. Although the state provided financial support through various measures for coping with the crisis a number of representatives of small and medium-sized businesses are under financial stress. A Business council should put its efforts in identifying the urgent needs and present them to the authorities at local and national level in view of their help. The interviewed representatives of the sector of Tourism in the border regions of Smolyan, Haskovo, Kardzhali and Blagoevgrad expect representatives of the institutions to provide them mainly with information about the possibilities for financing and/or assistance through various financial donors and about the business environment and new legislation (61), another large group of respondents (45) would like to receive consulting services from the institutions and assistance in mediation with national and European bodies and institutions. A portion of the respondents expect assistance with training (42), and only 10 would like assistance when looking for partners at the local and international markets Taking these data into account, the business council can set itself the goal of negotiating with municipal and/or regional administrations in the priority areas for assistance and conducting training for beneficiaries under the various programs, regardless of the type of funding, as well as assisting its members in the preparation of project proposals with the help of experts from the municipal administrations or through building long-term relationships with the local initiative groups in the various regions. The business council could build clear and transparent mechanisms by organising permanent working groups, holding meetings and informing and training target groups on how to interact and how to set realistic goals and expectations for the partnership process. This will guarantee not only the interested parties being proactive, but also the sustainability of the cooperation processes. The representatives of the sector of Tourism believe that a business council could be useful in providing services and protection of the interests of the target groups in labour mediation and labour legislation (61), accessing funding (61) and solving administrative obstacles and problems (61), assistance against administrative arbitrariness (57), help in digitalisation (43), assistance in establishing partnership relationships with local and foreign representatives (40). In the context of the answers received, a business council can set such goals as: facilitating the training processes and exchanging experiences in order to become familiar with the regulatory framework, creating relationships with the administartion to minimise its arbitrariness and foster their cooperation in solving problems within their expertise. According to the answers to question No. 11, half of the representatives of the sector of Tourism in the border regions of Smolyan, Blagoevgrad, Kardzhali and Haskovo or 49.6% are experiencing difficulty in finding workers. Second come those representatives of the target groups who can find workers easily or 27.2%, others 23.2% can find workers easily, but experience great difficulties in keeping them. One the one hand the results described above indicate that the lack of manpower for businesses is among the main problems in these priority sectors. A large proportion of these sectors have shortages of qualified workers. This shortage is getting worse more and more noticeable due to the pandemic, and the trend of lack of qualified work force is becoming one of the main challenges for businesses. Therefore, a business council can set itself the goal of initiating a dialogue with the representatives of the sector, which should say what kind of specialists it needs and, accordingly, bring this to the attention of the relevant institutions and/or universities. Those employed in this sector do not stay there long and leave as the work is not permanent which is directly linked to the restrictions during the crisis. A Business council should conduct an investigation among the people employed in this sectors, collate their problems and bring this to the attention of the relevant institutions. From the answers to question No. 12, it is clear that a very large part of the business representatives believe that by implementing a partnership with foreign representatives they could improve their sector and they may take actions in this direction (89.6%). A relatively small part of the respondents – 10.4% - answered negatively and would not like to take actions in the direction of partnership with foreign representatives. In the context of the above and the request for partnerships from the majority of the surveyed target groups, it is important to mention that the creation of a partnership is a long and difficult process that requires the partners to share resources and assets (time, knowledge and efforts). In relation to the above issue, a business council will engage in specific actions aimed at liasing individuals from the private sector with foreign ones on the principle of equality; joint work on defining and tracking the achievement of common goals; building on and complementing each other's positive sides and assets for a stronger partnership; work with the business council in Greece, etc According to the answers received to question No. 13, 69%of the surveyed representatives of the target group would become members of a Business Council in order to support the development of their businesses in the border areas, 31% would not participate in such a council. The reason for the negative answers can be found in the lack of coviction that there can be collaboration between the institutions and the business council and uncertainty that there could be an environment in which the various participants would work together. A Business Council should focus its efforts at showing that such collaboration is possible by using the opportunity to invite representatives of local authorities to attend its meetings, immediately listen to the problems and ensure personal commitment to their solution. As a whole the attitudes towards participating in a business council are positive but once it is set up it should aim at changing the negative opinions as it is the participation in such a council that can improve the situation in the sector. This question also could have multiple answers. As to the responses of the target groups to what they expect the powers of a business council should be, there are 4 answers with the same frequency - the business council should assist businesses in solving current issues (61), support and defend causes which would lead to the development of the sector at the cross-border level (61), cooperate with the business councils in Greece (60) and assist businesses by referring certain issues to the relevant institutions (59). What follow are making the problems of their businesses heard, if necessary using the mass media (40), holding regular meetings at which the problems would be heard (31) and lastly, if needed, to initiate changes in regulatory framework (17). Based on the results described above, there is a clear trend that the target groups expect the business council to have a broad key role. In this line of thinking, the business representatives need a community that stands behind them in all difficulties, supporting them adequately for any crisis situation they might face. The results of question #15, which allows multiple answers, are as follows – 61 respondents would like a business council to have the power to approve strategies for the development of businesses at the local level; 55 respondents would like a business council to organise training, seminars, information events about innovations and knowhow; 42 of the representatives demand that a business council have power to actively interact with public mediators and take part in the discussions of the municipal budgets in the region; 30 of the respondents would like a business council to be able to express opinions on issues concerning the development of businesses at the local level to the competent institutions; 26 of the respondents would like a business council to provide administrative assistance to the businesses in its communication with institutions about certain issues and problems; 19 people would prefer a business council to refer their business problems to the municipal councils in the region of the business council and lastly – to participate in the exchange of experiences and good practices in the crossborder region (14) and to participate actively in the development of regional and municipal strategic and planning documents (12). All the powers of a business council marked in the survey are possible to implement, and through their implementation, the representatives of the sector will be represented to the institutions, and it can work purposefully to support them on various topics. The responses to question #16 outline a main difficulty facing the representatives (61), i.e. the lack of qualified workers. The lack of industrial zones comes second (60), followed by access to financing (55); the lack of transport connectivity (40), the lack of transport connectivity (48), the lack of good infrastructure (29). The lack of knowledge of the instruments of the European funds and programs comes last (15). The results of the responses show that the sector is experiencing difficulties in many different directions, i.e. the business council should cover a wide range of problematic situations without limiting itself to specific ones and provide diverse support of the sector of Tourism. In connection with the above a business council will aim to assist the sector in all difficulties it is facing, including organizing training and encouraging life-long learning to address labour shortages. It will mediate between the representatives of the sector and the institutions, proposing specific projects and it could initiate meetings with various executives to improve transport connectivity and/or other infrastructure necessary for the development of the specific sector. In addition to the above, the business council will offer informational materials and/or organise training in order to acquaint the target groups with the tools of the European funds and programs, including inviting speakers/experts from the municipalities or local initiative groups. 5. Conclusions based on the survey of the sector of Tourism in the districts of Smolyan, Kardzhali, Haskovo and Blagoevgrad regarding the setting up of a Business Council The impact processes between business representatives and institutions are complex and multi-layered. Within the framework of the conducted survey of the attitudes towards the setting up and participation of the target group in a business council, several main points have been highlighted: 6. Conclusion Setting up a business council aims to improve the business climate by interacting with all stakeholders involved in the development of the sector. The business council will be guided entirely by the desire to build conditions for proper market relations, confirm lasting partnership relations in the cross-border region, interact with institutions and comply with the requirements of good European development practices. The business council will provide consulting, information and other types of services to the companies/enterprises that are members of it. The members of the management board will be ready to investigate any business issues that may arise and take appropriate legal action to protect the interests of the business representatives united in the business council.	<urn:uuid:c04399eb-134e-4963-83d2-05228921458d>	CC-MAIN-2024-30	https://www.bcouncil.eu/wp-content/uploads/2023/02/6__EN_1-1.pdf	2024-07-23T09:12:06+00:00	crawl-data/CC-MAIN-2024-30/segments/1720763518029.81/warc/CC-MAIN-20240723072353-20240723102353-00664.warc.gz	551,707,380	5,234	eng_Latn	eng_Latn	0.915612	eng_Latn	0.997575	[ "eng_Latn", "unknown", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "bul_Cyrl", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 235, 245, 2770, 4929, 6874, 8305, 9214, 9862, 11214, 12203, 13617, 15284, 16586, 17976, 19197, 20272, 21510, 22544, 23881, 25297, 26594, 27344, 28144 ]	[ 0.7578125, 0.83203125 ]	[ 2.921875, 3.578125 ]	[ 2.671875, 2.9375 ]	[ 2.09375, 2.453125 ]	1	0	HuggingFaceFW/finepdfs
Powered by TCPDF (www.tcpdf.org) ALSTON, Clarendon Listing details Common Listing name: ALSTON, Clarendon Price: JMD 14,500,000 Description: 5 acres of fertile, verdant land sits on 2 adjoining lots being sold together. A developer's dream. On this property sit a 2 bedroom,1 bathroom house, which can hold workmen whilst construction is being done.Call today for your viewing Square Feet: ft Lot Size: 152460 ft Garage: No Furnished: No Location Country: Jamaica Address: ALSTON Agent Info Name: CLAUDETTE TAYLOR First Name: CLAUDETTE Last Name: TAYLOR Phone: 876-368-0543 page 1 / 1	<urn:uuid:0cc87134-8c29-4725-9531-cf06c3cb74fa>	CC-MAIN-2020-24	https://www.realestatecari.com/jamaica/pdf-export.html?listingID=9470	2020-05-30T05:51:34+00:00	crawl-data/CC-MAIN-2020-24/segments/1590347407289.35/warc/CC-MAIN-20200530040743-20200530070743-00392.warc.gz	906,422,053	180	eng_Latn	eng_Latn	0.9244	eng_Latn	0.9244	[ "eng_Latn" ]	false	docling	[ 614 ]	[ 0.310546875 ]	[ 0.890625 ]	[ 0.87890625 ]	[ 1.7578125 ]	1	1	HuggingFaceFW/finepdfs
33-38-1. The purpose of this chapter is to protect policy owners, insureds, beneficiaries, annuitants, payees, and assignees of life insurance policies, health insurance policies, annuity contracts, and supplemental contracts, subject to certain limitations, against failure in the performance of contractual obligations due to the impairment or insolvency of the insurer issuing such policies or contracts. To provide this protection, (1) an association of insurers is created to enable the guaranty of payment of benefits and continuation of coverages, (2) members of the association are subject to assessment to provide funds to carry out the purpose of this chapter, and (3) the association is authorized to assist the Commissioner, in the prescribed manner, in the detection and prevention of insurer impairments or insolvencies. 33-38-2. (a) This chapter shall provide coverage to the persons specified in subsection (b) of this Code section for direct, nongroup life, health, annuity, and supplemental policies or contracts, for certificates under direct group policies and contracts, and for unallocated annuity contracts issued by member insurers, except as limited by this chapter. Annuity contracts and certificates under group annuity contracts include, but are not limited to, guaranteed investment contracts, deposit administration contracts, unallocated funding agreements, allocated funding agreements, structured settlement agreements, lottery contracts, and any immediate or deferred annuity contracts. (b) Coverage under this chapter shall be provided only: (1) To persons who, regardless of where they reside, except for nonresident certificate holders under group policies or contracts, are the beneficiaries, assignees, or payees of the persons covered under paragraph (2) of this subsection; and (2) To persons who are owners of or certificate holders under such policies or contracts or, in the case of unallocated annuity contracts, to the persons who are the contract holders and who: (A) Are residents; or (B) Are not residents, but only under all of the following conditions: (i) The insurers which issued such policies or contracts are domiciled in this state; (ii) Such insurers never held a license or certificate of authority in the states in which such persons reside; (iii) Such states have associations similar to the association created by this article; and (iv) Such persons are not eligible for coverage by such associations. (c) This chapter shall not apply to: (1) That portion or part of a variable life insurance or variable annuity contract not guaranteed by an insurer; (2) That portion or part of any policy or contract under which the risk is borne by the policyholder; (3) Any policy or contract or part thereof assumed by the impaired or insolvent insurer under a contract of reinsurance, other than reinsurance for which assumption certificates have been issued; (4) Any policy, contract, certificate, or subscriber agreement issued by a nonprofit hospital service corporation referred to in Chapter 19 of this title, a health care plan referred to in Chapter 20 of this title, a nonprofit medical service corporation referred to in Chapter 18 of this title, a prepaid legal services plan, as defined in Code Section 33-35-2, and a health maintenance organization, as defined in Code Section 33-21-1; (5) Any policy, contract, or certificate issued by a fraternal benefit society, as defined in Code Section 33-15-1; (6) Accident and sickness insurance as defined in Code Section 33-7-2 when written by a property and casualty insurer as part of an automobile insurance contract; (7) Any unallocated annuity contract issued to an employee benefit plan protected under the federal Pension Benefit Guaranty Corporation; or (8) Any portion of any unallocated annuity contract which is not issued to or in connection with a specific employee, union, or association of natural persons benefit plan. 33-38-3. This chapter shall be liberally construed to effect the purpose set forth in Code Section 33-38-1, which Code section shall constitute an aid and guide to interpretation. 33-38-4. As used in this chapter, the term: (1) 'Account' means any of the two accounts created under Code Section 33-38-5. (2) 'Affiliate' means any person that directly, or indirectly through one or more intermediaries, controls, is controlled by, or is under common control with the person specified. (3) 'Association' means the Georgia Life and Health Insurance Guaranty Association created under Code Section 33-38-5. (4) 'Contractual obligation' means any obligation under covered policies or contracts. Notwithstanding any other provision of this chapter, 'contractual obligation' shall not include a claim filed after the final date set by the court for the filing of claims against the liquidator or other such court appointed authority. (5) 'Control' or 'controlled' means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise. (6) 'Covered policy' means any policy or contract within the scope of this chapter under Code Section 33-38-2. (7) 'Health insurance' means accident and sickness insurance, as that class of insurance is defined in Code Section 33-7-2. (8) 'Impaired insurer' means a member insurer deemed by the Commissioner on or after July 1, 1981, to be potentially unable to fulfill its contractual obligations but not an insolvent insurer. (9) 'Insolvent insurer' means a member insurer against which a final order of liquidation containing a finding of insolvency has been entered by a court of competent jurisdiction on or after July 1, 1981. (10) 'Member insurer' means any insurer which is licensed or which holds a certificate of authority to transact in this state any kind of insurance for which coverage is provided under Code Section 33-38-2 and includes any insurer whose license or certificate of authority in this state may have been suspended, revoked, not renewed, or voluntarily withdrawn, but does not include: (A) A nonprofit hospital or medical service corporation; (B) A health care corporation; (C) A health maintenance organization; (D) A fraternal benefit society; (E) A mandatory state pooling plan; (F) A mutual assessment company or any entity that operates on an assessment basis; (G) An insurance exchange; or (H) Any entity similar to those described in subparagraphs (A) through (G) of this paragraph. (11) 'Person' means any individual, corporation, partnership, association, or voluntary organization. (12) 'Premiums' means direct gross insurance premiums and annuity considerations received on covered policies, less return premiums and considerations thereon and dividends paid or credited to policyholders on such direct business. The term 'premiums' does not include premiums and considerations on contracts between insurers and reinsurers. The term 'premiums' does not include any premiums in excess of $5 million on any unallocated annuity contract. (13) 'Resident' means any person who is domiciled in this state at the time a member insurer is determined to be an impaired or insolvent insurer and to whom contractual obligations are owed. A person may be a resident of only one state, which, in the case of a person other than a natural person, shall be its principal place of business. 33-38-5. (a) There is created a nonprofit, unincorporated association to be known as the Georgia Life and Health Insurance Guaranty Association. All member insurers shall be and remain members of the association as a condition of their authority to transact insurance in this state. The association shall perform its functions under the plan of operation established and approved under Code Section 33-38-8 and shall exercise its powers through a board of directors established under Code Section 33-38-6. (b) The association shall come under the immediate supervision of the Commissioner and shall be subject to the applicable provisions of the insurance laws of this state. (c) For purposes of administration and assessment, the association shall maintain two accounts: (1) the health insurance account; and (2) the life insurance and annuity account. The life insurance and annuity account shall contain three subaccounts: (A) the life insurance account; (B) the annuity account; and (C) the unallocated annuity account which shall include contracts qualified under Section 403(b) of the United States Internal Revenue Code. (d) For purposes of assessment, supplementary contracts shall be covered under the account in which the basic policy is covered. 33-38-6. (a) The board of directors of the association shall consist of seven members and shall at all times contain at least one member from a domestic insurer. The members, who shall not be considered employees of the Insurance Department, shall be appointed as follows: (1) The Commissioner shall compile a list of the two stock insurers most likely to incur the largest assessment, per insurer, for each of the accounts under Code Section 33-38-5; he shall compile a list of the two nonstock insurers most likely to incur the largest assessment, per insurer, for each of the accounts under Code Section 33-38-5; and he shall compile a list of the two domestic insurers, either stock or nonstock, most likely to incur the largest assessment, for each of the accounts listed under Code Section 33-38-5. The Commissioner shall solicit from these 18 insurers the names of 18 individuals as nominees for members to the board of directors. The Commissioner shall thereupon separately certify in writing the nominations from stock and nonstock insurers and separately for each account; (2) From the nominations so certified for each such account, the Commissioner shall appoint one stock member and one nonstock member to the board of directors until six directors have been appointed. Then the Commissioner shall appoint from the remaining nominations the chairman of the board who shall also be its chief executive; and (3) In approving selections or in appointing members to the board, the Commissioner shall consider, among other things, whether all member insurers are fairly represented. (b) Any member may be removed from office by the Commissioner when, in his judgment, the public interest may so require. (c) Each member so appointed shall serve for a term of three years and until his successor has been appointed and qualified. (d) If there occurs, for any reason, a vacancy in the board of directors, the Commissioner shall appoint a member to fill the unexpired term of office from the nominations as heretofore described. (e) Members of the board may be reimbursed from the assets of the association for reasonable expenses incurred by them in their capacity as members of the board of directors, but members of the board shall not otherwise be compensated by the association for their services. 33-38-7. In addition to the powers and duties enumerated elsewhere in this chapter, the association shall have the following powers and duties: (1) Whenever a domestic insurer is an impaired insurer, the association, subject to any conditions, other than those conditions which impair the contractual obligations of the impaired insurer, imposed by the association and approved by the impaired insurer and the Commissioner, may: (A) Guarantee or reinsure, or cause to be guaranteed, assumed, or reinsured, any or all of the covered policies of the impaired insurer; (B) Provide such moneys, pledges, notes, guarantees, or other means as are proper to effectuate subparagraph (A) of this paragraph and assure payment of the contractual obligations of the impaired insurer pending action under subparagraph (A) of this paragraph; and (C) Loan money to the impaired insurer; (2) Whenever a domestic insurer is an insolvent insurer, the association shall, subject to the approval of the Commissioner: (A) Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or reinsured, the covered policies of the insolvent insurer; (B) Assure payment of the contractual obligations of the insolvent insurer; and (C) Provide such moneys, pledges, notes, guarantees, or other means as are reasonably necessary to discharge such duties; (3) Whenever a foreign or alien insurer is an insolvent insurer, the association shall, subject to the approval of the Commissioner: (A) Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or reinsured, the covered policies of residents; (B) Assure payment of the contractual obligations of the insolvent insurer to residents; and (C) Provide such moneys, pledges, notes, guarantees, or other means as are reasonably necessary to discharge such duties. This paragraph shall not apply where the Commissioner has determined that the foreign or alien insurer’s domiciliary jurisdiction or state of entry provides protection by statute substantially similar to that provided by this chapter for residents of this state; (4)(A) In carrying out its duties under paragraphs (2) and (3) of this Code section, the association may impose permanent policy liens or contract liens in connection with any guarantee, assumption, or reinsurance agreement if the court: (i) Finds that the amounts which can be assessed under this chapter are less than the amounts needed to assure full and prompt performance of the insolvent insurer’s contractual obligations or that the economic or financial conditions as they affect member insurers are sufficiently adverse to render the imposition of policy or contract liens to be in the public interest; and (ii) Approves the specific policy liens or contract liens to be used. (B) Before being obligated under paragraphs (2) and (3) of this Code section, the association may request that there be imposed temporary moratoriums or liens on payments of cash values and policy loans in addition to any contractual provisions for deferral of such cash value payments or policy loans. Such temporary moratoriums and liens may be imposed if they are approved by a court of competent jurisdiction; (5) If the association fails to act within a reasonable period of time, as provided in paragraphs (2) and (3) of this Code section, the Commissioner shall have the powers and duties of the association under this chapter with respect to insolvent insurers; (6) Upon his request, the association may render assistance and advice to the Commissioner concerning rehabilitation, payment of claims, continuance of coverage, or the performance of other contractual obligations of any impaired or insolvent insurer; (7) The association shall have standing to appear before any court in this state with jurisdiction over an impaired or insolvent insurer concerning which the association is or may become obligated under this chapter. Such standing shall extend to all matters germane to the powers and duties of the association, including but not limited to proposals for reinsuring or guaranteeing the covered policies of the impaired or insolvent insurer and the determination of the covered policies and contractual obligations; (8)(A) Any person receiving benefits under this chapter shall be deemed to have assigned the rights under the covered policy to the association to the extent of the benefits received because of this chapter, whether the benefits are payments of contractual obligations or continuation of coverage. The association may require an assignment to it of such rights by any payee, policy or contract owner, beneficiary, insured, or annuitant as a condition precedent to the receipt of any rights or benefits conferred by this chapter upon such person. The association shall be subrogated to these rights against the assets of any insolvent insurer. (B) The subrogation rights of the association under this paragraph shall have the same priority against the assets of the insolvent insurer as that possessed by the person entitled to receive benefits under this chapter; (9) The contractual obligations of the insolvent insurer for which the association becomes or may become liable shall be as great as, but no greater than, the contractual obligations of the insolvent insurer would have been in the absence of an insolvency, unless such obligations are reduced as permitted by paragraph (4) of this Code section. With respect to any one contract holder covered by an unallocated annuity contract, the association shall be liable for not more than $5 million in benefits irrespective of the number of such contracts held by that contract holder. With respect to any other covered policy, the aggregate liability of the association on any one life shall not exceed $100,000.00 with respect to the payment of cash values or $300,000.00 for all benefits including cash values; provided, however, that with respect to claims under policies written to provide benefits as required under Chapter 9 of Title 34, relating to workers’ compensation, such claims shall be in the full amount as provided by such chapter; and (10) The association may: (A) Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this chapter; (B) Bring or defend actions, including taking any legal actions necessary or proper for recovery of any unpaid assessments under Code Section 33-38-15; (C) Borrow money to effect the purposes of this chapter. Any notes or other evidence of indebtedness of the association not in default shall be legal investments for domestic insurers and may be carried as admitted assets; (D) Employ or retain such persons as are necessary to handle the financial transactions of the association and to perform such other functions as become necessary or proper under this chapter; (E) Negotiate and contract with any liquidator, rehabilitator, conservator, or ancillary receiver to carry out the powers and duties of the association; (F) Take such legal action as may be necessary to avoid payment of improper claims; and (G) Exercise, for the purposes of this chapter and to the extent approved by the Commissioner, the powers of a domestic life or health insurer; but in no case may the association issue insurance policies or annuity contracts other than those necessary to perform the contractual obligations of the impaired or insolvent insurer. 33-38-8. (a) The association shall submit to the Commissioner a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon approval in writing by the Commissioner. If the association fails to submit a suitable plan of operation within 180 days following July 1, 1981, or, if at any time thereafter the association fails to submit suitable amendments to the plan, the Commissioner shall, after notice and hearing, adopt and promulgate such reasonable rules as are necessary or advisable to effectuate the provisions of this chapter. Such rules shall continue in force until modified by the Commissioner or superseded by a plan submitted by the association and approved in writing by the Commissioner. (b) All member insurers shall comply with the plan of operation. (c) The plan of operation shall, in addition to requirements enumerated elsewhere in this chapter: (1) Establish procedures for handling the assets of the association; (2) Establish the amount and method of reimbursing members of the board of directors under Code Section 33-38-6; (3) Establish regular places and times for meetings of the board of directors; (4) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors; (5) Establish any additional procedures for assessments under Code Section 33-38-15; and (6) Contain additional provisions necessary or proper for the execution of the powers and duties of the association. 33-38-9. The plan of operation described in Code Section 33-38-8 may provide that any or all powers and duties of the association, except those under subparagraph (C) of paragraph (10) of Code Section 33-38-7 and Code Section 33-38-15, shall be delegated to a corporation, association, or other organization which performs or will perform functions similar to those of this association or its equivalent in two or more states. Such a corporation, association, or organization shall be reimbursed for any payments made on behalf of the association and shall be paid for its performance of any function of the association. A delegation under this Code section shall take effect only with the approval of both the board of directors and the Commissioner and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided for by this chapter. 33-38-10. In addition to the duties and powers enumerated elsewhere in this chapter: (1) The Commissioner shall: (A) Upon request of the board of directors, provide the association with a statement of the premiums in the appropriate states for each member insurer; and (B) When an impairment is declared and the amount of the impairment is determined, serve a demand upon the impaired insurer to make good the impairment within a reasonable time. Notice to the impaired insurer shall constitute notice to its shareholders, if any. The failure of the insurer to comply promptly with such demand shall not excuse the association from the performance of its powers and duties under this chapter; and (2) The Commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. 33-38-11. Records shall be kept of all negotiations and meetings in which the association or its representatives are involved to discuss the activities of the association in carrying out its powers and duties under Code Section 33-38-7. Records of such negotiations or meetings shall be made public only upon the termination of a liquidation, rehabilitation, or conservation proceeding involving the impaired or insolvent insurer, upon the termination of the impairment or insolvency of the insurer, or upon the order of a court of competent jurisdiction. Nothing in this Code section shall limit the duty of the association to render a report of its activities under Code Section 33-38-12. 33-38-12. The association shall be subject to examination and regulation by the Commissioner. The board of directors shall submit to the Commissioner not later than May 1 of each year a financial report and a report of its activities for the preceding calendar year on forms approved by the Commissioner. 33-38-13. The association shall be exempt from all taxation in this state based upon income or gross receipts and shall likewise be exempt from all state and local occupation license and business fees and occupation license and business taxes. 33-38-14. There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the Commissioner or his representatives, for any action taken by them in the performance of their powers and duties under this chapter. 33-38-15. (a) For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers separately for the health account and for each subaccount of the life insurance and annuity account at such time and for such amounts as the board finds necessary. Assessment shall be due not less than 30 days after prior written notice to the member insurers. (b) There shall be two classes of assessments, as follows: (1) Class A assessments shall be made for the purpose of meeting administrative costs and other general expenses not related to a particular impaired or insolvent insurer, and examinations conducted under the authority of subsection (c) of Code Section 33-38-16; and (2) Class B assessments shall be made to the extent necessary to carry out the powers and duties of the association under Code Section 33-38-7 with regard to an impaired or insolvent insurer. (c)(1) The amount of any Class A assessment shall be determined by the board of directors and may be made on a pro rata or non-pro rata basis. If a Class A assessment is made on a pro rata basis, the board may provide that it be credited against future Class B assessments. An assessment for costs and expenses other than for examinations which is made on a non-pro rata basis shall not exceed $150.00 per company in any one calendar year. The amount of any Class B assessment shall be allocated for assessment purposes among the accounts or subaccounts in subsection (c) of Code Section 33-38-5 pursuant to an allocation formula which may be based on the premiums or reserves of the impaired or insolvent insurer or any other standard deemed by the board in its sole discretion as being fair and reasonable under the circumstances. (2) Class B assessments against member insurers for each account or subaccount shall be in the proportion that the premiums received on business in this state by each assessed member insurer on policies or contracts covered by each account or subaccount for the three most recent calendar years for which information is available preceding the year in which the insurer became impaired or insolvent, as the case may be, bears to such premiums received on business in this state for such calendar years by all assessed member insurers. (3) Assessments for funds to meet the requirements of the association with respect to an impaired or insolvent insurer shall not be made until necessary to implement the purposes of this chapter. Classification of assessments under subsection (b) of this Code section and computation of assessments under this subsection shall be made with a reasonable degree of accuracy, recognizing that exact determinations may not always be possible. (d) The association may abate or defer in whole or in part the assessment of a member insurer if, in the opinion of the board of directors, payment of the assessment would endanger the ability of the member insurer to fulfill its contractual obligations. In the event an assessment against a member insurer is abated or deferred in whole or in part, the amount by which such assessment is abated or deferred may be assessed against the other member insurers in a manner consistent with the basis for assessments set forth in this Code section. (e)(1) The total of all assessments upon a member insurer for each account shall not in any one calendar year exceed 2 percent of such insurer’s premiums received in this state on the policies covered by the account during the calendar year preceding the assessment. If the maximum assessment in any account, together with the other assets of the association, does not provide in any one year in such account an amount sufficient to carry out the responsibilities of the association, the necessary additional funds shall be assessed as soon thereafter as permitted by this chapter. (2) The total of all assessments upon a member insurer for each subaccount of the life insurance and annuity account shall not in any one calendar year exceed 2 percent of such insurer’s premiums received in this state on the policies covered by the subaccount during the calendar year preceding the assessment. If the maximum assessment for any subaccount of the life insurance and annuity account in any one year does not provide an amount sufficient to carry out the responsibilities of the association, then the board shall assess the other subaccounts of the life insurance and annuity account for the necessary additional amount up to the maximum assessment level provided in paragraph (1) of this subsection. (f) The board may, by an equitable method as established in the plan of operation, refund to member insurers, in proportion to the contribution of each insurer to that account or subaccount, the amount by which the assets of the account or subaccount exceed the amount the board finds is necessary to carry out the obligations of the association during the coming year with regard to that account or subaccount, including assets accruing from net realized gains and income from investments. A reasonable amount may be retained in any account or subaccount to provide funds for the continuing expenses of the association and for future losses if the board determines that refunds are impractical. (g) It shall be proper for any member insurer in determining its premium rates and policy owner dividends as to any kind of insurance within the scope of this chapter to consider the amount reasonably necessary to meet its assessment obligations under this chapter. (h) The association shall issue to each insurer paying an assessment under this chapter, other than a Class A assessment, a certificate of contribution, in a form prescribed by the Commissioner for the amount of the assessment paid. All outstanding certificates shall be of equal dignity and priority without reference to amounts or dates of issue. A certificate of contribution may be shown by the insurer in its financial statement as an asset in such form, for such an amount and for such period of time, not to exceed five years from the date of assessment, as the Commissioner may approve. 33-38-16. (a) The board of directors may, upon majority vote, make reports and recommendations to the Commissioner upon any matter germane to the solvency, liquidation, rehabilitation, or conservation of any member insurer, or to the solvency of any company seeking to do an insurance business in this state. Such reports and recommendations shall not be considered public documents. (b) It shall be the duty of the board of directors, upon majority vote, to notify the Commissioner of any information indicating any member insurer may be an impaired or insolvent insurer. (c) The board of directors may, upon majority vote, request that the Commissioner order an examination of any member insurer which the board in good faith believes may be an impaired or insolvent insurer. Within 30 days of the receipt of such request, the Commissioner shall begin such examination. The examination may be conducted as a National Association of Insurance Commissioners’ examination or may be conducted by such persons as the Commissioner designates. The cost of such examination shall be paid by the association and the examination report shall be treated the same as other examination reports. In no event shall such examination report be released to the board of directors prior to its release to the public, but this shall not preclude the Commissioner from complying with subsection (a) of this Code section. The Commissioner shall notify the board of directors when the examination is completed. The request for an examination shall be kept on file by the Commissioner, but it shall not be open to public inspection prior to the release of the examination report to the public. (d) The board of directors may, upon majority vote, make recommendations to the Commissioner for the detection and prevention of insurer insolvencies. (e) The board of directors shall, at the conclusion of any insurer insolvency in which the association was obligated to pay covered claims, prepare a report to the Commissioner containing such information as it may have in its possession bearing on the history and causes of such insolvency. The board shall cooperate with the board of directors of guaranty associations in other states in preparing a report on the history and causes of insolvency of a particular insurer and may adopt by reference any report prepared by such other associations. 33-38-17. (a) For the purpose of carrying out its obligations under this chapter, the association shall be deemed to be a creditor of the impaired or insolvent insurer to the extent of the assets attributable to covered policies, reduced by any amounts to which the association is entitled as subrogee pursuant to paragraph (8) of Code Section 33-38-7. All assets of the impaired or insolvent insurer attributable to covered policies shall be used by the association to continue all covered policies and pay all contractual obligations of the impaired or insolvent insurer as required by this chapter. For purposes of this subsection, that portion of the total assets of an impaired or insolvent insurer that is attributable to covered policies shall be determined by using the same proportion as the reserves that should have been established for such policies bears to the reserves that should have been established for all policies of insurance written by the impaired or insolvent insurer. (b)(1) Prior to the termination of any liquidation, rehabilitation, or conservation proceeding, the court may take into consideration the contributions of the respective parties, including the association, the shareholders, policy owners of the insolvent insurer, and any other party with a bona fide interest, in making an equitable distribution of the ownership rights of such insolvent insurer. In such a determination, consideration shall be given to the welfare of the policyholders of the continuing or successor insurer. (2) No distribution to stockholders of an impaired or insolvent insurer shall be made until and unless the total amount of valid claims of the association for funds expended in carrying out its powers and duties under Code Section 33-38-7, with respect to such insurer, has been fully recovered by the association. (c)(1) If an order for liquidation or rehabilitation of an insurer domiciled in this state has been entered, the receiver appointed under such order shall have a right on behalf of the insurer to recover from any affiliate the amount of distributions, other than stock dividends paid by the insurer on its capital stock, made at any time during the five years preceding the petition for liquidation or rehabilitation, subject to the limitations of this subsection and subsections (a) and (b) of this Code section. (2) No such distribution shall be recoverable if the insurer shows that the distribution was lawful and reasonable when paid and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations. (3) Any person who was an affiliate that controlled the insurer at the time the distributions were paid shall be liable to the extent of the distributions received. Any person who was an affiliate that controlled the insurer at the time the distributions were declared shall be liable to the extent of the distributions that would have been received if such distributions had been paid immediately. Whenever two persons are liable with respect to the same distribution, they shall be jointly and severally liable. (4) The maximum amount recoverable under this subsection shall be the amount needed, in excess of all other available assets of the insolvent insurer, to pay the contractual obligations of the insolvent insurer. (5) Whenever any person liable under paragraph (3) of this subsection is insolvent, all affiliates that controlled it at the time the distribution was paid shall be jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate. 33-38-18. All proceedings in any court in this state in which the insolvent insurer is a party shall be stayed 60 days from the date of a final order of liquidation, rehabilitation, or conservation to permit proper legal action by the association on any matters germane to its powers or duties. As to judgment entered under any decision, order, verdict, or finding based on default, the association may apply to have such judgment set aside by the same court that made such judgment and shall be permitted to defend against such action on the merits. 33-38-19. The liquidator, rehabilitator, or conservator of any impaired insurer may notify all interested persons of the effect of this chapter. 33-38-20. Any action of the board of directors may be appealed to the Commissioner by any member insurer if such appeal is taken within 30 days of the action being appealed. Any final action or order of the Commissioner shall be subject to judicial review in a court of competent jurisdiction. 33-38-21. (a) No person, including an insurer or agent or affiliate of an insurer, shall make, publish, disseminate, circulate, or place before the public or cause directly or indirectly to be made, published, disseminated, circulated, or placed before the public, in any newspaper, magazine, or other publication; in the form of a notice, circular, pamphlet, letter, or poster; over any radio station or television station; or in any other way, any advertisement, announcement, or statement which uses the existence of the association for the purposes of sales, solicitation, or inducement to purchase any form of insurance covered by this chapter. This Code section shall not apply to the association or any other entity which does not sell or solicit insurance. (b) Any person who violates subsection (a) of this Code section may, after notice and hearing and upon order of the Commissioner, be subject to one or more of the following: (1) A monetary penalty of not more than $1,000.00 for each act or violation, but not to exceed an aggregate penalty of $10,000.00; or (2) Suspension or revocation of his license or certificate of authority. 33-38-22. (a) A member insurer may offset against its premium tax liability to this state an assessment described in Code Section 33-38-15 to the extent of 20 percent of the amount of such assessment for each of the five calendar years following the year in which such assessment was paid. In the event a member insurer should cease doing business, all uncredited assessments may be credited against its premium tax liability for the year it ceases doing business. (b) Any sums which are acquired by refund, pursuant to subsection (f) of Code Section 33-38-15, from the association by member insurers and which have theretofore been offset against premium taxes as provided in subsection (a) of this Code section shall be paid by such insurers to this state in such manner as the Commissioner may require. The association shall notify the Commissioner that such refunds have been made.	<urn:uuid:7ef485c3-4be5-46c9-88ac-9fcf00263e03>	CC-MAIN-2023-23	https://www.gaiga.org/AdditionalInfo/Open/732/33381LHAct3	2023-06-05T23:55:16+00:00	crawl-data/CC-MAIN-2023-23/segments/1685224652184.68/warc/CC-MAIN-20230605221713-20230606011713-00558.warc.gz	843,774,836	7,628	eng_Latn	eng_Latn	0.983827	eng_Latn	0.987868	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	rolmOCR	[ 2909, 5635, 8561, 11517, 14538, 17932, 20849, 23460, 26681, 30092, 33448, 36565, 38900 ]	[ 0.2421875, 0.17578125 ]	[ 2.28125, 1.7421875 ]	[ 2.234375, 2.03125 ]	[ 2.640625, 2.828125 ]	1	0	HuggingFaceFW/finepdfs
To All Head of Office, Delhi Fire Service, H.Q. BCP, L.N. MN, & Shankar Road Govt. of NCT of Delhi New Delhi. Sub: - Circulation of Revised Tentative Seniority list of Leading Fireman, D.F.S as on 28.02.2020. Sir, I am directed to refer the subject cited above and enclosed herewith the Revised Tentative Seniority List of Leading Fireman, Delhi Fire Service, who have been promoted vide order dated 16.10.2015, 19.02.2019 & 19.08.2019 considering all of them as per prevailing rules of seniority. It is pertinent to mention that the existing final seniority list of Leading Fireman, Delhi Fire Service as on 31.01.2014 was circulated vide letter no. F.3(1)/Admn./DFS/HQ/2010/2905 dated 11.01.2016. Further a Tentative Seniority List was circulated vide letter No. F.3(1) Admn./DFS/HQ/2010/3210 dated 26.09.2017 in r/o Leading Fireman who were promoted on 16.10.2015 (From Sr. No. 618 to 659) and an order cum corrigendum in compliance of Hon’ble Central Administrative Tribunal Principal Bench Judgment O.A No. 1385/2013 dated 14.05.2019 was issued in r/o Seniority List of batch No. 50 Sr. No. 515 to 573 only, and circulated vide letter No. F.1(729)/Estt./DFS/HQ/2019/4020 dated 14.02.2020. Now, in continuation of above said Tentative seniority list and in terms of letter /order/ corrigendum dated 05.12.2019 and 14.02.2020 names of Leading Fireman from seniority No. 618 to 806 have been considered and accordingly Revised Tentative Seniority list is enclosed for inviting objections from the concerned officials. You are, therefore, requested that the tentative seniority list may be circulated amongst all the Leading Fireman under your charge for filing objections along with documentary proofs, if any within 30 days from the issue of this letter and no objection will be entertained thereafter. It is further requested that the said list may be put up on the notice board as well as copies may be provided to the concerned Leading Fire Men. This requires to ensured and a letter of confirmation may be sent to the undersigned. Yours Faithfully, (VIRENDRA AINGH) ASSTT. COMMISSIONER (FIRE) Encl: As above No.F.3 (1)/Admn. /DFS/HQ/2010/ Copy to: - 1. All Divisional Officer, DFS with the request to circulate the list at the fire stations under their division and the Station Officers may be directed to obtain the Signature of Leading Fireman against their name and a copy be sent to the undersigned for record. 2. A.D.O (M.S. Cell) for uploading on the website of the Department. 3. A.D.O.(M ) with the request to broadcast the message at all fire stations. (VIRENDRA AINGH) ASSTT. COMMISSIONER (FIRE) \| Snty. No as LF \| Name \| Rank No/DFS No \| DOB \| Snty. No as F.M./FO \| Category \| Date of initial Apptt. \| Date of Promotion As L.F.M \| Remarks \| \|---------------\|--------------------\|----------------\|---------\|---------------------\|----------\|------------------------\|----------------------------\|---------\| \| 618 \| Jagbir Singh \| F.M-33/53 \| 01.05.67\| 720 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 619 \| Vinod Sharma \| F.M-98/53 \| 06.02.67\| 723 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 620 \| Pradeep Kumar \| F.M-51/53 \| 14.01.67\| 724 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 621 \| Gulab Singh \| F.M-47/53 \| 05.02.68\| 725 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 622 \| Dharambir \| F.M-48/53 \| 11.05.68\| 726 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 623 \| Raj Kumar \| F.M-96/53 \| 02.05.64\| 727 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 624 \| Balkishan \| F.M-35/53 \| 05.01.65\| 728 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 625 \| Anoop Singh \| F.M-49/53 \| 10.05.68\| 729 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 626 \| Devender Kumar \| F.M-45/53 \| 02.12.66\| 732 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 627 \| Attar Singh \| F.M-119/53 \| 11.12.65\| 733 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 628 \| Kuldeep Singh \| F.M-17/53 \| 04.08.68\| 734 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 629 \| Mawashi Ram \| F.M-93/53 \| 17.11.65\| 735 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 630 \| Ranbir Singh \| F.M-102/53 \| 04.03.67\| 736 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 631 \| Ashok Kr. Bagga \| F.M-28/53 \| 01.07.67\| 738 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 632 \| Mohan Singh \| F.M-12/53 \| 01.09.65\| 741 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 633 \| Satpal Singh \| F.M-54/52 \| 05.01.66\| 742 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 634 \| Bijender Singh \| F.M-113/53 \| 07.06.63\| 743 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 635 \| Pappu \| F.M-86/53 \| 01.09.63\| 745 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 636 \| Vijender Singh \| F.M-109/53 \| 01.02.67\| 746 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 637 \| Hardeep Singh \| F.M-32/53 \| 01.05.69\| 748 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 638 \| Tejbir Singh \| F.M-97/53 \| 01.01.68\| 749 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 639 \| Rajpal \| F.M-99/53 \| 01.05.65\| 750 \| Gen. \| 20.06.92 \| 16.10.15 \| \| \| 640 \| Hariom \| F.M-101/53 \| 27.11.67\| 751 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 641 \| Virender Singh \| F.M-67/53 \| 20.05.66\| 752 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 642 \| Bhim Singh \| F.M-120/53 \| 20.03.64\| 754 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 643 \| Satish Kumar \| F.M-46/53 \| 28.04.66\| 755 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 644 \| Anil Kumar Rana \| F.M-100/53 \| 06.08.68\| 756 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 645 \| Mahipal Singh \| F.M-62/53 \| 01.04.65\| 757 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 646 \| Devender Singh Panwar \| F.M-41/53 \| 08.01.67\| 759 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 647 \| Jagbir Singh \| F.M-30/53 \| 15.07.67\| 760 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 648 \| Jikender Singh \| F.M-66/53 \| 15.10.67\| 761 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 649 \| Om Bhur Pal Singh \| F.M-95/53 \| 15.02.69\| 762 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 650 \| Jagbir Singh \| F.M-85/53 \| 04.08.67\| 764 \| Gen. \| 21.08.92 \| 16.10.15 \| \| \| 651 \| Narender \| F.O-1/61 \| 17.01.77\| 1335 \| Gen. \| 01.12.05 \| 16.10.15 \| \| \| 652 \| Surender Singh \| F.O-20/61 \| 01.05.78\| 1340 \| Gen. \| 01.12.05 \| 16.10.15 \| \| \| 653 \| Naveen Thakran \| F.O-81/61 \| 15.04.77\| 1356 \| Gen. \| 01.12.05 \| 16.10.15 \| \| \| 654 \| Devender \| F.O-49/61 \| 06.10.79\| 1376 \| Gen. \| 01.12.05 \| 16.10.15 \| \| \| 655 \| Sumit \| F.O-163/63 \| 20.01.84\| 1462 \| Gen. \| 18.09.09 \| 16.10.15 \| \| \| 656 \| Tasveer Singh \| F.O-177/63 \| 09.08.84\| 1489 \| Gen. \| 17.09.09 \| 16.10.15 \| \| \| 657 \| Vijay Dahiya \| F.O-316/63 \| 26.01.85\| 1501 \| Gen. \| 23.09.09 \| 16.10.15 \| \| \| 658 \| Nitin Joon \| F.O-77/63 \| 26.01.85\| 1564 \| Gen. \| 18.08.09 \| 16.10.15 \| \| \| 659 \| Sachin Thakran \| F.O-190/63 \| 06.01.82\| 1696 \| Gen. \| 17.09.09 \| 16.10.15 \| \| Cont. page No. 2/ \| No \| Name \| F.M./F.O. \| Date of Birth \| Age \| Category \| Date of Admission \| Date of Birth \| \|----\|-----------------------------\|-----------\|---------------\|-----\|----------\|-------------------\|--------------\| \| 660\| Sunder Singh \| F.M.-60/56\| 10.02.71 \| 963 \| SC \| 21.08.96 \| 19.02.19 \| \| 661\| Sunil Kumar \| F.M.-62/56\| 04.02.70 \| 965 \| SC \| 21.08.96 \| 19.02.19 \| \| 662\| Raj kumar \| F.M.-64/56\| 16.09.69 \| 967 \| SC \| 21.08.96 \| 19.02.19 \| \| 663\| Sahnder kumar \| F.M.-88/56\| 01.02.67 \| 988 \| SC \| 21.08.96 \| 19.02.19 \| \| 664\| Rohtash \| F.M.-92/56\| 05.10.68 \| 992 \| SC \| 21.08.96 \| 19.02.19 \| \| 665\| Sanohat lal meena \| F.O.-277/63\| 02.08.80 \| 1605\| ST \| 16.09.09 \| 19.02.19 \| \| 666\| Rajesh kumar meena \| F.O.-314/63\| 31.12.85 \| 1606\| ST \| 23.09.09 \| 19.02.19 \| \| 667\| Satish kumar meena \| F.O.-242/63\| 16.07.78 \| 1720\| ST \| 25.09.09 \| 19.02.19 \| \| 668\| Hari Prasad Meena \| F.O.-275/63\| 15.07.76 \| 1721\| ST \| 24.09.09 \| 19.02.19 \| \| 669\| Sunil Kumar \| F.M.-92/53\| 02.02.68 \| \| UR \| \| 19.02.19 \| \| 670\| Kali Charan \| F.M.-158/56\| 23.09.70 \| 1058\| SC \| 22.10.96 \| 19.02.19 \| \| 671\| Noor Singh \| F.M.-161/56\| 25.09.67 \| 1061\| SC \| 21.08.96 \| 19.02.19 \| \| 672\| Vinod Kumar \| F.M.-168/56\| 07.02.72 \| 1068\| SC \| 21.08.96 \| 19.02.19 \| \| 673\| Om Prakash \| F.M.-170/56\| 17.03.71 \| 1070\| SC \| 21.08.96 \| 19.02.19 \| \| 674\| Surender Singh \| F.M.-171/56\| 02.07.72 \| 1071\| SC \| 21.08.96 \| 19.02.19 \| \| 675\| Dinesh Chander \| F.M.-52/53\| 24.03.65 \| 766 \| UR \| 21.08.92 \| 19.02.19 \| \| 676\| Anand Singh \| F.M.-122/53\| 04.05.67 \| 767 \| UR \| 21.08.92 \| 19.02.19 \| \| 677\| Rakesh Chander \| F.M.-72/53\| 01.03.68 \| 768 \| UR \| 21.08.92 \| 19.02.19 \| \| 678\| Surender Kumar \| F.M.-89/53\| 28.12.66 \| 769 \| UR \| 21.08.92 \| 19.02.19 \| \| 679\| Ram Kumar Singh \| F.M.-117/53\| 01.04.69 \| 770 \| UR \| 21.08.92 \| 19.02.19 \| \| 680\| Virender Singh \| F.M.-02/53\| 20.06.67 \| 771 \| UR \| 21.08.92 \| 19.02.19 \| \| 681\| Satish Kumar \| F.M.-29/53\| 01.04.69 \| 772 \| UR \| 21.08.92 \| 19.02.19 \| \| 682\| Bijender Singh \| F.M.-55/53\| 05.01.65 \| 776 \| UR \| 21.08.92 \| 19.02.19 \| \| 683\| Ashok Kumar \| F.M.-172/56\| 16.09.71 \| 1072\| SC \| 21.08.96 \| 19.02.19 \| \| 684\| Mukesh Kumar Meena \| F.O.-184/63\| 01.12.77 \| 1722\| ST \| 16.09.09 \| 19.02.19 \| \| 685\| Sharad Kumar Tewatia \| F.O.-41/59\| 19.01.76 \| 1223\| UR \| 01.10.02 \| 19.02.19 \| \| 686\| Bijender Singh \| F.M.-16/53\| 10.06.68 \| 779 \| UR \| 21.08.92 \| 19.02.19 \| \| 687\| Harbans Lal \| F.M.-105/53\| 04.04.64 \| 780 \| UR \| 21.08.92 \| 19.02.19 \| \| 688\| Naresh Singh \| F.M.-37/53\| 17.03.65 \| 783 \| UR \| 21.08.92 \| 19.02.19 \| \| 689\| Bijender Singh \| F.M.-65/53\| 15.02.67 \| 782 \| UR \| 21.08.92 \| 19.02.19 \| \| 690\| Ashok Kumar \| F.M.-24/53\| 09.12.68 \| 783 \| UR \| 21.08.92 \| 19.02.19 \| \| 691\| Bijender Singh \| F.M.-71/53\| 01.07.69 \| 784 \| UR \| 21.08.92 \| 19.02.19 \| \| 692\| Pawan Kumar \| F.M.-27/53\| 10.11.67 \| 786 \| UR \| 21.08.92 \| 19.02.19 \| \| 693\| Udavir Singh \| F.M.-57/53\| 20.03.67 \| 787 \| UR \| 21.08.92 \| 19.02.19 \| \| 694\| Dharambir \| F.M.-73/53\| 02.11.67 \| 788 \| UR \| 21.08.92 \| 19.02.19 \| \| 695\| Satbir Singh \| F.M.-31/53\| 15.02.65 \| 789 \| UR \| 21.08.92 \| 19.02.19 \| \| 696\| Krishan Kumar \| F.M.-03.53\| 15.05.65 \| 790 \| UR \| 21.08.92 \| 19.02.19 \| \| 697\| Basanti Lal Meena \| F.O.-344/63\| 08.08.81 \| 1723\| ST \| 25.12.09 \| 19.02.19 \| \| 698\| Anand Singh \| F.O.-08/60\| 15.02.77 \| 1225\| UR \| 01.12.05 \| 19.02.19 \| \| 699\| Pradeep Kumar \| F.O.-01/60\| 15.01.74 \| 128 \| UR \| 25.03.03 \| 19.02.19 \| Cont. page No. 3/ \| No. \| Name \| Category \| Date of Birth \| Age \| ID Number \| Category \| Date of Birth \| Date of Admission \| Date of Release \| \|-----\|--------------------\|----------\|---------------\|-----\|-----------\|----------\|---------------\|------------------\|-----------------\| \| 700 \| Subhash Arya \| F.O.-20/60 \| 15.07.75 \| 1317 \| UR \| 25.07.03 \| 19.02.19 \| \| \| 701 \| Jagbir \| F.M.-53/53 \| 04.10.68 \| 791 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 702 \| Raj Pal Singh \| F.M.-106/53 \| 10.11.66 \| 793 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 703 \| Devender Singh \| F.M.-80/53 \| 09.05.67 \| 794 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 704 \| Ramesh Kumar \| F.M.-54/53 \| 31.07.66 \| 795 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 705 \| Ved Pal \| F.M.-88/53 \| 01.01.69 \| 796 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 706 \| Shamsher singh \| F.M.-74/53 \| 03.04.65 \| 797 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 707 \| Jeet Singh \| F.M.-61/53 \| 10.07.65 \| 798 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 708 \| Jai Prakash \| F.M.-21/53 \| 01.03.63 \| 799 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 709 \| Satpal Singh \| F.M.-01/53 \| 08.10.64 \| 800 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 710 \| Sudhir Kumar \| F.M.-25/53 \| 01.07.68 \| 802 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 711 \| Ram Chander \| F.M.-94/53 \| 01.07.64 \| 803 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 712 \| Rajbir Singh \| F.M.-43/53 \| 04.04.66 \| 804 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 713 \| Rambir Singh \| F.M.-07/53 \| 09.12.65 \| 808 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 714 \| Ram Niwas Shambu \| F.M.-87/53 \| 01.08.68 \| 809 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 715 \| Devender Singh \| F.M.-11/53 \| 08.09.67 \| 810 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 716 \| Rajender Singh \| F.M.-75/53 \| 12.05.65 \| 811 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 717 \| Suresh Kumar \| F.M.-08/53 \| 15.06.68 \| 812 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 718 \| Rajender Singh \| F.M.-10/53 \| 24.09.65 \| 816 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 719 \| Devki Nandan \| F.M.-123/53 \| 12.06.66 \| 818 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 720 \| Suresh Kumar \| F.M.-39/53 \| 10.01.65 \| 820 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 721 \| Azad Singh Dhama \| F.M.-91/53 \| 02.07.67 \| 821 \| UR \| 21.08.92 \| 19.02.19 \| \| \| 722 \| Gulab Singh \| F.M.-173/56 \| 15.01.73 \| 1073 \| SC \| 21.08.96 \| 19.02.19 \| \| \| 723 \| Manjit Pal Singh \| F.M.-174/56 \| 31.01.69 \| 1074 \| SC \| 21.08.96 \| 19.02.19 \| \| \| 724 \| Dal Singh Meena \| F.O.-256/63 \| 16.08.78 \| 1724 \| ST \| 23.09.09 \| 19.02.19 \| \| \| 725 \| Narendra Prasad Meena \| F.O.-246/63 \| 04.08.78 \| 1725 \| ST \| 25.09.09 \| 19.02.19 \| \| \| 726 \| Sunil Kumar \| F.O.-08/61 \| 06.07.78 \| 1355 \| UR \| 01.12.05 \| 19.02.19 \| \| \| 727 \| Pradeep Chillar \| F.O.-60/61 \| 06.08.78 \| 1357 \| UR \| 01.12.05 \| 19.02.19 \| \| \| 728 \| Sanjay \| F.O.-36/61 \| 01.12.75 \| 1361 \| UR \| 01.12.05 \| 19.02.19 \| \| \| 729 \| Vinod Kumar \| F.O.-80/61 \| 20.01.81 \| 1363 \| UR \| 01.12.05 \| 19.02.19 \| \| \| 730 \| Sanjay Kumar \| F.O.-22/61 \| 15.05.75 \| 1364 \| UR \| 01.12.05 \| 19.02.19 \| \| \| 731 \| Sunil Dutt \| F.O.-76/61 \| 13.11.79 \| 1373 \| UR \| 01.12.05 \| 19.02.19 \| \| \| 732 \| Ramesh Kumar \| L.F.M-116/53 \| 04.06.67 \| 822 \| Gen. \| 21.09.92 \| 19.08.19 \| \| \| 733 \| Shri Pal singh \| L.F.M-81/53 \| 27.08.67 \| 825 \| Gen. \| 21.09.92 \| 19.08.19 \| \| \| 734 \| Jai Parkash \| L.F.M-22/53 \| 20.04.67 \| 826 \| Gen. \| 21.09.92 \| 19.08.19 \| \| \| 735 \| Anil Kumar \| L.F.M-1/54 \| 24.10.70 \| 829 \| Gen. \| 21.09.92 \| 19.08.19 \| \| \| 736 \| Abbas Hader \| L.F.M-2/54 \| 01.07.74 \| 830 \| Gen. \| 21.09.92 \| 19.08.19 \| \| \| 737 \| Virender Singh \| L.F.M-3/54 \| 30.12.64 \| 831 \| Gen. \| 21.09.92 \| 19.08.19 \| \| \| 738 \| Rajiv Kumar \| L.F.M-42/55 \| 07.07.69 \| 874 \| Gen. \| 21.03.95 \| 19.08.19 \| \| \| 739 \| Ashok Kumar \| L.F.M-69/55 \| 25.07.74 \| 901 \| Gen. \| 21.03.95 \| 19.08.19 \| \| Cont. page No. 4/ \| No. \| Name \| Code \| Date of Birth \| Age \| Category \| Date of Joining \| Date of Release \| \|-----\|--------------------\|--------\|---------------\|------\|----------\|-----------------\|----------------\| \| 740 \| Ravinder Kumar \| F.M-1/56 \| 08.05.68 \| 904 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 741 \| P N Venkideswaran \| F.M-3/56 \| 24.05.72 \| 906 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 742 \| Joginder Singh \| F.M-7/56 \| 25.04.67 \| 908 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 743 \| Raghubir Singh \| F.M-8/56 \| 02.06.72 \| 909 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 744 \| Anand Kumar \| F.M-10/56\| 28.10.69 \| 910 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 745 \| Parveen Kumar \| F.M-11/56\| 01.04.71 \| 911 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 746 \| Balraj \| F.M-12/56\| 15.03.71 \| 912 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 747 \| Narendra \| F.M-14/56\| 08.10.73 \| 913 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 748 \| Tasveer Singh \| F.M-15/56\| 20.10.70 \| 914 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 749 \| Jitender Kumar \| F.M-16/56\| 05.02.72 \| 915 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 750 \| Jatinder Kumar \| F.M-17/56\| 05.05.73 \| 916 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 751 \| Bijender \| F.M-18/56\| 10.01.72 \| 917 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 752 \| Ashok Kumar \| F.M-19/56\| 05.04.68 \| 918 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 753 \| Jai Singh \| F.M-20/56\| 22.10.71 \| 919 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 754 \| Sunil Kumar \| F.M-21/56\| 29.06.68 \| 920 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 755 \| Sanjeev \| F.M-22/56\| 12.12.69 \| 921 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 756 \| Krishan Singh \| F.M-23/56\| 01.03.69 \| 922 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 757 \| Dalbir Singh \| F.M-24/56\| 22.03.69 \| 923 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 758 \| Tejbhan Bhardwaj \| F.M-27/56\| 14.10.69 \| 925 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 759 \| Rajender Singh \| F.M-28/56\| 06.09.72 \| 926 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 760 \| Mintoo Singh \| F.M-29/56\| 03.01.70 \| 927 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 761 \| Manoj Kumar \| F.M-33/56\| 01.02.73 \| 930 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 762 \| Surender Kumar \| F.M-34/56\| 02.10.72 \| 931 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 763 \| Kuldeep Kumar \| F.M-35/56\| 12.12.70 \| 932 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 764 \| Rajesh Sharma \| F.M-36/56\| 10.11.67 \| 933 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 765 \| Ombir \| F.M-38/56\| 01.01.71 \| 935 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 766 \| Jaiveer \| F.M-39/56\| 01.01.72 \| 936 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 767 \| Veena Kumar \| F.M-44/56\| 05.05.69 \| 941 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 768 \| Subhash \| F.M-46/56\| 17.01.70 \| 943 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 769 \| Ravinder Kumar \| F.M-47/56\| 01.12.70 \| 944 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 770 \| Maha Singh \| F.M-49/56\| 04.03.70 \| 945 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 771 \| Kalp Nath \| F.M-50/56\| 01.07.72 \| 946 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 772 \| Samunder Singh \| F.M-52/56\| 12.07.69 \| 948 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 773 \| Parmod Kumar \| F.M-53/56\| 24.09.71 \| 949 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 774 \| Ajit Singh \| F.M-54/56\| 15.06.70 \| 950 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 775 \| Mohan Singh Tomar \| F.M-57/56\| 29.10.69 \| 952 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 776 \| Sanjeev Kumar \| F.M-59/56\| 01.06.73 \| 954 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 777 \| Naveen Kumar \| F.M-72/56\| 02.11.73 \| 960 \| Gen. \| 21.08.96 \| 19.08.19 \| \| 778 \| Surender Pal \| F.M-177/56\| 15.02.71 \| 1046 A \| SC \| 22.10.96 \| 19.08.19 \| \| 779 \| Sadhu Ram \| F.M-178/56\| 05.08.71 \| 1047 \| SC \| 21.08.96 \| 19.08.19 \| \| 780 \| Ramvir \| F.M-180/56\| 01.01.74 \| 1048 \| SC \| 21.08.96 \| 19.08.19 \| \| 781 \| Bakshi Ram \| F.M-181/56\| 10.05.68 \| 1049 \| SC \| 21.08.96 \| 19.08.19 \| Cont. page No. 5/ \| No. \| Name \| Code \| Date of Birth \| Age \| Category \| Joining Date \| Promotion Date \| \|-----\|--------------------\|------------\|---------------\|-----\|----------\|--------------\|----------------\| \| 782 \| Rajesh Kumar \| F.M.183/56 \| 05.08.70 \| 1050\| SC \| 21.08.96 \| 19.08.19 \| \| 783 \| Ranbir Singh \| F.M.185/56 \| 24.04.73 \| 1051\| SC \| 21.08.96 \| 19.08.19 \| \| 784 \| Sunil Kumar \| F.M.186/56 \| 01.09.73 \| 1052\| SC \| 21.08.96 \| 19.08.19 \| \| 785 \| Padam Singh \| F.M.189/56 \| 10.09.66 \| 1054\| SC \| 21.08.96 \| 19.08.19 \| \| 786 \| Dayanand \| F.M.190/56 \| 30.04.66 \| 1055\| SC \| 21.08.96 \| 19.08.19 \| \| 787 \| Sukhbir Singh \| F.M.191/56 \| 20.04.68 \| 1056\| SC \| 21.08.96 \| 19.08.19 \| \| 788 \| Kali Charan \| F.M.193/56 \| 15.09.64 \| 1057\| SC \| 21.08.96 \| 19.08.19 \| \| 789 \| Surender Kumar \| F.M.194/56 \| 20.08.67 \| 1058\| SC \| 21.08.96 \| 19.08.19 \| \| 790 \| Ram Niwas \| F.M.195/56 \| 15.09.69 \| 1059\| SC \| 21.08.96 \| 19.08.19 \| \| 791 \| Ram Bhajan Meena \| F.O-222/63 \| 01.09.81 \| 1730\| ST \| 17.09.09 \| 19.08.19 \| \| 792 \| Chet Ram Meena \| F.O-253/63 \| 03.07.76 \| 1731\| ST \| 23.09.09 \| 19.08.19 \| \| 793 \| Rajendra Prasad Mena \| F.O-293/63 \| 04.02.77 \| 1732\| ST \| 23.09.09 \| 19.08.19 \| \| 794 \| Avadh Bihari Meena \| F.O-207/63 \| 01.05.82 \| 1733\| ST \| 20.09.09 \| 19.08.19 \| \| 795 \| Ram Niwas Meena \| F.O-189/63 \| 25.06.75 \| 1734\| ST \| 20.09.09 \| 19.08.19 \| \| 796 \| Meena Ram Bharosi \| F.O-298/63 \| 08.12.77 \| 1735\| ST \| 25.09.09 \| 19.08.19 \| \| 797 \| Puran Mal Meena \| F.O-359/63 \| 06.07.78 \| 1736\| ST \| 11.12.09 \| 19.08.19 \| \| 798 \| Rohit Sumar \| F.O-79/63 \| 16.06.84 \| 1488\| Gen. \| 17.08.09 \| 19.08.19 \| \| 799 \| Harish Kumar \| F.O-199/63 \| 27.12.85 \| 1547\| Gen. \| 16.09.09 \| 19.08.19 \| \| 800 \| Jagdish Kumar Yadav\| F.O-360/63 \| 01.01.81 \| 1571\| Gen. \| 19.06.09 \| 19.08.19 \| \| 801 \| Kailash Kumar Sharma \| F.O-303/63 \| 10.12.82 \| 1598\| Gen. \| 23.09.09 \| 19.08.19 \| \| 802 \| Yogesh Kumar Sharma \| F.O-171/63 \| 03.10.84 \| 1616\| Gen. \| 16.09.09 \| 19.08.19 \| \| 803 \| Sunil Kumar \| F.O-139/63 \| 08.07.72 \| 1698\| Gen. \| 23.09.09 \| 19.08.19 \| \| 804 \| Rajeev Sindhu \| F.O-111/64 \| 17.12.83 \| 1748\| Gen. \| 15.11.12 \| 19.08.19 \| \| 805 \| Pradeep \| F.O-184/64 \| 10.09.86 \| 1823\| Gen. \| 15.11.12 \| 19.08.19 \| \| 806 \| Adesh Kumar \| F.O-28/64 \| 14.04.83 \| 1882\| Gen. \| 11.07.12 \| 19.08.19 \| (VIRENDRA SINGH) HEAD OF OFFICE 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The information summarized in the profiles is intended to help policymakers and their partners assess progress, prioritize actions and ensure accountability for commitments to reduce maternal, newborn, and child mortality. The following section contains profiles for the 75 Countdown countries: Afghanistan Angola Azerbaijan Bangladesh Benin Bolivia Botswana Brazil Burkina Faso Burundi Cambodia Cameroon Central African Republic Chad China Comoros Congo Congo, Democratic Republic of the Côte d’Ivoire Djibouti Egypt Equatorial Guinea Eritrea Ethiopia Gabon Gambia, The Ghana Guatemala Guinea Guinea-Bissau Haiti India Indonesia Iraq Kenya Korea, Democratic People’s Republic of Kyrgyzstan Lao People’s Democratic Republic Lesotho Liberia Madagascar Malawi Mali Mauritania Mexico Morocco Mozambique Myanmar Nepal Niger Nigeria Pakistan Papua New Guinea Peru Philippines Rwanda São Tomé and Príncipe Senegal Sierra Leone Solomon Islands Somalia South Africa South Sudan Sudan Swaziland Tajikistan Tanzania, United Republic of Togo Turkmenistan Uganda Uzbekistan Viet Nam Yemen Zambia Zimbabwe The Countdown country profiles present in one place the latest evidence to assess country progress in improving reproductive, maternal, newborn and child health. The two-page profiles in this report are updated every two years with new data and analyses. Countdown has also committed to annually updating the core indicators selected by the Commission on Information and Accountability for Women’s and Children’s Health. Reviewing the information The first step in using the country profiles is to explore the range of data presented: demographics, mortality, coverage of evidence-based interventions, nutritional status and socioeconomic equity in coverage, and information on policies, health systems and financing. Key questions in reviewing the data include: - Are trends in mortality and nutritional status moving in the right direction? Is the country on track to achieve the health-related Millennium Development Goals? - How high is coverage for each intervention? Are trends moving in the right direction towards universal coverage? Are there gaps in coverage for specific interventions? - How equitable is coverage? Are certain interventions particularly inaccessible for the poorest segment of the population? - Are key policies and systems measures and adequate funding in place to bring coverage of key interventions to scale? Identifying areas to accelerate progress The second step in using the country profiles is to identify opportunities to address coverage gaps and accelerate progress in improving coverage and health outcomes across the continuum of care. Questions to ask include: - Are the coverage data consistent with the epidemiological situation? For example: - If pneumonia deaths are high, are policies in place to support community case management of pneumonia? Are coverage levels low for careseeking and antibiotic treatment for pneumonia, and what can be done to reach universal coverage? Are the rates of deaths due to diarrhoea consistent with the coverage levels and trends of improved water sources and sanitation facilities? - In priority countries for eliminating mother-to-child transmission of HIV, are sufficient resources being targeted to preventing mother-to-child transmission? - Does lagging progress on reducing maternal mortality or high newborn mortality reflect low coverage of family planning, antenatal care, skilled attendance at birth and postnatal care? - Do any patterns in the coverage data suggest clear action steps? For example, coverage for interventions involving treatment of an acute need (such as treatment of childhood diseases and childbirth services) is often lower than coverage for interventions delivered routinely through outreach or scheduled in advance (such as vaccinations). This gap suggests that health systems need to be strengthened, for example by training and deploying skilled health workers to increase access to care. - Do the gaps and inequities in coverage along the continuum of care suggest prioritizing specific interventions and increasing funding for reproductive, maternal, newborn and child health? For example, is universal access to labour, delivery and immediate postnatal care being prioritized in countries with gaps in interventions delivered around the time of birth? Sample country profile Key population characteristics These demographic indicators include the proportion of newborn deaths among all deaths of children under age 5, a Commission on Information and Accountability for Women’s and Children’s Health indicator. Intervention coverage These charts show most recent coverage levels and trends for selected reproductive, maternal, newborn and child health interventions. Impact: under-5 mortality rate and maternal mortality ratio These charts display trends over time, reflecting progress towards reaching the Millennium Development Goal 4 and 5 targets. Cause of death These charts provide information useful for interpreting the coverage measures and identifying programmatic priorities. Policies These indicators show whether needed policies are in place to support the introduction and scale-up of proven interventions. --- Ghana DEMOGRAPHICS - Total population (2013): 25,961,000 - Under-five mortality rate (2010): 74 - Maternal mortality ratio (2010): 280 - Total under-five deaths (2010): 184 - Total live births (2010): 1,040,000 - Total under-five deaths per 1,000 live births (2010): 17.8 - Total maternal deaths (2010): 280 - Total maternal deaths per 100,000 live births (2010): 27.0 - Total under-five deaths per 1,000 live births (2010): 17.8 MATERNAL AND NEWBORN HEALTH - Coverage along the continuum of care - Antenatal care: 85% - Deliveries attended by skilled personnel: 95% - Postnatal care: 85% - Immunization - Diphtheria, tetanus, pertussis (DTP) vaccine at age 1 month: 90% - Polio vaccine at age 1 month: 90% - BCG vaccine at birth: 90% - Measles vaccine at age 1 year: 90% - Prevention of mother-to-child transmission of HIV - HIV testing during pregnancy: 90% - Antiretroviral drugs for pregnant women with HIV: 90% - Antiretroviral drugs for breastfeeding mothers with HIV: 90% EQUITY - Socioeconomic inequities in coverage - Under-five mortality rate: 10% higher for poorest 20% than richest 20% - Antenatal care: 10% lower for poorest 20% than richest 20% - Deliveries attended by skilled personnel: 10% lower for poorest 20% than richest 20% - Postnatal care: 10% lower for poorest 20% than richest 20% - Immunization - Diphtheria, tetanus, pertussis (DTP) vaccine at age 1 month: 10% lower for poorest 20% than richest 20% - Polio vaccine at age 1 month: 10% lower for poorest 20% than richest 20% - BCG vaccine at birth: 10% lower for poorest 20% than richest 20% - Measles vaccine at age 1 year: 10% lower for poorest 20% than richest 20% CHILD HEALTH - Immunization - Diphtheria, tetanus, pertussis (DTP) vaccine at age 1 month: 90% - Polio vaccine at age 1 month: 90% - BCG vaccine at birth: 90% - Measles vaccine at age 1 year: 90% Nutrition - Underweight and stunting prevalence - Underweight: 15% of children under age 5 - Stunting: 15% of children under age 5 Exclusive breastfeeding - Exclusive breastfeeding: 15% of children under age 6 months WATER AND SANITATION - Improved drinking water coverage - 2000: 60% - 2010: 70% - 2015: 80% Improved sanitation coverage - 2000: 30% - 2010: 40% - 2015: 50% Health systems and financing - Health system strength - 2010: 60% - Financing - 2010: 60% Continuum of care Gaps in coverage along the continuum of care from pre-pregnancy and childbirth through childhood up to age 5 should serve as a call to action for a country to prioritize these interventions. ## DEMOGRAPHICS \| Metric \| 2013 \| 2012 \| \|---------------------------------------------\|----------\|----------\| \| Total population (000) \| 29,825 \| \| \| Total under-five population (000) \| 4,964 \| \| \| Births (000) \| 1,053 \| \| \| Birth registration (%) \| 37 \| \| \| Total under-five deaths (000) \| 103 \| \| \| Neonatal deaths: % of all under-5 deaths \| 36 \| \| \| Neonatal mortality rate (per 1000 live births)\| 36 \| \| \| Infant mortality rate (per 1000 live births)\| 71 \| \| \| Stillbirth rate (per 1000 total births) \| 29 \| \| \| Total maternal deaths \| 4,200 \| \| \| Lifetime risk of maternal death (1 in N) \| 49 \| \| \| Total fertility rate (per woman) \| 5.1 \| \| \| Adolescent birth rate (per 1000 girls) \| 90 \| \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|----------\|----------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (4+ visits) \| 15 \| \| \| Skilled attendant at delivery \| 39 \| \| \| Postnatal care \| 23 \| \| \| Exclusive breastfeeding \| 68 \| \| \| Measles \| \| \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| MICS \| Other NS \| DHS \| 2010-2011 MICS \| \|------\|------\|----------\|-----\|----------------\| \| 2003 \| 14 \| 24 \| 34 \| 39 \| \| 2008 \| \| \| \| \| \| 2010 \| \| \| \| \| \| 2011 \| \| \| \| \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| Year \| MICS \| Other NS \| DHS \| 2010-2011 MICS \| \|------\|------\|----------\|-----\|----------------\| \| 2003 \| 14 \| 24 \| 34 \| 39 \| \| 2008 \| \| \| \| \| \| 2010 \| \| \| \| \| \| 2011 \| \| \| \| \| ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% - Richest 20% \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|----------\|----------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| 15 \| \| \| Antenatal care (4+ visits) \| 39 \| \| \| Skilled attendant at delivery \| 23 \| \| \| Early initiation of breastfeeding \| 68 \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Careseeking for pneumonia \| \| \| ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| 1990 \| 1995 \| 2000 \| 2005 \| 2012 \| \|------\|------\|------\|------\|------\|------\| \| Measles \| 30 \| 40 \| 50 \| 60 \| 70 \| \| DTP3 \| 30 \| 40 \| 50 \| 60 \| 70 \| \| Hib \| 30 \| 40 \| 50 \| 60 \| 70 \| \| Rotavirus \| 30 \| 40 \| 50 \| 60 \| 70 \| \| Pneumococcal \| 30 \| 40 \| 50 \| 60 \| 70 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| 2010-2011 MICS \| \|------\|----------------\| \| 2010 \| 61 \| \| 2011 \| 64 \| ## NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| 2004 \| \|------\|------\| \| 1997 \| 9 \| \| 2004 \| - \| Low birthweight incidence (moderate and severe, %) \| Year \| 2004 \| \|------\|------\| \| 1997 \| - \| \| 2004 \| - \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| 2010-2011 \| \|------\|-----------\| \| 1997 \| 54 \| \| 2004 \| - \| Introduction of solid, semi-solid/soft foods (%) \| Year \| 2010-2011 \| \|------\|-----------\| \| 1997 \| 20 \| \| 2004 \| - \| Vitamin A two dose coverage (%) \| Year \| 2010-2011 \| \|------\|-----------\| \| 1997 \| - \| \| 2004 \| - \| ## Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| 1997 MICS \| 2004 Other NS \| \|------\|-----------\|---------------\| \| 1997 \| 45 \| 33 \| \| 2004 \| 53 \| 59 \| ## Exclusive breastfeeding Percent of infants <6 months exclusively breastfed No Data ## Afghanistan ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 36% - Pneumonia: 18% - Preterm: 11% - Asphyxia: 10% - Other: 23% - Global/early neonatal death: 4% attributable to undernutrition - HIV/AIDS: 0% - Malaria: 0% - Injuries: 7% - Measles: 3% - Diarrhoea: 1% Intrapartum-related events Sepsis/Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 39% - Indirect: 29% - Hypertension: 10% - Sepsis: 14% - Embolism: 2% - Abortion: 6% - Other direct: 8% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| MICS \| Other NS \| DHS \| 2010-2011 MICS \| \|------------\|------\|----------\|-------\|----------------\| \| 2003 \| 16 \| \| \| \| \| 2008 \| 36 \| \| \| \| \| 2010 \| 60 \| \| \| \| \| 2010-2011 \| 48 \| \| \| \| Demand for family planning satisfied (%) Antenatal care (4 or more visits, %) 15 (2011) Malaria during pregnancy - intermittent preventive treatment (%) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 4, 9, 2 (2010-2011) Neonatal tetanus vaccine 60 (2012) Postnatal visit for baby (within 2 days for home births, %) Postnatal visit for mother (within 2 days for home births, %) 23 (2010) Women with low body mass index (<18.5 kg/m², %) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS \| \|------------\|------\| \| 2003 \| 30 \| \| 2010-2011 \| 48 \| \| 2011 \| 53 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 2012 - Piped on premises - Other improved - Unimproved \| Source \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| Piped \| 9 \| 8 \| 11 \| \| Other \| 54 \| 62 \| 52 \| \| Surface \| 10 \| 7 \| 13 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 13 \| 15 \| 16 \| \| 2012 \| 38 \| 45 \| 46 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - Legal status of abortion (X of 5 circumstances) - Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) - Maternal deaths notification - Postnatal home visits in the first week after birth - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - Antenatal corticosteroids as part of management of preterm labour - International Code of Marketing of Breastmilk Substitutes - Community treatment of pneumonia with antibiotics - Low osmolarity ORS and zinc for management of diarrhoea ### SYSTEMS - Costed national implementation plan(s) for maternal, newborn and child health available - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) 1 (2013) - Maternal health (X of 3) 2 (2013) - Newborn health (X of 4) 3 (2013) - Child health (X of 3) 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population) 7.3 (2011) - National availability of Emergency Obstetric Care services (% of recommended minimum) ### FINANCING - Per capita total expenditure on health (Int$) 47 (2012) - General government expenditure on health as % of total government expenditure (%) 7 (2012) - Out of pocket expenditure as % of total expenditure on health (%) 74 (2012) - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 38 (2011) - ODA to maternal and neonatal health per live birth (US$) 91 (2011) ## DEMOGRAPHICS \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 20,821 \| \| \| Total under-five population (000) \| 3,966 \| \| \| Births (000) \| 934 \| \| \| Birth registration (%) \| 36 \| \| \| Total under-five deaths (000) \| 148 \| \| \| Neonatal deaths: % of all under-5 deaths \| 28 \| \| \| Neonatal mortality rate (per 1000 live births) \| 45 \| \| \| Infant mortality rate (per 1000 live births) \| 100 \| \| \| Stillbirth rate (per 1000 total births) \| 25 \| \| \| Total maternal deaths \| 4,400 \| \| \| Lifetime risk of maternal death (1 in N) \| 35 \| \| \| Total fertility rate (per woman) \| 6.0 \| \| \| Adolescent birth rate (per 1000 girls) \| 188 \| \| ## UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 213 \| \| 1995 \| 200 \| \| 2000 \| 175 \| \| 2005 \| 150 \| \| 2010 \| 130 \| \| 2015 \| 71 \| Source: IGME 2013 ## MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1400 \| \| 1995 \| 1200 \| \| 2000 \| 1000 \| \| 2005 \| 800 \| \| 2010 \| 600 \| \| 2015 \| 350 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| \| \| Antenatal care (4+ visits) \| 47 \| \| Skilled attendant at delivery \| 47 \| \| Postnatal care \| 11 \| \| Exclusive breastfeeding \| 97 \| \| Measles \| 97 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|----------\|---------\| \| 1996 MICS\| 23 \| \| 2006-2007\| 47 \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 21 \| \| 2011 \| 17 \| \| 2012 \| 17 \| Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| No Data \| \| Antenatal care (4+ visits) \| No Data \| \| Skilled attendant at delivery \| No Data \| \| Early initiation of breastfeeding \| No Data \| \| ITN use among children <5 yrs \| No Data \| \| DTP3 \| No Data \| \| Measles \| No Data \| \| Vitamin A (past 6 months) \| No Data \| \| ORT & continued feeding \| No Data \| \| Careseeking for pneumonia \| No Data \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 60 \| \| 2000 \| 80 \| \| 2005 \| 90 \| \| 2012 \| 97 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics No Data ## NUTRITION \| Indicator \| 2007 \| 2000 \| \|------------------------------------------------\|----------\|----------\| \| Wasting prevalence (moderate and severe, %) \| 8 \| 12 \| \| Low birthweight incidence (moderate and severe, %) \| 12 \| \| \| Early initiation of breastfeeding (within 1 hr of birth, %) \| 55 \| \| \| Introduction of solid, semi-solid/soft foods (%) \| 77 \| \| \| Vitamin A two dose coverage (%) \| 44 \| \| ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|----------\|---------\| \| 1996 MICS\| 37 \| \| 2007 Other NS \| 62 \| \| 2007 Other NS \| 16 \| \| 2007 Other NS \| 29 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2001 MICS \| 11 \| ## Angola ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 15% - Preterm: 8% - Asphyxia: 8% - Neonatal death: 28% - Other: 2% - HIV/AIDS: 1% - Malaria: 13% - Injuries: 5% - Measles: 1% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Other direct: 9% - Indirect: 29% - Hypertension: 16% Source: WHO 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Percent \| 2006-2007 \| Other NS \| \|---------\|-----------\|----------\| \| \| 80 \| \| Demand for family planning satisfied (%) Antenatal care (4 or more visits, %) Malaria during pregnancy - intermittent preventive treatment (%) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine Postnatal visit for baby (within 2 days for home births, %) Postnatal visit for mother (within 2 days for home births, %) Women with low body mass index (<18.5 kg/m², %) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS No Data Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial Percent children < 5 years sleeping under ITNs \| Percent \| 2006-2007 \| 2011 \| \|---------\|-----------\|------\| \| \| 18 \| 26 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Percent \| 1990 \| 2012 \| 1990 \| 2012 \| 1990 \| 2012 \| 1990 \| 2012 \| \|---------\|------\|------\|------\|------\|------\|------\|------\|------\| \| Total \| 24 \| 22 \| 13 \| 14 \| 30 \| 30 \| 51 \| 51 \| \| Urban \| 34 \| 33 \| 44 \| 34 \| 34 \| 34 \| \| \| \| Rural \| 36 \| 21 \| 16 \| 34 \| 41 \| 15 \| \| \| Source: WHO/UNICEF JMP 2014 Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation No Data ### POLICIES Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent Legal status of abortion (X of 5 circumstances) Midwives authorized for specific tasks (X of 7 tasks) Maternity protection (Convention 183) Maternal deaths notification Postnatal home visits in the first week after birth Kangaroo Mother Care in facilities for low birthweight/preterm newborns Antenatal corticosteroids as part of management of preterm labour International Code of Marketing of Breastmilk Substitutes Community treatment of pneumonia with antibiotics Low osmolarity ORS and zinc for management of diarrhoea ### SYSTEMS Costed national implementation plan(s) for: maternal, newborn and child health available Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - Maternal health (X of 3) - Newborn health (X of 4) - Child health (X of 3) Density of doctors, nurses and midwives (per 10,000 population) National availability of Emergency Obstetric Care services (% of recommended minimum) ### FINANCING Per capita total expenditure on health (int$) General government expenditure on health as % of total government expenditure (%) Out of pocket expenditure as % of total expenditure on health(%) Reproductive, maternal, newborn and child health expenditure by source ODA to child health per child (US$) ODA to maternal and neonatal health per live birth (US$) \| Indicator \| Value \| \|------------------------------------------------\|--------\| \| Total population (000) \| 9,309 \| \| Total under-five population (000) \| 768 \| \| Births (000) \| 168 \| \| Birth registration (%) \| 94 \| \| Total under-five deaths (000) \| 6 \| \| Neonatal deaths: % of all under-5 deaths \| 43 \| \| Neonatal mortality rate (per 1000 live births) \| 15 \| \| Infant mortality rate (per 1000 live births) \| 31 \| \| Stillbirth rate (per 1000 total births) \| 12 \| \| Total maternal deaths \| 43 \| \| Lifetime risk of maternal death (1 in N) \| 1,800 \| \| Total fertility rate (per woman) \| 1.9 \| \| Adolescent birth rate (per 1000 girls) \| 47 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 93 - 1995: 80 - 2000: 60 - 2005: 40 - 2010: 35 - 2015: 31 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births** - 1990: 60 - 1995: 80 - 2000: 60 - 2005: 40 - 2010: 26 - 2015: 15 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 77 \| \| Antenatal care (4+ visits) \| 45 \| \| Skilled attendant at delivery \| 99 \| \| Postnatal care \| 66 \| \| Exclusive breastfeeding \| 12 \| \| Measles \| 66 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1990: 97 - 1998: 100 - 2000: 84 - 2006: 88 - 2010: 99 #### Prevention of mother-to-child transmission of HIV - Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs): - - Percent HIV+ pregnant women receiving ARVs for PMTCT: - - Uncertainty range around the estimate: - Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| 80 \| 90 \| \| Antenatal care (4+ visits) \| 60 \| 80 \| \| Skilled attendant at delivery \| 80 \| 90 \| \| Early initiation of breastfeeding \| 60 \| 80 \| \| ITN use among children <5 yrs \| 60 \| 80 \| \| DTP3 \| 60 \| 80 \| \| Measles \| 60 \| 80 \| \| Vitamin A (past 6 months) \| 60 \| 80 \| \| ORT & continued feeding \| 60 \| 80 \| \| Caseseeking for pneumonia \| 60 \| 80 \| Source: DHS 2006 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 60 - 1995: 70 - 2000: 80 - 2005: 90 - 2012: 91 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2000: 36 MICS ### NUTRITION - Wasting prevalence (moderate and severe, %): 7 (2006) - Low birthweight incidence (moderate and severe, %): 10 (2006) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1996: 28 - 2000: 24 - 2001: 6 - 2006: 8 - 2012: 27 #### Early initiation of breastfeeding (within 1 hr of birth, %): 32 (2006) #### Introduction of solid, semi-solid/soft foods (%): 83 (2006) #### Vitamin A two dose coverage (%): 90 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2000: 7 - 2006: 12 DHS ## Azerbaijan ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 16% - Preterm: 17% - Neonatal death: 43% - Asphyxia: 8% - Other: 5% - Congenital: 6% - Sepsis: 5% - Diarrhoea: 8% - Measles: 0% - Injuries: 8% - Malaria: 0% - HIV/AIDS: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths (49%) are attributable to undernutrition. Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 15% - Indirect: 22% - Other direct: 17% - Abortion: 9% - Sepsis: 9% - Embolism: 11% Regional estimates for Caucasus and Central Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| MoH \| MICS \| Other NS \| DHS \| \|------\|-----\|------\|----------\|-----\| \| 1997 \| 98 \| 66 \| 70 \| 77 \| Demand for family planning satisfied (%) 77 (2006) Antenatal care (4 or more visits, %) 45 (2006) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 5, 5, 4 (2006) Neonatal tetanus vaccine - Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 66 (2006) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS \| DHS \| \|------\|------\|-----\| \| 2000 \| 40 \| 10 \| \| 2006 \| 31 \| 21 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial Percent children < 5 years sleeping under ITNs \| Year \| MICS \| \|------\|------\| \| 2000 \| 1 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 44 \| 67 \| 19 \| \| 2012 \| 51 \| 78 \| 20 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 37 \| 70 \| 52 \| \| 2012 \| 55 \| 76 \| 33 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - - Legal status of abortion (X of 5 circumstances) 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks) - - Maternity protection (Convention 183) Yes - Maternal deaths notification Yes - Postnatal home visits in the first week after birth No - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - - Antenatal corticosteroids as part of management of preterm labour - - International Code of Marketing of Breastmilk Substitutes Yes - Community treatment of pneumonia with antibiotics - - Low osmolarity ORS and zinc for management of diarrhoea - ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) 1 (2013) - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) - - Density of doctors, nurses and midwives (per 10,000 population) 101.2 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum) - ### FINANCING - Per capita total expenditure on health (int$) 572 (2012) - General government expenditure on health as % of total government expenditure (%) 4 (2012) - Out of pocket expenditure as % of total expenditure on health(%) 69 (2012) - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 9 (2011) - ODA to maternal and neonatal health per live birth (US$) 18 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| \|------------------------------------------------\|-----------\| \| Total population (000) \| 154,695 \| \| Total under-five population (000) \| 15,074 \| \| Births (000) \| 3,150 \| \| Birth registration (%) \| 31 \| \| Total under-five deaths (000) \| 127 \| \| Neonatal deaths: % of all under-5 deaths \| 60 \| \| Neonatal mortality rate (per 1000 live births) \| 24 \| \| Infant mortality rate (per 1000 live births) \| 33 \| \| Stillbirth rate (per 1000 total births) \| 36 \| \| Total maternal deaths \| 5,200 \| \| Lifetime risk of maternal death (1 in N) \| 250 \| \| Total fertility rate (per woman) \| 2.2 \| \| Adolescent birth rate (per 1000 girls) \| 128 \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 82 \| \| Antenatal care (4+ visits) \| 26 \| \| Skilled attendant at delivery \| 32 \| \| Postnatal care \| 27 \| \| Exclusive breastfeeding \| 64 \| \| Measles \| 96 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1993-94 DHS \| 10 \| \| 1999-00 DHS \| 12 \| \| 2003 MICS \| 14 \| \| 2007 DHS \| 18 \| \| 2011 DHS \| 32 \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| - \| \| 2011 \| - \| \| 2012 \| - \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Year \| Percent \| \|------\|---------\| \| 2010 \| - \| \| 2011 \| - \| \| 2012 \| - \| Uncertainty range around the estimate ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: ▲ Poorest 20% ● Richest 20% \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 82 \| \| Antenatal care (1+ visit) \| 26 \| \| Antenatal care (4+ visits) \| 26 \| \| Skilled attendant at delivery \| 32 \| \| Early initiation of breastfeeding \| 27 \| \| ITN use among children <5 yrs \| 27 \| \| DTP3 \| 27 \| \| Measles \| 27 \| \| Vitamin A (past 6 months) \| 27 \| \| ORT & continued feeding \| 27 \| \| Caseseeking for pneumonia \| 27 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 60 \| \| 1995 \| 60 \| \| 2000 \| 60 \| \| 2005 \| 60 \| \| 2012 \| 60 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1993-94 DHS \| 28 \| \| 1996-97 DHS \| 33 \| \| 1999-00 DHS \| 27 \| \| 2004 DHS \| 20 \| \| 2006 MICS \| 30 \| \| 2011 DHS \| 35 \| \| 2012 DHS \| 71 \| ## NUTRITION Wasting prevalence (moderate and severe, %) 16 (2011) Low birthweight incidence (moderate and severe, %) 22 (2006) Early initiation of breastfeeding (within 1 hr of birth, %) 47 (2011) Introduction of solid, semi-solid/soft foods (%) 62 (2011) Vitamin A two dose coverage (%) 99 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1989-90 Other NS \| 62 \| \| 1996-97 DHS \| 63 \| \| 1999-00 DHS \| 53 \| \| 2004 DHS \| 51 \| \| 2007 DHS \| 43 \| \| 2011 DHS \| 37 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1993-94 DHS \| 46 \| \| 1996-97 DHS \| 45 \| \| 1999-00 DHS \| 46 \| \| 2004 DHS \| 42 \| \| 2007 DHS \| 43 \| \| 2011 DHS \| 64 \| ## Bangladesh ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 60% - Asphyxia: 13% - Preterm: 19% - Pneumonia: 11% - Other: 7% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 6% - Measles: 2% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 30% - Sepsis: 14% - Embolism: 2% - Abortion: 8% - Other direct: 8% - Indirect: 29% - Hypertension: 10% Source: WHO 2014 Regional estimates for Southern Asia, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total DHS \| MICs \| DHS \| \|------------\|-----------\|------\|-----\| \| 1993-94 \| 26 \| \| \| \| 1999-00 \| 33 \| \| \| \| 2003 \| 40 \| \| \| \| 2007 \| 52 \| \| \| \| 2011 \| 55 \| \| \| Demand for family planning satisfied (%) 82 (2011) Antenatal care (4 or more visits, %) 26 (2011) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 17, 29, 14 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 94 (2012) Postnatal visit for baby (within 2 days for home births, %) 30 (2011) Postnatal visit for mother (within 2 days for home births, %) 27 (2011) Women with low body mass index (<18.5 kg/m², %) 28 (2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total DHS \| MICs \| DHS \| \|------------\|-----------\|------\|-----\| \| 1993-94 \| 50 \| \| \| \| 1999-00 \| 61 \| \| \| \| 2004 \| 52 \| \| \| \| 2007 \| 67 \| \| \| \| 2011 \| 77 \| \| \| \| 2011 \| 76 \| \| \| \| 2011 \| 78 \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 63 \| 10 \| 0 \| \| 2012 \| 75 \| 23 \| 32 \| \| 1990 \| 26 \| 15 \| 0 \| \| 2012 \| 58 \| 17 \| 30 \| \| 1990 \| 0 \| 0 \| 0 \| \| 2012 \| 0 \| 0 \| 0 \| Source: WHO/UNICEF JMP 2014 Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 14 \| 12 \| 10 \| \| 2012 \| 17 \| 28 \| 15 \| \| 1990 \| 16 \| 17 \| 19 \| \| 2012 \| 19 \| 25 \| 30 \| \| 1990 \| 33 \| 57 \| 46 \| \| 2012 \| 30 \| 50 \| 70 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 6 - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 2 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 5.7 (2011) - National availability of Emergency Obstetric Care services (% of recommended minimum): 54 (2007) ### FINANCING - Per capita total expenditure on health (int$): 68 (2012) - General government expenditure on health as % of total government expenditure (%): 8 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 63 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 7 (2011) - ODA to maternal and neonatal health per live birth (US$): 17 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 10,051 \| \| \| Total under-five population (000) \| 1,631 \| \| \| Births (000) \| 371 \| \| \| Birth registration (%) \| 80 \| 2011-2012\| \| Total under-five deaths (000) \| 32 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 31 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 28 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 59 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 24 \| 2009 \| \| Total maternal deaths \| 1,300 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 59 \| 2013 \| \| Total fertility rate (per woman) \| 4.9 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 98 \| 2009 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 181 - 1995: 150 - 2000: 120 - 2005: 100 - 2010: 80 - 2015: 60 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 600 - 1995: 500 - 2000: 400 - 2005: 300 - 2010: 200 - 2015*: 150 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 28 \| \| \| Antenatal care (4+ visits) \| 61 \| \| \| Skilled attendant at delivery \| 84 \| \| \| Postnatal care \| \| \| \| Exclusive breastfeeding \| 33 \| \| \| Measles \| 72 \| \| * See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1996 DHS: 60 - 2001 DHS: 66 - 2006 DHS: 74 - 2011-2012 DHS: 84 #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Uncertainty range around the estimate \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\|-------------------------------------\| \| 2010 \| 22 \| 22 \| 22 \| \| 2011 \| 32 \| 32 \| 32 \| \| 2012 \| 40 \| 40 \| 40 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 28 \| 61 \| \| Antenatal care (1+ visit) \| 61 \| 84 \| \| Antenatal care (4+ visits) \| 84 \| 100 \| \| Skilled attendant at delivery \| 84 \| 100 \| \| Early initiation of breastfeeding \| 84 \| 100 \| \| ITN use among children <5 yrs \| 84 \| 100 \| #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 60 - 1995: 60 - 2000: 60 - 2005: 60 - 2012: 60 Source: WHO/UNICEF 2013 ### CHILD HEALTH #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1996 DHS: 32 - 2001 DHS: 35 - 2006 DHS: 36 - 2011-2012 DHS: 31 #### NUTRITION Wasting prevalence (moderate and severe, %) - 2011-2012: 16 Low birthweight incidence (moderate and severe, %) - 2006: 15 Early initiation of breastfeeding (within 1 hr of birth, %) - 2011-2012: 50 Introduction of solid, semi-solid/soft foods (%) - 2008: 76 Vitamin A two dose coverage (%) - 2012: 99 #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1996 DHS: 26 - 2001 DHS: 39 - 2006 DHS: 45 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1996 DHS: 10 - 2001 DHS: 38 - 2006 DHS: 43 - 2011-2012 DHS: 33 ## Benin ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 13% - Preterm: 10% - Asphyxia: 9% - Globally nearly half child deaths are attributable to undernutrition - Neonatal death: 32% - Congenital: 3% - Sepsis: 6% - Other: 1% - HIV/AIDS: 1% - Malaria: 21% - Injuries: 5% - Measles: 1% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Other direct: 9% - Abortion: 10% Source: WHO 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| \|------------\|-------\| \| 1996 \| 80 \| \| 2001 \| 81 \| \| 2006 \| 84 \| \| 2011-2012 \| 86 \| Demand for family planning satisfied (%) 28 (2012) Antenatal care (4 or more visits, %) 61 (2006) Malaria during pregnancy - intermittent preventive treatment (%) 23 (2011-2012) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 4, 6, 2 (2006) Neonatal tetanus vaccine 93 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------------\|-------\| \| 1996 \| 26 \| \| 2001 \| 42 \| \| 2006 \| 23 \| \| 2011-2012 \| 29 \| \| 2011-2012 \| 50 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| \|------------\|-------\| \| 2001 \| 7 \| \| 2006 \| 20 \| \| 2011-2012 \| 71 \| Percent children < 5 years sleeping under ITNs 32 (2011-2012) ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 52 \| 16 \| 21 \| \| 2012 \| 65 \| 32 \| 4 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 14 \| 14 \| 0 \| \| 2012 \| 27 \| 11 \| 7 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 3 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Yes - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 8.3 (2008) - National availability of Emergency Obstetric Care services (% of recommended minimum): 34 (2011) ### FINANCING - Per capita total expenditure on health (int$): 70 (2012) - General government expenditure on health as % of total government expenditure (%): 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 44 (2012) Reproductive, maternal, newborn and child health expenditure by source - External sources - General government expenditure - Out-of-pocket expenditure - Other ODA to child health per child (US$): 26 (2011) ODA to maternal and neonatal health per live birth (US$): 43 (2011) \| Metric \| Value \| \|---------------------------------------------\|--------\| \| Total population (000) \| 10,496 \| \| Total under-five population (000) \| 1,264 \| \| Births (000) \| 273 \| \| Birth registration (%) \| 76 \| \| Total under-five deaths (000) \| 11 \| \| Neonatal deaths: % of all under-5 deaths \| 46 \| \| Neonatal mortality rate (per 1000 live births) \| 19 \| \| Infant mortality rate (per 1000 live births)\| 33 \| \| Stillbirth rate (per 1000 total births) \| 17 \| \| Total maternal deaths \| 550 \| \| Lifetime risk of maternal death (1 in N) \| 140 \| \| Total fertility rate (per woman) \| 3.3 \| \| Adolescent birth rate (per 1000 girls) \| 89 \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 123 \| \| 1995 \| 112 \| \| 2000 \| 100 \| \| 2005 \| 85 \| \| 2010 \| 61 \| \| 2015 \| 41 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|-------------------------------\| \| 1990 \| 510 \| \| 1995 \| 480 \| \| 2000 \| 450 \| \| 2005 \| 360 \| \| 2010 \| 270 \| \| 2015 \| 130 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 75 \| \| Antenatal care (4+ visits) \| 72 \| \| Skilled attendant at delivery \| 71 \| \| Postnatal care \| 77 \| \| Exclusive breastfeeding \| 60 \| \| Measles \| 84 \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1989 \| 43 \| \| 1994 \| 47 \| \| 1998 \| 59 \| \| 2000 \| 69 \| \| 2003 \| 61 \| \| 2008 \| 71 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| \|------\|-------------------------------------------------------------------------------------\| \| 2010 \| 75 \| \| 2011 \| 75 \| \| 2012 \| 75 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 60 \| 80 \| \| Antenatal care (1+ visit) \| 50 \| 70 \| \| Antenatal care (4+ visits) \| 50 \| 70 \| \| Skilled attendant at delivery \| 40 \| 60 \| \| Early initiation of breastfeeding \| 30 \| 50 \| \| ITN use among children <5 yrs \| 20 \| 40 \| \| DTP3 \| 10 \| 30 \| \| Measles \| 10 \| 30 \| \| Vitamin A (past 6 months) \| 10 \| 30 \| \| ORT & continued feeding \| 10 \| 30 \| \| Caseseeking for pneumonia \| 10 \| 30 \| Source: DHS 2008 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 60 \| \| 2000 \| 80 \| \| 2005 \| 100 \| \| 2012 \| 100 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1994 \| 40 \| \| 1998 \| 43 \| \| 2000 \| 54 \| \| 2003 \| 52 \| \| 2008 \| 51 \| \| 2012 \| 64 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 1 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 6 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 64 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 83 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 41 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1989 \| 8 \| \| 1994 \| 11 \| \| 1998 \| 6 \| \| 2003 \| 6 \| \| 2008 \| 5 \| \| 2012 \| 27 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1989 \| 51 \| \| 1994 \| 43 \| \| 1998 \| 50 \| \| 2000 \| 39 \| \| 2003 \| 54 \| \| 2008 \| 60 \| ## Bolivia ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 15% - Preterm: 13% - Neonatal death: 46% - Asphyxia: 13% - Other: 23% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 7% - Measles: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 22% - Indirect: 19% - Other direct: 15% - Sepsis: 8% - Embolism: 3% Source: WHO 2014 Regional estimates for Latin America, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total DHS \| Urban DHS \| Rural DHS \| \|------\|-----------\|-----------\|-----------\| \| 1989 \| 46 \| \| \| \| 1994 \| 53 \| \| \| \| 1998 \| 69 \| \| \| \| 2000 \| 83 \| \| \| \| 2003 \| 79 \| \| \| \| 2008 \| 86 \| \| \| Demand for family planning satisfied (%) 75 (2008) Antenatal care (4 or more visits, %) 72 (2008) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 19, 28, 8 (2008) Neonatal tetanus vaccine 76 (2012) Postnatal visit for baby (within 2 days for home births, %) 77 (2008) Postnatal visit for mother (within 2 days for home births, %) 77 (2008) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total DHS \| Urban DHS \| Rural DHS \| \|------\|-----------\|-----------\|-----------\| \| 1994 \| 33 \| 30 \| \| \| 1998 \| 59 \| 25 \| \| \| 2000 \| 54 \| 29 \| \| \| 2003 \| 29 \| \| \| \| 2008 \| 35 \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| Total DHS \| Urban DHS \| Rural DHS \| \|------\|-----------\|-----------\|-----------\| \| 1994 \| 33 \| 30 \| \| \| 1998 \| 59 \| 25 \| \| \| 2000 \| 54 \| 29 \| \| \| 2003 \| 29 \| \| \| \| 2008 \| 35 \| \| \| Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 49 \| 12 \| 1 \| \| 2012 \| 83 \| 12 \| 0 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 46 \| 14 \| 19 \| \| 2012 \| 46 \| 14 \| 19 \| Source: WHO/UNICEF JMP 2014 ### POLICIES Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent Partial Legal status of abortion (X of 5 circumstances) 3 (R) Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) Partial Maternal deaths notification Yes Postnatal home visits in the first week after birth No Kangaroo Mother Care in facilities for low birthweight/preterm newborns No Antenatal corticosteroids as part of management of preterm labour Yes International Code of Marketing of Breastmilk Substitutes Partial Community treatment of pneumonia with antibiotics No Low osmolarity ORS and zinc for management of diarrhoea Yes ### SYSTEMS Costed national implementation plan(s) for: maternal, newborn and child health available Partial (2013) Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) 3 (2013) - Maternal health (X of 3) 3 (2013) - Newborn health (X of 4) 3 (2013) - Child health (X of 3) 3 (2013) Density of doctors, nurses and midwives (per 10,000 population) 14.8 (2011) National availability of Emergency Obstetric Care services (% of recommended minimum) 48 (2003) ### FINANCING Per capita total expenditure on health (int$) 305 (2012) General government expenditure on health as % of total government expenditure (%) 10 (2012) Out of pocket expenditure as % of total expenditure on health(%) 23 (2012) Reproductive, maternal, newborn and child health expenditure by source No Data ODA to child health per child (US$) 18 (2011) ODA to maternal and neonatal health per live birth (US$) 34 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 2,004 \| 2013 \| \| Total under-five population (000) \| 232 \| 2013 \| \| Births (000) \| 48 \| 2012 \| \| Birth registration (%) \| 72 \| 2007 \| \| Total under-five deaths (000) \| 3 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 54 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 29 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 41 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 16 \| 2009 \| \| Total maternal deaths \| 83 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 200 \| 2013 \| \| Total fertility rate (per woman) \| 2.7 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 51 \| 2006 \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------\|------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (4+ visits) \| 73 \| 2012 \| \| Skilled attendant at delivery \| 95 \| 2012 \| \| Postnatal care \| \| \| \| Exclusive breastfeeding \| 20 \| 2012 \| \| Measles \| 94 \| 2012 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| DHS \| Other NS \| MICS \| Other NS \| \|------\|-----\|----------\|------\|----------\| \| 1988 \| 78 \| 87 \| 94 \| 95 \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| 2010 \| 2011 \| 2012 \| \|------\|------\|------\|------\| \| \| >95 \| >95 \| >95 \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Year \| 2010 \| 2011 \| 2012 \| \|------\|------\|------\|------\| \| \| >95 \| >95 \| >95 \| ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------\|------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| No Data \| \| \| ITN use among children <5 yrs \| No Data \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Careseeking for pneumonia \| \| \| ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| 1990 \| 1995 \| 2000 \| 2005 \| 2012 \| \|------\|------\|------\|------\|------\|------\| \| \| 96 \| 96 \| 96 \| 96 \| 94 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taking to appropriate health provider - receiving antibiotics \| Year \| 2000 \| \|------\|------\| \| \| 14 \| MICS ## NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| 2007 \| \|------\|------\| \| \| 7 \| Low birthweight incidence (moderate and severe, %) \| Year \| 2007 \| \|------\|------\| \| \| 13 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| 2007 \| \|------\|------\| \| \| 40 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| 2007 \| \|------\|------\| \| \| 46 \| Vitamin A two dose coverage (%) \| Year \| 2007 \| \|------\|------\| \| \| - \| ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| 1996 \| 2000 \| 2007 \| \|------\|------\|------\|------\| \| \| 15 \| 11 \| 11 \| \| \| 35 \| 29 \| 31 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| 2000 \| 2007 \| \|------\|------\|------\| \| \| 34 \| 20 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. Note: MDG target calculated by Countdown to 2015. ## Botswana ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 54% - Preterm: 21% - Asphyxia: 13% - Other: 3% - Sepsis: 9% - Congenital: 6% - Diarrhoea: 7% - Measles: 1% - Injuries: 5% - Malaria: 0% - HIV/AIDS: 5% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| MICS \| Other NS \| \|------\|-------\|------\|----------\| \| 1988 \| 92 \| \| \| \| 2000 \| 97 \| \| \| \| 2007 \| 94 \| \| \| Demand for family planning satisfied (%) Antenatal care (4 or more visits, %) 73 (2007) Malaria during pregnancy - intermittent preventive treatment (%) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 92 (2012) Postnatal visit for baby (within 2 days for home births, %) Postnatal visit for mother (within 2 days for home births, %) Women with low body mass index (<18.5 kg/m², %) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| Other NS \| \|------\|-------\|----------\| \| 2000 \| 49 \| 7 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 70 \| 0 \| 0 \| \| 2012 \| 90 \| 76 \| 55 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 15 \| 21 \| 5 \| \| 2012 \| 13 \| 8 \| 12 \| Source: WHO/UNICEF JMP 2014 ### POLICIES \| Policy \| Status \| \|----------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Yes \| \| Legal status of abortion (X of 5 circumstances) \| 3 (R,F)\| \| Midwives authorized for specific tasks (X of 7 tasks) \| 5 \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| No \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| Yes \| \| Community treatment of pneumonia with antibiotics \| No \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Status \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Yes \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 1 \| 2013 \| \| Maternal health (X of 3) \| 2 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 31.8 \| 2006 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| - \| - \| ### FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (int$) \| 872 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 8 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 6 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 10 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 26 \| 2011 \| \| Indicator \| Value 2012 \| Value 2010 \| \|------------------------------------------------\|------------\|------------\| \| Total population (000) \| 198,656 \| \| \| Total under-five population (000) \| 14,563 \| \| \| Births (000) \| 3,009 \| \| \| Birth registration (%) \| 93 \| \| \| Total under-five deaths (000) \| 42 \| \| \| Neonatal deaths: % of all under-5 deaths \| 64 \| \| \| Neonatal mortality rate (per 1000 live births) \| 9 \| \| \| Infant mortality rate (per 1000 live births) \| 13 \| \| \| Stillbirth rate (per 1000 total births) \| 10 \| \| \| Total maternal deaths \| 2,100 \| \| \| Lifetime risk of maternal death (1 in N) \| 780 \| \| \| Total fertility rate (per woman) \| 1.8 \| \| \| Adolescent birth rate (per 1000 girls) \| 65 \| \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 62 \| \| 1995 \| 60 \| \| 2000 \| 45 \| \| 2005 \| 14 \| \| 2010 \| 21 \| \| 2015 \| 21 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 120 \| \| 1995 \| 90 \| \| 2000 \| 60 \| \| 2005 \| 30 \| \| 2010 \| 30 \| \| 2015 \| 30 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 93 \| \| Antenatal care (1+ visit) \| 91 \| \| Skilled attendant at delivery \| 97 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 41 \| \| Measles \| 99 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1991 \| 70 \| \| 1996 \| 88 \| \| 2006 \| 97 \| Source: DHS, MoH #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| = \| \| 2011 \| = \| \| 2012 \| = \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: ● Poorest 20% ○ Richest 20% \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Careseeking for pneumonia \| \| Source: DHS 2006-2007 Coverage levels are shown for the poorest 20% (black circle) and the richest 20% (orange circle). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 90 \| \| 1995 \| 95 \| \| 2000 \| 95 \| \| 2005 \| 95 \| \| 2012 \| 89 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1996 \| 46 \| \| 2006 \| 50 \| Source: DHS, MoH ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2006-2007 \| 2 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 8 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 68 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2006 \| 70 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| \| - \| ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1989 \| 5 \| \| 1996 \| 5 \| \| 2002-2003 \| 4 \| \| 2006-2007 \| 2 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2006 \| 40 \| \| 2008 \| 41 \| Source: MoH ## Brazil ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 6% - Preterm: 21% - Neonatal death: 64% - Asphyxia: 10% - Other: 10% Intrapartum-related events Causes of maternal deaths, 2013 - Sepsis: 8% - Embolism: 3% - Haemorrhage: 23% - Hypertension: 22% - Indirect: 19% - Other direct: 15% ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1986 DHS \| 74 \| \| \| \| 1996 DHS \| 86 \| \| \| \| 2003 MoH \| 97 \| \| \| \| 2006 MoH \| 98 \| \| \| \| 2009 MoH \| 98 \| \| \| Demand for family planning satisfied (%) (2006) 93 Antenatal care (4 or more visits, %) (2009) 91 Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 50, -, - Neonatal tetanus vaccine (2012) 93 Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) (1996) 6 ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| \|------\|-------\| \| 1991 DHS \| 27 \| \| 1996 DHS \| 44 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 78 \| 92 \| 92 \| \| 2012 \| 92 \| 97 \| 67 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 15 \| 15 \| 11 \| \| 2012 \| 33 \| 33 \| 17 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of 5 circumstances): 1 (R) - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: - - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 0 (2013) - Maternal health (X of 3): - - Newborn health (X of 4): - - Child health (X of 3): - - Density of doctors, nurses and midwives (per 10,000 population): 94.9 (2013) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (in$): 1,109 (2012) - General government expenditure on health as % of total government expenditure (%): 8 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 31 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 1 (2011) - ODA to maternal and neonatal health per live birth (US$): 1 (2011) \| Metric \| Value \| Year \| \|---------------------------------------------\|-----------\|------\| \| Total population (000) \| 16,460 \| 2013 \| \| Total under-five population (000) \| 2,932 \| 2013 \| \| Births (000) \| 683 \| 2012 \| \| Birth registration (%) \| 77 \| \| \| Total under-five deaths (000) \| 66 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 27 \| \| \| Neonatal mortality rate (per 1000 live births)\| 28 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 66 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 26 \| 2009 \| \| Total maternal deaths \| 2,800 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 44 \| 2013 \| \| Total fertility rate (per woman) \| 5.7 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 136 \| 2008 \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 202 \| \| 1995 \| \| \| 2000 \| \| \| 2005 \| \| \| 2010 \| \| \| 2015 \| 67 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|-------------------------------\| \| 1990 \| 770 \| \| 1995 \| \| \| 2000 \| \| \| 2005 \| \| \| 2010 \| \| \| 2015 \| 190 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percent \| \|----------------------------------------------\|---------\| \| Demand for family planning satisfied \| 40 \| \| Antenatal care (4+ visits) \| 34 \| \| Skilled attendant at delivery \| 66 \| \| Postnatal care \| 72 \| \| Exclusive breastfeeding \| 38 \| \| Measles \| 87 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1993 \| 42 \| \| 1998-1999 \| 31 \| \| 2003 \| 38 \| \| 2006 \| 54 \| \| 2010 \| 66 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| Percent \| \|------\|-------------------------------------------------------------------------------------\|---------\| \| 2010 \| 50 \| \| 2011 \| 56 \| \| 2012 \| 66 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Caseseeking for pneumonia \| \| \| Source: DHS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 90 \| \| 1995 \| 87 \| \| 2000 \| 90 \| \| 2005 \| 90 \| \| 2012 \| 90 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1993 \| 19 \| \| 1998-1999 \| 12 \| \| 2003 \| 36 \| \| 2006 \| 39 \| \| 2010 \| 56 \| \| 2012 \| 47 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 11 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 14 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 42 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 57 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 99 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1993 \| 30 \| \| 1998-1999 \| 34 \| \| 2003 \| 43 \| \| 2006 \| 38 \| \| 2009 \| 42 \| \| 2012 \| 33 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1993 \| 3 \| \| 1998-1999 \| 6 \| \| 2003 \| 19 \| \| 2006 \| 7 \| \| 2010 \| 25 \| \| 2012 \| 38 \| ## Burkina Faso ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Malaria: 23% - Pneumonia: 14% - Diarrhoea: 10% - Injuries: 5% - Other: 20% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Sepsis: 10% - Embolism: 2% ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1993 DHS \| 59 \| 61 \| 57 \| \| 1998–1999 DHS \| 61 \| 61 \| 61 \| \| 2003 DHS \| 73 \| 73 \| 73 \| \| 2006 MICS \| 85 \| 85 \| 85 \| \| 2010 DHS \| 94 \| 94 \| 94 \| Demand for family planning satisfied (%) 40 (2010) Antenatal care (4 or more visits, %) 34 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 11 (2012) C-section rate (total, urban, rural; %) 2, 6, 1 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 88 (2012) Postnatal visit for baby (within 2 days for home births, %) 26 (2010) Postnatal visit for mother (within 2 days for home births, %) 72 (2010) Women with low body mass index (<18.5 kg/m², %) 14 (2010) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1993 DHS \| 12 \| 15 \| 12 \| \| 1998–1999 DHS \| 15 \| 15 \| 15 \| \| 2003 DHS \| 47 \| 47 \| 47 \| \| 2006 MICS \| 19 \| 19 \| 19 \| \| 2010 DHS \| 42 \| 42 \| 42 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2003 DHS \| 2 \| 2 \| 2 \| \| 2006 MICS \| 10 \| 10 \| 10 \| \| 2010 DHS \| 47 \| 47 \| 47 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990–2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 42 \| 48 \| 42 \| \| 2012 \| 75 \| 14 \| 75 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990–2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 7 \| 7 \| 7 \| \| 2012 \| 17 \| 17 \| 17 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 3 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Yes - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 6.1 (2010) - National availability of Emergency Obstetric Care services (% of recommended minimum): 16 (2011) ### FINANCING - Per capita total expenditure on health (int$): 90 (2012) - General government expenditure on health as % of total government expenditure (%): 12 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 36 (2012) - Reproductive, maternal, newborn and child health expenditure by source: - External sources: 28 (2013) - General government expenditure: 40 (2013) - Out-of-pocket expenditure: 30 (2013) - Other: 2 (2013) - ODA to child health per child (US$): 14 (2013) - ODA to maternal and neonatal health per live birth (US$): 31 (2011) \| Indicator \| Value \| \|------------------------------------------------\|-----------\| \| Total population (000) \| 9,850 \| \| Total under-five population (000) \| 1,839 \| \| Births (000) \| 443 \| \| Birth registration (%) \| 75 \| \| Total under-five deaths (000) \| 43 \| \| Neonatal deaths: % of all under-5 deaths \| 35 \| \| Neonatal mortality rate (per 1000 live births) \| 36 \| \| Infant mortality rate (per 1000 live births) \| 67 \| \| Stillbirth rate (per 1000 total births) \| 28 \| \| Total maternal deaths \| 3,400 \| \| Lifetime risk of maternal death (1 in N) \| 22 \| \| Total fertility rate (per woman) \| 6.1 \| \| Adolescent birth rate (per 1000 girls) \| 65 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 164 - 1995: 150 - 2000: 130 - 2005: 110 - 2010: 104 - 2015: 55 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 1300 - 1995: 1200 - 2000: 1000 - 2005: 800 - 2010: 740 - 2015: 330 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 40 \| \| Antenatal care (4+ visits) \| 33 \| \| Skilled attendant at delivery \| 60 \| \| Postnatal care \| 30 \| \| Exclusive breastfeeding \| 69 \| \| Measles \| 93 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1987 DHS: 19 - 2000 MICS: 25 - 2005 MICS: 34 - 2010 DHS: 60 #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| 47 \| 49 \| \| 2011 \| 51 \| 51 \| \| 2012 \| 54 \| 54 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 30 \| 90 \| \| Antenatal care (1+ visit) \| 30 \| 90 \| \| Antenatal care (4+ visits) \| 30 \| 90 \| \| Skilled attendant at delivery \| 50 \| 90 \| \| Early initiation of breastfeeding \| 50 \| 90 \| \| ITN use among children <5 yrs \| 30 \| 90 \| \| DTP3 \| 30 \| 90 \| \| Measles \| 30 \| 90 \| \| Vitamin A (past 6 months) \| 30 \| 90 \| \| ORT & continued feeding \| 30 \| 90 \| \| Case-seeking for pneumonia \| 30 \| 90 \| Source: DHS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 100 - 1995: 80 - 2000: 60 - 2005: 80 - 2012: 90 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2000 MICS: 40 - 2005 MICS: 38 - 2010 DHS: 55 ### NUTRITION - Wasting prevalence (moderate and severe, %): 6 (2010) - Low birthweight incidence (moderate and severe, %): 13 (2010) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1987 DHS: 34/56 - 2000 MICS: 39/63 - 2005 Other NS: 35/58 - 2010 DHS: 29/58 #### Early initiation of breastfeeding (within 1 hr of birth, %): 74 (2010) #### Introduction of solid, semi-solid/soft foods (%): 70 (2010) #### Vitamin A two dose coverage (%): - #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1987 DHS: 77 - 2000 MICS: 62 - 2005 Other NS: 45 - 2010 DHS: 69 ## Burundi ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 17% - Preterm: 11% - Neonatal death: 35% - Asphyxia: 10% - Other: 2% - Globally nearly half child deaths are attributable to undernutrition - HIV/AIDS: 1% - Malaria: 5% - Injuries: 6% - Measles: 0% - Diphtheria: 9% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Other direct: 9% - Indirect: 29% - Hypertension: 16% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS/MICS \| \|------\|----------\| \| 1987 \| 79 \| \| 2000 \| 78 \| \| 2005 \| 92 \| \| 2010 \| 99 \| Demand for family planning satisfied (%) 40 (2010) Antenatal care (4 or more visits, %) 33 (2010) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 4, 12, 3 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) 8 (2010) Postnatal visit for mother (within 2 days for home births, %) 30 (2012) Women with low body mass index (<18.5 kg/m², %) 12 (2012) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS/DHS \| \|------\|----------\| \| 2000 \| 16 \| \| 2005 \| 23 \| \| 2010 \| 43 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| MICS/DHS \| \|------\|----------\| \| 2000 \| 1 \| \| 2005 \| 8 \| \| 2010 \| 45 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 66 \| 6 \| 10 \| \| 2012 \| 72 \| 48 \| 13 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 48 \| 40 \| 10 \| \| 2012 \| 43 \| 37 \| 9 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of S circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 2.2 (2004) - National availability of Emergency Obstetric Care services (% of recommended minimum): 27 (2010) ### FINANCING - Per capita total expenditure on health (int$): 45 (2012) - General government expenditure on health as % of total government expenditure (%): 14 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 28 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 21 (2013) - ODA to maternal and neonatal health per live birth (US$): 30 (2011) ## DEMOGRAPHICS \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 14,865 \| \| \| Total under-five population (000) \| 1,669 \| \| \| Births (000) \| 386 \| \| \| Birth registration (%) \| 62 \| \| \| Total under-five deaths (000) \| 14 \| \| \| Neonatal deaths: % of all under-5 deaths \| 47 \| \| \| Neonatal mortality rate (per 1000 live births) \| 18 \| \| \| Infant mortality rate (per 1000 live births) \| 34 \| \| \| Stillbirth rate (per 1000 total births) \| 18 \| \| \| Total maternal deaths \| 670 \| \| \| Lifetime risk of maternal death (1 in N) \| 180 \| \| \| Total fertility rate (per woman) \| 2.9 \| \| \| Adolescent birth rate (per 1000 girls) \| 30 \| \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Demand for family planning satisfied \| 75 \| \| \| Antenatal care (4+ visits) \| 59 \| \| \| Skilled attendant at delivery \| 72 \| \| \| Postnatal care \| 70 \| \| \| Exclusive breastfeeding \| 74 \| \| \| Measles \| 93 \| \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| 1998 MOH \| 2000 DHS \| 2005 DHS \| 2010 DHS \| 2011 Other NS \| \|------\|-----------\|----------\|----------\|----------\|---------------\| \| \| 34 \| 32 \| 44 \| 71 \| 72 \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| 2010 \| 2011 \| 2012 \| \|------\|------\|------\|------\| \| \| 80 \| 80 \| 80 \| ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: ▶ Poorest 20% ▶ Richest 20% \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Demand for family planning satisfied \| 75 \| \| \| Antenatal care (1+ visit) \| 59 \| \| \| Antenatal care (4+ visits) \| 72 \| \| \| Skilled attendant at delivery \| 70 \| \| \| Early initiation of breastfeeding \| 74 \| \| \| ITN use among children <5 yrs \| 93 \| \| ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| 1990 \| 1995 \| 2000 \| 2005 \| 2012 \| \|------\|------\|------\|------\|------\|------\| \| \| 30 \| 40 \| 50 \| 60 \| 70 \| ## CHILD HEALTH ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| 2000 DHS \| 2005 DHS \| 2010 DHS \| \|------\|----------\|----------\|----------\| \| \| 37 \| 48 \| 64 \| ## NUTRITION Wasting prevalence (moderate and severe, %): 11 (2010) Low birthweight incidence (moderate and severe, %): 11 (2010) Early initiation of breastfeeding (within 1 hr of birth, %): 66 (2010) Introduction of solid, semi-solid/soft foods (%): 88 (2010) Vitamin A two dose coverage (%): 98 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| 1996 Other NS \| 2000 DHS \| 2005 DHS \| 2008 Other NS \| 2010 DHS \| \|------\|---------------\|----------\|----------\|---------------\|----------\| \| \| 43 \| 40 \| 28 \| 29 \| 29 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| 2000 DHS \| 2005 DHS \| 2008 Other NS \| 2010 DHS \| \|------\|----------\|----------\|---------------\|----------\| \| \| 12 \| 60 \| 66 \| 74 \| ## Cambodia ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 15% - Preterm: 14% - Neonatal death: 48% - Asphyxia: 12% - Globally nearly half child deaths are attributable to undernutrition - Other: 21% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 0% - Measles: 0% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 30% - Indirect: 17% - Other direct: 14% - Sepsis: 6% - Abortion: 7% - Embolism: 12% Regional estimates for South-eastern Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| MoH \| DHS \| \|------\|-----\|-----\| \| 1998 \| 34 \| 38 \| \| 2000 \| \| \| \| 2005 \| 69 \| \| \| 2010 \| 89 \| \| Demand for family planning satisfied (%) 75 (2010) Antenatal care (4 or more visits, %) 59 (2010) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 3, -, - (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 91 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 70 (2012) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------\|-----\| \| 2000 \| 18 \| \| 2005 \| 50 \| \| 2010 \| 48 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| \|------\|-----\| \| 2005 \| 4 \| Percent children < 5 years sleeping under ITNs \| Year \| DHS \| \|------\|-----\| \| 2005 \| 4 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 36 \| 17 \| 42 \| \| 2012 \| 53 \| 27 \| 18 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 9 \| 14 \| 41 \| \| 2012 \| 54 \| 66 \| 66 \| Source: WHO/UNICEF JMP 2014 ### POLICIES \| Policy \| Status \| \|----------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Yes \| \| Legal status of abortion (X of 5 circumstances) \| 5 (R,F)\| \| Midwives authorized for specific tasks (X of 7 tasks) \| 7 \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| Yes \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| Yes \| \| Community treatment of pneumonia with antibiotics \| No \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Status \| \|----------------------------------------------------------------------\|--------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Partial (2013) \| \| Life Saving Commodities in Essential Medicine List: \| \| \| Reproductive health (X of 3) \| 1 (2013) \| \| Maternal health (X of 3) \| 3 (2013) \| \| Newborn health (X of 4) \| 3 (2013) \| \| Child health (X of 3) \| 3 (2013) \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 10.1 (2008) \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| 33 (2008) \| ### FINANCING \| Financing \| Status \| \|--------------------------------------------------------------------------\|--------\| \| Per capita total expenditure on health (int$) \| 135 (2012) \| \| General government expenditure on health as % of total government expenditure (%) \| 7 (2012) \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 62 (2012) \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data \| \| ODA to child health per child (US$) \| 27 (2011) \| \| ODA to maternal and neonatal health per live birth (US$) \| 64 (2011) \| \| Metric \| Value \| Year \| \|---------------------------------------------\|-----------\|------\| \| Total population (000) \| 21,700 \| 2013 \| \| Total under-five population (000) \| 3,572 \| 2013 \| \| Births (000) \| 820 \| 2012 \| \| Birth registration (%) \| 61 \| \| \| Total under-five deaths (000) \| 74 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 30 \| \| \| Neonatal mortality rate (per 1000 live births)\| 28 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 61 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 26 \| 2009 \| \| Total maternal deaths \| 4,900 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 34 \| 2013 \| \| Total fertility rate (per woman) \| 4.9 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 128 \| 2008 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 135 \| \| 1995 \| 120 \| \| 2000 \| 110 \| \| 2005 \| 100 \| \| 2010 \| 90 \| \| 2015 \| 45 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|-------------------------------\| \| 1990 \| 720 \| \| 1995 \| 650 \| \| 2000 \| 550 \| \| 2005 \| 450 \| \| 2010 \| 350 \| \| 2015 \| 180 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 50 \| \| Antenatal care (4+ visits) \| 62 \| \| Skilled attendant at delivery \| 64 \| \| Postnatal care \| 37 \| \| Exclusive breastfeeding \| 20 \| \| Measles \| 82 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1991 \| 64 \| \| 1998 \| 58 \| \| 2000 \| 60 \| \| 2004 \| 62 \| \| 2006 \| 63 \| \| 2011 \| 64 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| 56 \| 55 \| \| 2011 \| 55 \| 64 \| \| 2012 \| 64 \| \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Caseseeking for pneumonia \| \| \| Source: DHS 2011 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 40 \| \| 2000 \| 40 \| \| 2005 \| 40 \| \| 2012 \| 85 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1991 \| 44 \| \| 1998 \| 34 \| \| 2000 \| 25 \| \| 2004 \| 40 \| \| 2006 \| 35 \| \| 2011 \| 30 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2011 \| 6 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2006 \| 11 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2006 \| 20 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2006 \| 63 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 88 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1991 \| 18 \| \| 1998 \| 17 \| \| 2004 \| 15 \| \| 2006 \| 17 \| \| 2011 \| 15 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1991 \| 7 \| \| 1998 \| 12 \| \| 2004 \| 24 \| \| 2006 \| 21 \| \| 2011 \| 20 \| Causes of under-five deaths, 2012 - Pneumonia: 15% - Preterm: 8% - Asphyxia: 10% - Globally nearly half of child deaths are attributable to undernutrition - Neontal death: 30% - Other: 1% - Congenital: 2% - HIV/AIDS: 3% - Malaria: 12% - Injuries: 6% - Measles: 1% - Diarrhoea: 7% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Other direct: 9% - Indirect: 29% - Hypertension: 16% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1991 \| 79 \| 75 \| \| 1998 \| 79 \| \| \| 2000 \| \| \| \| 2004 \| 83 \| \| \| 2006 \| 82 \| \| \| 2011 \| 85 \| \| Demand for family planning satisfied (%) 50 (2011) Antenatal care (4 or more visits, %) 62 (2011) Malaria during pregnancy - intermittent preventive treatment (%) 26 (2011) C-section rate (total, urban, rural; %) 4, 7, 2 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 37 (2011) Women with low body mass index (<18.5 kg/m², %) 8 (2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1991 \| 18 \| 14 \| \| 1998 \| 22 \| 17 \| \| 2000 \| 32 \| 22 \| \| 2004 \| 43 \| 13 \| \| 2006 \| 47 \| 17 \| \| 2011 \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 2000 \| 1 \| 1 \| \| 2004 \| 13 \| \| \| 2006 \| 21 \| \| \| 2011 \| \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 35 \| 11 \| 16 \| \| 2012 \| 58 \| 20 \| 18 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 36 \| 13 \| 45 \| \| 2012 \| 54 \| 17 \| 54 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of 5 circumstances): 3 (R) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: No - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 5.2 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): 60 (2010) ### FINANCING - Per capita total expenditure on health (int$): 120 (2012) - General government expenditure on health as % of total government expenditure (%): 9 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 63 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 1,819 (2011) - ODA to maternal and neonatal health per live birth (US$): 23 (2011) ## Central African Republic ### DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 4,525 \| 2013 \| \| Total under-five population (000) \| 662 \| 2013 \| \| Births (000) \| 156 \| 2012 \| \| Birth registration (%) \| 61 \| \| \| Total under-five deaths (000) \| 19 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 32 \| \| \| Neonatal mortality rate (per 1000 live births) \| 41 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 91 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 24 \| 2009 \| \| Total maternal deaths \| 1,400 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 27 \| 2013 \| \| Total fertility rate (per woman) \| 4.5 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 229 \| 2009 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 171 \| \| 1995 \| 158 \| \| 2000 \| 145 \| \| 2005 \| 132 \| \| 2010 \| 129 \| \| 2015 \| 57 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1200 \| \| 1995 \| 1000 \| \| 2000 \| 800 \| \| 2005 \| 600 \| \| 2010 \| 400 \| \| 2015 \| 300 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 36 \| \| Antenatal care (4+ visits) \| 38 \| \| Skilled attendant at delivery \| 54 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 34 \| \| Measles \| 49 \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1994–1995 \| 46 \| \| 2000 \| 44 \| \| 2006 \| 53 \| \| 2009 \| 44 \| \| 2010 \| 54 \| #### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| No Data \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| No Data \| \| Uncertainty range around the estimate \| No Data \| ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 36 \| 46 \| \| Antenatal care (1+ visit) \| 50 \| 60 \| \| Antenatal care (4+ visits) \| 30 \| 50 \| \| Skilled attendant at delivery \| 30 \| 50 \| \| Early initiation of breastfeeding \| 30 \| 50 \| \| ITN use among children <5 yrs \| 30 \| 50 \| \| DTP3 \| 30 \| 50 \| \| Measles \| 30 \| 50 \| \| Vitamin A (past 6 months) \| 30 \| 50 \| \| ORT & continued feeding \| 30 \| 50 \| \| Caseseeking for pneumonia \| 30 \| 50 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Percent of children immunized: \| \| \| against measles \| 49 \| \| with 3 doses DTP \| 47 \| \| with 3 doses Hib \| 47 \| \| conjugate vaccine \| 47 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment \| Year \| Percent \| \|------\|---------\| \| 1994–1995 \| 41 \| \| 2000 \| 32 \| \| 2006 \| 32 \| \| 2010 \| 30 \| #### NUTRITION \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Wasting prevalence (moderate and severe, %) \| 7 \| \| Low birthweight incidence (moderate and severe, %) \| 14 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| 44 \| Introduction of solid, semi-solid/soft foods (%) \| 60 \| Vitamin A two dose coverage (%) \| 83 \| #### Underweight and stunting prevalence \| Year \| Underweight \| Stunted \| \|------\|-------------\|---------\| \| 1994–1995 \| 24 \| 42 \| \| 2000 \| 22 \| 45 \| \| 2006 \| 28 \| 45 \| \| 2010 \| 24 \| 41 \| #### Exclusive breastfeeding \| Year \| Percent \| \|------\|---------\| \| 1994–1995 \| 3 \| \| 2000 \| 17 \| \| 2006 \| 23 \| \| 2010 \| 34 \| ## Central African Republic ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Malaria: 25% - HIV/AIDS: 3% - Pneumonia: 12% - Diarrhoea: 9% - Measles: 1% - Injuries: 4% - Other: 15% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| MICS \| \|------------\|-----\|------\| \| 1994-1995 \| 67 \| 62 \| \| 2000 \| 69 \| \| \| 2006 \| 68 \| \| Demand for family planning satisfied (%) 36 (2010) Antenatal care (4 or more visits, %) 38 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 38 (2012) C-section rate (total, urban, rural; %) 5, 8, 2 (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 66 (2012) Postnatal visit for baby (within 2 days for home births, %) - - Postnatal visit for mother (within 2 days for home births, %) - - Women with low body mass index (<18.5 kg/m², %) 15 (1994-1995) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------------\|-----\|------\| \| 1994-1995 \| 28 \| 47 \| \| 2000 \| 17 \| 47 \| \| 2006 \| 13 \| 38 \| \| 2010 \| 16 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| MICS \| \|------------\|------\| \| 2000 \| 2 \| \| 2006 \| 15 \| \| 2010 \| 36 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 56 \| 18 \| 35 \| \| 2012 \| 66 \| 46 \| 54 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 45 \| 13 \| 20 \| \| 2012 \| 56 \| 37 \| 56 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: No - Postnatal home visits in the first week after birth: No - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: - - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: - ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): - - Newborn health (X of 4): - - Child health (X of 3): - - Density of doctors, nurses and midwives (per 10,000 population): 3.1 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 32 (2012) - General government expenditure on health as % of total government expenditure (%): 11 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 46 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 22 (2013) - ODA to maternal and neonatal health per live birth (US$): 31 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 12,448 \| 2013 \| \| Total under-five population (000) \| 2,406 \| 2013 \| \| Births (000) \| 579 \| 2012 \| \| Birth registration (%) \| 16 \| \| \| Total under-five deaths (000) \| 82 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 27 \| \| \| Neonatal mortality rate (per 1000 live births) \| 40 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 89 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 29 \| 2013 \| \| Total maternal deaths \| 5,800 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 15 \| 2013 \| \| Total fertility rate (per woman) \| 6.4 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 203 \| 2009 \| ## UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 209 \| \| 1995 \| 170 \| \| 2000 \| 150 \| \| 2005 \| 130 \| \| 2010 \| 110 \| \| 2015 \| 70 \| Source: IGME 2013 ## MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1700 \| \| 1995 \| 1600 \| \| 2000 \| 1400 \| \| 2005 \| 1200 \| \| 2010 \| 1000 \| \| 2015 \| 430 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 15 \| \| Antenatal care (4+ visits) \| 23 \| \| Skilled attendant at delivery \| 23 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 3 \| \| Measles \| 64 \| See Annex/website for indicator definition ### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1996-1997 \| 15 \| \| 2000 \| 16 \| \| 2004 \| 14 \| \| 2010 \| 23 \| ### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| 8 \| 10 \| \| 2011 \| 13 \| 14 \| \| 2012 \| 14 \| 14 \| Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 15 \| 64 \| \| Antenatal care (1+ visit) \| 10 \| 70 \| \| Antenatal care (4+ visits) \| 10 \| 70 \| \| Skilled attendant at delivery \| 10 \| 70 \| \| Early initiation of breastfeeding \| 10 \| 70 \| \| ITN use among children <5 yrs \| 10 \| 70 \| \| DTP3 \| 10 \| 70 \| \| Measles \| 10 \| 70 \| \| Vitamin A (past 6 months) \| 10 \| 70 \| \| ORT & continued feeding \| 10 \| 70 \| \| Careseeking for pneumonia \| 10 \| 70 \| Source: DHS 2004 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 20 \| \| 1995 \| 20 \| \| 2000 \| 20 \| \| 2005 \| 20 \| \| 2012 \| 20 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1996-1997 \| 19 \| \| 2000 \| 22 \| \| 2004 \| 12 \| \| 2010 \| 26 \| ## NUTRITION Wasting prevalence (moderate and severe, %) \| 16 \| (2010) Low birthweight incidence (moderate and severe, %) \| 20 \| (2010) Early initiation of breastfeeding (within 1 hr of birth, %) \| 29 \| (2010) Introduction of solid, semi-solid/soft foods (%) \| 46 \| (2010) Vitamin A two dose coverage (%) \| 0 \| (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1996-1997 \| 34 \| \| 2000 \| 29 \| \| 2004 \| 34 \| \| 2010 \| 30 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1996-1997 \| 2 \| \| 2000 \| 10 \| \| 2004 \| 2 \| \| 2010 \| 3 \| ## Chad ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 15% - Neonatal death: 27% - Asphyxia: 7% - Preterm: 9% - Other: 2% - Congenital: 1% - Sepsis: 5% - HIV/AIDS: 2% - Malaria: 19% - Injuries: 4% - Diarrhoea: 0% - Measles: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1996-1997 \| 23 \| 42 \| \| 2000 \| 42 \| 39 \| \| 2004 \| 39 \| 53 \| Demand for family planning satisfied (%) 15 (2010) Antenatal care (4 or more visits, %) 23 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 22 (2012) C-section rate (total, urban, rural; %) 2, 4, 1 (2012) Neonatal tetanus vaccine 43 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 23 (2004) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1996-1997 \| 23 \| 44 \| \| 2000 \| 16 \| 27 \| \| 2004 \| 15 \| 23 \| \| 2010 \| 13 \| 13 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| MICS \| \|------\|------\| \| 2000 \| 1 \| \| 2010 \| 10 \| Percent children < 5 years sleeping under ITNs \| Year \| MICS \| \|------\|------\| \| 2000 \| 1 \| \| 2010 \| 10 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 38 \| 46 \| 46 \| \| 2012 \| 45 \| 47 \| 44 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 79 \| 10 \| 25 \| \| 2012 \| 65 \| 18 \| 14 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 2 (F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 2.3 (2006) - National availability of Emergency Obstetric Care services (% of recommended minimum): 20 (2011) ### FINANCING - Per capita total expenditure on health (int$): 53 (2012) - General government expenditure on health as % of total government expenditure (%): 6 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 53 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 11 (2013) - ODA to maternal and neonatal health per live birth (US$): 16 (2011) ## DEMOGRAPHICS \| Metric \| Value \| Year \| \|---------------------------------------------\|-------------\|------\| \| Total population (000) \| 1,377,065 \| 2013 \| \| Total under-five population (000) \| 88,934 \| 2013 \| \| Births (000) \| 18,455 \| 2012 \| \| Birth registration (%) \| - \| 2012 \| \| Total under-five deaths (000) \| 258 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 61 \| 2012 \| \| Neonatal mortality rate (per 1000 live births)\| 9 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 12 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 10 \| 2009 \| \| Total maternal deaths \| 5,900 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 1,800 \| 2013 \| \| Total fertility rate (per woman) \| 1.7 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 6 \| 2009 \| ## UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 54 \| \| 1995 \| 47 \| \| 2000 \| 36 \| \| 2005 \| 26 \| \| 2010 \| 14 \| \| 2015 \| 18 \| Source: IGME 2013 ## MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|-------------------------------\| \| 1990 \| 97 \| \| 1995 \| 82 \| \| 2000 \| 60 \| \| 2005 \| 40 \| \| 2010 \| 22 \| \| 2015 \| 24 \| Source: MM&EIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Percent \| \|----------------------------------------------\|---------\| \| Demand for family planning satisfied \| 97 \| \| Antenatal care (4+ visits) \| 100 \| \| Skilled attendant at delivery \| 100 \| \| Postnatal care \| 28 \| \| Exclusive breastfeeding \| 99 \| \| Measles \| 99 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1990 \| 94 \| \| 1995 \| 89 \| \| 2000 \| 97 \| \| 2005 \| 98 \| \| 2008 \| 99 \| \| 2011 \| 100 \| MoH ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) Percent HIV+ pregnant women receiving ARVs for PMTCT Uncertainty range around the estimate No Data ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% (red circles) and Richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. \| Service \| Percent \| \|----------------------------------------------\|---------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Careseeking for pneumonia \| \| No Data ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 99 \| \| 1995 \| 99 \| \| 2000 \| 99 \| \| 2005 \| 99 \| \| 2012 \| 99 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics No Data ## NUTRITION Wasting prevalence (moderate and severe, %) 2 (2010) Low birthweight incidence (moderate and severe, %) 3 (2008) Early initiation of breastfeeding (within 1 hr of birth, %) 41 (2008) Introduction of solid, semi-solid/soft foods (%) 43 (2008) Vitamin A two dose coverage (%) - ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1990 \| 32 \| \| 1995 \| 31 \| \| 2000 \| 18 \| \| 2005 \| 12 \| \| 2010 \| 9 \| Other NS ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2008 \| 28 \| Other NS ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Neonatal death: 61% - Preterm: 14% - Asphyxia: 15% - Other: 15% - Pneumonia: 10% - Other: 16% Intrapartum-related events ### Causes of maternal deaths, 2013 - Haemorrhage: 36% - Indirect: 25% - Hypertension: 10% - Other direct: 14% - Sepsis: 3% - Embolism: 12% - Abortion: 1% Source: WHO/CHERG 2014 ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| Total MoH \| \|------\|-----------\| \| 1992 \| 70 \| \| 1995 \| 79 \| \| 2000 \| 89 \| \| 2005 \| 90 \| \| 2008 \| 91 \| \| 2011 \| 94 \| ### Demand for family planning satisfied (%) 97 (2001) ### Antenatal care (4 or more visits, %) - - ### Malaria during pregnancy - intermittent preventive treatment (%) - - ### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 36, 47, 33 (2011) ### Neonatal tetanus vaccine - - ### Postnatal visit for baby (within 2 days for home births, %) - - ### Postnatal visit for mother (within 2 days for home births, %) - - ### Women with low body mass index (<18.5 kg/m², %) - - ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS No Data ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved ### Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation ## POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - Legal status of abortion (X of 5 circumstances) - Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) - Maternal deaths notification - Postnatal home visits in the first week after birth - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - Antenatal corticosteroids as part of management of preterm labour - International Code of Marketing of Breastmilk Substitutes - Community treatment of pneumonia with antibiotics - Low osmolarity ORS and zinc for management of diarrhoea ## SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - Maternal health (X of 3) - Newborn health (X of 4) - Child health (X of 3) - Density of doctors, nurses and midwives (per 10,000 population) - National availability of Emergency Obstetric Care services (% of recommended minimum) ## FINANCING - Per capita total expenditure on health (int$) - General government expenditure on health as % of total government expenditure (%) - Out of pocket expenditure as % of total expenditure on health(%) - Reproductive, maternal, newborn and child health expenditure by source ## Note See annexes for additional information on the indicators above. \| Metric \| Value \| Year \| \|---------------------------------------------\|--------\|------\| \| Total population (000) \| 718 \| 2013 \| \| Total under-five population (000) \| 115 \| 2013 \| \| Births (000) \| 26 \| 2012 \| \| Birth registration (%) \| 88 \| 2009 \| \| Total under-five deaths (000) \| 2 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 40 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 31 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 58 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 27 \| 2009 \| \| Total maternal deaths \| 90 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 58 \| 2013 \| \| Total fertility rate (per woman) \| 4.8 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 70 \| 2011 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 124 - 1995: 100 - 2000: 80 - 2005: 60 - 2010: 40 - 2015: 41 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 630 - 1995: 520 - 2000: 400 - 2005: 300 - 2010: 200 - 2015: 160 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 37 \| \| Antenatal care (4+ visits) \| 82 \| \| Skilled attendant at delivery \| 85 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 21 \| \| Measles \| \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1996 DHS: 52 - 2000 MICS: 62 - 2012 pDHS: 82 #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| - \| 10 \| \| 2011 \| - \| 10 \| \| 2012 \| - \| 10 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| 60 \| 80 \| \| Antenatal care (4+ visits) \| 50 \| 70 \| \| Skilled attendant at delivery \| 40 \| 60 \| \| Early initiation of breastfeeding \| 10 \| 30 \| \| ITN use among children <5 yrs \| 20 \| 40 \| \| DTP3 \| 50 \| 70 \| \| Measles \| 50 \| 70 \| \| Vitamin A (past 6 months) \| 50 \| 70 \| \| ORT & continued feeding \| 30 \| 50 \| \| Caseseeking for pneumonia \| 20 \| 40 \| Source: DHS 1996 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 80% - 1995: 70% - 2000: 60% - 2005: 50% - 2012: 40% Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1996 DHS: 53% - 2000 MICS: 56% - 2012 pDHS: 38% ### NUTRITION #### Wasting prevalence (moderate and severe, %) - 2012: 11% #### Low birthweight incidence (moderate and severe, %) - 2000: 25% #### Early initiation of breastfeeding (within 1 hr of birth, %) - 1996: 25% #### Introduction of solid, semi-solid/soft foods (%) - 2000: 34% #### Vitamin A two dose coverage (%) - - ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1991-1992 Other NS: 15% - 1996 DHS: 39% - 1996 DHS: 21% - 2000 MICS: 40% - 2000 MICS: 25% - 2012 pDHS: 47% - 2012 pDHS: 15% - 2012 pDHS: 30% ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1996 DHS: 3% - 2000 MICS: 21% ## Comoros ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 40% - Preterm: 13% - Pneumonia: 13% - Asphyxia: 12% - Congenital: 3% - Other: 17% - HIV/AIDS: 1% - Malaria: 15% - Injuries: 5% - Measles: 0% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Sepsis: 10% - Embolism: 2% - Other direct: 9% ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| MICS \| Other NS \| pDHS \| \|------\|-----\|------\|----------\|------\| \| 1996 \| 85 \| 74 \| 75 \| 92 \| Demand for family planning satisfied (%) 37 (1996) Antenatal care (4 or more visits, %) - Malaria during pregnancy - intermittent preventive treatment (%) 28 (2012) C-section rate (total, urban, rural; %) 5, 9, 4 (1996) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 10 (1996) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| pDHS \| \|------\|-----\|------\|------\| \| 1996 \| 29 \| 31 \| 19 \| \| 2000 \| \| \| 38 \| \| 2012 \| \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| MICS \| pDHS \| \|------\|-----\|------\|------\| \| 1996 \| 9 \| \| 41 \| \| 2000 \| \| \| \| \| 2012 \| \| \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water No Data Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation No Data ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): - - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: - - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 2 (2013) - Child health (X of 3): 2 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 8.9 (2004) - National availability of Emergency Obstetric Care services (% of recommended minimum): 33 (2005) ### FINANCING - Per capita total expenditure on health (int$): 56 (2012) - General government expenditure on health as % of total government expenditure (%): 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 44 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 21 (2011) - ODA to maternal and neonatal health per live birth (US$): 52 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 4,337 \| 2013 \| \| Total under-five population (000) \| 722 \| 2013 \| \| Births (000) \| 165 \| 2012 \| \| Birth registration (%) \| 91 \| 2011-2012 \| \| Total under-five deaths (000) \| 15 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 32 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 62 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 26 \| 2009 \| \| Total maternal deaths \| 690 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 48 \| 2013 \| \| Total fertility rate (per woman) \| 5.0 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 147 \| 2009 \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 71 \| \| Antenatal care (4+ visits) \| 75 \| \| Skilled attendant at delivery \| 94 \| \| Postnatal care \| 64 \| \| Exclusive breastfeeding \| 19 \| \| Measles \| 80 \| See Annex/Note for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| DHS \| \|------\|-----\| \| 2005 \| 83 \| \| 2011-2012 \| 94 \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| DHS \| \|------\|-----\| \| 2010 \| 19 \| \| 2011 \| 7 \| \| 2012 \| 19 \| ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 60 \| 80 \| \| Antenatal care (1+ visit) \| 70 \| 90 \| \| Antenatal care (4+ visits) \| 60 \| 80 \| \| Skilled attendant at delivery \| 60 \| 80 \| \| Early initiation of breastfeeding \| 40 \| 60 \| \| ITN use among children <5 yrs \| 20 \| 40 \| \| DTP3 \| 60 \| 80 \| \| Measles \| 60 \| 80 \| \| Vitamin A (past 6 months) \| 60 \| 80 \| \| ORT & continued feeding \| 40 \| 60 \| \| Caseseeking for pneumonia \| 40 \| 60 \| Source: DHS 2011-2012 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| DHS \| \|------\|-----\| \| 1990 \| 85 \| \| 1995 \| 85 \| \| 2000 \| 80 \| \| 2005 \| 85 \| \| 2012 \| 10 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| DHS \| \|------\|-----\| \| 2005 \| 48 \| \| 2011-2012 \| 52 \| ## NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| DHS \| \|------\|-----\| \| 2011-2012 \| 6 \| Low birthweight incidence (moderate and severe, %) \| Year \| DHS \| \|------\|-----\| \| 2005 \| 13 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| DHS \| \|------\|-----\| \| 2005 \| 39 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| DHS \| \|------\|-----\| \| 2005 \| 78 \| Vitamin A two dose coverage (%) \| Year \| DHS \| \|------\|-----\| \| 2005 \| - \| ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| DHS \| \|------\|-----\| \| 1987 \| 16 \| \| 2005 \| 12 \| \| 2011-2012 \| 12 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| DHS \| \|------\|-----\| \| 2005 \| 19 \| ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Pneumonia: 10% - Preterm: 12% - Neontal (death): 33% - Asphyxia: 9% - Congenital: 3% - Sepsis: 6% - Malaria: 25% - Injuries: 4% - Measles: 9% - Diarrhoea: 7% Intrapartum-related events ** Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 ### Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Other direct: 9% - Indirect: 29% - Hypertension: 16% Source: WHO 2014 ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| 2005 \| 2011–2012 \| \|------------\|-------\|------\|-----------\| \| Antenatal care (%) \| 86 \| 93 \| Demand for family planning satisfied (%) \| Year \| DHS \| 2011–2012 \| \|------------\|-------\|-----------\| \| Antenatal care (4 or more visits, %) \| 75 \| Malaria during pregnancy - intermittent preventive treatment (%) \| Year \| DHS \| 2011–2012 \| \|------------\|-------\|-----------\| \| C-section rate (total, urban, rural; %) \| 3, 4, 2 \| Neonatal tetanus vaccine \| Year \| DHS \| 2012 \| \|------------\|-------\|------\| \| Postnatal visit for baby (within 2 days for home births, %) \| - \| Postnatal visit for mother (within 2 days for home births, %) \| Year \| DHS \| 2011–2012 \| \|------------\|-------\|-----------\| \| Women with low body mass index (<18.5 kg/m², %) \| 13 \| ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| 2005 \| 2011–2012 \| \|------------\|-------\|------\|-----------\| \| Percent \| 39 \| 18 \| 35 \| ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| 2012 \| \|------------\|-------\|------\| \| Percent children < 5 years sleeping under ITNs \| 26 \| ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 2012 - Piped on premises - Other improved - Unimproved \| Source \| Total \| Urban \| Rural \| \|--------------\|-------\|-------\|-------\| \| Piped on premises \| 25 \| 38 \| 25 \| \| Other improved \| 50 \| 58 \| 36 \| \| Unimproved \| 9 \| 0 \| 37 \| Source: WHO/UNICEF JMP 2014 ### Improved sanitation coverage Percent of population by type of sanitation facility, 2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Source \| Total \| Urban \| Rural \| \|--------------\|-------\|-------\|-------\| \| Improved facilities \| 15 \| 20 \| 9 \| \| Shared facilities \| 47 \| 37 \| 65 \| \| Unimproved facilities \| 8 \| 7 \| 20 \| \| Open defecation \| 41 \| 41 \| 6 \| Source: WHO/UNICEF JMP 2014 ## POLICIES \| Policy \| Status \| \|---------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| No \| \| Legal status of abortion (X of 5 circumstances) \| 1 \| \| Midwives authorized for specific tasks (X of 7 tasks) \| - \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| Yes \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| No \| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ## SYSTEMS \| System \| Status \| Year \| \|------------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Yes \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 2 \| 2013 \| \| Maternal health (X of 3) \| 3 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 9.2 \| 2007 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| 25 \| 2010 \| ## FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (int$) \| 140 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 6 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 25 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 15 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 20 \| 2011 \| ## DEMOGRAPHICS \| Metric \| Value \| Year \| \|---------------------------------------------\|-----------\|------\| \| Total population (000) \| 65,705 \| 2013 \| \| Total under-five population (000) \| 11,691 \| 2013 \| \| Births (000) \| 2,839 \| 2012 \| \| Birth registration (%) \| 28 \| \| \| Total under-five deaths (000) \| 391 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 30 \| \| \| Neonatal mortality rate (per 1000 live births)\| 44 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 100 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 29 \| 2009 \| \| Total maternal deaths \| 21,000 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 23 \| 2013 \| \| Total fertility rate (per woman) \| 6.0 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 135 \| 2009 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 171 - 1995: 150 - 2000: 146 - 2005: 146 - 2010: 146 - 2015: 57 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 1000 - 1995: 900 - 2000: 730 - 2005: 570 - 2010: 250 - 2015: MDG Target Source: MM&EIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 42 \| \| Antenatal care (4+ visits) \| 45 \| \| Skilled attendant at delivery \| 80 \| \| Postnatal care \| 37 \| \| Exclusive breastfeeding \| 73 \| \| Measles \| \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 2001 MICS: 61 - 2007 DHS: 74 - 2010 MICS: 80 ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 1% - 2011: 6% - 2012: 13% Percent HIV+ pregnant women receiving ARVs for PMTCT - 2010: Uncertainty range around the estimate - 2011: Uncertainty range around the estimate - 2012: Uncertainty range around the estimate Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20%: Red circles - Richest 20%: Orange circles \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 42 \| \| Antenatal care (1+ visit) \| 45 \| \| Antenatal care (4+ visits) \| 80 \| \| Skilled attendant at delivery \| 37 \| \| Early initiation of breastfeeding \| 73 \| \| ITN use among children <5 yrs \| 37 \| \| DTP3 \| 42 \| \| Measles \| 73 \| \| Vitamin A (past 6 months) \| 37 \| \| ORT & continued feeding \| 73 \| \| Careseeking for pneumonia \| 37 \| Source: MICS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 36 - 1995: 42 - 2000: 42 - 2005: 42 - 2012: 42 Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2001 MICS: 36 - 2007 DHS: 42 - 2010 MICS: 40 ## NUTRITION Wasting prevalence (moderate and severe, %): 9 (2010) Low birthweight incidence (moderate and severe, %): 10 (2010) Early initiation of breastfeeding (within 1 hr of birth, %): 43 (2010) Introduction of solid, semi-solid/soft foods (%): 52 (2010) Vitamin A two dose coverage (%): 84 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1995 Other NS: 31 - 2001 MICS: 51 - 2007 DHS: 28 - 2010 MICS: 24 ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1995 MICS: 24 - 2001 MICS: 24 - 2007 DHS: 36 - 2010 MICS: 37 ## Congo, Democratic Republic of the ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 14% - Neonatal death: 30% - Asphyxia: 8% - Preterm: 10% - Other: 2% - Congenital: 1% - Other: 19% - HIV/AIDS: 1% - Malaria: 16% - Injuries: 4% - Measles: 4% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Sepsis: 10% - Embolism: 2% - Other direct: 9% - Other: 2% - Indirect: 29% - Hypertension: 16% Source: WHO 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| MICS \| DHS \| \|------\|------\|-----\| \| 2001 \| 68 \| \| \| 2007 \| 85 \| \| \| 2010 \| 89 \| \| Demand for family planning satisfied (%) 42 (2010) Antenatal care (4 or more visits, %) 45 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 21 (2012) C-section rate (total, urban, rural; %) 7, 10, 6 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 70 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS \| DHS \| \|------\|------\|-----\| \| 2001 \| 17 \| 17 \| \| 2007 \| 42 \| 31 \| \| 2010 \| 39 \| 27 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| MICS \| \|------\|------\| \| 2001 \| 1 \| \| 2007 \| 6 \| \| 2010 \| 38 \| Percent children < 5 years sleeping under ITNs \| Year \| MICS \| \|------\|------\| \| 2001 \| 1 \| \| 2007 \| 6 \| \| 2010 \| 38 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 24 \| 14 \| 33 \| \| 2012 \| 48 \| 28 \| 28 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 11 \| 11 \| 11 \| \| 2012 \| 41 \| 33 \| 33 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 4 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 6.4 (2004) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 24 (2012) - General government expenditure on health as % of total government expenditure (%): 13 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 32 (2012) Reproductive, maternal, newborn and child health expenditure by source - External sources - General government expenditure - Out-of-pocket expenditure - Other ODA to child health per child (US$): 21 (2013) ODA to maternal and neonatal health per live birth (US$): 23 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 19,840 \| 2013 \| \| Total under-five population (000) \| 3,088 \| 2013 \| \| Births (000) \| 731 \| 2012 \| \| Birth registration (%) \| 65 \| 2011-2012 \| \| Total under-five deaths (000) \| 75 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 38 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 40 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 76 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 27 \| 2009 \| \| Total maternal deaths \| 5,300 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 29 \| 2013 \| \| Total fertility rate (per woman) \| 4.9 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 125 \| 2009 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 152 - 1995: 140 - 2000: 128 - 2005: 116 - 2010: 108 - 2015: 51 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births** - 1990: 740 - 1995: 640 - 2000: 600 - 2005: 600 - 2010: 720 - 2015: 190 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 45 \| \| Antenatal care (4+ visits) \| 44 \| \| Skilled attendant at delivery \| 59 \| \| Postnatal care \| 70 \| \| Exclusive breastfeeding \| 12 \| \| Measles \| 85 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1994 DHS: 45 - 1998-99 DHS: 47 - 2000 MICS: 63 - 2005 Other NS: 55 - 2006 MICS: 57 - 2011-12 DHS: 59 #### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| \|---------------------------------------------------------------------------\|-------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| 34 \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| 68 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Caseseeking for pneumonia \| \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 40 - 1995: 45 - 2000: 50 - 2005: 55 - 2012: 94 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1994 DHS: 39 - 1998-99 DHS: 35 - 2000 MICS: 38 - 2006 MICS: 35 - 2011-12 DHS: 19 ### NUTRITION #### Wasting prevalence (moderate and severe, %) - 7 (2011-2012) #### Low birthweight incidence (moderate and severe, %) - 17 (2006) #### Early initiation of breastfeeding (within 1 hr of birth, %) - 31 (2011-2012) #### Introduction of solid, semi-solid/soft foods (%) - 64 (2011-2012) #### Vitamin A two dose coverage (%) - 99 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1994 DHS: 20 - 1998-99 DHS: 34 - 2006 MICS: 18 - 2011-12 DHS: 17 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1994 DHS: 3 - 1998-99 DHS: 4 - 2000 MICS: 10 - 2003-04 Other NS: 5 - 2006 MICS: 4 - 2011-12 DHS: 12 Causes of under-five deaths, 2012 - Pneumonia: 12% - Neonatal death: 38% - Asphyxia: 11% - Preterm: 12% - Other: 18% - HIV/AIDS: 2% - Malaria: 16% - Injuries: 4% - Measles: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Causes of maternal deaths, 2013 - Sepsis: 10% - Abortion: 10% - Other direct: 9% - Indirect: 29% - Haemorrhage: 25% - Hypertension: 16% - Embolism: 2% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| MICS \| Other NS \| \|------\|-----\|------\|----------\| \| 1994 \| 83 \| 84 \| 88 \| \| 1998-99 \| 87 \| 87 \| \| \| 2000 \| 85 \| \| \| \| 2005 \| \| \| \| \| 2006 \| \| \| \| \| 2011-12 \| 91 \| \| \| Demand for family planning satisfied (%) 45 (2011-2012) Antenatal care (4 or more visits, %) 44 (2011-2012) Malaria during pregnancy - intermittent preventive treatment (%) 18 (2011-2012) C-section rate (total, urban, rural; %) 3, 5, 1 (2011-2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 82 (2012) Postnatal visit for baby (within 2 days for home births, %) 34 (2011-2012) Postnatal visit for mother (within 2 days for home births, %) 70 (2011-2012) Women with low body mass index (<18.5 kg/m², %) 6 (2011-2012) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| Other NS \| \|------\|-----\|------\|----------\| \| 1994 \| 11 \| 24 \| 34 \| \| 1998-99 \| 16 \| 45 \| \| \| 2000 \| 10 \| \| \| \| 2006 \| 36 \| \| \| \| 2011-12 \| 17 \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| MICS \| Other NS \| \|------\|-----\|------\|----------\| \| 2000 \| 1 \| 4 \| 3 \| \| 2003-04 \| 37 \| \| \| \| 2006 \| \| \| \| \| 2011-12 \| 37 \| \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 53 \| 23 \| 14 \| \| 2012 \| 80 \| 40 \| 17 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 36 \| 29 \| 16 \| \| 2012 \| 56 \| 27 \| 10 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 6.3 (2008) - National availability of Emergency Obstetric Care services (% of recommended minimum): 7 (2010) ### FINANCING - Per capita total expenditure on health (int$): 144 (2012) - General government expenditure on health as % of total government expenditure (%): 8 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 56 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 15 (2011) - ODA to maternal and neonatal health per live birth (US$): 23 (2011) ## Djibouti ### DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 860 \| 2013 \| \| Total under-five population (000) \| 108 \| 2013 \| \| Births (000) \| 24 \| 2012 \| \| Birth registration (%) \| 92 \| \| \| Total under-five deaths (000) \| 2 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 39 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 31 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 66 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 34 \| 2009 \| \| Total maternal deaths \| 55 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 130 \| 2013 \| \| Total fertility rate (per woman) \| 3.5 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 21 \| 2010 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 119 - 1995: 107 - 2000: 90 - 2005: 81 - 2010: 40 - 2015: MDG Target Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 400 - 1995: 300 - 2000: 230 - 2005: 100 - 2010: MDG Target Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (4+ visits) \| 7 \| \| Skilled attendant at delivery \| 93 \| \| Postnatal care \| 1 \| \| Exclusive breastfeeding \| 83 \| \| Measles \| \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 2003 MoH: 61% - 2006 MICS: 93% #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs - 2010: 10% - 2011: 13% - 2012: 20% Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20%: No Data - Richest 20%: No Data Demand for family planning satisfied \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| DTP3 Measles Vitamin A (past 6 months) ORT & continued feeding Careseeking for pneumonia No Data Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 85% - 1995: 81% - 2000: 81% - 2005: 81% - 2012: 81% Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2002: 62% - 2006: 62% Source: Other NS, MICS ### NUTRITION Wasting prevalence (moderate and severe, %): 22 (2012) Low birthweight incidence (moderate and severe, %): 10 (2006) Early initiation of breastfeeding (within 1 hr of birth, %): 55 (2006) Introduction of solid, semi-solid/soft foods (%): 35 (2006) Vitamin A two dose coverage (%): 88 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1989: 28% - 1996: 16% - 2002: 25% - 2006: 30% - 2012: 30% (p)Other NS #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2006: 1% ## Djibouti ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 33% - Pneumonia: 13% - Preterm: 12% - Asphyxia: 9% - Other 2% - Congenital: 3% - Sepsis: 6% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| MoH \| MICS \| \|------\|-----\|------\| \| 2003 \| 67 \| 92 \| Demand for family planning satisfied (%) - - Antenatal care (4 or more visits, %) 7 (2012) Malaria during pregnancy – intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 12, -, - (2008) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 79 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MoH \| MICS \| \|------\|-----\|------\| \| 2006 \| 33 \| 62 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| MoH \| Other NS \| \|------\|-----\|----------\| \| 2006 \| 1 \| 20 \| Percent children < 5 years sleeping under ITNs \| Year \| MoH \| Other NS \| \|------\|-----\|----------\| \| 2006 \| 1 \| 20 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 54 \| 18 \| 13 \| \| 2012 \| 63 \| 21 \| 9 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 9 \| 14 \| 10 \| \| 2012 \| 14 \| 20 \| 5 \| Source: WHO/UNICEF JMP 2014 ### POLICIES \| Policy \| Status \| \|------------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Partial \| \| Legal status of abortion (X of 5 circumstances) \| 1 \| \| Midwives authorized for specific tasks (X of 7 tasks) \| 7 \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| No \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| Partial \| \| Community treatment of pneumonia with antibiotics \| No \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Status \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Partial \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 1 \| 2013 \| \| Maternal health (X of 3) \| 3 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 2 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 10.3 \| 2008 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| 50 \| 2004 \| ### FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (int$) \| 231 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 14 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 40 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 42 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 99 \| 2011 \| \| Metric \| Value \| Year \| \|---------------------------------------------\|-----------\|------\| \| Total population (000) \| 80,722 \| 2013 \| \| Total under-five population (000) \| 9,237 \| 2013 \| \| Births (000) \| 1,898 \| 2012 \| \| Birth registration (%) \| 99 \| \| \| Total under-five deaths (000) \| 40 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 56 \| \| \| Neonatal mortality rate (per 1000 live births)\| 12 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 18 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 13 \| 2009 \| \| Total maternal deaths \| 860 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 710 \| 2013 \| \| Total fertility rate (per woman) \| 2.8 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 50 \| 2005 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 86 \| \| 1995 \| 80 \| \| 2000 \| 74 \| \| 2005 \| 69 \| \| 2010 \| 21 \| \| 2015 \| 29 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|-------------------------------\| \| 1990 \| 120 \| \| 1995 \| 100 \| \| 2000 \| 80 \| \| 2005 \| 60 \| \| 2010 \| 45 \| \| 2015 \| 30 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 84 \| \| Antenatal care (4+ visits) \| 66 \| \| Skilled attendant at delivery \| 79 \| \| Postnatal care \| 65 \| \| Exclusive breastfeeding \| 53 \| \| Measles \| 93 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1988 \| 35 \| \| 1992 \| 41 \| \| 1995 \| 46 \| \| 1998 \| 55 \| \| 2000 \| 61 \| \| 2003 \| 69 \| \| 2005 \| 74 \| \| 2008 \| 79 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| 0 \| 0 \| \| 2011 \| 0 \| 0 \| \| 2012 \| 0 \| 0 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| 50 \| 80 \| \| Antenatal care (4+ visits) \| 40 \| 70 \| \| Skilled attendant at delivery \| 40 \| 70 \| \| Early initiation of breastfeeding \| 20 \| 50 \| \| ITN use among children <5 yrs \| 10 \| 40 \| \| DTP3 \| 10 \| 40 \| \| Measles \| 10 \| 40 \| \| Vitamin A (past 6 months) \| 10 \| 40 \| \| ORT & continued feeding \| 10 \| 40 \| \| Case-seeking for pneumonia \| 10 \| 40 \| Source: DHS 2008 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 93 \| \| 1995 \| 93 \| \| 2000 \| 93 \| \| 2005 \| 93 \| \| 2012 \| 93 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1992 \| 59 \| \| 1995 \| 62 \| \| 2000 \| 66 \| \| 2003 \| 75 \| \| 2008 \| 73 \| \| 2012 \| 58 \| #### Nutrition Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 8 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 13 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2005 \| 43 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 70 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 62 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1992 \| 31 \| \| 1995 \| 35 \| \| 2000 \| 25 \| \| 2003 \| 9 \| \| 2005 \| 20 \| \| 2008 \| 5 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1992 \| 46 \| \| 1995 \| 56 \| \| 2000 \| 57 \| \| 2003 \| 30 \| \| 2005 \| 38 \| \| 2008 \| 53 \| Causes of under-five deaths, 2012 - Neonatal death: 58% - Preterm: 23% - Asphyxia: 12% - Other: 4% - Congenital: 12% - Pneumonia: 8% - Other: 27% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 3% - Measles: 0% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 37% - Hypertension: 17% - Indirect: 18% - Other direct: 17% - Abortion: 2% - Sepsis: 6% - Embolism: 3% Regional estimates for North Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| \|------\|-----\| \| 1988 \| 53 \| \| 1992 \| 53 \| \| 1995 \| 39 \| \| 1998 \| 47 \| \| 2000 \| 53 \| \| 2003 \| 69 \| \| 2005 \| 70 \| \| 2008 \| 74 \| Demand for family planning satisfied (%) 84 (2008) Antenatal care (4 or more visits, %) 66 (2008) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 28, 37, 22 (2008) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 86 (2012) Postnatal visit for baby (within 2 days for home births, %) 8 (2008) Postnatal visit for mother (within 2 days for home births, %) 65 (2008) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------\|-----\| \| 1992 \| 29 \| \| 1995 \| 40 \| \| 2000 \| 29 \| \| 2003 \| 34 \| \| 2005 \| 26 \| \| 2008 \| 28 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 61 \| 90 \| 39 \| \| 2012 \| 96 \| 90 \| 93 \| Source: WHO/UNICEF JMP 2014 Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 72 \| 91 \| 37 \| \| 2012 \| 84 \| 94 \| 84 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 0 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 2 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 63.5 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 323 (2012) - General government expenditure on health as % of total government expenditure (%): 6 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 60 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 2 (2011) - ODA to maternal and neonatal health per live birth (US$): 5 (2011) \| Metric \| Value \| Year \| \|---------------------------------------------\|-----------\|------\| \| Total population (000) \| 736 \| 2013 \| \| Total under-five population (000) \| 113 \| 2013 \| \| Births (000) \| 26 \| 2012 \| \| Birth registration (%) \| 37 \| \| \| Total under-five deaths (000) \| 3 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| \| \| Neonatal mortality rate (per 1000 live births)\| 34 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 72 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 17 \| 2009 \| \| Total maternal deaths \| 79 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 72 \| 2013 \| \| Total fertility rate (per woman) \| 4.9 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 128 \| 2001 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 182 - 1995: 150 - 2000: 100 - 2005: 61 - 2010: 100 - 2015: MDG Target Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births** - 1990: 1600 - 1995: 1200 - 2000: 800 - 2005: 400 - 2010: 290 - 2015: 400 MDG Target Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 27 \| \| Antenatal care (4+ visits) \| 65 \| \| Skilled attendant at delivery \| 65 \| \| Postnatal care \| 51 \| \| Exclusive breastfeeding \| 24 \| \| Measles \| \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1994: 5 - 2000: 65 #### Prevention of mother-to-child transmission of HIV - Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs): No Data - Percent HIV+ pregnant women receiving ARVs for PMTCT: No Data - Uncertainty range around the estimate: No Data ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Careseeking for pneumonia \| \| \| No Data ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 80 - 1995: 60 - 2000: 51 - 2005: 33 - 2012: 33 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics No Data ### NUTRITION - Wasting prevalence (moderate and severe, %): 3 (2004) - Low birthweight incidence (moderate and severe, %): 13 (2000) - Early initiation of breastfeeding (within 1 hr of birth, %): - - Introduction of solid, semi-solid/soft foods (%): - - Vitamin A two dose coverage (%): - #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1997: 14 - 2000: 16 - 2004: 11 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2000: 24 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. Causes of under-five deaths, 2012 - Pneumonia: 13% - Preterm: 11% - Neontal death: 33% - Asphyxia: 10% - Other: 17% - HIV/AIDS: 7% - Malaria: 15% - Injuries: 4% - Measles: 4% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Sepsis: 10% - Embolism: 2% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| Percent \| \|------\|---------\| \| 1994 \| 37 \| \| 2000 \| 86 \| Demand for family planning satisfied (%): 27 (2011) Antenatal care (4 or more visits, %): - Malaria during pregnancy - intermittent preventive treatment (%): - C-section rate (total, urban, rural; %): - (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine: 75 (2012) Postnatal visit for baby (within 2 days for home births, %): - Postnatal visit for mother (within 2 days for home births, %): - Women with low body mass index (<18.5 kg/m², %): - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - Receiving oral rehydration therapy/increased fluids with continued feeding - Treated with ORS \| Year \| Percent \| \|------\|---------\| \| 2000 \| 36 \| \| \| 29 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Percent \| \|------\|---------\| \| 2000 \| 1 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water No Data Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation No Data ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: - - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 8.4 (2004) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 1,432 (2012) - General government expenditure on health as % of total government expenditure (%): 7 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 44 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 16 (2013) - ODA to maternal and neonatal health per live birth (US$): 48 (2011) ## Eritrea ### DEMOGRAPHICS \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 6,131 \| \| \| Total under-five population (000) \| 1,034 \| \| \| Births (000) \| 230 \| \| \| Birth registration (%) \| - \| \| \| Total under-five deaths (000) \| 11 \| \| \| Neonatal deaths: % of all under-5 deaths \| 36 \| \| \| Neonatal mortality rate (per 1000 live births) \| 18 \| \| \| Infant mortality rate (per 1000 live births) \| 37 \| \| \| Stillbirth rate (per 1000 total births) \| 21 \| \| \| Total maternal deaths \| 880 \| \| \| Lifetime risk of maternal death (1 in N) \| 52 \| \| \| Total fertility rate (per woman) \| 4.8 \| \| \| Adolescent birth rate (per 1000 girls) \| 85 \| \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 150 - 1995: 100 - 2000: 50 - 2005: 50 - 2010: 52 - 2015: MDG Target Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 1700 - 1995: 1500 - 2000: 1000 - 2005: 500 - 2010: 380 - 2015: 430 MDG Target Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 22 \| \| \| Antenatal care (4+ visits) \| 41 \| \| \| Skilled attendant at delivery \| 28 \| \| \| Postnatal care \| 52 \| \| \| Exclusive breastfeeding \| 99 \| \| \| Measles \| \| \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1995: 21 - 2002: 28 DHS #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 5 - 2011: 0 - 2012: 46 Percent Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile - Poorest 20% - Richest 20% \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 22 \| \| \| Antenatal care (1+ visit) \| 41 \| \| \| Antenatal care (4+ visits) \| 28 \| \| \| Skilled attendant at delivery \| 52 \| \| \| Early initiation of breastfeeding \| 99 \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Careseeking for pneumonia \| \| \| No Data Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 39 - 1995: 70 - 2000: 99 - 2005: 99 - 2012: 99 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2002: 44 DHS ### NUTRITION Wasting prevalence (moderate and severe, %) - 2002: 15 Low birthweight incidence (moderate and severe, %) - 2002: 14 Early initiation of breastfeeding (within 1 hr of birth, %) - 2002: 78 Introduction of solid, semi-solid/soft foods (%) - 2002: 43 Vitamin A two dose coverage (%) - 2012: 38 #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1993: 37 - 1995: 40 - 2002: 35 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1995: 59 - 2002: 52 DHS ## Eritrea ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 17% - Preterm: 7% - Neonatal death: 34% - Asphyxia: 11% - Other: 2% - Congenital: 5% - Other: 23% - HIV/AIDS: 1% - Malaria: 0% - Measles: 6% - Injuries: 8% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition. Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Other direct: 9% - Indirect: 29% - Haemorrhage: 25% - Hypertension: 16% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| Percent \| \|------\|-----\|---------\| \| 1995 \| \| 49 \| \| 2002 \| \| 70 \| Demand for family planning satisfied (%) 22 (2002) Antenatal care (4 or more visits, %) 41 (2002) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 3, 7, 1 (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 94 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 38 (2002) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| Percent \| \|------\|-----\|---------\| \| 1995 \| \| 33 \| \| 2002 \| \| 54 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| Percent \| \|------\|-----\|---------\| \| 2002 \| \| 4 \| \| 2008 \| Other NS \| 49 \| Percent children < 5 years sleeping under ITNs 5 (2008) ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water No Data Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation No Data ### POLICIES \| Policy \| Yes/No \| \|----------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Yes \| \| Legal status of abortion (X of 5 circumstances) \| 3 (R,F)\| \| Midwives authorized for specific tasks (X of 7 tasks) \| 7 \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| Yes \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| No \| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Yes/No \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Yes \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 2 \| 2013 \| \| Maternal health (X of 3) \| 3 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 6.3 \| 2004 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| - \| - \| ### FINANCING \| Financing \| Yes/No \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (int$) \| 17 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 4 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 53 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 8 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 21 \| 2011 \| \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 91,729 \| 2013 \| \| Total under-five population (000) \| 14,095 \| 2013 \| \| Births (000) \| 3,084 \| 2012 \| \| Birth registration (%) \| 7 \| \| \| Total under-five deaths (000) \| 205 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 43 \| \| \| Neonatal mortality rate (per 1000 live births) \| 29 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 47 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 26 \| 2009 \| \| Total maternal deaths \| 13,000 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 52 \| 2013 \| \| Total fertility rate (per woman) \| 4.6 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 87 \| 2008 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 204 - 1995: 140 - 2000: 100 - 2005: 68 - 2010: 68 - 2015: 68 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births** - 1990: 1400 - 1995: 1200 - 2000: 900 - 2005: 600 - 2010: 420 - 2015: 350 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 52 \| \| Antenatal care (4+ visits) \| 19 \| \| Skilled attendant at delivery \| 10 \| \| Postnatal care \| 7 \| \| Exclusive breastfeeding \| 52 \| \| Measles \| 66 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 2000: 6 - 2005: 6 - 2011: 10 #### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| \|---------------------------------------------------------------------------\|-------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| 38 \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| 41 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 52 \| 66 \| \| Antenatal care (1+ visit) \| 19 \| 26 \| \| Antenatal care (4+ visits) \| 10 \| 16 \| \| Skilled attendant at delivery \| 7 \| 10 \| \| Early initiation of breastfeeding \| 52 \| 66 \| \| ITN use among children <5 yrs \| 19 \| 26 \| \| DTP3 \| 10 \| 16 \| \| Measles \| 10 \| 16 \| \| Vitamin A (past 6 months) \| 10 \| 16 \| \| ORT & continued feeding \| 10 \| 16 \| \| Caseseeking for pneumonia \| 10 \| 16 \| Source: DHS 2011 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 12 - 1995: 66 - 2000: 61 - 2005: 66 - 2012: 66 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2000: 16 - 2005: 19 - 2011: 27 ### NUTRITION #### Wasting prevalence (moderate and severe, %) - 10 (2011) #### Low birthweight incidence (moderate and severe, %) - 20 (2005) #### Early initiation of breastfeeding (within 1 hr of birth, %) - 52 (2011) #### Introduction of solid, semi-solid/soft foods (%) - 49 (2011) #### Vitamin A two dose coverage (%) - 31 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1992: 42 - Other NS: 67 - 2000: 42 - DHS: 57 - 2005: 35 - DHS: 51 - 2011: 29 - DHS: 44 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2000: 54 - DHS: 49 - 2005: 49 - DHS: 52 - 2011: 52 - DHS: 52 ## Ethiopia ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 43% - Pneumonia: 16% - Preterm: 11% - Asphyxia: 14% - Other: 19% - HIV/AIDS: 8% - Malaria: 3% - Injuries: 6% - Measles: 2% - Diarrhoea*: 1% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Sepsis: 10% - Embolism: 2% Source: WHO 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| \|------\|-----\| \| 2000 \| 27 \| \| 2005 \| 28 \| \| 2011 \| 43 \| Demand for family planning satisfied (%) 52 (2011) Antenatal care (4 or more visits, %) 19 (2011) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 2, 8, 1 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 68 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 7 (2011) Women with low body mass index (<18.5 kg/m², %) 24 (2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------\|-----\| \| 2000 \| 13 \| \| 2005 \| 15 \| \| 2011 \| 25 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| \|------\|-----\| \| 2005 \| 2 \| \| 2007 \| 33 \| \| 2011 \| 30 \| Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 38 \| 12 \| 49 \| \| 2012 \| 71 \| 10 \| 42 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 9 \| 10 \| 55 \| \| 2012 \| 46 \| 10 \| 38 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 3 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 2.8 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): 11 (2008) ### FINANCING - Per capita total expenditure on health (int$): 44 (2012) - General government expenditure on health as % of total government expenditure (%): 11 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 41 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 17 (2011) - ODA to maternal and neonatal health per live birth (US$): 33 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 1,633 \| 2013 \| \| Total under-five population (000) \| 238 \| 2013 \| \| Births (000) \| 53 \| 2012 \| \| Birth registration (%) \| 90 \| \| \| Total under-five deaths (000) \| 3 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 41 \| \| \| Neonatal mortality rate (per 1000 live births) \| 25 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 42 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 17 \| 2009 \| \| Total maternal deaths \| 130 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 94 \| 2013 \| \| Total fertility rate (per woman) \| 4.1 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 115 \| 2009 \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 54 \| \| Antenatal care (4+ visits) \| 78 \| \| Skilled attendant at delivery \| 89 \| \| Postnatal care \| 59 \| \| Exclusive breastfeeding \| 6 \| \| Measles \| 71 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| DHS \| \|------\|-----\| \| 2000 \| 86 \| \| 2012 \| 89 \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| DHS \| \|------\|-----\| \| 2010 \| 48 \| \| 2011 \| 50 \| \| 2012 \| 70 \| ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Case-seeking for pneumonia \| \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| DHS \| \|------\|-----\| \| 1990 \| 82 \| \| 1995 \| 82 \| \| 2000 \| 71 \| \| 2005 \| 82 \| \| 2012 \| 82 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| DHS \| \|------\|-----\| \| 2000 \| 48 \| \| 2012 \| 68 \| ## NUTRITION Wasting prevalence (moderate and severe, %): 3 (2012) Low birthweight incidence (moderate and severe, %): 14 (2000) Early initiation of breastfeeding (within 1 hr of birth, %): 32 (2012) Introduction of solid, semi-solid/soft foods (%): 62 (2000) Vitamin A two dose coverage (%): 2 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| DHS \| \|------\|-----\| \| 2000-2001 \| 9 \| \| Other NS \| 26 \| \| 2012 \| 6 \| \| 2012 \| 17 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| DHS \| \|------\|-----\| \| 2000 \| 6 \| \| 2012 \| 6 \| ## Gabon ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 41% - Pneumonia: 10% - Asphyxia: 11% - Preterm: 15% - Other: 17% - HIV/AIDS: 2% - Malaria: 19% - Injuries: 4% - Measles: 1% Intrapartum-related events Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% Source: WHO/CHERG 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| Percent \| \|------\|-----\|---------\| \| 2000 \| 94 \| \| \| 2012 \| 95 \| \| Demand for family planning satisfied (%) 54 (2012) Antenatal care (4 or more visits, %) 78 (2012) Malaria during pregnancy - intermittent preventive treatment (%) 3 (2012) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 10, 11, 6 (2012) Neonatal tetanus vaccine 75 (2012) Postnatal visit for baby (within 2 days for home births, %) 25 (2012) Postnatal visit for mother (within 2 days for home births, %) 59 (2012) Women with low body mass index (<18.5 kg/m², %) 5 (2012) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| Percent \| \|------\|-----\|---------\| \| 2000 \| 44 \| \| \| 2012 \| 52 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| Percent \| \|------\|-----\|---------\| \| 2008 \| 55 \| \| \| 2012 \| 39 \| \| Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1995-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 35 \| 45 \| 17 \| \| 2012 \| 61 \| 68 \| 14 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 38 \| 34 \| 39 \| \| 2012 \| 41 \| 45 \| 33 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 4 - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 53.1 (2004) - National availability of Emergency Obstetric Care services (% of recommended minimum): 123 (2001) ### FINANCING - Per capita total expenditure on health (int$): 558 (2012) - General government expenditure on health as % of total government expenditure (%): 7 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 41 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 6 (2011) - ODA to maternal and neonatal health per live birth (US$): 28 (2011) ## Gambia ### DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 1,791 \| 2013 \| \| Total under-five population (000) \| 328 \| 2013 \| \| Births (000) \| 77 \| 2012 \| \| Birth registration (%) \| 53 \| \| \| Total under-five deaths (000) \| 5 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 40 \| \| \| Neonatal mortality rate (per 1000 live births) \| 28 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 49 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 26 \| 2009 \| \| Total maternal deaths \| 340 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 39 \| 2013 \| \| Total fertility rate (per woman) \| 5.8 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 88 \| 2011 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 170 - 1995: 150 - 2000: 130 - 2005: 110 - 2010: 90 - 2015: 73 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 710 - 1995: 600 - 2000: 400 - 2005: 300 - 2010: 200 - 2015: 180 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 38 \| \| Antenatal care (4+ visits) \| 72 \| \| Skilled attendant at delivery \| 57 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 34 \| \| Measles \| 95 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1990: 44 - 2000: 55 - 2005-2006: 57 - 2010: 57 #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 100% - 2011: 100% - 2012: 100% Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Caseseeking for pneumonia \| \| Source: MICS 2005-2006 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 98 - 1995: 98 - 2000: 95 - 2005: 98 - 2012: 98 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2000: 75 - 2005-2006: 69 - 2010: 69 ### NUTRITION Wasting prevalence (moderate and severe, %): 10 (2010) Low birthweight incidence (moderate and severe, %): 10 (2010) Early initiation of breastfeeding (within 1 hr of birth, %): 52 (2010) Introduction of solid, semi-solid/soft foods (%): 34 (2010) Vitamin A two dose coverage (%): 46 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1996: 23 - 2000: 36 - 2005-2006: 15 - 2010: 24 - 2005-2006: 16 - 2010: 28 - 2005-2006: 17 - 2010: 23 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2000: 26 - 2005-2006: 41 - 2010: 34 ## Gambia ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Malaria: 20% - Injuries: 4% - Measles: 0% - Other: 17% - HIV/AIDS: 1% - Pneumonia: 11% - Neonatal death: 40% - Preterm: 11% - Asphyxia: 12% - Congenital: 4% - Sepsis: 8% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 91 \| 91 \| 91 \| \| 2005-2006 MICS \| 98 \| 98 \| 98 \| \| 2010 MICS \| 98 \| 98 \| 98 \| Demand for family planning satisfied (%) 38 (2010) Antenatal care (4 or more visits, %) 72 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 62 (2013) C-section rate (total, urban, rural; %) 3, 5, 1 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 92 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 38 \| 33 \| 38 \| \| 2005-2006 MICS \| 38 \| 39 \| 39 \| \| 2010 MICS \| 67 \| 39 \| 67 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 15 \| 15 \| 15 \| \| 2005-2006 MICS \| 49 \| 49 \| 49 \| \| 2010 MICS \| 33 \| 33 \| 33 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 11 \| 11 \| 11 \| \| 2012 \| 58 \| 58 \| 58 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1995 \| 12 \| 12 \| 12 \| \| 2012 \| 21 \| 21 \| 21 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 9.7 (2008) - National availability of Emergency Obstetric Care services (% of recommended minimum): 50 (2012) ### FINANCING - Per capita total expenditure on health (int$): 98 (2012) - General government expenditure on health as % of total government expenditure (%): 11 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 16 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 27 (2013) - ODA to maternal and neonatal health per live birth (US$): 31 (2011) \| Statistic \| Value \| \|------------------------------------------------\|-----------\| \| Total population (000) \| 25,366 \| \| Total under-five population (000) \| 3,640 \| \| Births (000) \| 794 \| \| Birth registration (%) \| 63 \| \| Total under-five deaths (000) \| 56 \| \| Neonatal deaths: % of all under-5 deaths \| 40 \| \| Neonatal mortality rate (per 1000 live births) \| 28 \| \| Infant mortality rate (per 1000 live births) \| 49 \| \| Stillbirth rate (per 1000 total births) \| 22 \| \| Total maternal deaths \| 3,100 \| \| Lifetime risk of maternal death (1 in N) \| 66 \| \| Total fertility rate (per woman) \| 3.9 \| \| Adolescent birth rate (per 1000 girls) \| 70 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 128 - 1995: 112 - 2000: 96 - 2005: 80 - 2010: 64 - 2015: 43 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 760 - 1995: 600 - 2000: 440 - 2005: 320 - 2010: 240 - 2015*: 190 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 34 \| \| Antenatal care (4+ visits) \| 87 \| \| Skilled attendant at delivery \| 68 \| \| Postnatal care \| 83 \| \| Exclusive breastfeeding \| 46 \| \| Measles \| 88 \| * See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1988 DHS: 40 - 1998 DHS: 44 - 2003 DHS: 47 - 2006 MICS: 50 - 2008 DHS: 57 - 2011 MICS: 68 #### Prevention of mother-to-child transmission of HIV \| Year \| ART for own health (%) \| ARVs for PMTCT (%) \| \|------\|------------------------\|--------------------\| \| 2010 \| 55 \| 76 \| \| 2011 \| 80 \| 95 \| \| 2012 \| 80 \| 95 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 34 \| 87 \| \| Antenatal care (1+ visit) \| 60 \| 92 \| \| Antenatal care (4+ visits) \| 60 \| 92 \| \| Skilled attendant at delivery \| 40 \| 80 \| \| Early initiation of breastfeeding \| 40 \| 80 \| \| ITN use among children <5 yrs \| 40 \| 80 \| \| DTP3 \| 40 \| 80 \| \| Measles \| 40 \| 80 \| \| Vitamin A (past 6 months) \| 40 \| 80 \| \| ORT & continued feeding \| 40 \| 80 \| \| Case-seeking for pneumonia \| 40 \| 80 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 80% - 1995: 85% - 2000: 90% - 2005: 95% - 2012: 98% Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1993 DHS: 43/24 - 1998 DHS: 26/16 - 2003 DHS: 44/16 - 2006 MICS: 34/13 - 2008 DHS: 51/24 - 2011 MICS: 56/41 ### NUTRITION #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1988 DHS: 25/43 - 1993 DHS: 26/41 - 1998 DHS: 20/31 - 2003 DHS: 19/36 - 2006 MICS: 14/28 - 2011 MICS: 13/23 #### Wasting prevalence (moderate and severe, %) - 6 (2011) #### Low birthweight incidence (moderate and severe, %) - 11 (2011) #### Early initiation of breastfeeding (within 1 hr of birth, %) - 46 (2011) #### Introduction of solid, semi-solid/soft foods (%) - 75 (2011) #### Vitamin A two dose coverage (%) - 17 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1988 DHS: 4 - 1993 DHS: 7 - 1998 DHS: 31 - 2003 DHS: 53 - 2008 DHS: 63 - 2011 MICS: 46 ## Ghana ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 40% - Pneumonia: 11% - Preterm: 12% - Asphyxia: 12% - Other: 17% - HIV/AIDS: 1% - Malaria: 19% - Injuries: 4% - Measles: 3% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1988 \| 82 \| \| \| 1998 \| 88 \| \| \| 2003 \| 92 \| \| \| 2006 \| 92 \| \| \| 2008 \| 90 \| \| \| 2011 \| 96 \| \| Demand for family planning satisfied (%) 34 (2013) Antenatal care (4 or more visits, %) 87 (2011) Malaria during pregnancy - intermittent preventive treatment (%) 67 (2011) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 11, 17, 7 (2011) Neonatal tetanus vaccine 88 (2012) Postnatal visit for baby (within 2 days for home births, %) 83 (2011) Postnatal visit for mother (within 2 days for home births, %) 83 (2011) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1993 \| 29 \| \| \| 1998 \| 29 \| \| \| 2003 \| 40 \| \| \| 2006 \| 39 \| \| \| 2008 \| 29 \| \| \| 2011 \| 45 \| \| \| 2011 \| 44 \| \| \| 2011 \| 35 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 2003 \| 4 \| \| \| 2006 \| 22 \| \| \| 2008 \| 28 \| \| \| 2011 \| 39 \| \| Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 38 \| 16 \| 5 \| \| 2012 \| 68 \| 19 \| 5 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 42 \| 14 \| 29 \| \| 2012 \| 59 \| 13 \| 46 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - Legal status of abortion (X of 5 circumstances) 3 (R,F) - Midwives authorized for specific tasks (X of 7 tasks) 7 - Maternity protection (Convention 183) Partial - Maternal deaths notification Yes - Postnatal home visits in the first week after birth Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - - Antenatal corticosteroids as part of management of preterm labour - - International Code of Marketing of Breastmilk Substitutes Yes - Community treatment of pneumonia with antibiotics Yes - Low osmolarity ORS and zinc for management of diarrhoea Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) 3 (2013) - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) 2 (2013) - Density of doctors, nurses and midwives (per 10,000 population) 10.2 (2010) - National availability of Emergency Obstetric Care services (% of recommended minimum) 37 (2011) ### FINANCING - Per capita total expenditure on health (int$) 106 (2012) - General government expenditure on health as % of total government expenditure (%) 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%) 29 (2012) - Reproductive, maternal, newborn and child health expenditure by source Partially available - ODA to child health per child (US$) 24 (2011) - ODA to maternal and neonatal health per live birth (US$) 56 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|--------\| \| Total population (000) \| 15,083 \| 2013 \| \| Total under-five population (000) \| 2,215 \| 2013 \| \| Births (000) \| 474 \| 2012 \| \| Birth registration (%) \| 97 \| (2008-2009) \| \| Total under-five deaths (000) \| 15 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 48 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 15 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 27 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 10 \| (2009) \| \| Total maternal deaths \| 660 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 170 \| 2013 \| \| Total fertility rate (per woman) \| 3.8 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 92 \| (2011) \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 80 - 1995: 70 - 2000: 60 - 2005: 50 - 2010: 40 - 2015: 32 MDG Target: 27 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 270 - 1995: 240 - 2000: 180 - 2005: 120 - 2010: 140 - 2015: 68 MDG Target*: 68 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 72 \| \| Antenatal care (4+ visits) \| 52 \| \| Skilled attendant at delivery \| 50 \| \| Postnatal care \| 93 \| \| Exclusive breastfeeding \| \| \| Measles \| \| * See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1987 DHS: 29 - 1995 DHS: 35 - 1998-1999 DHS: 41 - 2002 Other NS: 41 - 2008-2009 Other NS: 52 #### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|--------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| - \| - \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| - \| - \| \| Uncertainty range around the estimate \| - \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| 60 \| 90 \| \| Antenatal care (4+ visits) \| 50 \| 80 \| \| Skilled attendant at delivery \| 40 \| 70 \| \| Early initiation of breastfeeding \| 30 \| 60 \| \| ITN use among children <5 yrs \| 20 \| 50 \| \| DTP3 \| 60 \| 90 \| \| Measles \| 60 \| 90 \| \| Vitamin A (past 6 months) \| 60 \| 90 \| \| ORT & continued feeding \| 40 \| 70 \| \| Caseseeking for pneumonia \| 30 \| 60 \| Source: DHS 1998-1999 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 60 - 1995: 70 - 2000: 80 - 2005: 90 - 2012: 96 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1995 DHS: 41 - 1998-1999 DHS: 37 - 2002 Other NS: 64 ### NUTRITION - Wasting prevalence (moderate and severe, %): 1 (2008-2009) - Low birthweight incidence (moderate and severe, %): 11 (2008-2009) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1997 DHS: 28 - 1995 DHS: 22 - 1998-1999 DHS: 20 - 2002 Other NS: 18 - 2008-2009 Other NS: 13 #### Early initiation of breastfeeding (within 1 hr of birth, %): 56 (2008-2009) #### Introduction of solid, semi-solid/soft foods (%): 71 (2008-2009) #### Vitamin A two dose coverage (%): 14 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1995 DHS: 46 - 2002 Other NS: 51 - 2008-2009 Other NS: 50 Guatemala DEMOGRAPHICS - Causes of under-five deaths, 2012 - Neonatal death: 48% - Pneumonia: 15% - Preterm: 11% - Asphyxia: 14% - Other: 20% - Malaria: 0% - HIV/AIDS: 1% - Injuries: 8% - Measles: 0% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 22% - Indirect: 19% - Other direct: 15% - Sepsis: 8% - Embolism: 3% POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 - Maternal health (X of 3): 3 - Newborn health (X of 4): 3 - Child health (X of 3): 3 - Density of doctors, nurses and midwives (per 10,000 population): 18.3 - National availability of Emergency Obstetric Care services (% of recommended minimum): - FINANCING - Per capita total expenditure on health (US$): 368 - General government expenditure on health as % of total government expenditure (%): 19 - Out of pocket expenditure as % of total expenditure on health (%): 50 - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 6 - ODA to maternal and neonatal health per live birth (US$): 24 Note: See annexes for additional information on the indicators above. --- MATERNAL AND NEWBORN HEALTH - Antenatal care - Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy - 1987 DHS: 35 - 1995 DHS: 53 - 1998–1999 DHS: 60 - 2002 Other NS: 84 - 2008–2009 Other NS: 93 - Demand for family planning satisfied (%): 72 (2008–2009) - Antenatal care (4 or more visits, %): - - Malaria during pregnancy – intermittent preventive treatment (%): - - C-section rate (total, urban, rural; %): 16, 26, 11 (2008–2009) - Minimum target is 5% and maximum target is 15% - Neonatal tetanus vaccine: 85 (2012) - Postnatal visit for baby (within 2 days for home births, %): - - Postnatal visit for mother (within 2 days for home births, %): - - Women with low body mass index (<18.5 kg/m², %): - CHILD HEALTH - Diarrhoeal disease treatment - Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS - 1995 DHS: 22 - 1998–1999 DHS: 30 - 2002 Other NS: 34 - 2008–2009 Other NS: 37 - Malaria prevention and treatment - Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs - 1999 Other NS: 1 WATER AND SANITATION - Improved drinking water coverage - Percent of population by type of drinking water source, 1990–2012 - Piped on premises - Other improved - Unimproved - 1990 Total: 49 - 2012 Total: 86 - 1990 Urban: 68 - 2012 Urban: 98 - 1990 Rural: 35 - 2012 Rural: 73 - Improved sanitation coverage - Percent of population by type of sanitation facility, 1990–2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation - 1990 Total: 62 - 2012 Total: 80 - 1990 Urban: 81 - 2012 Urban: 88 - 1990 Rural: 49 - 2012 Rural: 72 \| Statistic \| Value \| \|------------------------------------------------\|-----------\| \| Total population (000) \| 11,451 \| \| Total under-five population (000) \| 1,856 \| \| Births (000) \| 428 \| \| Birth registration (%) \| 43 \| \| Total under-five deaths (000) \| 41 \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| \| Neonatal mortality rate (per 1000 live births)\| 34 \| \| Infant mortality rate (per 1000 live births) \| 65 \| \| Stillbirth rate (per 1000 total births) \| 24 \| \| Total maternal deaths \| 2,800 \| \| Lifetime risk of maternal death (1 in N) \| 30 \| \| Total fertility rate (per woman) \| 5.0 \| \| Adolescent birth rate (per 1000 girls) \| 154 \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 241 \| \| 1995 \| 217 \| \| 2000 \| 183 \| \| 2005 \| 156 \| \| 2010 \| 101 \| \| 2012 \| 80 \| \| 2013 \| 80 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1100 \| \| 1995 \| 1000 \| \| 2000 \| 750 \| \| 2005 \| 500 \| \| 2010 \| 280 \| \| 2013 \| 650 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 29 \| \| Antenatal care (4+ visits) \| 50 \| \| Skilled attendant at delivery \| 45 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 48 \| \| Measles \| 58 \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1992 \| 31 \| \| 1999 \| 35 \| \| 2003 \| 56 \| \| 2005 \| 38 \| \| 2007 \| 46 \| \| 2012 \| 45 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| 17 \| 17 \| \| 2011 \| 31 \| 31 \| \| 2012 \| 44 \| 44 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 29 \| 58 \| \| Antenatal care (1+ visit) \| 50 \| 70 \| \| Antenatal care (4+ visits) \| 30 \| 60 \| \| Skilled attendant at delivery \| 45 \| 58 \| \| Early initiation of breastfeeding \| 30 \| 58 \| \| ITN use among children <5 yrs \| 10 \| 20 \| \| DTP3 \| 40 \| 58 \| \| Measles \| 30 \| 58 \| \| Vitamin A (past 6 months) \| 50 \| 58 \| \| ORT & continued feeding \| 30 \| 58 \| \| Caseseeking for pneumonia \| 30 \| 58 \| Source: DHS 2005 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 50 \| \| 2000 \| 60 \| \| 2005 \| 70 \| \| 2012 \| 80 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1999 \| 39 \| \| 2003 \| 33 \| \| 2005 \| 42 \| \| 2012 \| 37 \| Source: DHS ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2011-2012 \| 6 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2005 \| 12 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2005 \| 40 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2008 \| 32 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 99 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1994-1995 \| 21 \| \| 1999 \| 21 \| \| 2005 \| 23 \| \| 2008 \| 21 \| \| 2011-2012 \| 16 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1999 \| 11 \| \| 2003 \| 23 \| \| 2005 \| 27 \| \| 2008 \| 48 \| Guinea DEMOGRAPHICS - Causes of under-five deaths, 2012 - Neonatal death: 34% - Pneumonia: 11% - Preterm: 10% - Asphyxia: 11% - Other: 2% - Congenital: 2% - Sepsis*: 7% - Diarrhoea: 0% - Measles: 0% - Injuries: 4% - Malaria: 27% - HIV/AIDS: 2% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition - Causes of maternal deaths, 2013 - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Emballon: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO/CHERG 2014 MATERNAL AND NEWBORN HEALTH - Antenatal care - Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy - 1992 DHS: 58 - 1999 DHS: 71 - 2003 MICS: 84 - 2005 DHS: 82 - 2007 Other NS: 88 - 2012 DHS: 85 - Demand for family planning satisfied (%) - 29 (2005) - Antenatal care (4 or more visits, %) - 50 (2007) - Malaria during pregnancy – intermittent preventive treatment (%) - 18 (2012) - C-section rate (total, urban, rural; %) - 2, 5, 2 (2007) - (Minimum target is 5% and maximum target is 15%) - Neonatal tetanus vaccine - 80 (2012) - Postnatal visit for baby (within 2 days for home births, %) - - - Postnatal visit for mother (within 2 days for home births, %) - - - Women with low body mass index (<18.5 kg/m², %) - 11 (2012) CHILD HEALTH - Diarrhoeal disease treatment - Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS - 1992 DHS: 25 - 1999 DHS: 35 - 2003 MICS: 44 - 2005 DHS: 40 - 2007 Other NS: 38 - 2012 DHS: 33 - Malaria prevention and treatment - Percent children receiving first line treatment among those receiving any antimalarial - 5 (2012) - Percent children < 5 years sleeping under ITNs - 26 (2012) WATER AND SANITATION - Improved drinking water coverage - Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water - Total - Urban - Rural - 1990 - 2012 - 1990 - 2012 - 1990 - 2012 - 47 - 62 - 67 - 57 - 35 - 65 - 5 - 13 - 19 - 39 - 0 - 11 Source: WHO/UNICEF JMP 2014 - Improved sanitation coverage - Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation - Total - Urban - Rural - 1990 - 2012 - 1990 - 2012 - 1990 - 2012 - 42 - 43 - 41 - 17 - 23 - 26 - 9 - 21 - 18 - 3 - 11 Source: WHO/UNICEF JMP 2014 POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 3 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 6.1 (2005) - National availability of Emergency Obstetric Care services (% of recommended minimum): 13 (2013) FINANCING** - Per capita total expenditure on health (int$): 67 (2012) - General government expenditure on health as % of total government expenditure (%): 7 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 67 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 5 (2011) - ODA to maternal and neonatal health per live birth (US$): 17 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|--------\|--------\| \| Total population (000) \| 1,664 \| \| \| Total under-five population (000) \| 265 \| \| \| Births (000) \| 63 \| \| \| Birth registration (%) \| 24 \| \| \| Total under-five deaths (000) \| 8 \| \| \| Neonatal deaths: % of all under-5 deaths \| 36 \| \| \| Neonatal mortality rate (per 1000 live births) \| 46 \| \| \| Infant mortality rate (per 1000 live births) \| 81 \| \| \| Stillbirth rate (per 1000 total births) \| 30 \| \| \| Total maternal deaths \| 360 \| \| \| Lifetime risk of maternal death (1 in N) \| 36 \| \| \| Total fertility rate (per woman) \| 5.0 \| \| \| Adolescent birth rate (per 1000 girls) \| 137 \| \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 206 \| \| 1995 \| 180 \| \| 2000 \| 160 \| \| 2005 \| 140 \| \| 2010 \| 129 \| \| 2015 \| 69 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 930 \| \| 1995 \| 800 \| \| 2000 \| 600 \| \| 2005 \| 400 \| \| 2010 \| 230 \| \| 2015 \| MDG Target \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 70 \| \| \| Antenatal care (4+ visits) \| 68 \| \| \| Skilled attendant at delivery \| 43 \| \| \| Postnatal care \| 38 \| \| \| Exclusive breastfeeding \| 69 \| \| \| Measles \| 69 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1990-1995 \| 25 \| \| 2000 \| 35 \| \| 2006 \| 39 \| \| 2010 \| 43 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Percent \| \|------\|---------\| \| 2010 \| 15 \| \| 2011 \| 22 \| \| 2012 \| 33 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 70 \| 80 \| \| Antenatal care (1+ visit) \| 68 \| 80 \| \| Antenatal care (4+ visits) \| 43 \| 69 \| \| Skilled attendant at delivery \| 38 \| 69 \| \| Early initiation of breastfeeding \| 38 \| 69 \| \| ITN use among children <5 yrs \| 38 \| 69 \| \| DTP3 \| 38 \| 69 \| \| Measles \| 38 \| 69 \| \| Vitamin A (past 6 months) \| 38 \| 69 \| \| ORT & continued feeding \| 38 \| 69 \| \| Caseseeking for pneumonia \| 38 \| 69 \| Source: MICS 2006 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 60 \| \| 1995 \| 60 \| \| 2000 \| 60 \| \| 2005 \| 60 \| \| 2012 \| 60 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2000 \| 64 \| \| 2006 \| 57 \| \| 2010 \| 52 \| Source: MICS ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 6 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 11 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 55 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 43 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 95 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 2000 \| 22 \| \| 2006 \| 17 \| \| 2008 \| 17 \| \| 2010 \| 18 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2000 \| 37 \| \| 2006 \| 16 \| \| 2010 \| 38 \| Guinea-Bissau DEMOGRAPHICS - Causes of under-five deaths, 2012 - Neonatal death: 36% - Pneumonia: 12% - Malaria: 18% - HIV/AIDS: 3% - Other: 17% - Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Sepsis: 10% - Embolism: 2% Intrapartum-related events Source: WHO/CHERG 2014 Source: WHO 2014 Globally nearly half of child deaths are attributable to undernutrition. Regional estimates for Sub-Saharan Africa, 2013 MATERNAL AND NEWBORN HEALTH - Antenatal care - Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy - 2000 MICS: 62% - 2006 MICS: 78% - 2010 MICS: 93% - Demand for family planning satisfied (%) - 70 (2010) - Antenatal care (4 or more visits, %) - 68 (2010) - Malaria during pregnancy – intermittent preventive treatment (%) - 14 (2012) - C-section rate (total, urban, rural; %) - 2, 5, 1 (Minimum target is 5% and maximum target is 15%) - Neonatal tetanus vaccine - 80 (2012) - Postnatal visit for baby (within 2 days for home births, %) - - - Postnatal visit for mother (within 2 days for home births, %) - - - Women with low body mass index (<18.5 kg/m², %) - - CHILD HEALTH - Diarrhoeal disease treatment - Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS - 2000 MICS: 23%, 39% - 2006 MICS: 25%, 23% - 2010 MICS: 53%, 19% - Malaria prevention and treatment - Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs - 2000 MICS: 7% - 2006 MICS: 39% - 2010 MICS: 36% WATER AND SANITATION - Improved drinking water coverage - Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water - 1990 Total: 32% - 2012 Total: 69% - 1990 Urban: 0% - 2012 Urban: 55% - 1990 Rural: 14% - 2012 Rural: 85% - Improved sanitation coverage - Percent of population by type of sanitation facility, 2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation - 2012 Total: 41% - 2012 Urban: 36% - 2012 Rural: 43% Policies - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - - - Legal status of abortion (X of 5 circumstances) - 1 - Midwives authorized for specific tasks (X of 7 tasks) - - - Maternity protection (Convention 183) - No - Maternal deaths notification - Yes - Postnatal home visits in the first week after birth - - - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - - - Antenatal corticosteroids as part of management of preterm labour - - - International Code of Marketing of Breastmilk Substitutes - Partial - Community treatment of pneumonia with antibiotics - No - Low osmolarity ORS and zinc for management of diarrhoea - - Systems - Costed national implementation plan(s) for: maternal, newborn and child health available - - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - Maternal health (X of 3) - Newborn health (X of 4) - Child health (X of 3) - - - Density of doctors, nurses and midwives (per 10,000 population) - 6.6 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum) - 127 (2002) Financing - Per capita total expenditure on health (int$) - 66 (2012) - General government expenditure on health as % of total government expenditure (%) - 8 (2012) - Out of pocket expenditure as % of total expenditure on health(%) - 43 (2012) - Reproductive, maternal, newborn and child health expenditure by source - No Data - ODA to child health per child (US$) - 18 (2011) - ODA to maternal and neonatal health per live birth (US$) - 47 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 10,174 \| 2013 \| \| Total under-five population (000) \| 1,250 \| 2013 \| \| Births (000) \| 265 \| 2012 \| \| Birth registration (%) \| 80 \| 2012 \| \| Total under-five deaths (000) \| 20 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 25 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 57 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 15 \| 2009 \| \| Total maternal deaths \| 1,000 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 80 \| 2013 \| \| Total fertility rate (per woman) \| 3.2 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 65 \| 2009 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 144 \| \| 1995 \| 150 \| \| 2000 \| 100 \| \| 2005 \| 76 \| \| 2010 \| 48 \| \| 2015 \| 48 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 670 \| \| 1995 \| 500 \| \| 2000 \| 400 \| \| 2005 \| 380 \| \| 2010 \| 170 \| \| 2015 \| 170 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 49 \| \| Antenatal care (4+ visits) \| 67 \| \| Skilled attendant at delivery \| 37 \| \| Postnatal care \| 32 \| \| Exclusive breastfeeding \| 40 \| \| Measles \| 58 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1989 \| 23 \| \| 1994-1995 \| 21 \| \| 2000 \| 24 \| \| 2005-2006 \| 26 \| \| 2012 \| 37 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 40 \| \| 2011 \| 71 \| \| 2012 \| >95 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% (red circles) and Richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 49 \| \| Antenatal care (1+ visit) \| 67 \| \| Antenatal care (4+ visits) \| 37 \| \| Skilled attendant at delivery \| 32 \| \| Early initiation of breastfeeding \| 40 \| \| ITN use among children <5 yrs \| 58 \| \| DTP3 \| 60 \| \| Measles \| 71 \| \| Vitamin A (past 6 months) \| 38 \| \| ORT & continued feeding \| 46 \| \| Caseseeking for pneumonia \| 40 \| Source: DHS 2012 ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 58 \| \| 2000 \| 60 \| \| 2005 \| 60 \| \| 2012 \| 60 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1994-1995 \| 17 \| \| 2000 \| 26 \| \| 2005-2006 \| 31 \| \| 2012 \| 38 \| ### NUTRITION Wasting prevalence (moderate and severe, %) 5 (2012) Low birthweight incidence (moderate and severe, %) 23 (2012) Early initiation of breastfeeding (within 1 hr of birth, %) 47 (2012) Introduction of solid, semi-solid/soft foods (%) 87 (2012) Vitamin A two dose coverage (%) 54 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1990 \| 24 \| \| 1994-1995 \| 40 \| \| 2000 \| 24 \| \| 2005-2006 \| 37 \| \| 2012 \| 14 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2000 \| 24 \| \| 2005-2006 \| 41 \| \| 2012 \| 40 \| ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Pneumonia: 20% - Preterm: 11% - Neonatal death: 34% - Asphyxia: 9% - Other: 3% - Congenital: 2% - Sepsis: 6% - Measles: 0% - Diarrhoea: 0% - HIV/AIDS: 1% - Malaria: 1% - Injuries: 7% Intrapartum-related events ** Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 ### Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 22% - Indirect: 19% - Other direct: 15% - Abortion: 10% - Sepsis: 8% - Embolism: 3% Regional estimates for Caribbean, 2013 Source: WHO 2014 ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| DHS \| \|------------\|-------\|-------\| \| 1984–1989 \| 71 \| 68 \| \| 1994–1995 \| 79 \| 79 \| \| 2000 \| 85 \| 85 \| \| 2005–2006 \| 90 \| 90 \| ### Demand for family planning satisfied (%) 49 (2012) ### Antenatal care (4 or more visits, %) 67 (2012) ### Malaria during pregnancy - intermittent preventive treatment (%) - (2012) ### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 6, 10, 3 (2012) ### Neonatal tetanus vaccine 76 (2012) ### Postnatal visit for baby (within 2 days for home births, %) 19 (2012) ### Postnatal visit for mother (within 2 days for home births, %) 32 (2012) ### Women with low body mass index (<18.5 kg/m², %) 9 (2012) ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| DHS \| \|------------\|-------\|-------\| \| 1994–1995 \| 26 \| 41 \| \| 2000 \| 35 \| 43 \| \| 2005–2006 \| 40 \| 57 \| \| 2012 \| 53 \| 53 \| ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total \| DHS \| \|------------\|-------\|-------\| \| 2012 \| 12 \| 12 \| ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 1990–2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 53 \| 22 \| 8 \| \| 2012 \| 53 \| 34 \| 9 \| ### Improved sanitation coverage Percent of population by type of sanitation facility, 1990–2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 48 \| 16 \| 19 \| \| 2012 \| 21 \| 31 \| 24 \| Source: WHO/UNICEF JMP 2014 ## POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - Legal status of abortion (X of 5 circumstances) - Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) - Maternal deaths notification - Postnatal home visits in the first week after birth - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - Antenatal corticosteroids as part of management of preterm labour - International Code of Marketing of Breastmilk Substitutes - Community treatment of pneumonia with antibiotics - Low osmolarity ORS and zinc for management of diarrhoea ## SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): - - Newborn health (X of 4): - - Child health (X of 3): - - Density of doctors, nurses and midwives (per 10,000 population): 3.6 (1998) - National availability of Emergency Obstetric Care services (% of recommended minimum): 12 (2008) ## FINANCING - Per capita total expenditure on health (int$): 84 (2012) - General government expenditure on health as % of total government expenditure (%): 5 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 3 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 74 (2013) - ODA to maternal and neonatal health per live birth (US$): 283 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------------\|------\| \| Total population (000) \| 1,236,687 \| 2013 \| \| Total under-five population (000) \| 120,581 \| 2013 \| \| Births (000) \| 25,642 \| 2012 \| \| Birth registration (%) \| 41 \| 2005-2006 \| \| Total under-five deaths (000) \| 1,414 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 55 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 31 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 44 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 22 \| 2009 \| \| Total maternal deaths \| 50,000 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 190 \| 2013 \| \| Total fertility rate (per woman) \| 2.5 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 39 \| 2009 \| ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 73 \| \| Antenatal care (4+ visits) \| 37 \| \| Skilled attendant at delivery \| 52 \| \| Postnatal care \| 37 \| \| Exclusive breastfeeding \| 46 \| \| Measles \| 74 \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|-----------------\|---------\| \| 1992-1993 NFHS \| 34 \| \| 1998-1999 NFHS \| 42 \| \| 2000 MICS \| 43 \| \| 2005-2006 NFHS \| 47 \| \| 2007-2008 Other NS \| 52 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs - Percent HIV+ pregnant women receiving ARVs for PMTCT - Uncertainty range around the estimate No Data ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 73 \| 80 \| \| Antenatal care (1+ visit) \| 50 \| 60 \| \| Antenatal care (4+ visits) \| 37 \| 46 \| \| Skilled attendant at delivery \| 52 \| 60 \| \| Early initiation of breastfeeding \| 37 \| 46 \| \| ITN use among children <5 yrs \| 37 \| 46 \| \| DTP3 \| 73 \| 80 \| \| Measles \| 50 \| 60 \| \| Vitamin A (past 6 months) \| 37 \| 46 \| \| ORT & continued feeding \| 52 \| 60 \| \| Caseseeking for pneumonia \| 37 \| 46 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 60 \| \| 2000 \| 70 \| \| 2005 \| 80 \| \| 2012 \| 74 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|-----------------\|---------\| \| 1992-1993 NFHS \| 69 \| \| 1998-1999 NFHS \| 33 \| \| 2005-2006 NFHS \| 67 \| \| 2005-2006 NFHS \| 13 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2005-2006 \| 20 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2005-2006 \| 28 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2007-2008 \| 41 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2005-2006 \| 56 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 59 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|-----------------\|---------\| \| 1992-1993 NFHS \| 51 \| \| 1998-1999 NFHS \| 58 \| \| 2005-2006 NFHS \| 46 \| \| 1992-1993 NFHS \| 54 \| \| 1998-1999 NFHS \| 44 \| \| 2005-2006 NFHS \| 48 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|-----------------\|---------\| \| 1992-1993 NFHS \| 44 \| \| 1998-1999 NFHS \| 46 \| \| 2000 MICS \| 37 \| \| 2005-2006 NFHS \| 46 \| ## India ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 55% - Preterm: 25% - Asphyxia: 11% - Other: 5% - Congenital: 4% - Sepsis: 9% - Diarrhoea: 3% - Measles: 2% - Injuries: 3% - HIV/AIDS: 0% - Malaria: 0% * Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 38% - Indirect: 29% - Hypertension: 10% - Other direct: 8% - Embolism: 2% - Sepsis: 14% Source: WHO 2014 Regional estimates for Southern Asia, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| NFHS \| MICS \| \|------------\|------\|------\| \| 1992-1993 \| 62 \| \| \| 1998-1999 \| 65 \| 62 \| \| 2005-2006 \| 74 \| \| Demand for family planning satisfied (%) 73 (2008) Antenatal care (4 or more visits, %) 37 (2005-2006) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 9, 17, 6 (2005-2006) Neonatal tetanus vaccine 87 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 37 (2005-2006) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| NHIS \| \|------------\|------\| \| 1992-1993 \| 18 \| \| 1998-1999 \| 27 \| \| 2005-2006 \| 33 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs No Data ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 53 \| 17 \| 36 \| \| 2012 \| 87 \| 67 \| 14 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 5 \| 1 \| 4 \| \| 2012 \| 8 \| 2 \| 6 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 4 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 24.1 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 157 (2012) - General government expenditure on health as % of total government expenditure (%): 9 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 58 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 2 (2011) - ODA to maternal and neonatal health per live birth (US$): 6 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------------\|------\| \| Total population (000) \| 246,864 \| 2013 \| \| Total under-five population (000) \| 24,622 \| 2013 \| \| Births (000) \| 4,736 \| 2012 \| \| Birth registration (%) \| 67 \| 2012 \| \| Total under-five deaths (000) \| 152 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 48 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 15 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 26 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 15 \| 2013 \| \| Total maternal deaths \| 8,800 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 220 \| 2013 \| \| Total fertility rate (per woman) \| 2.4 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 47 \| 2009 \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 84 \| \| 1995 \| 78 \| \| 2000 \| 68 \| \| 2005 \| 58 \| \| 2010 \| 31 \| \| 2015 \| 28 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 430 \| \| 1995 \| 370 \| \| 2000 \| 280 \| \| 2005 \| 200 \| \| 2010 \| 190 \| \| 2015 \| 110 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 84 \| \| Antenatal care (4+ visits) \| 88 \| \| Skilled attendant at delivery \| 83 \| \| Postnatal care \| 80 \| \| Exclusive breastfeeding \| 42 \| \| Measles \| 80 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1991 \| 32 \| \| 1994 \| 37 \| \| 1997 \| 43 \| \| 2002-2003 \| 66 \| \| 2007 \| 79 \| \| 2012 \| 83 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent \| \|------\|----------------------------------------------------------------------------------\|---------\| \| 2010 \| 5 \| \| 2011 \| 5 \| \| 2012 \| 5 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 60 \| 80 \| \| Antenatal care (1+ visit) \| 60 \| 80 \| \| Antenatal care (4+ visits) \| 60 \| 80 \| \| Skilled attendant at delivery \| 60 \| 80 \| \| Early initiation of breastfeeding \| 60 \| 80 \| \| ITN use among children <5 yrs \| 60 \| 80 \| \| DTP3 \| 60 \| 80 \| \| Measles \| 60 \| 80 \| \| Vitamin A (past 6 months) \| 60 \| 80 \| \| ORT & continued feeding \| 60 \| 80 \| \| Caseseeking for pneumonia \| 60 \| 80 \| Source: DHS 2012 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 60 \| \| 1995 \| 60 \| \| 2000 \| 60 \| \| 2005 \| 60 \| \| 2012 \| 60 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1991 \| 64 \| \| 1994 \| 63 \| \| 1997 \| 69 \| \| 2002-2003 \| 61 \| \| 2007 \| 66 \| \| 2012 \| 75 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| 12 \| (2010) Low birthweight incidence (moderate and severe, %) \| 9 \| (2007) Early initiation of breastfeeding (within 1 hr of birth, %) \| 29 \| (2010) Introduction of solid, semi-solid/soft foods (%) \| 85 \| (2007) Vitamin A two dose coverage (%) \| 73 \| (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1995 \| 30 \| \| 2001 \| 48 \| \| 2007 \| 23 \| \| 2010 \| 42 \| \| 2007 \| 20 \| \| 2010 \| 19 \| \| 2010 \| 39 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1987 \| 63 \| \| 1991 \| 45 \| \| 1994 \| 37 \| \| 1997 \| 42 \| \| 2002-2003 \| 40 \| \| 2007 \| 32 \| \| 2012 \| 42 \| ## Indonesia ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 48% - Preterm: 18% - Asphyxia: 10% - Congenital: 7% - Sepsis: 6% - Other: 5% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 30% - Indirect: 17% - Hypertension: 15% - Other direct: 14% - Embolism: 12% - Sepsis: 6% - Abortion: 7% Regional estimates for South-eastern Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total DHS \| \|------\|-----------\| \| 1991 \| 76 \| \| 1994 \| 82 \| \| 1997 \| 89 \| \| 2002-2003 \| 92 \| \| 2007 \| 93 \| \| 2012 \| 96 \| Demand for family planning satisfied (%) 84 (2012) Antenatal care (4 or more visits, %) 88 (2012) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 12, 17, 8 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) 48 (2012) Postnatal visit for mother (within 2 days for home births, %) 80 (2012) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total DHS \| \|------\|-----------\| \| 1991 \| 43 \| \| 2000 \| 61 \| \| 2002-2003 \| 56 \| \| 2007 \| 36 \| \| 2012 \| 54 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total DHS \| \|------\|-----------\| \| 2007 \| 3 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 61 \| 24 \| 9 \| \| 2012 \| 88 \| 64 \| 21 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 40 \| 18 \| 7 \| \| 2012 \| 61 \| 59 \| 8 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 1 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 15.9 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 150 (2012) - General government expenditure on health as % of total government expenditure (%): 7 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 45 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 3 (2011) - ODA to maternal and neonatal health per live birth (US$): 7 (2011) DEMOGRAPHICS - Total population (000): 32,778 - Total under-five population (000): 4,824 - Births (000): 1,037 - Birth registration (%): 99 - Total under-five deaths (000): 35 - Neonatal deaths: % of all under-5 deaths: 56 - Neonatal mortality rate (per 1000 live births): 19 - Infant mortality rate (per 1000 live births): 28 - Stillbirth rate (per 1000 total births): 9 - Total maternal deaths: 710 - Lifetime risk of maternal death (1 in N): 340 - Total fertility rate (per woman): 4.1 - Adolescent birth rate (per 1000 girls): 68 Under-five mortality rate - Deaths per 1000 live births: 53 (1990), 45 (1995), 34 (2012) Maternal mortality ratio - Deaths per 100,000 live births: 110 (1990), 67 (2012) MATERNAL AND NEWBORN HEALTH Coverage along the continuum of care** \| Service \| Percent \| \|----------------------------------\|---------\| \| Demand for family planning satisfied \| 87 \| \| Antenatal care (4+ visits) \| 50 \| \| Skilled attendant at delivery \| 91 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 20 \| \| Measles \| 69 \| See Annex/website for indicator definition Skilled attendant at delivery - Percent live births attended by skilled health personnel: 54 (1989), 72 (2000), 89 (2006), 80 (2006-2007), 91 (2011) Prevention of mother-to-child transmission of HIV - Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs): No Data - Percent HIV+ pregnant women receiving ARVs for PMTCT: No Data - Uncertainty range around the estimate: No Data EQUITY Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 87 \| 91 \| \| Antenatal care (1+ visit) \| 50 \| 69 \| \| Antenatal care (4+ visits) \| 91 \| 100 \| \| Skilled attendant at delivery \| 69 \| 80 \| \| Early initiation of breastfeeding \| 80 \| 91 \| \| ITN use among children <5 yrs \| 91 \| 100 \| \| DTP3 \| 80 \| 91 \| \| Measles \| 91 \| 100 \| \| Vitamin A (past 6 months) \| 91 \| 100 \| \| ORT & continued feeding \| 91 \| 100 \| \| Caseseeking for pneumonia \| 91 \| 100 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. CHILD HEALTH Immunization - Percent of children immunized: - against measles: 80 (1990), 85 (1995), 90 (2000), 95 (2005), 98 (2012) - with 3 doses DTP: 80 (1990), 85 (1995), 90 (2000), 95 (2005), 98 (2012) - with 3 doses Hib: 80 (1990), 85 (1995), 90 (2000), 95 (2005), 98 (2012) - with 3 doses pneumococcal conjugate vaccine: 80 (1990), 85 (1995), 90 (2000), 95 (2005), 98 (2012) Pneumonia treatment - Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider: 76 (2000), 82 (2006), 74 (2011) - receiving antibiotics: 67 (2000), 82 (2006), 67 (2011) NUTRITION - Wasting prevalence (moderate and severe, %): 7 (2011) - Low birthweight incidence (moderate and severe, %): 13 (2011) Underweight and stunting prevalence - Percent of children <5 years who are moderately or severely: - underweight: 10 (1991), 13 (2000), 10 (2003), 7 (2006), 9 (2011) - stunted: 28 (1991), 28 (2000), 34 (2003), 28 (2006), 23 (2011) Exclusive breastfeeding - Percent of infants <6 months exclusively breastfed: 12 (2000), 25 (2006), 20 (2011) Iraq ### DEMOGRAPHICS #### Causes of under-five deaths, 2012 - Neonatal death: 56% - Preterm: 18% - Asphyxia: 14% - Other: 38% Intrapartum-related events #### Causes of maternal deaths, 2013 - Haemorrhage: 31% - Indirect: 23% - Hypertension: 13% - Sepsis: 5% - Embolism: 9% - Other direct: 16% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH #### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| MICS \| \|------\|-------\|------\| \| 1996 \| 78 \| 77 \| \| 2000 \| 84 \| \| \| 2006 \| 78 \| \| \| 2011 \| 84 \| \| #### Demand for family planning satisfied (%) 87 (2011) #### Antenatal care (4 or more visits, %) 50 (2011) #### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 22, 25, 16 (2011) #### Neonatal tetanus vaccine 85 (2012) #### Postnatal visit for baby (within 2 days for home births, %) - - #### Postnatal visit for mother (within 2 days for home births, %) - - #### Women with low body mass index (<18.5 kg/m², %) - - ### CHILD HEALTH #### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - Receiving oral rehydration therapy/increased fluids with continued feeding - Treated with ORS \| Year \| MICS \| \|------\|------\| \| 2000 \| 54 \| \| 2006 \| 64 \| \| 2011 \| 26 \| #### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION #### Improved drinking water coverage Percent of population by type of drinking water source, 1990–2012 - Piped on premises - Other improved - Surface water - Unimproved #### Improved sanitation coverage Percent of population by type of sanitation facility, 1995–2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 6.1 (2010) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 149 (2012) - General government expenditure on health as % of total government expenditure (%): 4 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 46 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 6 (2011) - ODA to maternal and neonatal health per live birth (US$): 7 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 43,178 \| \| \| Total under-five population (000) \| 6,956 \| \| \| Births (000) \| 1,535 \| \| \| Birth registration (%) \| 60 \| \| \| Total under-five deaths (000) \| 108 \| \| \| Neonatal deaths: % of all under-5 deaths \| 37 \| \| \| Neonatal mortality rate (per 1000 live births) \| 27 \| \| \| Infant mortality rate (per 1000 live births) \| 49 \| \| \| Stillbirth rate (per 1000 total births) \| 22 \| \| \| Total maternal deaths \| 6,300 \| \| \| Lifetime risk of maternal death (1 in N) \| 53 \| \| \| Total fertility rate (per woman) \| 4.5 \| \| \| Adolescent birth rate (per 1000 girls) \| 106 \| \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 98 - 1995: 90 - 2000: 82 - 2005: 73 - 2010: 63 - 2015: 33 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 490 - 1995: 450 - 2000: 400 - 2005: 350 - 2010: 300 - 2015: 120 Source: MMIEG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 64 \| \| \| Antenatal care (4+ visits) \| 47 \| \| \| Skilled attendant at delivery \| 44 \| \| \| Postnatal care \| 42 \| \| \| Exclusive breastfeeding \| 32 \| \| \| Measles \| 93 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1989: 50 - 1993: 45 - 1998: 44 - 2003: 42 - 2008-2009: 44 #### Prevention of mother-to-child transmission of HIV \| Indicator \| 2012 \| \|---------------------------------------------------------------------------\|------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| 58 \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| 66 \| \| Uncertainty range around the estimate \| 53 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 64 \| 93 \| \| Antenatal care (1+ visit) \| 47 \| 93 \| \| Antenatal care (4+ visits) \| 44 \| 93 \| \| Skilled attendant at delivery \| 42 \| 93 \| \| Early initiation of breastfeeding \| 32 \| 93 \| \| ITN use among children <5 yrs \| 32 \| 93 \| \| DTP3 \| 47 \| 93 \| \| Measles \| 47 \| 93 \| \| Vitamin A (past 6 months) \| 47 \| 93 \| \| ORT & continued feeding \| 47 \| 93 \| \| Caseseeking for pneumonia \| 47 \| 93 \| Source: DHS 2008-2009 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 93 - 1995: 83 - 2000: 82 - 2005: 83 - 2012: 83 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - to attend appropriate health provider - receiving antibiotics - 1993: 52 - 1998: 57 - 2003: 49 - 2008-2009: 56 ### NUTRITION - Wasting prevalence (moderate and severe, %): 7 (2008-2009) - Low birthweight incidence (moderate and severe, %): 8 (2008-2009) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1993: 40 - 1998: 37 - 2000: 18 - 2003: 17 - 2008-2009: 16 #### Early initiation of breastfeeding (within 1 hr of birth, %): 58 (2008-2009) #### Introduction of solid, semi-solid/soft foods (%): 85 (2008-2009) #### Vitamin A two dose coverage (%): 66 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1989: 23 - 1993: 12 - 1998: 12 - 2003: 13 - 2008-2009: 32 ## Kenya ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 15% - Preterm: 10% - Asphyxia: 12% - Neglected death: 37% - Other: 22% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Sepsis: 10% - Embolism: 2% - Other direct: 9% - Indirect: 29% - Hypertension: 16% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1989 \| 77 \| 95 \| \| 1993 \| 92 \| 92 \| \| 1998 \| 76 \| \| \| 2000 \| 88 \| \| \| 2003 \| 92 \| \| Demand for family planning satisfied (%): 64 (2008-2009) Antenatal care (4 or more visits, %): 47 (2008-2009) Malaria during pregnancy - intermittent preventive treatment (%): 15 (2008-2009) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%): 6, 11, 5 (2008-2009) Neonatal tetanus vaccine: 73 (2012) Postnatal visit for baby (within 2 days for home births, %): - Postnatal visit for mother (within 2 days for home births, %): 42 (2008-2009) Women with low body mass index (<18.5 kg/m², %): - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1993 \| 32 \| 37 \| \| 1998 \| 15 \| 39 \| \| 2000 \| 33 \| 39 \| \| 2003 \| 29 \| \| \| 2008-2009 \| 43 \| 39 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| \|------\|-----\| \| 2000 \| 3 \| \| 2003 \| 5 \| \| 2008-2009 \| 47 \| Percent children < 5 years sleeping under ITNs \| Year \| DHS \| \|------\|-----\| \| 2000 \| 3 \| \| 2003 \| 5 \| \| 2008-2009 \| 47 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 41 \| 23 \| 16 \| \| 2012 \| 81 \| 42 \| 13 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 49 \| 13 \| 36 \| \| 2012 \| 22 \| 17 \| 35 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: - - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (x of 3): - - Newborn health (x of 4): 1 (2013) - Child health (X of 3): - - Density of doctors, nurses and midwives (per 10,000 population): 9.7 (2011) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (in$): 84 (2012) - General government expenditure on health as % of total government expenditure (%): 6 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 48 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 23 (2013) - ODA to maternal and neonatal health per live birth (US$): 27 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 24,763 \| 2013 \| \| Total under-five population (000) \| 1,690 \| 2013 \| \| Births (000) \| 356 \| 2012 \| \| Birth registration (%) \| 100 \| \| \| Total under-five deaths (000) \| 10 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 54 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 16 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 23 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 13 \| 2013 \| \| Total maternal deaths \| 310 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 630 \| 2013 \| \| Total fertility rate (per woman) \| 2.0 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 1 \| 2008 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 44 - 1995: 70 - 2000: 50 - 2005: 30 - 2010: 29 - 2015: 15 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 85 - 1995: 125 - 2000: 100 - 2005: 87 - 2010: 21 - 2015: MDG Target Source: MM&EIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 83 \| \| Antenatal care (4+ visits) \| 94 \| \| Skilled attendant at delivery \| 100 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 65 \| \| Measles \| 99 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 2000 MICS: 97 - 2004 Other NS: 97 - 2009 MICS: 100 ### Prevention of mother-to-child transmission of HIV - Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs): No Data - Percent HIV+ pregnant women receiving ARVs for PMTCT: No Data - Uncertainty range around the estimate: No Data ## EQUITY ### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| No Data \| No Data \| \| Antenatal care (1+ visit) \| No Data \| No Data \| \| Antenatal care (4+ visits) \| No Data \| No Data \| \| Skilled attendant at delivery \| No Data \| No Data \| \| Early initiation of breastfeeding \| No Data \| No Data \| \| ITN use among children <5 yrs \| No Data \| No Data \| \| DTP3 \| No Data \| No Data \| \| Measles \| No Data \| No Data \| \| Vitamin A (past 6 months) \| No Data \| No Data \| \| ORT & continued feeding \| No Data \| No Data \| \| Careseeking for pneumonia \| No Data \| No Data \| ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 100 - 1995: 40 - 2000: 99 - 2005: 96 - 2012: 96 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2004 Other NS: 93 - 2009 MICS: 80 ## NUTRITION ### Wasting prevalence (moderate and severe, %) - 2012: 4 ### Low birthweight incidence (moderate and severe, %) - 2009: 6 ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1998 Other NS: 56 - 2000 MICS: 64 - 2004 Other NS: 51 - 2009 MICS: 43 - 2012 Other NS: 32 ### Early initiation of breastfeeding (within 1 hr of birth, %) - 2009: 18 ### Introduction of solid, semi-solid/soft foods (%) - 2004: 31 ### Vitamin A two dose coverage (%) - 2012: 99 ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2004 Other NS: 65 ## Korea, Democratic People’s Republic of ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 54% - Preterm: 20% - Asphyxia: 10% - Other: 7% - Congenital: 9% - Pneumonia: 1% - Other: 18% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 7% - Measles: 0% - Diarrhoea: 6% - Sepsis: 6% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 36% - Indirect: 25% - Hypertension: 10% - Other direct: 14% - Abortion: 1% - Sepsis: 3% - Embolism: 12% Regional estimates for Eastern Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| \|------\|-------\| \| 2000 MICS \| 97 \| \| 2009 MICS \| 100 \| Demand for family planning satisfied (%) 83 (2012) Antenatal care (4 or more visits, %) 94 (2009) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 13, 15, 9 (2009) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 93 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| \|------\|-------\| \| 2009 MICS \| 67 \| \| 2009 MICS \| 74 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 2012 - Piped on premises - Other improved - Unimproved \| Type \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| Piped \| 89 \| 94 \| 80 \| \| Other \| 9 \| 5 \| 17 \| \| Unimproved \| 12 \| 1 \| 0 \| Source: WHO/UNICEF JMP 2014 Improved sanitation coverage Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 44 \| 83 \| 0 \| \| 2012 \| 57 \| 82 \| 0 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - - Legal status of abortion (X of 5 circumstances) 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks) - - Maternity protection (Convention 183) No - Maternal deaths notification - - Postnatal home visits in the first week after birth Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - - Antenatal corticosteroids as part of management of preterm labour - - International Code of Marketing of Breastmilk Substitutes No - Community treatment of pneumonia with antibiotics Yes - Low osmolarity ORS and zinc for management of diarrhoea Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - - Life Saving Commodities in Essential Medicine List: - Reproductive health (x of 3) - - Maternal health (x of 3) - - Newborn health (x of 4) - - Child health (x of 3) - - Density of doctors, nurses and midwives (per 10,000 population) 74.1 (2003) - National availability of Emergency Obstetric Care services (% of recommended minimum) - ### FINANCING - Per capita total expenditure on health (int$) - - General government expenditure on health as % of total government expenditure (%) - - Out of pocket expenditure as % of total expenditure on health(%) - - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 3 (2011) - ODA to maternal and neonatal health per live birth (US$) 5 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 5,474 \| 2013 \| \| Total under-five population (000) \| 659 \| 2013 \| \| Births (000) \| 148 \| 2012 \| \| Birth registration (%) \| 96 \| \| \| Total under-five deaths (000) \| 4 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 54 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 14 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 24 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 10 \| 2009 \| \| Total maternal deaths \| 110 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 390 \| 2013 \| \| Total fertility rate (per woman) \| 3.1 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 41 \| 2011 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 71 - 1995: 60 - 2000: 50 - 2005: 40 - 2010: 30 - 2015: 24 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 85 - 1995: 90 - 2000: 75 - 2005: 60 - 2010: 45 - 2015: 21 Source:** MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 67% \| \| Antenatal care (4+ visits) \| 99% \| \| Skilled attendant at delivery \| 99% \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 32% \| \| Measles \| 98% \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1997 DHS: 98% - 2006 MICS: 98% - 2012 DHS: 99% ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: - - 2011: - - 2012: - Percent HIV+ pregnant women receiving ARVs for PMTCT - 2010: - - 2011: - - 2012: - Uncertainty range around the estimate - 2010: - - 2011: - - 2012: - Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% - Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Caseseeking for pneumonia \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 98% - 1995: 98% - 2000: 98% - 2005: 98% - 2012: 96% Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1997 DHS: 48% - 2006 MICS: 62% ## NUTRITION Wasting prevalence (moderate and severe, %) - 3 (2012) Low birthweight incidence (moderate and severe, %) - 5 (2006) Early initiation of breastfeeding (within 1 hr of birth, %) - 65 (2006) Introduction of solid, semi-solid/soft foods (%) - 60 (2006) Vitamin A two dose coverage (%) - - ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1997 DHS: 10%, 36% - 2006 MICS: 3%, 18% - 2009 Other NS: 5%, 23% - 2012 DHS: 3%, 18% ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1997 DHS: 24% - 2006 MICS: 32% ## Kyrgyzstan ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 54% - Pneumonia: 12% - Preterm: 16% - Other: 21% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 7% - Measles: 0% - Diarrhoea: 6% - Sepsis: 8% - Congenital: 13% Intrapartum related events Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 15% - Indirect: 22% - Other direct: 17% - Sepsis: 9% - Abortion: 5% - Embolism: 11% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| DHS \| \|------\|-----\|------\|-----\| \| 1997 \| 97 \| 97 \| 97 \| Demand for family planning satisfied (%) 67 (2012) Antenatal care (4 or more visits, %) - Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 6, 7, 6 (1997) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine - Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 6 (2012) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| DHS \| \|------\|-----\|------\|-----\| \| 1997 \| 40 \| 22 \| 35 \| \| 2006 \| 20 \| \| \| \| 2012 \| \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 29 \| 7 \| 44 \| \| 2012 \| 54 \| 17 \| 36 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 10 \| 17 \| 30 \| \| 2012 \| 15 \| 11 \| 36 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - - Legal status of abortion (X of S circumstances) 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks) - - Maternity protection (Convention 183) Partial - Maternal deaths notification Yes - Postnatal home visits in the first week after birth Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - - Antenatal corticosteroids as part of management of preterm labour - - International Code of Marketing of Breastmilk Substitutes Partial - Community treatment of pneumonia with antibiotics - - Low osmolarity ORS and zinc for management of diarrhoea Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) - - Density of doctors, nurses and midwives (per 10,000 population) 80.9 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum) - ### FINANCING - Per capita total expenditure on health (int) (US$) 175 (2012) - General government expenditure on health as % of total government expenditure (%) 12 (2012) - Out of pocket expenditure as % of total expenditure on health(%) 35 (2012) - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 22 (2013) - ODA to maternal and neonatal health per live birth (US$) 38 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 6,646 \| \| \| Total under-five population (000) \| 889 \| \| \| Births (000) \| 181 \| \| \| Birth registration (%) \| 75 \| 75 \| \| Total under-five deaths (000) \| 14 \| 14 \| \| Neonatal deaths: % of all under-5 deaths \| 38 \| 38 \| \| Neonatal mortality rate (per 1000 live births) \| 27 \| 27 \| \| Infant mortality rate (per 1000 live births) \| 54 \| 54 \| \| Stillbirth rate (per 1000 total births) \| 14 \| 14 \| \| Total maternal deaths \| 400 \| 400 \| \| Lifetime risk of maternal death (1 in N) \| 130 \| 130 \| \| Total fertility rate (per woman) \| 3.1 \| 3.1 \| \| Adolescent birth rate (per 1000 girls) \| 94 \| 94 \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 163 \| \| 1995 \| 150 \| \| 2000 \| 140 \| \| 2005 \| 130 \| \| 2010 \| 120 \| \| 2015 \| 110 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1100 \| \| 1995 \| 1000 \| \| 2000 \| 900 \| \| 2005 \| 800 \| \| 2010 \| 700 \| \| 2015 \| 600 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 71 \| \| \| Antenatal care (4+ visits) \| 37 \| \| \| Skilled attendant at delivery \| 42 \| \| \| Postnatal care \| 40 \| \| \| Exclusive breastfeeding \| 26 \| \| \| Measles \| 72 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 2000 \| 19 \| \| 2005 \| 15 \| \| 2006 \| 20 \| \| 2011-2012 \| 42 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| \| \| \| 2011 \| \| \| \| 2012 \| \| \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 71 \| 80 \| \| Antenatal care (1+ visit) \| 37 \| 45 \| \| Antenatal care (4+ visits) \| 42 \| 50 \| \| Skilled attendant at delivery \| 40 \| 50 \| \| Early initiation of breastfeeding \| 26 \| 35 \| \| ITN use among children <5 yrs \| 72 \| 80 \| \| DTP3 \| 79 \| 85 \| \| Measles \| 72 \| 80 \| \| Vitamin A (past 6 months) \| 79 \| 85 \| \| ORT & continued feeding \| 72 \| 80 \| \| Caseseeking for pneumonia \| 79 \| 85 \| Source: MICS 2011-2012 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 30 \| \| 1995 \| 40 \| \| 2000 \| 50 \| \| 2005 \| 60 \| \| 2012 \| 70 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2000 \| 36 \| \| 2006 \| 52 \| \| 2011-2012 \| 54 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| 7 \| (2006) Low birthweight incidence (moderate and severe, %) \| 15 \| (2011-2012) Early initiation of breastfeeding (within 1 hr of birth, %) \| 30 \| (2006) Introduction of solid, semi-solid/soft foods (%) \| 41 \| (2006) Vitamin A two dose coverage (%) \| 47 \| (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1993 \| 40 \| \| 1994 \| 36 \| \| 2000 \| 36 \| \| 2006 \| 32 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2000 \| 23 \| \| 2006 \| 26 \| ## Lao People's Democratic Republic ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 18% - Preterm: 10% - Asphyxia: 12% - Neonatal death: 38% - Other: 3% - Congenital: 3% - Sepsis: 7% - Other: 24% - HIV/AIDS: 0% - Malaria: 1% - Injuries: 7% - Measles: 0% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 30% - Hypertension: 15% - Indirect: 17% - Other direct: 14% - Abortion: 7% - Sepsis: 6% - Embolism: 12% Regional estimates for South-eastern Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 27 \| - \| - \| \| 2005 Other NS \| 29 \| - \| - \| \| 2006 MICS \| 35 \| - \| - \| \| 2011-2012 MICS \| 54 \| - \| - \| Demand for family planning satisfied (%) - 71 (2011-2012) Antenatal care (4 or more visits, %) - 37 (2011-2012) Malaria during pregnancy – intermittent preventive treatment (%) - 1 (2006) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) - 4, 10, 2 (2011-2012) Neonatal tetanus vaccine - 80 (2012) Postnatal visit for baby (within 2 days for home births, %) - 41 (2011-2012) Postnatal visit for mother (within 2 days for home births, %) - 40 (2011-2012) Women with low body mass index (<18.5 kg/m², %) - - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 37 \| 32 \| - \| \| 2006 MICS \| 49 \| 46 \| - \| \| 2011-2012 MICS \| 57 \| 42 \| - \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - 11 (2011-2012) Percent children < 5 years sleeping under ITNs \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 18 \| - \| - \| \| 2006 MICS \| 41 \| - \| - \| \| 2011-2012 MICS \| 43 \| - \| - \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 2012 - Piped on premises - Other improved - Unimproved \| Source Type \| Total \| Urban \| Rural \| \|-------------\|-------\|-------\|-------\| \| Piped \| 25 \| 15 \| 6 \| \| Other Improved \| 47 \| 24 \| 59 \| \| Unimproved \| 7 \| 1 \| 10 \| Source: WHO/UNICEF JMP 2014 Improved sanitation coverage** Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 69 \| 85 \| 20 \| \| 2012 \| 78 \| 95 \| 42 \| Source: WHO/UNICEF JMP 2014 ### POLICIES \| Policy \| Status \| \|------------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Partial \| \| Legal status of abortion (X of 5 circumstances) \| 2 \| \| Midwives authorized for specific tasks (X of 7 tasks) \| 7 \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| Yes \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| Partial \| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Status \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Partial \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| - \| \| \| Maternal health (X of 3) \| 3 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 10.6 \| 2012 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| 46 \| 2011 \| ### FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (US$) \| 84 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 6 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 38 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 21 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 36 \| 2011 \| \| Indicator \| Value \| \|------------------------------------------------\|-----------\| \| Total population (000) \| 2,052 \| \| Total under-five population (000) \| 260 \| \| Births (000) \| 57 \| \| Birth registration (%) \| 45 \| \| Total under-five deaths (000) \| 6 \| \| Neonatal deaths: % of all under-5 deaths \| 46 \| \| Neonatal mortality rate (per 1000 live births) \| 45 \| \| Infant mortality rate (per 1000 live births) \| 74 \| \| Stillbirth rate (per 1000 total births) \| 25 \| \| Total maternal deaths \| 280 \| \| Lifetime risk of maternal death (1 in N) \| 64 \| \| Total fertility rate (per woman) \| 3.1 \| \| Adolescent birth rate (per 1000 girls) \| 92 \| ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 67 \| \| Antenatal care (4+ visits) \| 70 \| \| Skilled attendant at delivery \| 62 \| \| Postnatal care \| 48 \| \| Exclusive breastfeeding \| 54 \| \| Measles \| 85 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1993 \| 61 \| \| 2000 \| 60 \| \| 2004 \| 55 \| \| 2009 \| 62 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 77 \| \| 2011 \| 64 \| \| 2012 \| 58 \| ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% - Richest 20% \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 50 \| \| Antenatal care (1+ visit) \| 70 \| \| Antenatal care (4+ visits) \| 62 \| \| Skilled attendant at delivery \| 48 \| \| Early initiation of breastfeeding \| 54 \| \| ITN use among children <5 yrs \| 85 \| \| DTP3 \| 70 \| \| Measles \| 62 \| \| Vitamin A (past 6 months) \| 48 \| \| ORT & continued feeding \| 36 \| \| Caseseeking for pneumonia \| 54 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 85 \| \| 1995 \| 83 \| \| 2000 \| 85 \| \| 2005 \| 83 \| \| 2012 \| 83 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taking to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2000 \| 49 \| \| 2004 \| 59 \| \| 2009 \| 66 \| ### NUTRITION Wasting prevalence (moderate and severe, %) 4 [2009] Low birthweight incidence (moderate and severe, %) 11 [2009] Early initiation of breastfeeding (within 1 hr of birth, %) 53 [2009] Introduction of solid, semi-solid/soft foods (%) 68 [2009] Vitamin A two dose coverage (%) - - #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1992 \| 39 \| \| 1993 \| 38 \| \| 2000 \| 53 \| \| 2004 \| 17 \| \| 2009 \| 14 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1996 \| 16 \| \| 2000 \| 15 \| \| 2004 \| 36 \| \| 2009 \| 54 \| ## Lesotho ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 46% - Preterm: 15% - Asphyxia: 14% - Other: 21% - Congenital: 3% - Sepsis: 9% - Diarrhoea: 7% - Measles: 1% - Injuries: 4% - Malaria: 0% - HIV/AIDS: 0% - Other: 14% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Other NS \| MICS \| DHS \| \|------\|-------\|---------\|------\|-----\| \| 1993 \| 91 \| \| \| \| \| 1995 \| 88 \| \| \| \| \| 2000 \| 85 \| \| \| \| \| 2004 \| 90 \| \| \| \| \| 2009 \| 92 \| \| \| \| Demand for family planning satisfied (%) 67 (2009) Antenatal care (4 or more visits, %) 70 (2009) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 7, 11, 5 (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 83 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 48 (2009) Women with low body mass index (<18.5 kg/m², %) 4 (2009) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| Other NS \| MICS \| DHS \| \|------\|-------\|---------\|------\|-----\| \| 2000 \| 54 \| \| \| \| \| 2004 \| 53 \| \| \| \| \| 2009 \| 42 \| \| \| \| \| 2009 \| 48 \| \| \| \| \| 2009 \| 51 \| \| \| \| Very limited risk Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 72 \| 26 \| 4 \| \| 2012 \| 59 \| 66 \| 4 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 49 \| 20 \| 8 \| \| 2012 \| 34 \| 23 \| 13 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 4 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 6.7 (2013) - National availability of Emergency Obstetric Care services (% of recommended minimum): 29 (2004) ### FINANCING - Per capita total expenditure on health (int$): 227 (2012) - General government expenditure on health as % of total government expenditure (%): 14 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 15 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 52 (2011) - ODA to maternal and neonatal health per live birth (US$): 89 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 4,190 \| 2013 \| \| Total under-five population (000) \| 678 \| 2013 \| \| Births (000) \| 150 \| 2012 \| \| Birth registration (%) \| 4 \| 2007 \| \| Total under-five deaths (000) \| 11 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 36 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 27 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 56 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 27 \| 2009 \| \| Total maternal deaths \| 980 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 31 \| 2013 \| \| Total fertility rate (per woman) \| 4.9 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 149 \| 2011 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 250 \| \| 1995 \| 248 \| \| 2000 \| 200 \| \| 2005 \| 150 \| \| 2010 \| 75 \| \| 2015 \| 83 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1200 \| \| 1995 \| 1600 \| \| 2000 \| 640 \| \| 2005 \| 300 \| \| 2010 \| \| \| 2015 \| \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 24 \| \| Antenatal care (4+ visits) \| 66 \| \| Skilled attendant at delivery \| 46 \| \| Postnatal care \| 60 \| \| Exclusive breastfeeding \| 34 \| \| Measles \| 80 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1986 \| 58 \| \| 1999-2000 \| 51 \| \| 2007 \| 46 \| #### Prevention of mother-to-child transmission of HIV \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Uncertainty range around the estimate \| \|-------------------------------------------------------------------------------------\|------------------------------------------------------\|--------------------------------------\| \| No Data \| No Data \| No Data \| ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Caseseeking for pneumonia \| \| \| Source: DHS 2007 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 80 \| \| 1995 \| 77 \| \| 2000 \| 60 \| \| 2005 \| 60 \| \| 2012 \| 80 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2007 \| 62 \| Source: DHS 2007 #### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percentage \| \|------\|------------\| \| 2010 \| 3 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percentage \| \|------\|------------\| \| 2007 \| 14 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percentage \| \|------\|------------\| \| 2007 \| 67 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percentage \| \|------\|------------\| \| \| - \| Vitamin A two dose coverage (%) \| Year \| Percentage \| \|------\|------------\| \| 2012 \| 13 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percentage \| \|------\|------------\| \| 1999-2000 \| 45 \| \| 2007 \| 39 \| \| 2010 \| 42 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percentage \| \|------\|------------\| \| 1986 \| 12 \| \| 1999-2000 \| 35 \| \| 2007 \| 29 \| \| 2010 \| 34 \| Source: DHS 2007 ## Liberia ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 35% - Pneumonia: 12% - Preterm: 9% - Asphyxia: 12% - Globally nearly half child deaths are attributable to undernutrition - Other: 16% - HIV/AIDS: 1% - Malaria: 21% - Injuries: 5% - Measles: 1% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Sepsis: 10% - Embolism: 2% - Regional estimates for Sub-Saharan Africa, 2013 - Other direct: 9% - Indirect: 29% - Hypertension: 16% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| \|------\|-----\| \| 1986 \| 83 \| \| 1999-2000 \| 84 \| \| 2007 \| 79 \| Demand for family planning satisfied (%) 24 (2007) Antenatal care (4 or more visits, %) 66 (2007) Malaria during pregnancy - intermittent preventive treatment (%) 48 (2013) C-section rate (total, urban, rural; %) 4, 5, 3 (2007) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 91 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 60 (2007) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------\|-----\| \| 1986 \| 7 \| \| 2007 \| 47 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| Other NS \| \|------\|----------\| \| 2009 \| 26 \| \| 2011 \| 37 \| Percent children < 5 years sleeping under ITNs \| Year \| Other NS \| \|------\|----------\| \| 2009 \| \| \| 2011 \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 2012 - Piped on premises - Other improved - Unimproved \| Type \| Total \| Urban \| Rural \| \|----------\|-------\|-------\|-------\| \| Piped \| 13 \| 1 \| 24 \| \| Other improved \| 12 \| 12 \| 13 \| \| Unimproved \| 71 \| 81 \| 62 \| Source: WHO/UNICEF JMP 2014 Improved sanitation coverage** Percent of population by type of sanitation facility, 2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Type \| Total \| Urban \| Rural \| \|----------\|-------\|-------\|-------\| \| Improved \| 13 \| 17 \| 6 \| \| Shared \| 23 \| 29 \| 19 \| \| Unimproved \| 17 \| 28 \| 6 \| \| Open defecation \| 47 \| 17 \| 67 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 3 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 2 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 2.9 (2008) - National availability of Emergency Obstetric Care services (% of recommended minimum): 27 (2011) ### FINANCING - Per capita total expenditure on health (int$): 102 (2012) - General government expenditure on health as % of total government expenditure (%): 19 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 21 (2012) - Reproductive, maternal, newborn and child health expenditure by source: Partially available ODA to child health per child (US$): 98 (2013) ODA to maternal and neonatal health per live birth (US$): 118 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 22,294 \| \| \| Total under-five population (000) \| 3,529 \| \| \| Births (000) \| 781 \| \| \| Birth registration (%) \| 80 \| (2008-2009) \| \| Total under-five deaths (000) \| 44 \| (2012) \| \| Neonatal deaths: % of all under-5 deaths \| 38 \| (2012) \| \| Neonatal mortality rate (per 1000 live births) \| 22 \| (2012) \| \| Infant mortality rate (per 1000 live births) \| 41 \| (2012) \| \| Stillbirth rate (per 1000 total births) \| 21 \| (2009) \| \| Total maternal deaths \| 3,500 \| (2013) \| \| Lifetime risk of maternal death (1 in N) \| 47 \| (2013) \| \| Total fertility rate (per woman) \| 4.5 \| (2012) \| \| Adolescent birth rate (per 1000 girls) \| 147 \| (2006) \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 159 \| \| 1995 \| 139 \| \| 2000 \| 119 \| \| 2005 \| 100 \| \| 2010 \| 58 \| \| 2015 \| 53 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 740 \| \| 1995 \| 600 \| \| 2000 \| 400 \| \| 2005 \| 200 \| \| 2010 \| 190 \| \| 2015 \| 190 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percent \| \|----------------------------------------------\|---------\| \| Demand for family planning satisfied \| 68 \| \| Antenatal care (4+ visits) \| 49 \| \| Skilled attendant at delivery \| 44 \| \| Postnatal care \| 46 \| \| Exclusive breastfeeding \| 51 \| \| Measles \| 69 \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1992 \| 57 \| \| 1997 \| 47 \| \| 2000 \| 46 \| \| 2003-2004 \| 51 \| \| 2008-2009 \| 44 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| Percent \| \|------\|----------------------------------------------------------------------------------\|---------\| \| 2010 \| - \| \| \| 2011 \| - \| \| \| 2012 \| - \| \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 68 \| 70 \| \| Antenatal care (1+ visit) \| 49 \| 51 \| \| Antenatal care (4+ visits) \| 44 \| 46 \| \| Skilled attendant at delivery \| 44 \| 46 \| \| Early initiation of breastfeeding \| 51 \| 53 \| \| ITN use among children <5 yrs \| 69 \| 71 \| \| DTP3 \| 69 \| 71 \| \| Measles \| 69 \| 71 \| \| Vitamin A (past 6 months) \| 69 \| 71 \| \| ORT & continued feeding \| 69 \| 71 \| \| Caseseeking for pneumonia \| 69 \| 71 \| Source: DHS 2008-2009 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 40 \| \| 2000 \| 40 \| \| 2005 \| 40 \| \| 2012 \| 40 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1992 \| 42 \| \| 1997 \| 37 \| \| 2000 \| 47 \| \| 2003-2004 \| 48 \| \| 2008-2009 \| 42 \| ### NUTRITION Wasting prevalence (moderate and severe, %): 15 (2003-2004) Low birthweight incidence (moderate and severe, %): 16 (2008-2009) Early initiation of breastfeeding (within 1 hr of birth, %): 72 (2008-2009) Introduction of solid, semi-solid/soft foods (%): 86 (2008-2009) Vitamin A two dose coverage (%): 88 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1992 \| 36 \| \| 1995 \| 30 \| \| 1997 \| 38 \| \| 2003-2004 \| 37 \| \| 2008-2009 \| 49 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1992 \| 38 \| \| 1997 \| 48 \| \| 2000 \| 41 \| \| 2003-2004 \| 67 \| \| 2008-2009 \| 51 \| ## Madagascar ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 16% - Neonatal death: 38% - Asphyxia: 12% - Preterm: 10% - Congenital: 4% - Sepsis: 7% - Other: 20% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Other direct: 9% - Indirect: 29% - Hypertension: 16% Source: WHO 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 78 \| 77 \| \| 1997 \| 77 \| 71 \| \| 2000 \| 80 \| \| \| 2003-2004 \| 86 \| \| Demand for family planning satisfied (%) (2008-2009) 68 Antenatal care (4 or more visits, %) (2008-2009) 49 Malaria during pregnancy - intermittent preventive treatment (%) (2011) 20 C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) (2008-2009) 2, 6, 1 Neonatal tetanus vaccine (2012) 78 Postnatal visit for baby (within 2 days for home births, %) - - Postnatal visit for mother (within 2 days for home births, %) (2008-2009) 46 Women with low body mass index (<18.5 kg/m², %) - - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 14 \| 23 \| \| 1997 \| 47 \| 10 \| \| 2000 \| 47 \| 12 \| \| 2003-2004 \| 49 \| 17 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| Other NS \| \|------\|-----\|----------\| \| 2000 \| 0 \| \| \| 2008-2009 \| 46 \| \| \| 2011 \| 77 \| \| Percent children < 5 years sleeping under ITNs \| Year \| DHS \| Other NS \| \|------\|-----\|----------\| \| 2000 \| 0 \| \| \| 2008-2009 \| 46 \| \| \| 2011 \| 77 \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 41 \| 22 \| 7 \| \| 2012 \| 50 \| 33 \| 2 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 54 \| 12 \| 23 \| \| 2012 \| 39 \| 14 \| 48 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of S circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 4.8 (2007) - National availability of Emergency Obstetric Care services (% of recommended minimum): 11 (2010) ### FINANCING - Per capita total expenditure on health (int$): 40 (2012) - General government expenditure on health as % of total government expenditure (%): 13 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 31 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 13 (2011) - ODA to maternal and neonatal health per live birth (US$): 19 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 15,906 \| \| \| Total under-five population (000) \| 2,859 \| \| \| Births (000) \| 639 \| \| \| Birth registration (%) \| - \| \| \| Total under-five deaths (000) \| 43 \| \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| \| \| Neonatal mortality rate (per 1000 live births) \| 24 \| \| \| Infant mortality rate (per 1000 live births) \| 46 \| \| \| Stillbirth rate (per 1000 total births) \| 24 \| \| \| Total maternal deaths \| 3,400 \| \| \| Lifetime risk of maternal death (1 in N) \| 34 \| \| \| Total fertility rate (per woman) \| 5.5 \| \| \| Adolescent birth rate (per 1000 girls) \| 157 \| \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 244 \| \| 1995 \| 225 \| \| 2000 \| 150 \| \| 2005 \| 75 \| \| 2010 \| 71 \| \| 2015 \| 81 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1100 \| \| 1995 \| 900 \| \| 2000 \| 600 \| \| 2005 \| 300 \| \| 2010 \| 510 \| \| 2015 \| 280 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 64 \| \| \| Antenatal care (4+ visits) \| 46 \| \| \| Skilled attendant at delivery \| 71 \| \| \| Postnatal care \| 43 \| \| \| Exclusive breastfeeding \| 71 \| \| \| Measles \| 90 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1992 \| 55 \| \| 2000 \| 56 \| \| 2004 \| 56 \| \| 2006 \| 54 \| \| 2010 \| 71 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| 26 \| 26 \| \| 2011 \| 49 \| 49 \| \| 2012 \| 60 \| 60 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 50 \| 90 \| \| Antenatal care (1+ visit) \| 30 \| 90 \| \| Antenatal care (4+ visits) \| 30 \| 90 \| \| Skilled attendant at delivery \| 60 \| 90 \| \| Early initiation of breastfeeding \| 30 \| 90 \| \| ITN use among children <5 yrs \| 30 \| 90 \| \| DTP3 \| 30 \| 90 \| \| Measles \| 30 \| 90 \| \| Vitamin A (past 6 months) \| 30 \| 90 \| \| ORT & continued feeding \| 30 \| 90 \| \| Case-seeking for pneumonia \| 30 \| 90 \| Source: DHS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 99 \| \| 1995 \| 96 \| \| 2000 \| 96 \| \| 2005 \| 96 \| \| 2012 \| 96 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1992 \| 54 \| \| 2000 \| 24 \| \| 2004 \| 37 \| \| 2006 \| 52 \| \| 2010 \| 70 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| 4 \| (2010) Low birthweight incidence (moderate and severe, %) \| 14 \| (2010) Early initiation of breastfeeding (within 1 hr of birth, %) \| 95 \| (2010) Introduction of solid, semi-solid/soft foods (%) \| 86 \| (2010) Vitamin A two dose coverage (%) \| 60 \| (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1992 \| 24 \| \| 1997-1998 \| 26 \| \| 2000 \| 22 \| \| 2004 \| 18 \| \| 2006 \| 16 \| \| 2010 \| 14 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2000 \| 44 \| \| 2004 \| 53 \| \| 2006 \| 57 \| \| 2010 \| 71 \| ## Malawi ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 34% - Pneumonia: 11% - Preterm: 10% - Asphyxia: 10% - Other: 2% - Congenital: 3% - Sepsis: 7% - Diarrhoea: 0% - Measles: 1% - Injuries: 5% - Malaria: 15% - HIV/AIDS: 12% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 90 \| 92 \| \| 2000 \| 91 \| 92 \| \| 2004 \| 92 \| 92 \| \| 2006 \| \| \| \| 2010 \| 95 \| \| Demand for family planning satisfied (%) 64 (2010) Antenatal care (4 or more visits, %) 46 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 53 (2012) C-section rate (total, urban, rural; %) 5, 8, 4 (2012) Neonatal tetanus vaccine 89 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 43 (2012) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 32 \| 51 \| \| 2000 \| 48 \| 54 \| \| 2004 \| 51 \| 51 \| \| 2006 \| 27 \| 55 \| \| 2010 \| 48 \| 69 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 3 \| 15 \| \| 2000 \| 15 \| 25 \| \| 2006 \| 27 \| 39 \| \| 2010 \| 33 \| 56 \| \| 2012 \| \| \| Percent children < 5 years sleeping under ITNs 91 (2012) ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 36 \| 41 \| 6 \| \| 2012 \| 77 \| 55 \| 12 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 29 \| 55 \| 6 \| \| 2012 \| 77 \| 47 \| 8 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 3.6 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): 32 (2010) ### FINANCING - Per capita total expenditure on health (int$): 83 (2012) - General government expenditure on health as % of total government expenditure (%): 18 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 13 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 37 (2011) - ODA to maternal and neonatal health per live birth (US$): 52 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|--------\|--------\| \| Total population (000) \| 14,854 \| \| \| Total under-five population (000) \| 2,865 \| \| \| Births (000) \| 705 \| \| \| Birth registration (%) \| 81 \| \| \| Total under-five deaths (000) \| 83 \| \| \| Neonatal deaths: % of all under-5 deaths \| 33 \| \| \| Neonatal mortality rate (per 1000 live births) \| 42 \| \| \| Infant mortality rate (per 1000 live births) \| 80 \| \| \| Stillbirth rate (per 1000 total births) \| 23 \| \| \| Total maternal deaths \| 4,000 \| \| \| Lifetime risk of maternal death (1 in N) \| 26 \| \| \| Total fertility rate (per woman) \| 6.9 \| \| \| Adolescent birth rate (per 1000 girls) \| 172 \| \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 253 \| \| 1995 \| 225 \| \| 2000 \| 150 \| \| 2005 \| 128 \| \| 2010 \| 84 \| \| 2015 \| 84 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1100 \| \| 1995 \| 900 \| \| 2000 \| 600 \| \| 2005 \| 300 \| \| 2010 \| 280 \| \| 2015 \| 280 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 23 \| \| \| Antenatal care (4+ visits) \| 35 \| \| \| Skilled attendant at delivery \| 56 \| \| \| Postnatal care \| 20 \| \| \| Exclusive breastfeeding \| 59 \| \| \| Measles \| \| \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1987 \| 32 \| \| 1995-1996 \| 40 \| \| 2001 \| 41 \| \| 2006 \| 49 \| \| 2010 \| 56 \| \| MICS \| \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|-----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| \| \| \| 2011 \| \| \| \| 2012 \| \| \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 23 \| 56 \| \| Antenatal care (1+ visit) \| 35 \| 60 \| \| Antenatal care (4+ visits) \| 56 \| 60 \| \| Skilled attendant at delivery \| 20 \| 59 \| \| Early initiation of breastfeeding \| 35 \| 60 \| \| ITN use among children <5 yrs \| 56 \| 60 \| \| DTP3 \| 20 \| 59 \| \| Measles \| 35 \| 60 \| \| Vitamin A (past 6 months) \| 56 \| 60 \| \| ORT & continued feeding \| 20 \| 59 \| \| Caseseeking for pneumonia \| 35 \| 60 \| Source: DHS 2006 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 20 \| \| 1995 \| 25 \| \| 2000 \| 30 \| \| 2005 \| 35 \| \| 2012 \| 40 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1995-1996 \| 22 \| \| 2001 \| 36 \| \| 2006 \| 38 \| \| 2010 \| 42 \| \| MICS \| 44 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 9 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 18 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 57 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 27 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 93 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1987 \| 29 \| \| 1995-1996 \| 36 \| \| 2001 \| 40 \| \| 2006 \| 30 \| \| 2010 \| 28 \| \| MICS \| 28 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1987 \| 9 \| \| 1995-1996 \| 8 \| \| 2001 \| 25 \| \| 2006 \| 38 \| \| 2010 \| 20 \| \| MICS \| \| ## Mali ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 14% - Neoplastic death: 34% - Preterm: 11% - Asphyxia: 9% - Globally nearly half child deaths are attributable to undernutrition - Other: 20% - HIV/AIDS: 1% - Malaria: 14% - Injuries: 9% - Measles: 1% - Congenital: 2% - Sepsis: 7% - Diarrhoea: 11% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Emballon: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| Total DHS \| 1987 DHS \| 1995-1996 DHS \| 2001 DHS \| 2006 DHS \| 2010 MICS \| \|------------\|-----------\|----------\|---------------\|---------\|---------\|-----------\| \| Percent \| 100 \| 31 \| 47 \| 57 \| 70 \| 75 \| Demand for family planning satisfied (%) 23 (2006) Antenatal care (4 or more visits, %) 35 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 20 (2012-2013) C-section rate (total, urban, rural; %) 4, 8, 2 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 89 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total DHS \| 1995-1996 DHS \| 2001 DHS \| 2006 DHS \| 2010 MICS \| \|------------\|-----------\|---------------\|---------\|---------\|-----------\| \| Percent \| 100 \| 16 \| 45 \| 38 \| 32 \| 11 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total DHS \| 2006 DHS \| 2010 Other NS \| \|------------\|-----------\|----------\|----------------\| \| Percent \| 100 \| 27 \| 70 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| Percent \| 100 \| 100 \| 100 \| \| 1990 \| 63 \| 63 \| 63 \| \| 2012 \| 53 \| 53 \| 53 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| Percent \| 100 \| 100 \| 100 \| \| 1990 \| 43 \| 43 \| 43 \| \| 2012 \| 38 \| 38 \| 38 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 1 (R) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Yes - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 5.1 (2010) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 74 (2012) - General government expenditure on health as % of total government expenditure (%): 13 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 61 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 29 (2011) - ODA to maternal and neonatal health per live birth (US$): 61 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|--------\|--------\| \| Total population (000) \| 3,796 \| \| \| Total under-five population (000) \| 575 \| \| \| Births (000) \| 131 \| \| \| Birth registration (%) \| 59 \| \| \| Total under-five deaths (000) \| 11 \| \| \| Neonatal deaths: % of all under-5 deaths \| 40 \| \| \| Neonatal mortality rate (per 1000 live births) \| 34 \| \| \| Infant mortality rate (per 1000 live births) \| 65 \| \| \| Stillbirth rate (per 1000 total births) \| 27 \| \| \| Total maternal deaths \| 430 \| \| \| Lifetime risk of maternal death (1 in N) \| 66 \| \| \| Total fertility rate (per woman) \| 4.7 \| \| \| Adolescent birth rate (per 1000 girls) \| 88 \| \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 128 \| \| 1995 \| 112 \| \| 2000 \| 100 \| \| 2005 \| 84 \| \| 2010 \| 43 \| \| 2015 \| 43 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 630 \| \| 1995 \| 500 \| \| 2000 \| 320 \| \| 2005 \| 160 \| \| 2010 \| 160 \| \| 2015 \| 160 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 20 \| \| \| Antenatal care (4+ visits) \| 48 \| \| \| Skilled attendant at delivery \| 65 \| \| \| Postnatal care \| \| \| \| Exclusive breastfeeding \| 46 \| \| \| Measles \| 75 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|---------------\|---------\| \| 1990-1991 Other NS \| 40 \| \| 2000-2001 DHS \| 57 \| \| 2007 MICS \| 61 \| \| 2011 pMICS \| 65 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|-------------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| - \| - \| \| 2011 \| - \| - \| \| 2012 \| - \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 20 \| 80 \| \| Antenatal care (1+ visit) \| 50 \| 80 \| \| Antenatal care (4+ visits) \| 50 \| 80 \| \| Skilled attendant at delivery \| 40 \| 80 \| \| Early initiation of breastfeeding \| 40 \| 80 \| \| ITN use among children <5 yrs \| 40 \| 80 \| \| DTP3 \| 50 \| 80 \| \| Measles \| 50 \| 80 \| \| Vitamin A (past 6 months) \| 50 \| 80 \| \| ORT & continued feeding \| 40 \| 80 \| \| Caseseeking for pneumonia \| 40 \| 80 \| Source: MICS 2007 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 30 \| \| 1995 \| 40 \| \| 2000 \| 50 \| \| 2005 \| 60 \| \| 2012 \| 70 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2000-2001 DHS \| 41 \| \| 2007 MICS \| 45 \| \| 2011 pMICS \| 43 \| #### NUTRITION Wasting prevalence (moderate and severe, %) \| 12 \| (2012) Low birthweight incidence (moderate and severe, %) \| 35 \| (2011) Early initiation of breastfeeding (within 1 hr of birth, %) \| 81 \| (2010) Introduction of solid, semi-solid/soft foods (%) \| 61 \| (2010) Vitamin A two dose coverage (%) \| 99 \| (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1990 \| 43 \| \| 1995-1996 MICS \| 20 \| \| 2000-2001 DHS \| 30 \| \| 2007 MICS \| 23 \| \| 2012 Other NS \| 20 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2007 MICS \| 11 \| \| 2008 Other NS \| 16 \| \| 2009 Other NS \| 35 \| \| 2010 Other NS \| 46 \| ## Mauritania ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 41% - Preterm: 15% - Pneumonia: 14% - Other: 21% - HIV/AIDS: 6% - Malaria: 10% - Injuries: 9% - Measles: 1% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| Total \| DHS \| MICS \| pMICS \| \|------------\|-------\|-------\|-------\|-------\| \| 1990-1991 \| 48 \| 64 \| 75 \| 84 \| Demand for family planning satisfied (%) - 20 (2001) Antenatal care (4 or more visits, %) - 48 (2011) Malaria during pregnancy - intermittent preventive treatment (%) - 19 (2011) C-section rate (total, urban, rural; %) - 10, 18, 4 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine - 80 (2012) Postnatal visit for baby (within 2 days for home births, %) - - Postnatal visit for mother (within 2 days for home births, %) - - Women with low body mass index (<18.5 kg/m², %) - 9 (2009-2001) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| DHS \| MICS \| pMICS \| \|------------\|-------\|-------\|-------\|-------\| \| 2000-2001 \| 9 \| 23 \| 32 \| 20 \| \| 2007 \| 34 \| 19 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - 7 (2011) Percent children < 5 years sleeping under ITNs - 2 (2003-2004) - 19 (2011) ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 64 \| 24 \| 6 \| \| 2012 \| 47 \| 23 \| 14 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 51 \| 27 \| 6 \| \| 2012 \| 51 \| 12 \| 4 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - Legal status of abortion (X of 5 circumstances) - Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) Partial - Maternal deaths notification - Postnatal home visits in the first week after birth - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - Antenatal corticosteroids as part of management of preterm labour - International Code of Marketing of Breastmilk Substitutes No - Community treatment of pneumonia with antibiotics Yes - Low osmolarity ORS and zinc for management of diarrhoea ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) 1 (2013) - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) - - Density of doctors, nurses and midwives (per 10,000 population) 8.0 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum) 31 (2004) ### FINANCING - Per capita total expenditure on health (int$) 122 (2012) - General government expenditure on health as % of total government expenditure (%) 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%) 34 (2012) - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 12 (2011) - ODA to maternal and neonatal health per live birth (US$) 42 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 120,847 \| 2013 \| \| Total under-five population (000) \| 11,405 \| 2013 \| \| Births (000) \| 2,269 \| 2012 \| \| Birth registration (%) \| 93 \| \| \| Total under-five deaths (000) \| 37 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 44 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 7 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 14 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 5 \| 2013 \| \| Total maternal deaths \| 1,100 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 900 \| 2013 \| \| Total fertility rate (per woman) \| 2.2 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 85 \| 2012 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 46 \| \| 1995 \| 38 \| \| 2000 \| 26 \| \| 2005 \| 18 \| \| 2010 \| 16 \| \| 2015 \| 15 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 88 \| \| 1995 \| 68 \| \| 2000 \| 49 \| \| 2005 \| 22 \| \| 2010 \| \| \| 2015 \| \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 88 \| \| Antenatal care (4+ visits) \| 86 \| \| Skilled attendant at delivery \| 96 \| \| Postnatal care \| 19 \| \| Exclusive breastfeeding \| 99 \| \| Measles \| 99 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1990 \| 84 \| \| 1997 \| 86 \| \| 2006 \| 93 \| \| 2004-2009 \| 95 \| \| 2012 \| 96 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Percent \| \|------\|---------\| \| 2010 \| 0 \| \| 2011 \| 0 \| \| 2012 \| 0 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| No Data \| No Data \| \| Antenatal care (1+ visit) \| No Data \| No Data \| \| Antenatal care (4+ visits) \| No Data \| No Data \| \| Skilled attendant at delivery \| No Data \| No Data \| \| Early initiation of breastfeeding \| No Data \| No Data \| \| ITN use among children <5 yrs \| No Data \| No Data \| \| DTP3 \| No Data \| No Data \| \| Measles \| No Data \| No Data \| \| Vitamin A (past 6 months) \| No Data \| No Data \| \| ORT & continued feeding \| No Data \| No Data \| \| Careseeking for pneumonia \| No Data \| No Data \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 99 \| \| 1995 \| 99 \| \| 2000 \| 99 \| \| 2005 \| 99 \| \| 2012 \| 99 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics No Data ### NUTRITION \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Wasting prevalence (moderate and severe, %) \| 2 \| 2011-2012 \| \| Low birthweight incidence (moderate and severe, %) \| 9 \| 2012 \| \| Early initiation of breastfeeding (within 1 hr of birth, %) \| 18 \| 2009 \| \| Introduction of solid, semi-solid/soft foods (%) \| 27 \| 2009 \| \| Vitamin A two dose coverage (%) \| - \| - \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1988 \| 12 \| \| 1996 \| 10 \| \| 1998-1999 \| 6 \| \| 2006 \| 3 \| \| 2011-2012 \| 3 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1987 \| 38 \| \| 1999 \| 20 \| \| 2009 \| 19 \| Source: DHS ## Mexico ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 44% - Preterm: 16% - Asphyxia: 6% - Other: 3% - Congenital: 11% - Sepsis: 6% - Pneumonia: 9% - Other: 36% Globally nearly half of child deaths are attributable to undernutrition. Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 22% - Indirect: 19% - Other direct: 15% - Abortion: 10% - Sepsis: 8% - Embolism: 3% Regional estimates for Latin America, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1987 \| 78 \| 86 \| 69 \| \| 1995 \| 86 \| 96 \| 76 \| \| 2004-2009 \| 96 \| 98 \| 90 \| Demand for family planning satisfied (%) 88 (2009) Antenatal care (4 or more visits, %) 86 (2009) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 46, 49, 36 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 88 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1996-1997 \| 81 \| 81 \| 81 \| \| 2012 \| 52 \| 52 \| 52 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 75 \| 85 \| 65 \| \| 2012 \| 91 \| 95 \| 77 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 22 \| 11 \| 11 \| \| 2012 \| 85 \| 78 \| 51 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of 5 circumstances): 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: No - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: - - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: - ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): - - Newborn health (X of 4): - - Child health (X of 3): - - Density of doctors, nurses and midwives (per 10,000 population): 46.2 (2011) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 1,062 (2012) - General government expenditure on health as % of total government expenditure (%): 16 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 44 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 0 (2011) - ODA to maternal and neonatal health per live birth (US$): 0 (2011) \| Metric \| Value \| Year \| \|---------------------------------------------\|-----------\|--------\| \| Total population (000) \| 32,521 \| 2013 \| \| Total under-five population (000) \| 3,234 \| 2013 \| \| Births (000) \| 739 \| 2012 \| \| Birth registration (%) \| 94 \| 2010-2011 \| \| Total under-five deaths (000) \| 23 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 59 \| 2012 \| \| Neonatal mortality rate (per 1000 live births)\| 18 \| 2012 \| \| Infant mortality rate (per 1000 live births)\| 27 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 20 \| 2009 \| \| Total maternal deaths \| 880 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 300 \| 2013 \| \| Total fertility rate (per woman) \| 2.7 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 32 \| 2008 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 80 \| \| 1995 \| 60 \| \| 2000 \| 40 \| \| 2005 \| 20 \| \| 2010 \| 10 \| \| 2015 \| 27 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|-------------------------------\| \| 1990 \| 310 \| \| 1995 \| 280 \| \| 2000 \| 250 \| \| 2005 \| 220 \| \| 2010 \| 120 \| \| 2015 \| 78 \| Source: MMIEG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 86 \| \| Antenatal care (4+ visits) \| 31 \| \| Skilled attendant at delivery \| 74 \| \| Postnatal care \| 31 \| \| Exclusive breastfeeding \| 99 \| \| Measles \| 74 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1987 \| 26 \| \| 1992 \| 31 \| \| 1995 \| 40 \| \| 2003-2004 \| 63 \| \| 2010-2011 \| 74 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Uncertainty range around the estimate \| \|------\|-------------------------------------------------------------------------------------\|-----------------------------------------------------\|--------------------------------------\| \| 2010 \| - \| - \| - \| \| 2011 \| - \| - \| - \| \| 2012 \| - \| - \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| 60 \| 90 \| \| Antenatal care (4+ visits) \| 30 \| 70 \| \| Skilled attendant at delivery \| 30 \| 70 \| \| Early initiation of breastfeeding \| 50 \| 90 \| \| ITN use among children <5 yrs \| 70 \| 90 \| \| DTP3 \| 90 \| 90 \| \| Measles \| 90 \| 90 \| \| Vitamin A (past 6 months) \| 70 \| 90 \| \| ORT & continued feeding \| 50 \| 90 \| \| Caseseeking for pneumonia \| 30 \| 90 \| Source: DHS 2003-2004 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 90 \| \| 1995 \| 90 \| \| 2000 \| 90 \| \| 2005 \| 90 \| \| 2012 \| 99 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1992 \| 17 \| \| 1997 \| 7 \| \| 2003-2004 \| 28 \| \| 2010-2011 \| 38 \| \| 2012 \| 70 \| ### NUTRITION \| Metric \| Value \| Year \| \|---------------------------------------------\|-----------\|--------\| \| Wasting prevalence (moderate and severe, %) \| 2 \| 2010-2011 \| \| Low birthweight incidence (moderate and severe, %) \| 15 \| 2003-2004 \| \| Early initiation of breastfeeding (within 1 hr of birth, %) \| 52 \| 2003-2004 \| \| Introduction of solid, semi-solid/soft foods (%) \| 52 \| 2003-2004 \| \| Vitamin A two dose coverage (%) \| - \| - \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1987 \| 13 \| \| 1992 \| 35 \| \| 1996-1997 \| 30 \| \| 2003-2004 \| 8 \| \| 2010-2011 \| 10 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1987 \| 37 \| \| 1992 \| 50 \| \| 1995 \| 25 \| \| 2003-2004 \| 31 \| Source: DHS 2003-2004 ## Morocco ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 58% - Preterm: 20% - Asphyxia: 12% - Other: 5% - Congenital: 9% - Sepsis: 9% - Pneumonia: 6% - Other: 19% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 37% - Hypertension: 17% - Indirect: 18% - Other direct: 17% - Abortion: 2% - Sepsis: 6% - Embolism: 3% Regional estimates for Northern Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| Other NS \| \|------\|-----\|----------\| \| 1987 \| 25 \| \| \| 1992 \| 32 \| \| \| 1995 \| 45 \| \| \| 1997 \| 42 \| \| \| 2003-2004 \| 68 \| \| \| 2010-2012 \| 77 \| \| Demand for family planning satisfied (%) 86 (2011) Antenatal care (4 or more visits, %) 31 (2003-2004) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 16, 19, 11 (2007-2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 89 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 4 (2003-2004) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------\|-----\| \| 1992 \| 14 \| \| 1995 \| 28 \| \| 2003-2004 \| 46 \| \| 2003-2004 \| 23 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 38 \| 19 \| 49 \| \| 2012 \| 61 \| 75 \| 42 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 18 \| 13 \| 15 \| \| 2012 \| 25 \| 27 \| 25 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): Yes - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: - - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 0 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 1 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 15.1 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): 69 (2000) ### FINANCING - Per capita total expenditure on health (US$): 340 (2012) - General government expenditure on health as % of total government expenditure (%): 6 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 59 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 4 (2011) - ODA to maternal and neonatal health per live birth (US$): 7 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 25,203 \| 2013 \| \| Total under-five population (000) \| 4,332 \| 2013 \| \| Births (000) \| 995 \| 2012 \| \| Birth registration (%) \| 48 \| \| \| Total under-five deaths (000) \| 84 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| \| \| Neonatal mortality rate (per 1000 live births) \| 30 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 63 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 28 \| 2009 \| \| Total maternal deaths \| 4,800 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 41 \| 2013 \| \| Total fertility rate (per woman) \| 5.3 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 166 \| 2009 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 250 \| \| 1995 \| 233 \| \| 2000 \| 200 \| \| 2005 \| 175 \| \| 2010 \| 150 \| \| 2015 \| 90 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1300 \| \| 1995 \| 1200 \| \| 2000 \| 900 \| \| 2005 \| 600 \| \| 2010 \| 300 \| \| 2015 \| 150 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 29 \| \| Antenatal care (4+ visits) \| 51 \| \| Skilled attendant at delivery \| 54 \| \| Postnatal care \| 43 \| \| Exclusive breastfeeding \| 82 \| \| Measles \| \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1997 \| 44 \| \| 2003 \| 48 \| \| 2008 \| 55 \| \| 2011 \| 54 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 54 \| \| 2011 \| 53 \| \| 2012 \| 86 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 29 \| \| Antenatal care (1+ visit) \| 51 \| \| Antenatal care (4+ visits) \| 54 \| \| Skilled attendant at delivery \| 43 \| \| Early initiation of breastfeeding \| 82 \| \| ITN use among children <5 yrs \| 43 \| \| DTP3 \| 51 \| \| Measles \| 54 \| \| Vitamin A (past 6 months) \| 57 \| \| ORT & continued feeding \| 54 \| \| Caseseeking for pneumonia \| 51 \| Source: DHS 2011 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 50 \| \| 2000 \| 60 \| \| 2005 \| 70 \| \| 2012 \| 80 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1997 \| 39 \| \| 2003 \| 55 \| \| 2008 \| 65 \| \| 2011 \| 50 \| Source: DHS ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 1995 \| 6 \| \| 2000 \| 17 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 1995 \| 77 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 1995 \| 90 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 1995 \| 20 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1995 \| 24 \| \| 1997 \| 26 \| \| 2000-2001 \| 23 \| \| 2003 \| 21 \| \| 2008 \| 18 \| \| 2011 \| 16 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1997 \| 30 \| \| 2003 \| 30 \| \| 2008 \| 37 \| \| 2011 \| 43 \| ## Mozambique ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 12% - Preterm: 11% - Asphyxia: 10% - Globally nearly half of child deaths are attributable to undernutrition - Neonatal death: 34% - Other: 26% - Congenital: 2% - Other: 16% - HIV/AIDS: 6% - Malaria: 18% - Injuries: 5% - Measles: 0% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Other direct: 9% - Other: 2% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| Other NS \| DHS \| MICS \| DHS \| \|------\|-----\|----------\|-----\|------\|-----\| \| 1997 \| 71 \| 76 \| 85 \| 92 \| 91 \| Demand for family planning satisfied (%) 29 (2011) Antenatal care (4 or more visits, %) 51 (2011) Malaria during pregnancy - intermittent preventive treatment (%) 19 (2011) C-section rate (total, urban, rural; %) 4, 9, 2 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 83 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 7 (2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| DHS \| \|------\|-----\|------\|-----\| \| 1997 \| 42 \| 47 \| 49 \| \| 2003 \| 47 \| 46 \| \| \| 2008 \| 56 \| 55 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| \|------\|-----\| \| 2007 \| 7 \| \| 2008 \| 23 \| \| 2011 \| 36 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 29 \| 26 \| 26 \| \| 2012 \| 41 \| 40 \| 41 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 23 \| 24 \| 23 \| \| 2012 \| 35 \| 40 \| 35 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 4.5 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum): - - Per capita total expenditure on health (int$): 66 (2012) - General government expenditure on health as % of total government expenditure (%): 9 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 5 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data ### FINANCING - ODA to child health per child (US$): 24 (2013) - ODA to maternal and neonatal health per live birth (US$): 60 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------------\|------\| \| Total population (000) \| 52,797 \| 2013 \| \| Total under-five population (000) \| 4,434 \| 2013 \| \| Births (000) \| 922 \| 2012 \| \| Birth registration (%) \| 72 \| 2009-2010 \| \| Total under-five deaths (000) \| 48 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 51 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 26 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 41 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 20 \| 2009 \| \| Total maternal deaths \| 1,900 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 250 \| 2013 \| \| Total fertility rate (per woman) \| 2.0 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 17 \| 2006 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 106 \| \| 1995 \| 90 \| \| 2000 \| 73 \| \| 2005 \| 57 \| \| 2010 \| 52 \| \| 2015 \| 35 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 580 \| \| 1995 \| 400 \| \| 2000 \| 200 \| \| 2005 \| 150 \| \| 2010 \| \| \| 2015 \| \| Source: MMIEG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 66 \| \| Antenatal care (4+ visits) \| 73 \| \| Skilled attendant at delivery \| 71 \| \| Postnatal care \| 24 \| \| Exclusive breastfeeding \| 84 \| \| Measles \| \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1991 \| 46 \| \| 1997 \| 56 \| \| 2001 \| 57 \| \| 2007 \| 64 \| \| 2009-2010 \| 71 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 80 \| \| 2011 \| 80 \| \| 2012 \| 80 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Indicator \| Poorest 20% \| Richest 20% \| \|------------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Careseeking for pneumonia \| \| \| No Data Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 85 \| \| 1995 \| 84 \| \| 2000 \| 85 \| \| 2005 \| 84 \| \| 2012 \| 84 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taking to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2000 \| 48 \| \| 2003 \| 66 \| \| 2009-2010 \| 69 \| ### NUTRITION Wasting prevalence (moderate and severe, %): 8 (2009-2010) Low birthweight incidence (moderate and severe, %): 9 (2009-2010) Early initiation of breastfeeding (within 1 hr of birth, %): 76 (2009-2010) Introduction of solid, semi-solid/soft foods (%): 76 (2009-2010) Vitamin A two dose coverage (%): 86 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1991 \| 37 \| \| 1997 \| 28 \| \| 2000 \| 30 \| \| 2003 \| 30 \| \| 2009-2010 \| 23 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2003 \| 15 \| \| 2009-2010 \| 24 \| ## Myanmar ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 50% - Pneumonia: 15% - Preterm: 18% - Asphyxia: 11% - Other: 17% - HIV/AIDS: 0% - Malaria: 2% - Injuries: 5% - Measles: 4% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 6% - Abortion: 7% - Other direct: 14% - Indirect: 17% - Haemorrhage: 30% - Hypertension: 15% - Embolism: 12% Regional estimates for South-eastern Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Other NS \| \|------\|-------\|---------\| \| 1997 \| 76 \| \| \| 2001 \| 76 \| \| \| 2007 \| 80 \| \| \| 2009-2010 \| 83 \| \| Demand for family planning satisfied (%) 66 (2001) Antenatal care (4 or more visits, %) 73 (2007) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) - (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 93 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS \| \|------\|------\| \| 2000 \| 48 \| \| 2003 \| 65 \| \| 2009-2010 \| 50 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| Other NS \| \|------\|----------\| \| 2009-2010 \| 11 \| Percent children < 5 years sleeping under ITNs - ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 51 \| 27 \| 5 \| \| 2012 \| 78 \| 11 \| 8 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 23 \| 9 \| 13 \| \| 2012 \| 77 \| 77 \| 84 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: - - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: - - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 2 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 16.2 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 25 (2012) - General government expenditure on health as % of total government expenditure (%): 2 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 71 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 6 (2011) - ODA to maternal and neonatal health per live birth (US$): 13 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 27,474 \| 2013 \| \| Total under-five population (000) \| 2,984 \| 2013 \| \| Births (000) \| 593 \| 2012 \| \| Birth registration (%) \| 42 \| \| \| Total under-five deaths (000) \| 24 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 57 \| \| \| Neonatal mortality rate (per 1000 live births) \| 24 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 34 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 23 \| 2009 \| \| Total maternal deaths \| 1,100 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 200 \| 2013 \| \| Total fertility rate (per woman) \| 2.4 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 87 \| 2008 \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 64 \| \| Antenatal care (4+ visits) \| 50 \| \| Skilled attendant at delivery \| 36 \| \| Postnatal care \| 45 \| \| Exclusive breastfeeding \| 70 \| \| Measles \| 86 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Other NS \| DHS \| \|------\|----------\|-----\| \| 1991 \| 7 \| 9 \| \| 1996 \| 9 \| 11 \| \| 2001 \| 11 \| 16 \| \| 2003-04 \| 16 \| 19 \| \| 2006 \| 19 \| 36 \| \| 2011 \| 36 \| \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| - \| \| 2011 \| - \| \| 2012 \| - \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Year \| Percent \| \|------\|---------\| \| 2010 \| - \| \| 2011 \| - \| \| 2012 \| - \| Uncertainty range around the estimate \| Year \| Percent \| \|------\|---------\| \| 2010 \| - \| \| 2011 \| - \| \| 2012 \| - \| Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: ▶ Poorest 20% □ Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Caseseeking for pneumonia \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. Source: DHS 2011 ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| 1990 \| 1995 \| 2000 \| 2005 \| 2012 \| \|------\|------\|------\|------\|------\|------\| \| Measles \| 50 \| 60 \| 70 \| 80 \| 90 \| \| DTP3 \| 40 \| 50 \| 60 \| 70 \| 80 \| \| Hib \| 30 \| 40 \| 50 \| 60 \| 70 \| \| Rotavirus \| 20 \| 30 \| 40 \| 50 \| 60 \| \| Pneumococcal \| 10 \| 20 \| 30 \| 40 \| 50 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| 1996 DHS \| 2001 DHS \| 2006 DHS \| 2011 DHS \| \|------\|----------\|----------\|----------\|----------\| \| Taken to health provider \| 18 \| 26 \| 43 \| 50 \| \| Receiving antibiotics \| 7 \| 25 \| 7 \| 7 \| ## NUTRITION Wasting prevalence (moderate and severe, %) 11 (2011) Low birthweight incidence (moderate and severe, %) 18 (2011) Early initiation of breastfeeding (within 1 hr of birth, %) 45 (2011) Introduction of solid, semi-solid/soft foods (%) 66 (2011) Vitamin A two dose coverage (%) 95 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| 1996 DHS \| 1997-1998 Other NS \| 2001 DHS \| 2006 DHS \| 2011 DHS \| \|------\|----------\|---------------------\|----------\|----------\|----------\| \| Underweight \| 47 \| 38 \| 43 \| 39 \| 29 \| \| Stunted \| 66 \| 61 \| 57 \| 49 \| 41 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| 1996 DHS \| 2001 DHS \| 2006 DHS \| 2011 DHS \| \|------\|----------\|----------\|----------\|----------\| \| Exclusive breastfeeding \| 74 \| 68 \| 53 \| 70 \| ## Nepal ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 52% - Preterm: 16% - Asphyxia: 12% - Other: 5% - Congenital: 6% - Sepsis: 10% - Measles: 9% - Diarrhoea: 6% - Injuries: 6% - Malaria: 0% - HIV/AIDS: 0% - Other: 15% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 30% - Indirect: 29% - Hypertension: 10% - Other direct: 8% - Embolism: 2% - Sepsis: 14% Regional estimates for Southern Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Other NS \| DHS \| \|------\|-------\|----------\|-----\| \| 1991 \| 15 \| \| \| \| 1996 \| 24 \| \| \| \| 2001 \| 28 \| \| \| \| 2006 \| 44 \| \| \| \| 2011 \| 58 \| \| \| Demand for family planning satisfied (%) 64 (2011) Antenatal care (4 or more visits, %) 50 (2011) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 5, 15, 4 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 82 (2012) Postnatal visit for baby (within 2 days for home births, %) 30 (2011) Postnatal visit for mother (within 2 days for home births, %) 45 (2011) Women with low body mass index (<18.5 kg/m², %) 20 (2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------\|-----\| \| 1996 \| 26 \| \| 2001 \| 32 \| \| 2006 \| 37 \| \| 2011 \| 47 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 27 \| 1 \| 2 \| \| 2012 \| 67 \| 51 \| 41 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 5 \| 37 \| 34 \| \| 2012 \| 40 \| 33 \| 37 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 4 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 6.7 (2004) - National availability of Emergency Obstetric Care services (% of recommended minimum): 46 (2007) ### FINANCING - Per capita total expenditure on health (int$): 80 (2012) - General government expenditure on health as % of total government expenditure (%): 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 49 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 13 (2011) - ODA to maternal and neonatal health per live birth (US$): 31 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 17,157 \| \| \| Total under-five population (000) \| 3,557 \| \| \| Births (000) \| 858 \| \| \| Birth registration (%) \| 32 \| \| \| Total under-five deaths (000) \| 91 \| \| \| Neonatal deaths: % of all under-5 deaths \| 26 \| \| \| Neonatal mortality rate (per 1000 live births) \| 28 \| \| \| Infant mortality rate (per 1000 live births) \| 63 \| \| \| Stillbirth rate (per 1000 total births) \| 23 \| \| \| Total maternal deaths \| 5,600 \| \| \| Lifetime risk of maternal death (1 in N) \| 20 \| \| \| Total fertility rate (per woman) \| 7.6 \| \| \| Adolescent birth rate (per 1000 girls) \| 206 \| \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 326 \| \| 1995 \| 284 \| \| 2000 \| 240 \| \| 2005 \| 200 \| \| 2010 \| 114 \| \| 2012 \| 109 \| \| 2013 \| 109 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1000 \| \| 1995 \| 900 \| \| 2000 \| 800 \| \| 2005 \| 700 \| \| 2010 \| 630 \| \| 2012 \| 250 \| \| 2013 \| 250 \| Source: MM&EIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percent \| \|----------------------------------------------\|---------\| \| Demand for family planning satisfied \| 47 \| \| Antenatal care (4+ visits) \| 15 \| \| Skilled attendant at delivery \| 29 \| \| Postnatal care \| 23 \| \| Exclusive breastfeeding \| 73 \| \| Measles \| 73 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1992 \| 15 \| \| 1998 \| 18 \| \| 2000 \| 16 \| \| 2006 \| 18 \| \| 2012 \| 29 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 60 \| \| 2011 \| 60 \| \| 2012 \| 60 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% / Richest 20% \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 47 \| 73 \| \| Antenatal care (1+ visit) \| 15 \| 29 \| \| Antenatal care (4+ visits) \| 15 \| 29 \| \| Skilled attendant at delivery \| 15 \| 29 \| \| Early initiation of breastfeeding \| 15 \| 29 \| \| ITN use among children <5 yrs \| 15 \| 29 \| \| DTP3 \| 15 \| 29 \| \| Measles \| 15 \| 29 \| \| Vitamin A (past 6 months) \| 15 \| 29 \| \| ORT & continued feeding \| 15 \| 29 \| \| Caseseeking for pneumonia \| 15 \| 29 \| Source: DHS 2012 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 10 \| \| 1995 \| 20 \| \| 2000 \| 30 \| \| 2005 \| 40 \| \| 2012 \| 50 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1992 \| 14 \| \| 1998 \| 9 \| \| 2000 \| 26 \| \| 2006 \| 27 \| \| 2012 \| 47 \| \| 2013 \| 58 \| Source: DHS ### NUTRITION Wasting prevalence (moderate and severe, %) 18 (2012) Low birthweight incidence (moderate and severe, %) 27 (2006) Early initiation of breastfeeding (within 1 hr of birth, %) 42 (2010) Introduction of solid, semi-solid/soft foods (%) 65 (2010) Vitamin A two dose coverage (%) 98 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1992 \| 41 \| \| 1998 \| 48 \| \| 2000 \| 51 \| \| 2006 \| 54 \| \| 2012 \| 55 \| \| 2013 \| 55 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1992 \| 3 \| \| 2000 \| 1 \| \| 2006 \| 14 \| \| 2008 \| 4 \| \| 2010 \| 27 \| \| 2012 \| 23 \| \| 2013 \| 23 \| Source: DHS ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Pneumonia: 16% - Diarrhoea: 12% - Measles: 0% - Injuries: 5% - Other: 20% - HIV/AIDS: 0% - Malaria: 19% - Neonatal death: 25% - Preterm: 9% - Asphyxia: 6% - Congenital: 1% - Sepsis: 5% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of all deaths are attributable to undernutrition. Source: WHO/CHERG 2014 ### Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 30 \| 39 \| \| 1998 \| 39 \| 41 \| \| 2000 \| 41 \| \| \| 2006 \| 46 \| \| \| 2012 \| 83 \| \| ### Demand for family planning satisfied (%) 47 (2012) ### Antenatal care (4 or more visits, %) 15 (2006) ### Malaria during pregnancy - intermittent preventive treatment (%) 35 (2012) ### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 1, 5, 0 (2006) ### Neonatal tetanus vaccine 84 (2012) ### Postnatal visit for baby (within 2 days for home births, %) - - ### Postnatal visit for mother (within 2 days for home births, %) - - ### Women with low body mass index (<18.5 kg/m², %) 13 (2012) ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 10 \| 20 \| \| 1998 \| 20 \| 43 \| \| 2000 \| 14 \| 34 \| \| 2006 \| 18 \| 44 \| \| 2012 \| 18 \| 44 \| ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 2000 \| 1 \| 7 \| \| 2006 \| 7 \| 43 \| \| 2009 \| 43 \| 64 \| \| 2010 \| 20 \| \| \| 2012 \| 20 \| \| ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 30 \| 1 \| 0 \| \| 2012 \| 44 \| 38 \| 41 \| ### Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 25 \| 9 \| 22 \| \| 2012 \| 76 \| 36 \| 89 \| Source: WHO/UNICEF JMP 2014 ## POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 3 (F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ## SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 1.6 (2008) - National availability of Emergency Obstetric Care services (% of recommended minimum): 29 (2010) ## FINANCING - Per capita total expenditure on health (int$): 44 (2012) - General government expenditure on health as % of total government expenditure (%): 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 53 (2012) - Reproductive, maternal, newborn and child health expenditure by source: - External sources: 7 (2011) - General government expenditure: 61 - Out-of-pocket expenditure: 13 - Other: 20 ODA to child health per child (US$): 14 (2013) ODA to maternal and neonatal health per live birth (US$): 27 (2011) \| Indicator \| Value \| \|------------------------------------------------\|-------------\| \| Total population (000) \| 168,834 \| \| Total under-five population (000) \| 29,697 \| \| Births (000) \| 7,028 \| \| Birth registration (%) \| 42 \| \| Total under-five deaths (000) \| 827 \| \| Neonatal deaths: % of all under-5 deaths \| 32 \| \| Neonatal mortality rate (per 1000 live births) \| 39 \| \| Infant mortality rate (per 1000 live births) \| 78 \| \| Stillbirth rate (per 1000 total births) \| 42 \| \| Total maternal deaths \| 40,000 \| \| Lifetime risk of maternal death (1 in N) \| 31 \| \| Total fertility rate (per woman) \| 6.0 \| \| Adolescent birth rate (per 1000 girls) \| 122 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 213 - 1995: 190 - 2000: 165 - 2005: 140 - 2010: 124 - 2015: 71 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births** - 1990: 1200 - 1995: 1000 - 2000: 800 - 2005: 600 - 2010: 560 - 2015: 300 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 43 \| \| Antenatal care (4+ visits) \| 57 \| \| Skilled attendant at delivery \| 49 \| \| Postnatal care \| 38 \| \| Exclusive breastfeeding \| 15 \| \| Measles \| 42 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1990: 31 - 1999: 42 - 2003: 35 - 2008: 39 - 2011: 49 #### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| \|---------------------------------------------------------------------------\|-------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| 18 \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| 10 \| \| Uncertainty range around the estimate \| 10-17 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Caseseeking for pneumonia \| \| \| Source: MICS 2011 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 51 - 1995: 44 - 2000: 43 - 2005: 41 - 2012: 42 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1990: 37 - 2003: 33 - 2008: 45 - 2011: 40 Source: DHS ### NUTRITION #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1990: 35 - 1993: 35 - 2003: 27 - 2008: 27 - 2011: 24 #### Wasting prevalence (moderate and severe, %) - 10 (2011) #### Low birthweight incidence (moderate and severe, %) - 15 (2011) #### Early initiation of breastfeeding (within 1 hr of birth, %) - 23 (2011) #### Introduction of solid, semi-solid/soft foods (%) - 33 (2011) #### Vitamin A two dose coverage (%) - 78 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1990: 1 - 1999: 17 - 2003: 17 - 2008: 13 - 2011: 15 Source: MICS ## Nigeria ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 14% - Neontal death: 32% - Preterm: 10% - Asphyxia: 10% - Other: 2% - Congenital: 1% - Sepsis*: 6% - HIV/AIDS: 3% - Malaria: 20% - Injuries: 4% - Measles: 1% - Diarrhoea: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Other direct: 9% - Abortion: 10% - Embolism: 2% Source: WHO 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1986 \| 79 \| \| \| 1990 \| 57 \| \| \| 1999 \| 64 \| \| \| 2003 \| 58 \| \| \| 2008 \| 58 \| \| \| 2011 \| 66 \| \| Demand for family planning satisfied (%) 43 (2011) Antenatal care (4 or more visits, %) 57 (2011) Malaria during pregnancy - intermittent preventive treatment (%) 13 (2012) C-section rate (total, urban, rural; %) 5, 9, 3 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 60 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 38 (2008) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1990 \| 12 \| \| \| 1999 \| 34 \| \| \| 2003 \| 28 \| \| \| 2008 \| 18 \| \| \| 2011 \| 25 \| \| \| 2012 \| 26 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 2003 \| 1 \| \| \| 2008 \| 6 \| \| \| 2010 \| 29 \| \| \| 2011 \| 16 \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 54 \| 16 \| 25 \| \| 2012 \| 60 \| 45 \| 30 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 28 \| 11 \| 28 \| \| 2012 \| 37 \| 26 \| 31 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 4.1 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): - - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 161 (2012) - General government expenditure on health as % of total government expenditure (%): 7 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 66 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 9 (2011) - ODA to maternal and neonatal health per live birth (US$): 10 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------------\|------\| \| Total population (000) \| 179,160 \| 2013 \| \| Total under-five population (000) \| 21,996 \| 2013 \| \| Births (000) \| 4,604 \| 2012 \| \| Birth registration (%) \| 27 \| 2006-2007 \| \| Total under-five deaths (000) \| 409 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 50 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 42 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 69 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 47 \| 2009 \| \| Total maternal deaths \| 7,900 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 170 \| 2013 \| \| Total fertility rate (per woman) \| 3.3 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 48 \| 2010 \| ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 64 \| \| Antenatal care (4+ visits) \| 28 \| \| Skilled attendant at delivery \| 43 \| \| Postnatal care \| 39 \| \| Exclusive breastfeeding \| 37 \| \| Measles \| 83 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| DHS \| Other NS \| 2001-02 \| Other NS \| 2004-05 \| Other NS \| 2006-07 \| DHS \| 2010-11 \| Other NS \| \|------------\|-----\|----------\|---------\|----------\|---------\|----------\|---------\|-----\|---------\|----------\| \| 1990-91 \| 19 \| 18 \| 23 \| 31 \| 39 \| 43 \| \| \| \| \| \| 1996-97 \| \| \| \| \| \| \| \| \| \| \| \| 2001-02 \| \| \| \| \| \| \| \| \| \| \| \| 2004-05 \| \| \| \| \| \| \| \| \| \| \| \| 2006-07 \| \| \| \| \| \| \| \| \| \| \| \| 2010-11 \| \| \| \| \| \| \| \| \| \| \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 0 \| \| 2011 \| 0 \| \| 2012 \| 0 \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Year \| Percent \| \|------\|---------\| \| 2010 \| 0 \| \| 2011 \| 0 \| \| 2012 \| 0 \| Uncertainty range around the estimate \| Year \| Range \| \|------\|-------\| \| 2010 \| - \| \| 2011 \| - \| \| 2012 \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% (red circles) and Richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 64 \| \| Antenatal care (1+ visit) \| 28 \| \| Antenatal care (4+ visits) \| 43 \| \| Skilled attendant at delivery \| 39 \| \| Early initiation of breastfeeding \| 37 \| \| ITN use among children <5 yrs \| 83 \| \| DTP3 \| 66 \| \| Measles \| 69 \| \| Vitamin A (past 6 months) \| 50 \| \| ORT & continued feeding \| 81 \| \| Caseseeking for pneumonia \| 81 \| Source: DHS 2012 ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 40 \| \| 1995 \| 40 \| \| 2000 \| 40 \| \| 2005 \| 40 \| \| 2012 \| 40 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1990-91 \| 66 \| \| 2006-07 \| 69 \| Source: DHS ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2011 \| 15 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2006-2007 \| 32 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2006-2007 \| 29 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2006-2007 \| 36 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 99 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1985-87 \| 44 \| \| 1990-91 \| 39 \| \| 1995 \| 34 \| \| 2001 \| 31 \| \| 2011 \| 31 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1995 \| 16 \| \| 2006-07 \| 37 \| Source: DHS ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Neonatal death: 50% - Pneumonia: 14% - Preterm: 17% - Asphyxia: 12% - Other: 3% - Congenital: 3% - Sepsis: 11% - Intrapartum-related events: 10% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 6% - Measles: 1% Globally nearly half of child deaths are attributable to undernutrition. Source: WHO/CHERG 2014 ### Causes of maternal deaths, 2013 - Haemorrhage: 30% - Indirect: 29% - Hypertension: 10% - Other direct: 8% - Abortion: 6% - Sepsis: 14% - Embolism: 2% - Regional estimates for Southern Asia, 2013 Source: WHO 2014 --- ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| Other NS \| \|------------\|-----\|----------\| \| 1990–91 \| 26 \| 26 \| \| 1996–97 \| \| \| \| 2001 \| 43 \| \| \| 2004–05 \| 36 \| \| \| 2006–07 \| 61 \| \| ### Demand for family planning satisfied (%) 64 (2013) ### Antenatal care (4 or more visits, %) 28 (2006–2007) ### Malaria during pregnancy - intermittent preventive treatment (%) - - (2006–2007) ### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 7, 13, 5 (2006–2007) ### Neonatal tetanus vaccine 75 (2012) ### Postnatal visit for baby (within 2 days for home births, %) - - (2006–2007) ### Postnatal visit for mother (within 2 days for home births, %) 39 (2006–2007) ### Women with low body mass index (<18.5 kg/m², %) 17 (2012–2013) --- ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - Receiving oral rehydration therapy/increased fluids with continued feeding - Treated with ORS \| Year \| DHS \| \|------------\|-----\| \| 1990–91 \| 39 \| \| 2006–07 \| 37 \| ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk --- ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 1990–2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 62 \| 56 \| 73 \| \| 2012 \| 91 \| 66 \| 23 \| Source: WHO/UNICEF JMP 2014 ### Improved sanitation coverage Percent of population by type of sanitation facility, 1990–2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 52 \| 14 \| 72 \| \| 2012 \| 62 \| 18 \| 73 \| Source: WHO/UNICEF JMP 2014 --- ## POLICIES \| Policy \| Status \| \|----------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| No \| \| Legal status of abortion (X of 5 circumstances) \| 3 \| \| Midwives authorized for specific tasks (X of 7 tasks) \| - \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| No \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| Yes \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| Yes \| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| --- ## SYSTEMS \| System \| Status \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Yes \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 3 \| 2013 \| \| Maternal health (X of 3) \| 3 \| 2013 \| \| Newborn health (X of 4) \| 2 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 14.0 \| 2010 \| \| National availability of Emergency Obstetric Care services (%) of recommended minimum \| - \| - \| --- ## FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (US$) \| 91 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 5 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health (%) \| 62 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 12 \| 2013 \| \| ODA to maternal and neonatal health per live birth (US$) \| 13 \| 2014 \| ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------------\|------\| \| Total population (000) \| 7,167 \| 2013 \| \| Total under-five population (000) \| 982 \| 2013 \| \| Births (000) \| 210 \| 2012 \| \| Birth registration (%) \| - \| \| \| Total under-five deaths (000) \| 13 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 39 \| \| \| Neonatal mortality rate (per 1000 live births) \| 24 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 48 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 15 \| 2009 \| \| Total maternal deaths \| 460 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 120 \| 2013 \| \| Total fertility rate (per woman) \| 3.8 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 65 \| 2004 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 89 - 1995: 80 - 2000: 70 - 2005: 60 - 2010: 50 - 2015: 40 MDG Target: 30 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 470 - 1995: 380 - 2000: 300 - 2005: 220 - 2010: 120 - 2015: 80 MDG Target: 70 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 54 \| \| Antenatal care (4+ visits) \| 55 \| \| Skilled attendant at delivery \| 53 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 56 \| \| Measles \| 67 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1996: 53 - 2006: 53 ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 22 - 2011: 23 - 2012: 39 Percent HIV+ pregnant women receiving ARVs for PMTCT - 2010: 22 - 2011: 23 - 2012: 39 Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile - Poorest 20% - Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Careseeking for pneumonia \| \| No Data Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 80 - 1995: 60 - 2000: 40 - 2005: 20 - 2012: 0 Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1996: 75 - 2006: 63 Source: DHS ## NUTRITION ### Wasting prevalence (moderate and severe, %) - 2009-2011: 16 ### Low birthweight incidence (moderate and severe, %) - 2005: 11 ### Early initiation of breastfeeding (within 1 hr of birth, %) - - ### Introduction of solid, semi-solid/soft foods (%) - 2006: 76 ### Vitamin A two dose coverage (%) - 2012: 15 ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1982-1983: 23, 46 - 2005: 18, 44 - 2009-2011: 27, 48 ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1996: 59 - 2006: 56 Source: DHS ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Neonatal death: 38% - Pneumonia: 15% - Preterm: 11% - Asphyxia: 12% - Globally nearly half child deaths are attributable to undernutrition - Other: 19% - HIV/AIDS: 11% - Malaria: 11% - Injuries: 6% - Measles: 1% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis ### Causes of maternal deaths, 2013 - Haemorrhage: 30% - Indirect: 17% - Hypertension: 14% - Other direct: 12% - Abortion: 7% - Sepsis: 5% - Embolism: 15% - Regional estimates for Oceania, 2013 Source: WHO/CHERG 2014 ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| Percent \| \|------\|-----\|---------\| \| 1996 \| 77 \| \| \| 2006 \| 79 \| \| ### Demand for family planning satisfied (%) - 54 (2006) ### Antenatal care (4 or more visits, %) - 55 (2006) ### Malaria during pregnancy - intermittent preventive treatment (%) - - ### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) - - ### Neonatal tetanus vaccine - 70 (2012) ### Postnatal visit for baby (within 2 days for home births, %) - - ### Postnatal visit for mother (within 2 days for home births, %) - - ### Women with low body mass index (<18.5 kg/m², %) - - ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS No Data ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs No Data ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 43 \| 23 \| 12 \| \| 2012 \| 42 \| 31 \| 9 \| ### Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Unimproved facilities - Shared facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 100 \| 4 \| 10 \| \| 2012 \| 100 \| 12 \| 13 \| Source: WHO/UNICEF JMP 2014 ## POLICIES \| Policy \| Status \| \|----------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Yes \| \| Legal status of abortion (X of 5 circumstances) \| 1 \| \| Midwives authorized for specific tasks (X of 7 tasks) \| - \| \| Maternity protection (Convention 183) \| Partial\| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| No \| \| Antenatal corticosteroids as part of management of preterm labour \| - \| \| International Code of Marketing of Breastmilk Substitutes \| Partial\| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ## SYSTEMS \| System \| Status \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Partial \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 0 \| 2013 \| \| Maternal health (X of 3) \| 2 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 5.1 \| 2008 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| - \| - \| ## FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (int$) \| 151 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 14 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 9 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 40 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 62 \| 2011 \| ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 29,988 \| 2013 \| \| Total under-five population (000) \| 2,925 \| 2013 \| \| Births (000) \| 600 \| 2012 \| \| Birth registration (%) \| 96 \| \| \| Total under-five deaths (000) \| 11 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 51 \| \| \| Neonatal mortality rate (per 1000 live births) \| 9 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 14 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 10 \| 2009 \| \| Total maternal deaths \| 530 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 440 \| 2013 \| \| Total fertility rate (per woman) \| 2.5 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 67 \| 2010 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 79 - 1995: 68 - 2000: 59 - 2005: 48 - 2010: 18 - 2015: 26 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 250 - 1995: 210 - 2000: 180 - 2005: 120 - 2010: 89 - 2015: 63 Source*: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 90 \| \| Antenatal care (4+ visits) \| 94 \| \| Skilled attendant at delivery \| 87 \| \| Postnatal care \| 93 \| \| Exclusive breastfeeding \| 71 \| \| Measles \| 94 \| * See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1992: 53 - 1996: 56 - 2000: 59 - 2004: 71 - 2009: 83 - 2012: 87 ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: - - 2011: - - 2012: - Percent HIV+ pregnant women receiving ARVs for PMTCT - 2010: 80% - 2011: 85% - 2012: 90% Uncertainty range around the estimate - 2010: 70% - 90% - 2011: 75% - 90% - 2012: 80% - 90% Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% - Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Caseseeking for pneumonia \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 80% - 1995: 90% - 2000: 95% - 2005: 95% - 2012: 95% Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1992: 33% - 1996: 46% - 2000: 58% - 2004-2006: 67% - 2009: 72% - 2012: 59% Source: DHS ## NUTRITION ### Wasting prevalence (moderate and severe, %) - 1 (2012) ### Low birthweight incidence (moderate and severe, %) - 8 (2007) ### Early initiation of breastfeeding (within 1 hr of birth, %) - 51 (2010) ### Introduction of solid, semi-solid/soft foods (%) - 82 (2004-2008) ### Vitamin A two dose coverage (%) - - ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1992: 37% - 1996: 32% - 2000: 31% - 2005: 30% - 2009: 24% - 2012: 18% ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1986: 28% - 1992: 33% - 1996: 53% - 2000: 67% - 2004: 61% - 2008: 66% - 2011: 71% Peru ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 51% - Preterm: 19% - Asphyxia: 7% - Other: 5% - Congenital: 12% - Diarrhoea: 3% - Sepsis*: 6% - Pneumonia: 8% - Other: 30% - HIV/AIDS: 1% - Malaria: 0% - Injuries: 6% - Measles: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 22% - Indirect: 19% - Other direct: 15% - Abortion: 10% - Sepsis: 8% - Embolism: 3% Source: WHO 2014 Regional estimates for Latin America, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| \|------\|-----\| \| 1992 \| 64 \| \| 1996 \| 67 \| \| 2000 \| 84 \| \| 2004 \| 91 \| \| 2009 \| 94 \| \| 2012 \| 96 \| Demand for family planning satisfied (%) 90 (2012) Antenatal care (4 or more visits, %) 94 (2012) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 25, 33, 11 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 93 (2012) Women with low body mass index (<18.5 kg/m², %) 1 (2007-2008) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------\|-----\| \| 1992 \| 20 \| \| 1996 \| 26 \| \| 2000 \| 22 \| \| 2004-2006 \| 60 \| \| 2010 \| 25 \| \| 2012 \| 32 \| \| 2012 \| 64 \| \| 2012 \| 31 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 54 \| 17 \| 20 \| \| 2012 \| 82 \| 11 \| 8 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 78 \| 11 \| 13 \| \| 2012 \| 73 \| 6 \| 9 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: - - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: - - Antenatal corticosteroids as part of management of preterm labour: - - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 0 (2013) - Maternal health (X of 3): - - Newborn health (X of 4): - - Child health (X of 3): - - Density of doctors, nurses and midwives (per 10,000 population): 26.5 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (US$): 555 (2012) - General government expenditure on health as % of total government expenditure (%): 18 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 36 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 4 (2013) - ODA to maternal and neonatal health per live birth (US$): 13 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 96,707 \| 2013 \| \| Total under-five population (000) \| 11,165 \| 2013 \| \| Births (000) \| 2,383 \| 2012 \| \| Birth registration (%) \| 90 \| \| \| Total under-five deaths (000) \| 69 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 47 \| \| \| Neonatal mortality rate (per 1000 live births) \| 14 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 24 \| \| \| Stillbirth rate (per 1000 total births) \| 16 \| 2009 \| \| Total maternal deaths \| 3,000 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 250 \| 2013 \| \| Total fertility rate (per woman) \| 3.1 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 53 \| 2006 \| ### Under-five mortality rate Deaths per 1000 live births \| Year \| Value \| \|------\|-------\| \| 1990 \| 59 \| \| 1995 \| 53 \| \| 2000 \| 56 \| \| 2005 \| 58 \| \| 2010 \| 60 \| \| 2015 \| 20 \| Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births \| Year \| Value \| \|------\|-------\| \| 1990 \| 110 \| \| 1995 \| 100 \| \| 2000 \| 90 \| \| 2005 \| 80 \| \| 2010 \| 70 \| \| 2015 \| 28 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Value \| \|----------------------------------------------\|-------\| \| Demand for family planning satisfied \| 72 \| \| Antenatal care (4+ visits) \| 78 \| \| Skilled attendant at delivery \| 62 \| \| Postnatal care \| 77 \| \| Exclusive breastfeeding \| 34 \| \| Measles \| 85 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Value \| \|------\|-------\| \| 1993 \| 53 \| \| 1998 \| 56 \| \| 2000 \| 58 \| \| 2003 \| 60 \| \| 2008 \| 62 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Value \| \|------\|-------\| \| 2010 \| 5 \| \| 2011 \| 10 \| \| 2012 \| 15 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% richest 20% \| Service \| Value \| \|----------------------------------------------\|-------\| \| Demand for family planning satisfied \| 60 \| \| Antenatal care (1+ visit) \| 70 \| \| Antenatal care (4+ visits) \| 70 \| \| Skilled attendant at delivery \| 50 \| \| Early initiation of breastfeeding \| 50 \| \| ITN use among children <5 yrs \| 50 \| \| DTP3 \| 60 \| \| Measles \| 60 \| \| Vitamin A (past 6 months) \| 60 \| \| ORT & continued feeding \| 60 \| \| Caseseeking for pneumonia \| 60 \| Source: DHS 2008 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with Rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Value \| \|------\|-------\| \| 1990 \| 90 \| \| 1995 \| 85 \| \| 2000 \| 80 \| \| 2005 \| 75 \| \| 2012 \| 65 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Value \| \|------\|-------\| \| 1993 \| 51 \| \| 1998 \| 44 \| \| 2003 \| 58 \| \| 2008 \| 36 \| \| 2012 \| 55 \| Source: DHS #### NUTRITION Wasting prevalence (moderate and severe, %) 7 (2011) Low birthweight incidence (moderate and severe, %) 21 (2008) Early initiation of breastfeeding (within 1 hr of birth, %) 54 (2008) Introduction of solid, semi-solid/soft foods (%) 90 (2008) Vitamin A two dose coverage (%) 90 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Value \| \|------\|-------\| \| 1987 \| 29 \| \| 1993 \| 26 \| \| 1998 \| 28 \| \| 2003 \| 21 \| \| 2008 \| 21 \| \| 2011 \| 20 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Value \| \|------\|-------\| \| 1993 \| 26 \| \| 1998 \| 37 \| \| 2003 \| 34 \| \| 2008 \| 34 \| Source: DHS Philippines ### DEMOGRAPHICS #### Causes of under-five deaths, 2012 - Neonatal death: 47% - Preterm: 15% - Asphyxia: 11% - Other: 3% - Congenital: 8% - Pneumonia: 17% - Other: 21% Globally nearly half of child deaths are attributable to undernutrition. #### Causes of maternal deaths, 2013 - Haemorrhage: 30% - Indirect: 17% - Hypertension: 15% - Diarrhoea: 0% - Sepsis: 6% - Abortion: 7% - Embolism: 12% - Other direct: 14% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH #### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1993 \| 83 \| 86 \| 85 \| \| 1998 \| 86 \| 86 \| 85 \| \| 2000 \| 86 \| 86 \| 85 \| \| 2003 \| 88 \| 88 \| 85 \| \| 2008 \| 91 \| 91 \| 91 \| #### Demand for family planning satisfied (%) - 72 (2011) #### Antenatal care (4 or more visits, %) - 78 (2008) #### Malaria during pregnancy - intermittent preventive treatment (%) - - #### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) - 10, 14, 5 (2008) #### Neonatal tetanus vaccine - 76 (2012) #### Postnatal visit for baby (within 2 days for home births, %) - - #### Postnatal visit for mother (within 2 days for home births, %) - 77 (2008) #### Women with low body mass index (<18.5 kg/m², %) - - ### CHILD HEALTH #### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - Receiving oral rehydration therapy/increased fluids with continued feeding - Treated with ORS \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1993 \| 27 \| 43 \| 76 \| \| 1998 \| 43 \| 42 \| 60 \| \| 2003 \| 42 \| 47 \| 47 \| \| 2008 \| 47 \| 47 \| 47 \| #### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs No Data ### WATER AND SANITATION #### Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 14 \| 7 \| 0 \| \| 2012 \| 49 \| 31 \| 22 \| \| 1990 \| 52 \| 61 \| 66 \| \| 2012 \| 65 \| 26 \| 9 \| Source: WHO/UNICEF JMP 2014 #### Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 15 \| 8 \| 12 \| \| 2012 \| 16 \| 17 \| 16 \| \| 1990 \| 15 \| 15 \| 15 \| \| 2012 \| 17 \| 16 \| 16 \| Source: WHO/UNICEF JMP 2014 ### POLICIES \| Policy \| Status \| \|----------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Partial \| \| Legal status of abortion (X of S circumstances) \| 1 \| \| Midwives authorized for specific tasks (X of 7 tasks) \| 3 \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| No \| \| Antenatal corticosteroids as part of management of preterm labour \| - \| \| International Code of Marketing of Breastmilk Substitutes \| Yes \| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Status \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Partial \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 0 \| 2013 \| \| Maternal health (X of 3) \| 2 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 71.5 \| 2004 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| - \| - \| ### FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (int$) \| 203 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 10 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 52 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 2 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 5 \| 2011 \| ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 11,458 \| 2013 \| \| Total under-five population (000) \| 1,945 \| 2013 \| \| Births (000) \| 410 \| 2012 \| \| Birth registration (%) \| 63 \| \| \| Total under-five deaths (000) \| 24 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 39 \| \| \| Neonatal mortality rate (per 1000 live births) \| 21 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 39 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 23 \| 2009 \| \| Total maternal deaths \| 1,300 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 66 \| 2013 \| \| Total fertility rate (per woman) \| 4.6 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 41 \| 2008 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 157 - 1995: 210 - 2000: 140 - 2005: 70 - 2010: 55 - 2015: 50 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 1400 - 1995: 1200 - 2000: 800 - 2005: 400 - 2010: 320 - 2015: 350 Source: MM&EIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 71 \| \| Antenatal care (4+ visits) \| 35 \| \| Skilled attendant at delivery \| 69 \| \| Postnatal care \| 18 \| \| Exclusive breastfeeding \| 85 \| \| Measles \| 97 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1992 DHS: 26 - 2000 DHS: 31 - 2005 DHS: 39 - 2007-2008 DHS: 52 - 2010 DHS: 69 ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 67 - 2011: 56 - 2012: 87 Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% - Richest 20% \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 71 \| \| Antenatal care (1+ visit) \| 35 \| \| Antenatal care (4+ visits) \| 69 \| \| Skilled attendant at delivery \| 18 \| \| Early initiation of breastfeeding \| 85 \| \| ITN use among children <5 yrs \| 97 \| \| DTP3 \| 50 \| \| Measles \| 50 \| \| Vitamin A (past 6 months) \| 50 \| \| ORT & continued feeding \| 50 \| \| Caseseeking for pneumonia \| 50 \| Source: DHS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 98 - 1995: 98 - 2000: 98 - 2005: 98 - 2012: 98 Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1992 DHS: 30 - 2000 DHS: 4 - 2005 DHS: 16 - 2007-2008 DHS: 28 - 2010 DHS: 12 ## NUTRITION ### Wasting prevalence (moderate and severe, %) - 3 (2010) ### Low birthweight incidence (moderate and severe, %) - 7 (2010) ### Early initiation of breastfeeding (within 1 hr of birth, %) - 71 (2010) ### Introduction of solid, semi-solid/soft foods (%) - 79 (2010) ### Vitamin A two dose coverage (%) - 3 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1992 DHS: 24 - 1996 Other NS: 57 - 2000 DHS: 23 - 2005 DHS: 45 - 2010 DHS: 20 - 2000 DHS: 48 - 2005 DHS: 52 - 2010 DHS: 18 - 2000 DHS: 12 - 2010 DHS: 44 ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1992 DHS: 83 - 2000 DHS: 83 - 2005 DHS: 88 - 2010 DHS: 85 ## Rwanda ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 39% - Pneumonia: 16% - Preterm: 10% - Asphyxia: 12% - Other: 21% - Congenital: 5% - Sepsis: 8% - HIV/AIDS: 1% - Malaria: 4% - Measles: 1% - Injuries: 7% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 94 \| 92 \| \| 2000 \| 92 \| \| \| 2005 \| 94 \| \| \| 2007-2008 \| 96 \| \| \| 2010 \| 98 \| \| Demand for family planning satisfied (%) 71 (2010) Antenatal care (4 or more visits, %) 35 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 17 (2007-2008) C-section rate (total, urban, rural; %) 7, 16, 6 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) 5 (2010) Postnatal visit for mother (within 2 days for home births, %) 18 (2012) Women with low body mass index (<18.5 kg/m², %) 5 (2012) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1992 \| 28 \| 16 \| \| 2000 \| 10 \| 24 \| \| 2005 \| 12 \| 21 \| \| 2007-2008 \| 21 \| 29 \| \| 2010 \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 2000 \| 5 \| 13 \| \| 2005 \| \| \| \| 2007-2008 \| 56 \| \| \| 2010 \| 70 \| \| 97 (2010) ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 59 \| 28 \| 28 \| \| 2012 \| 67 \| 13 \| 13 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 59 \| 23 \| 23 \| \| 2012 \| 64 \| 15 \| 15 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 7.5 (2010) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 144 (2012) - General government expenditure on health as % of total government expenditure (%): 22 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 21 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 39 (2011) - ODA to maternal and neonatal health per live birth (US$): 52 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 188 \| 2013 \| \| Total under-five population (000) \| 31 \| 2013 \| \| Births (000) \| 7 \| 2012 \| \| Birth registration (%) \| 75 \| 2008-2009 \| \| Total under-five deaths (000) \| 0 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 38 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 20 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 38 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 22 \| 2009 \| \| Total maternal deaths \| 14 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 100 \| 2013 \| \| Total fertility rate (per woman) \| 4.1 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 110 \| 2006 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 104 - 1995: 90 - 2000: 72 - 2005: 53 - 2010: 35 - 2015: 35 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births** - 1990: 410 - 1995: 310 - 2000: 210 - 2005: 100 - 2010: 100 - 2015: 100 Source: MMIEG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 51 \| \| Antenatal care (4+ visits) \| 72 \| \| Skilled attendant at delivery \| 82 \| \| Postnatal care \| 37 \| \| Exclusive breastfeeding \| 51 \| \| Measles \| 92 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 2000 MICS: 79 - 2006 MICS: 81 - 2008-2009 DHS: 82 #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (%), of total ARVs \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|-------------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| - \| - \| \| 2011 \| - \| - \| \| 2012 \| - \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 51 \| 92 \| \| Antenatal care (1+ visit) \| 72 \| 92 \| \| Antenatal care (4+ visits) \| 82 \| 92 \| \| Skilled attendant at delivery \| 37 \| 92 \| \| Early initiation of breastfeeding \| 51 \| 92 \| \| ITN use among children <5 yrs \| 37 \| 92 \| \| DTP3 \| 72 \| 92 \| \| Measles \| 82 \| 92 \| \| Vitamin A (past 6 months) \| 37 \| 92 \| \| ORT & continued feeding \| 72 \| 92 \| \| Caseseeking for pneumonia \| 82 \| 92 \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 96 - 1995: 92 - 2000: 92 - 2005: 92 - 2012: 92 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2000 MICS: 47 - 2008-2009 DHS: 75 - 2008-2009 DHS: 60 ### NUTRITION #### Wasting prevalence (moderate and severe, %) - 2008-2009: 11 #### Low birthweight incidence (moderate and severe, %) - 2008-2009: 10 #### Early initiation of breastfeeding (within 1 hr of birth, %) - 2006: 35 #### Introduction of solid, semi-solid/soft foods (%) - 2008-2009: 74 #### Vitamin A two dose coverage (%) - 2012: 34 #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1986 Other NS: 32 - 2000 MICS: 10 - 2006 MICS: 8 - 2008-2009 Other NS: 14 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2000 MICS: 56 - 2006 MICS: 60 - 2008-2009 DHS: 51 Causes of under-five deaths, 2012 - Neonatal death: 38% - Pneumonia: 14% - Preterm: 10% - Asphyxia: 11% - Other: 29% - Other: 2% - Congenital: 5% - Sepsis: 7% - Diarrhoea: 0% - Measles: 1% - Malaria: 8% - Injuries: 7% - HIV/AIDS: 1% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half child deaths (46%) attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| MICS \| DHS \| \|------\|------\|-----\| \| 2000 \| 91 \| \| \| 2006 \| 97 \| \| \| 2008-2009 \| 98 \| \| Demand for family planning satisfied (%) 51 (2008-2009) Antenatal care (4 or more visits, %) 72 (2008-2009) Malaria during pregnancy - intermittent preventive treatment (%) 60 (2008-2009) C-section rate (total, urban, rural; %) 5, 7, 4 (2008-2009) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine - Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 37 (2008-2009) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS \| DHS \| \|------\|------\|-----\| \| 2000 \| 50 \| 31 \| \| 2006 \| 63 \| 31 \| \| 2008-2009 \| 49 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| MICS \| DHS \| \|------\|------\|-----\| \| 2000 \| 23 \| \| \| 2006 \| 42 \| \| \| 2008-2009 \| 56 \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1995-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 54 \| 20 \| 7 \| \| 2012 \| 64 \| 33 \| 12 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1995-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 74 \| 16 \| 5 \| \| 2012 \| 54 \| 34 \| 24 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - Legal status of abortion (X of 5 circumstances) - Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) - Maternal deaths notification - Postnatal home visits in the first week after birth - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - Antenatal corticosteroids as part of management of preterm labour - International Code of Marketing of Breastmilk Substitutes - Community treatment of pneumonia with antibiotics - Low osmolarity ORS and zinc for management of diarrhoea ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - Maternal health (X of 3) - Newborn health (X of 4) - Child health (X of 3) - Density of doctors, nurses and midwives (per 10,000 population) 23.6 (2004) - National availability of Emergency Obstetric Care services (% of recommended minimum) ### FINANCING - Per capita total expenditure on health (US$) 144 (2012) - General government expenditure on health as % of total government expenditure (%) 6 (2012) - Out of pocket expenditure as % of total expenditure on health (%) 52 (2012) - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 112 (2011) - ODA to maternal and neonatal health per live birth (US$) 234 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 13,726 \| \| \| Total under-five population (000) \| 2,313 \| \| \| Births (000) \| 524 \| \| \| Birth registration (%) \| 75 \| (2010-2011) \| \| Total under-five deaths (000) \| 30 \| (2012) \| \| Neonatal deaths: % of all under-5 deaths \| 42 \| (2012) \| \| Neonatal mortality rate (per 1000 live births) \| 24 \| (2012) \| \| Infant mortality rate (per 1000 live births) \| 45 \| (2012) \| \| Stillbirth rate (per 1000 total births) \| 34 \| (2009) \| \| Total maternal deaths \| 1,700 \| (2013) \| \| Lifetime risk of maternal death (1 in N) \| 60 \| (2013) \| \| Total fertility rate (per woman) \| 5.0 \| (2012) \| \| Adolescent birth rate (per 1000 girls) \| 80 \| (2011) \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 142 - 1995: 130 - 2000: 110 - 2005: 90 - 2010: 60 - 2015: 47 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 530 - 1995: 450 - 2000: 350 - 2005: 250 - 2010: 120 - 2015: 130 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Percent \| \|------------------------------------------------\|---------\| \| Demand for family planning satisfied \| 38 \| \| Antenatal care (4+ visits) \| 50 \| \| Skilled attendant at delivery \| 65 \| \| Postnatal care \| 68 \| \| Exclusive breastfeeding \| 39 \| \| Measles \| 84 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1992-93 DHS: 47 - 1997 DHS: 47 - 2000 MICS: 58 - 2002 Other NS: 58 - 2005 DHS: 52 - 2010-11 DHS: 65 #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 40% - 2011: 45% - 2012: 50% Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Indicator \| Poorest 20% \| Richest 20% \| \|------------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 38 \| 50 \| \| Antenatal care (1+ visit) \| 50 \| 68 \| \| Antenatal care (4+ visits) \| 65 \| 84 \| \| Skilled attendant at delivery \| 65 \| 84 \| \| Early initiation of breastfeeding \| 39 \| 84 \| \| ITN use among children <5 yrs \| 47 \| 65 \| \| DTP3 \| 58 \| 84 \| \| Measles \| 65 \| 84 \| \| Vitamin A (past 6 months) \| 84 \| 84 \| \| ORT & continued feeding \| 84 \| 84 \| \| Caseseeking for pneumonia \| 84 \| 84 \| Source: DHS 2010-2011 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 30% - 1995: 40% - 2000: 50% - 2005: 60% - 2012: 70% Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1992-93 DHS: 31% - 2000 MICS: 18% - 2005 DHS: 27% - 2010-11 DHS: 47% - 2010-11 DHS: 50% ### NUTRITION Wasting prevalence (moderate and severe, %): 9 (2012) Low birthweight incidence (moderate and severe, %): 19 (2010-2011) Early initiation of breastfeeding (within 1 hr of birth, %): 48 (2010-2011) Introduction of solid, semi-solid/soft foods (%): 67 (2010-2011) Vitamin A two dose coverage (%): - #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1992-93 DHS: 22% - 1996 MICS: 34% - 2000 MICS: 20% - 2005 DHS: 15% - 2012 Other NS: 20% #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1986 DHS: 5% - 1992-93 DHS: 6% - 1997 DHS: 12% - 2005 DHS: 34% - 2010-11 DHS: 39% ## Senegal ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 42% - Pneumonia: 11% - Preterm: 13% - Asphyxia: 12% - Other: 17% - HIV/AIDS: 1% - Malaria: 17% - Injuries: 5% - Measles: 1% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Sepsis: 10% - Embolism: 2% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| MICS \| \|------------\|-------\|------\| \| 1992-93 \| 74 \| \| \| 1997 \| 82 \| \| \| 2000 \| 79 \| \| \| 2005 \| 87 \| \| \| 2010-11 \| 93 \| \| Demand for family planning satisfied (%) 38 (2012-2013) Antenatal care (4 or more visits, %) 50 (2010-2011) Malaria during pregnancy - intermittent preventive treatment (%) 41 (2012-2013) C-section rate (total, urban, rural; %) 6, 11, 3 (2010-2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 91 (2012) Postnatal visit for baby (within 2 days for home births, %) 41 (2010-2011) Postnatal visit for mother (within 2 days for home births, %) 68 (2010-2011) Women with low body mass index (<18.5 kg/m², %) 19 (2010-2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------------\|-------\|------\| \| 1992-93 \| 7 \| \| \| 1997 \| 15 \| \| \| 2000 \| 34 \| \| \| 2005 \| 13 \| \| \| 2010-11 \| 43 \| \| \| \| 15 \| \| \| \| 42 \| \| \| \| 22 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| MICS \| \|------------\|-------\|------\| \| 2000 \| 2 \| \| \| 2005 \| 7 \| \| \| 2006 \| 16 \| \| \| 2008-09 \| 29 \| \| \| 2010-11 \| 35 \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 42 \| 18 \| 1 \| \| 2012 \| 77 \| 46 \| 23 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 11 \| 17 \| 11 \| \| 2012 \| 15 \| 16 \| 16 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 4.8 (2008) - National availability of Emergency Obstetric Care services (% of recommended minimum): 38 (2000) ### FINANCING - Per capita total expenditure on health (int$): 96 (2012) - General government expenditure on health as % of total government expenditure (%): 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 34 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 22 (2011) - ODA to maternal and neonatal health per live birth (US$): 44 (2011) \| Metric \| Value \| \|---------------------------------------------\|--------\| \| Total population (000) \| 5,979 \| \| Total under-five population (000) \| 928 \| \| Births (000) \| 222 \| \| Birth registration (%) \| 78 \| \| Total under-five deaths (000) \| 39 \| \| Neonatal deaths: % of all under-5 deaths \| 27 \| \| Neonatal mortality rate (per 1000 live births) \| 50 \| \| Infant mortality rate (per 1000 live births)\| 117 \| \| Stillbirth rate (per 1000 total births) \| 30 \| \| Total maternal deaths \| 2,400 \| \| Lifetime risk of maternal death (1 in N) \| 21 \| \| Total fertility rate (per woman) \| 4.8 \| \| Adolescent birth rate (per 1000 girls) \| 125 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 257 - 1995: 230 - 2000: 210 - 2005: 190 - 2010: 170 - 2015: 150 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 2300 - 1995: 2100 - 2000: 1900 - 2005: 1700 - 2010: 1500 - 2015: 1300 Source: MM&EIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 29 \| \| Antenatal care (4+ visits) \| 75 \| \| Skilled attendant at delivery \| 63 \| \| Postnatal care \| 58 \| \| Exclusive breastfeeding \| 32 \| \| Measles \| 80 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 2000: 42 - 2005: 43 - 2008: 42 - 2010: 63 #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 51 - 2011: 69 - 2012: 93 Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Caseseeking for pneumonia \| \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 84 - 1995: 84 - 2000: 80 - 2005: 83 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2000: 50 - 2005: 48 - 2008: 46 - 2010: 74 ### NUTRITION - Wasting prevalence (moderate and severe, %): 9 (2010) - Low birthweight incidence (moderate and severe, %): 11 (2010) - Early initiation of breastfeeding (within 1 hr of birth, %): 45 (2010) - Introduction of solid, semi-solid/soft foods (%): 25 (2010) - Vitamin A two dose coverage (%): 99 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1990: 25 - 2000: 25 - 2005: 28 - 2008: 21 - 2010: 21 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2000: 4 - 2005: 8 - 2008: 11 - 2010: 32 ## Sierra Leone ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 14% - Preterm: 7% - Neontal death: 27% - Asphyxia: 8% - Other: 21% - HIV/AIDS: 0% - Malaria: 14% - Injuries: 4% - Measles: 6% - Diarrhoea: 14% Intrapartum-related events Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Other direct: 9% - Indirect: 29% - Abortion: 10% - Sepsis*: 6% - Congenital: 2% - Other: 1% Sepsis/ Tetanus/ Meningitis/ Encephalitis ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| MICS \| DHS \| MICS \| \|------\|------\|-----\|------\| \| 2000 \| 68 \| \| \| \| 2005 \| 81 \| \| \| \| 2008 \| 87 \| \| \| \| 2010 \| 93 \| \| \| Demand for family planning satisfied (%) 29 (2010) Antenatal care (4 or more visits, %) 75 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 41 (2012) C-section rate (total, urban, rural; %) 5, 6, 4 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 87 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 58 (2008) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - Receiving oral rehydration therapy/increased fluids with continued feeding - Treated with ORS \| Year \| MICS \| DHS \| MICS \| \|------\|------\|-----\|------\| \| 2000 \| 39 \| 54 \| 57 \| \| 2005 \| 42 \| 57 \| 55 \| \| 2008 \| 68 \| 68 \| 73 \| \| 2010 \| 73 \| 55 \| 73 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| MICS \| DHS \| MICS \| \|------\|------\|-----\|------\| \| 2000 \| 2 \| 5 \| 26 \| \| 2005 \| 5 \| 26 \| 30 \| \| 2008 \| \| \| \| \| 2010 \| \| \| \| Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 35 \| 28 \| 12 \| \| 2012 \| 55 \| 50 \| 11 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 48 \| 23 \| 13 \| \| 2012 \| 31 \| 28 \| 19 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 1 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 1.9 (2010) - National availability of Emergency Obstetric Care services (% of recommended minimum): 24 (2008) ### FINANCING - Per capita total expenditure on health (int$): 205 (2012) - General government expenditure on health as % of total government expenditure (%): 12 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 76 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 39 (2011) - ODA to maternal and neonatal health per live birth (US$): 64 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 550 \| 2013 \| \| Total under-five population (000) \| 82 \| 2013 \| \| Births (000) \| 17 \| 2012 \| \| Birth registration (%) \| - \| - \| \| Total under-five deaths (000) \| 1 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 44 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 14 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 26 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 15 \| 2009 \| \| Total maternal deaths \| 23 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 180 \| 2013 \| \| Total fertility rate (per woman) \| 4.1 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 62 \| 2008 \| ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Indicator \| Value \| \|------------------------------------------------\|--------\| \| Demand for family planning satisfied \| 76 \| \| Antenatal care (4+ visits) \| 65 \| \| Skilled attendant at delivery \| 86 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 74 \| \| Measles \| 85 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Other NS \| Other NS \| DHS \| \|------\|----------\|----------\|-----\| \| 1994 \| 84 \| \| \| \| 1999 \| 85 \| \| \| \| 2007 \| 86 \| \| \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Indicator \| Value \| \|------------------------------------------------\|--------\| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| No Data \| ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Indicator \| Value \| \|------------------------------------------------\|--------\| \| Demand for family planning satisfied \| No Data\| \| Antenatal care (1+ visit) \| No Data\| \| Antenatal care (4+ visits) \| No Data\| \| Skilled attendant at delivery \| No Data\| \| Early initiation of breastfeeding \| No Data\| \| ITN use among children <5 yrs \| No Data\| \| DTP3 \| No Data\| \| Measles \| No Data\| \| Vitamin A (past 6 months) \| No Data\| \| ORT & continued feeding \| No Data\| \| Careseeking for pneumonia \| No Data\| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Other NS \| Other NS \| DHS \| \|------\|----------\|----------\|-----\| \| 1990 \| 80 \| \| \| \| 1995 \| 85 \| \| \| \| 2000 \| 90 \| \| \| \| 2005 \| 90 \| \| \| \| 2012 \| 85 \| \| \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| DHS \| \|------\|-----\| \| 2007 \| 73 \| \| \| 23 \| ## NUTRITION \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Wasting prevalence (moderate and severe, %) \| 4 \| 2007 \| \| Low birthweight incidence (moderate and severe, %) \| 13 \| 2007 \| \| Early initiation of breastfeeding (within 1 hr of birth, %) \| 75 \| 2007 \| \| Introduction of solid, semi-solid/soft foods (%) \| 80 \| 2007 \| \| Vitamin A two dose coverage (%) \| - \| - \| ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Other NS \| DHS \| \|------\|----------\|-----\| \| 1989 \| 16 \| 12 \| \| 2007 \| 34 \| 33 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Other NS \| DHS \| \|------\|----------\|-----\| \| 2000 \| 65 \| \| \| 2007 \| 74 \| \| ## Solomon Islands ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 44% - Preterm: 12% - Asphyxia: 12% - Other: 3% - Other: 22% - HIV/AIDS: 0% - Malaria: 2% - Injuries: 9% - Measles: 0% - Diarrhoea: 0% - Pneumonia: 16% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 30% - Indirect: 17% - Hypertension: 14% - Other direct: 12% - Abortion: 7% - Sepsis: 5% - Embolism: 15% Regional estimates for Oceania, 2013 Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Percent \| 2007 DHS \| \|---------\|----------\| \| 100 \| 74 \| Demand for family planning satisfied (%) 76 (2007) Antenatal care (4 or more visits, %) 65 (2007) Malaria during pregnancy - intermittent preventive treatment (%) 1 (2007) C-section rate (total, urban, rural; %) 6, 8, 6 (2007) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Percent \| 2007 DHS \| \|---------\|----------\| \| 100 \| 76 \| \| 80 \| \| \| 60 \| 38 \| \| 40 \| \| \| 20 \| \| \| 0 \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Percent \| 2007 DHS \| \|---------\|----------\| \| 100 \| 40 \| \| 80 \| \| \| 60 \| \| \| 40 \| \| \| 20 \| \| \| 0 \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 2012 - Piped on premises - Other improved - Unimproved \| Percent \| Total \| Urban \| Rural \| \|---------\|-------\|-------\|-------\| \| 100 \| 7 \| 6 \| 9 \| \| 80 \| 12 \| 32 \| 14 \| \| 60 \| 55 \| 61 \| 61 \| \| 40 \| 26 \| 16 \| \| \| 20 \| \| \| \| \| 0 \| \| \| \| Source: WHO/UNICEF JMP 2014 Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation No Data ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: No - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: - - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: No ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (x of 3): 1 (2013) - Maternal health (x of 3): 3 (2013) - Newborn health (x of 4): 2 (2013) - Child health (x of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 22.8 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (US$): 252 (2012) - General government expenditure on health as % of total government expenditure (%): 20 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 2 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 142 (2011) - ODA to maternal and neonatal health per live birth (US$): 335 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 10,195 \| \| \| Total under-five population (000) \| 1,923 \| \| \| Births (000) \| 452 \| \| \| Birth registration (%) \| 3 \| \| \| Total under-five deaths (000) \| 65 \| \| \| Neonatal deaths: % of all under-5 deaths \| 31 \| \| \| Neonatal mortality rate (per 1000 live births) \| 46 \| \| \| Infant mortality rate (per 1000 live births) \| 91 \| \| \| Stillbirth rate (per 1000 total births) \| 30 \| \| \| Total maternal deaths \| 3,900 \| \| \| Lifetime risk of maternal death (1 in N) \| 18 \| \| \| Total fertility rate (per woman) \| 6.7 \| \| \| Adolescent birth rate (per 1000 girls) \| 123 \| \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 177 \| \| 1995 \| 150 \| \| 2000 \| 147 \| \| 2005 \| 147 \| \| 2010 \| 147 \| \| 2015 \| 59 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1300 \| \| 1995 \| 1050 \| \| 2000 \| 850 \| \| 2005 \| 330 \| \| 2010 \| 330 \| \| 2015 \| 330 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (4+ visits) \| 6 \| \| \| Skilled attendant at delivery \| 33 \| \| \| Postnatal care \| \| \| \| Exclusive breastfeeding \| 9 \| \| \| Measles \| 46 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1999 \| 33 \| \| 2002 \| 25 \| \| 2006 \| 33 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Percent \| \|------\|---------\| \| 2010 \| - \| \| 2011 \| - \| \| 2012 \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| 3 \| 5 \| \| Antenatal care (4+ visits) \| 3 \| 5 \| \| Skilled attendant at delivery \| 3 \| 5 \| \| Early initiation of breastfeeding \| 3 \| 5 \| \| ITN use among children <5 yrs \| 3 \| 5 \| \| DTP3 \| 3 \| 5 \| \| Measles \| 3 \| 5 \| \| Vitamin A (past 6 months) \| 3 \| 5 \| \| ORT & continued feeding \| 3 \| 5 \| \| Case-seeking for pneumonia \| 3 \| 5 \| Source: MICS 2006 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 46 \| \| 1995 \| 42 \| \| 2000 \| 46 \| \| 2005 \| 42 \| \| 2012 \| 42 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2006 \| 32 \| \| 2013 \| 13 \| Source: MICS ### NUTRITION #### Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2006 \| 13 \| #### Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2006 \| - \| #### Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2006 \| 26 \| #### Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2006 \| 16 \| #### Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2006 \| - \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1999 \| 23 \| \| 2006 \| 29 \| \| 2006 \| 33 \| \| 2006 \| 42 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1999 \| 9 \| \| 2006 \| 9 \| ## Somalia ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 31% - Pneumonia: 17% - Preterm: 8% - Asphyxia: 10% - Other: 2% - HIV/AIDS: 0% - Malaria: 2% - Injuries: 4% - Measles: 13% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Percent \| \|------\|---------\| \| 1999 MICS \| 32 \| \| 2006 MICS \| 26 \| Demand for family planning satisfied (%) Antenatal care (4 or more visits, %) 6 (2006) Malaria during pregnancy - intermittent preventive treatment (%) 1 (2006) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 64 (2012) Postnatal visit for baby (within 2 days for home births, %) Postnatal visit for mother (within 2 days for home births, %) Women with low body mass index (<18.5 kg/m², %) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Percent \| \|------\|---------\| \| 1999 MICS \| 30 \| \| 2006 MICS \| 7 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial Percent children < 5 years sleeping under ITNs \| Year \| Percent \| \|------\|---------\| \| 2006 MICS \| 11 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water No Data Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation No Data ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): 5 - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: No - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: No - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: - ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 0 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 1.5 (2006) - National availability of Emergency Obstetric Care services (% of recommended minimum): 56 (2005) ### FINANCING - Per capita total expenditure on health (int$) - General government expenditure on health as % of total government expenditure (%) - Out of pocket expenditure as % of total expenditure on health(%) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 11 (2013) - ODA to maternal and neonatal health per live birth (US$): 19 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 52,386 \| 2013 \| \| Total under-five population (000) \| 5,525 \| 2013 \| \| Births (000) \| 1,102 \| 2012 \| \| Birth registration (%) \| 95 \| 2012 \| \| Total under-five deaths (000) \| 50 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 15 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 33 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 20 \| 2009 \| \| Total maternal deaths \| 1,500 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 300 \| 2013 \| \| Total fertility rate (per woman) \| 2.4 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 54 \| 2007 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 61 - 1995: 61 - 2000: 75 - 2005: 75 - 2010: 45 - 2015: 20 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 150 - 1995: 140 - 2000: 140 - 2005: 140 - 2010: 140 - 2015: 38 MDG Target: 140 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 81 \| \| Antenatal care (4+ visits) \| 87 \| \| Skilled attendant at delivery \| 91 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 8 \| \| Measles \| 79 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1995: 82 - 1998: 84 - 2003: 91 #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 86 - 2011: 91 - 2012: 83 Percent HIV+ pregnant women receiving ARVs for PMTCT - 2010: 86 - 2011: 91 - 2012: 83 Uncertainty range around the estimate ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% - Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Caseseeking for pneumonia \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 81 - 1995: 78 - 2000: 68 - 2005: 68 - 2012: 68 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1998: 75 - 2003: 65 ### NUTRITION Wasting prevalence (moderate and severe, %) - 5 (2008) Low birthweight incidence (moderate and severe, %) - 15 (1998) Early initiation of breastfeeding (within 1 hr of birth, %) - 61 (2003) Introduction of solid, semi-solid/soft foods (%) - 49 (2003) Vitamin A two dose coverage (%) - - #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1994-1995: 29 - 1999: 30 - 2003: 33 - 2008: 24 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1998: 7 - 2003: 8 ## South Africa ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 34% - Pneumonia: 14% - Preterm: 12% - *Asphyxia: 8% - Other: 6% - Congenital: 2% - Sepsis**: 4% - Measles: 1% - Injuries: 6% - HIV/AIDS: 17% - Malaria: 0% - Other:** 21% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Causes of maternal deaths, 2013* - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Embolism: 2% - Sepsis: 10% - Abortion: 10% - Other direct: 9% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| DHS \| \|------------\|-------\|-------\| \| 1994–1995 \| 89 \| 94 \| \| 1998 \| 92 \| 97 \| Demand for family planning satisfied (%) 81 (2004) Antenatal care (4 or more visits, %) 87 (2008) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 21, 24, 15 (2013) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 77 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| DHS \| \|------\|-------\|-------\| \| 1998 \| 51 \| 40 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs Very limited risk ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - Legal status of abortion (X of S circumstances) - Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) - Maternal deaths notification - Postnatal home visits in the first week after birth - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - Antenatal corticosteroids as part of management of preterm labour - International Code of Marketing of Breastmilk Substitutes - Community treatment of pneumonia with antibiotics - Low osmolarity ORS and zinc for management of diarrhoea ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) 1 (2013) - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) - - Density of doctors, nurses and midwives (per 10,000 population) 56.8 (2013) - National availability of Emergency Obstetric Care services (% of recommended minimum) ### FINANCING - Per capita total expenditure on health (int$) 982 (2012) - General government expenditure on health as % of total government expenditure (%) 13 (2012) - Out of pocket expenditure as % of total expenditure on health(%) - - Reproductive, maternal, newborn and child health expenditure by source No Data ODA to child health per child (US$) 8 (2011) ODA to maternal and neonatal health per live birth (US$) 17 (2011) \| Indicator \| Value \| \|------------------------------------------------\|-------------\| \| Total population (000) \| 10,838 \| \| Total under-five population (000) \| 1,726 \| \| Births (000) \| 396 \| \| Birth registration (%) \| 35 \| \| Total under-five deaths (000) \| 40 \| \| Neonatal deaths: % of all under-5 deaths \| 35 \| \| Neonatal mortality rate (per 1000 live births) \| 36 \| \| Infant mortality rate (per 1000 live births) \| 67 \| \| Stillbirth rate (per 1000 total births) \| - \| \| Total maternal deaths \| 3,000 \| \| Lifetime risk of maternal death (1 in N) \| 28 \| \| Total fertility rate (per woman) \| 5.0 \| \| Adolescent birth rate (per 1000 girls) \| 38 \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 251 \| \| 1995 \| 200 \| \| 2000 \| 150 \| \| 2005 \| 100 \| \| 2010 \| 84 \| \| 2012 \| 104 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 1800 \| \| 1995 \| 1500 \| \| 2000 \| 1200 \| \| 2005 \| 900 \| \| 2010 \| 730 \| \| 2012 \| 450 \| MDG Target: 130 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 13 \| \| Antenatal care (4+ visits) \| 17 \| \| Skilled attendant at delivery \| 19 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 45 \| \| Measles \| 62 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 2006 \| 10 \| \| 2010 \| 19 \| #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|------\|---------\| \| 2010 \| - \| \| 2011 \| 7 \| \| 2012 \| 13 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Careseeking for pneumonia \| \| \| No Data Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 62 \| \| 1995 \| 59 \| \| 2000 \| \| \| 2005 \| \| \| 2012 \| \| #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2010 \| 48 \| \| 2012 \| 33 \| ### NUTRITION Wasting prevalence (moderate and severe, %) 23 (2010) Low birthweight incidence (moderate and severe, %) - Early initiation of breastfeeding (within 1 hr of birth, %) - Introduction of solid, semi-solid/soft foods (%) 21 (2010) Vitamin A two dose coverage (%) 70 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 2006 \| 33 \| \| 2010 \| 28 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2010 \| 45 \| ## South Sudan ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 18% - Preterm: 12% - Neonatal death: 34% - Asphyxia: 9% - Other: 1% - Congenital: 2% - Sepsis: 7% - Diarrhoea: 11% - Other: 22% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition. Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 10% - Embolism: 2% - Haemorrhage: 25% - Indirect: 29% - Hypertension: 16% - Abortion: 10% - Other direct: 9% Source: WHO 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| MICS \| \|------\|------\| \| 2006 \| 25 \| \| 2010 \| 40 \| Demand for family planning satisfied (%) 13 (2010) Antenatal care (4 or more visits, %) 17 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 19 (2012) C-section rate (total, urban, rural; %) 1, 1, 0 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine - Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS \| \|------\|------\| \| 2010 \| 23 \| \| \| 39 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| MICS \| Other NS \| \|------\|------\|----------\| \| 2006 \| 21 \| 25 \| \| 2009 \| \| \| Percent children < 5 years sleeping under ITNs 8 (2010) ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water No Data Improved sanitation coverage Percent of population by type of sanitation facility, 2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Type \| Total \| Urban \| Rural \| \|--------------------\|-------\|-------\|-------\| \| Improved facilities\| 77 \| 58 \| 81 \| \| Shared facilities \| 11 \| 20 \| 10 \| \| Unimproved facilities \| 3 \| 6 \| 7 \| \| Open defecation \| 9 \| \| \| Source: WHO/UNICEF JMP 2014 ### POLICIES Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent No Legal status of abortion (X of 5 circumstances) - Midwives authorized for specific tasks (X of 7 tasks) - Maternity protection (Convention 183) - Maternal deaths notification No Postnatal home visits in the first week after birth No Kangaroo Mother Care in facilities for low birthweight/preterm newborns No Antenatal corticosteroids as part of management of preterm labour No International Code of Marketing of Breastmilk Substitutes - Community treatment of pneumonia with antibiotics Yes Low osmolarity ORS and zinc for management of diarrhoea No ### SYSTEMS Costed national implementation plan(s) for: maternal, newborn and child health available Partial (2013) Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) 2 (2013) - Maternal health (X of 3) 2 (2013) - Newborn health (X of 4) 1 (2013) - Child health (X of 3) 2 (2013) Density of doctors, nurses and midwives (per 10,000 population) - National availability of Emergency Obstetric Care services (% of recommended minimum) - ### FINANCING Per capita total expenditure on health (int) 33 (2012) General government expenditure on health as % of total government expenditure (%) 4 (2012) Out of pocket expenditure as % of total expenditure on health(%) 57 (2012) Reproductive, maternal, newborn and child health expenditure by source No Data ODA to child health per child (US$) - ODA to maternal and neonatal health per live birth (US$) - \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------------\|------\| \| Total population (000) \| 37,195 \| 2013 \| \| Total under-five population (000) \| 5,671 \| 2013 \| \| Births (000) \| 1,263 \| 2012 \| \| Birth registration (%) \| 59 \| 2012 \| \| Total under-five deaths (000) \| 89 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 39 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 29 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 49 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 24 \| 2009 \| \| Total maternal deaths \| 4,600 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 60 \| 2013 \| \| Total fertility rate (per woman) \| 4.5 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 102 \| 2009 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 128 - 1995: 100 - 2000: 80 - 2005: 60 - 2010: 40 - 2015: 20 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 720 - 1995: 500 - 2000: 360 - 2005: 240 - 2010: 180 - 2015: 180 Source:** MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 24 \| \| Antenatal care (4+ visits) \| 47 \| \| Skilled attendant at delivery \| 23 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 41 \| \| Measles \| 85 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 2006 MICS: 29 - 2010 MICS: 23 #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - Percent HIV+ pregnant women receiving ARVs for PMTCT - Uncertainty range around the estimate No Data ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Careseeking for pneumonia \| \| No Data ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 60, 60, 60, 60, 60 - 1995: 60, 60, 60, 60, 60 - 2000: 60, 60, 60, 60, 60 - 2005: 60, 60, 60, 60, 60 - 2012: 92, 92, 92, 92, 92 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2010 MICS: 56, 66 ### NUTRITION Wasting prevalence (moderate and severe, %): 16 (2010) Low birthweight incidence (moderate and severe, %): - Early initiation of breastfeeding (within 1 hr of birth, %): - Introduction of solid, semi-solid/soft foods (%): 51 (2010) Vitamin A two dose coverage (%): 83 (2012) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 2006 MICS: 27, 38 - 2010 MICS: 32, 35 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2010 MICS: 41 ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Neonatal death: 38% - Pneumonia: 16% - Preterm: 11% - Asphyxia: 11% - Other: 1% - Congenital: 1% - Sepsis: 9% - HIV/AIDS: 1% - Malaria: 2% - Measles: 4% - Injuries: 7% Intrapartum-related events ** Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition. Source: WHO/CHERG 2014 ### Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| \|------\|-------\| \| 2006 MICS \| 74 \| \| 2010 MICS \| 74 \| ### Demand for family planning satisfied (%) 24 (2010) ### Antenatal care (4 or more visits, %) 47 (2010) ### Malaria during pregnancy - intermittent preventive treatment (%) 2 (2012) ### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 7, 12, 5 (2012) ### Neonatal tetanus vaccine 74 (2012) ### Postnatal visit for baby (within 2 days for home births, %) - ### Postnatal visit for mother (within 2 days for home births, %) - ### Women with low body mass index (<18.5 kg/m², %) - ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| \|------\|-------\| \| 2000 MICS \| 27 \| \| 2006 MICS \| 31 \| \| 2010 MICS \| 12 \| \| 2010 MICS \| 22 \| ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total \| \|------\|-------\| \| 2006 MICS \| 30 \| ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 32 \| 25 \| 35 \| \| 2012 \| 10 \| 16 \| 14 \| ### Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 7 \| 28 \| 46 \| \| 2012 \| 10 \| 28 \| 26 \| Source: WHO/UNICEF JMP 2014 ## POLICIES \| Policy \| Status \| \|----------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Partial \| \| Legal status of abortion (X of 5 circumstances) \| 1 (R,F) \| \| Midwives authorized for specific tasks (X of 7 tasks) \| - \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| No \| \| Antenatal corticosteroids as part of management of preterm labour \| Yes \| \| International Code of Marketing of Breastmilk Substitutes \| Partial \| \| Community treatment of pneumonia with antibiotics \| No \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ## SYSTEMS \| System \| Status \| \|----------------------------------------------------------------------\|--------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Yes (2013) \| \| Life Saving Commodities in Essential Medicine List: \| \| \| Reproductive health (X of 3) \| 0 (2013) \| \| Maternal health (X of 3) \| 3 (2013) \| \| Newborn health (X of 4) \| 3 (2013) \| \| Child health (X of 3) \| 3 (2013) \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 11.2 (2008) \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| 35 (2005) \| ## FINANCING \| Financing \| Status \| \|--------------------------------------------------------------------------\|--------\| \| Per capita total expenditure on health (int$) \| 159 (2012) \| \| General government expenditure on health as % of total government expenditure (%) \| 11 (2012) \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 74 (2012) \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data \| ODA to child health per child (US$) 11 (2011) ODA to maternal and neonatal health per live birth (US$) 35 (2011) \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|--------\|--------\| \| Total population (000) \| 1,231 \| \| \| Total under-five population (000) \| 169 \| \| \| Births (000) \| 37 \| \| \| Birth registration (%) \| 50 \| \| \| Total under-five deaths (000) \| 3 \| \| \| Neonatal deaths: % of all under-5 deaths \| 37 \| \| \| Neonatal mortality rate (per 1000 live births) \| 30 \| \| \| Infant mortality rate (per 1000 live births) \| 56 \| \| \| Stillbirth rate (per 1000 total births) \| 18 \| \| \| Total maternal deaths \| 120 \| \| \| Lifetime risk of maternal death (1 in N) \| 94 \| \| \| Total fertility rate (per woman) \| 3.4 \| \| \| Adolescent birth rate (per 1000 girls) \| 89 \| \| ### UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 71 \| \| 1995 \| 80 \| \| 2000 \| 120 \| \| 2005 \| 120 \| \| 2010 \| 80 \| \| 2015 \| 24 \| Source: IGME 2013 ### MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 550 \| \| 1995 \| 450 \| \| 2000 \| 450 \| \| 2005 \| 300 \| \| 2010 \| 240 \| \| 2015 \| 140 \| Source: MM&EIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|------\|------\| \| Demand for family planning satisfied \| 83 \| \| \| Antenatal care (4+ visits) \| 77 \| \| \| Skilled attendant at delivery \| 82 \| \| \| Postnatal care \| 22 \| \| \| Exclusive breastfeeding \| 44 \| \| \| Measles \| 88 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1994 \| 56 \| \| 2000 \| 70 \| \| 2002 \| 74 \| \| 2006-2007 \| 69 \| \| 2010 \| 82 \| #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| 79 \| 76 \| \| 2011 \| 87 \| 87 \| \| 2012 \| 83 \| 83 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 83 \| 88 \| \| Antenatal care (1+ visit) \| 77 \| 88 \| \| Antenatal care (4+ visits) \| 82 \| 88 \| \| Skilled attendant at delivery \| 82 \| 88 \| \| Early initiation of breastfeeding \| 44 \| 88 \| \| ITN use among children <5 yrs \| 22 \| 88 \| \| DTP3 \| 83 \| 88 \| \| Measles \| 83 \| 88 \| \| Vitamin A (past 6 months) \| 83 \| 88 \| \| ORT & continued feeding \| 83 \| 88 \| \| Case-seeking for pneumonia \| 83 \| 88 \| Source: MICS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 95 \| \| 1995 \| 95 \| \| 2000 \| 95 \| \| 2005 \| 95 \| \| 2012 \| 88 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2000 \| 60 \| \| 2006-2007 \| 73 \| \| 2010 \| 58 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 1 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 9 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 55 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|------\|---------\| \| 2010 \| 66 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|------\|---------\| \| 2012 \| 33 \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 2000 \| 37 \| \| 2006-2007 \| 30 \| \| 2008 \| 40 \| \| 2010 \| 31 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 2000 \| 24 \| \| 2006-2007 \| 32 \| \| 2008 \| 33 \| \| 2010 \| 44 \| ## Swaziland ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 37% - Preterm: 12% - Asphyxia: 11% - Other 2% - Congenital: 3% - Sepsis: 7% - Diarrhoea: 6% - Measles: 0% - Malaria: 0% - HIV/AIDS: 15% - Injuries: 5% - Other: 20% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half all child deaths are attributable to undernutrition Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Source: WHO/CHERG 2014 Regional estimates for Sub-Saharan Africa, 2013 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 87 \| - \| - \| \| 2002 Other NS \| 90 \| - \| - \| \| 2006-2007 DHS \| 85 \| - \| - \| \| 2010 MICS \| 97 \| - \| - \| Demand for family planning satisfied (%) 83 (2010) Antenatal care (4 or more visits, %) 77 (2010) Malaria during pregnancy – intermittent preventive treatment (%) 1 (2012) C-section rate (total, urban, rural; %) 12, 12, 13 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 86 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 22 (2006-2007) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 25 \| 66 \| - \| \| 2006-2007 DHS \| 22 \| 86 \| - \| \| 2010 MICS \| 48 \| 57 \| - \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 2000 MICS \| 0 \| 1 \| 2 \| \| 2006-2007 DHS \| 0 \| 0 \| 0 \| \| 2010 MICS \| 18 \| 18 \| 18 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 43 \| 16 \| 21 \| \| 2012 \| 12 \| 37 \| 42 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 25 \| 18 \| 49 \| \| 2012 \| 14 \| 21 \| 57 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 3 (F) - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: No - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 17.7 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 447 (2012) - General government expenditure on health as % of total government expenditure (%): 18 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 11 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 32 (2013) - ODA to maternal and neonatal health per live birth (US$): 131 (2011) \| Indicator \| Value \| \|------------------------------------------------\|-----------\| \| Total population (000) \| 8,009 \| \| Total under-five population (000) \| 1,150 \| \| Births (000) \| 265 \| \| Birth registration (%) \| 88 \| \| Total under-five deaths (000) \| 15 \| \| Neonatal deaths: % of all under-5 deaths \| 40 \| \| Neonatal mortality rate (per 1000 live births) \| 23 \| \| Infant mortality rate (per 1000 live births) \| 49 \| \| Stillbirth rate (per 1000 total births) \| 12 \| \| Total maternal deaths \| 120 \| \| Lifetime risk of maternal death (1 in N) \| 530 \| \| Total fertility rate (per woman) \| 3.8 \| \| Adolescent birth rate (per 1000 girls) \| 47 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 105 - 1995: 105 - 2000: 105 - 2005: 105 - 2010: 105 - 2015: 105 MDG Target: 35 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 68 - 1995: 120 - 2000: 80 - 2005: 40 - 2010: 44 - 2015: 17 MDG Target*: 17 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Demand for family planning satisfied \| 55 \| \| Antenatal care (4+ visits) \| 49 \| \| Skilled attendant at delivery \| 87 \| \| Postnatal care \| 80 \| \| Exclusive breastfeeding \| 25 \| \| Measles \| 94 \| * See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1991: 90 - 1996: 79 - 2000: 71 - 2005: 83 - 2010: 88 - 2012: 87 DHS #### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| - \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| - \| \| Uncertainty range around the estimate \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 55 \| 80 \| \| Antenatal care (1+ visit) \| 49 \| 70 \| \| Antenatal care (4+ visits) \| 30 \| 60 \| \| Skilled attendant at delivery \| 87 \| 90 \| \| Early initiation of breastfeeding \| 25 \| 40 \| \| ITN use among children <5 yrs \| 94 \| 90 \| \| DTP3 \| 94 \| 90 \| \| Measles \| 94 \| 90 \| \| Vitamin A (past 6 months) \| 94 \| 90 \| \| ORT & continued feeding \| 94 \| 90 \| \| Careseeking for pneumonia \| 94 \| 90 \| Source: DHS 2012 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 60 - 1995: 60 - 2000: 60 - 2005: 60 - 2012: 60 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2000: 51 - 2005: 64 - 2012: 63 Source: MICS ### NUTRITION - Wasting prevalence (moderate and severe, %): 10 (2012) - Low birthweight incidence (moderate and severe, %): 10 (2005) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1999: 42 - 2003: 42 - 2005: 33 - 2007: 39 - 2012: 26 Source: Other NS #### Early initiation of breastfeeding (within 1 hr of birth, %): 61 (2005) #### Introduction of solid, semi-solid/soft foods (%): 41 (2005) #### Vitamin A two dose coverage (%): 97 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 2000: 14 - 2005: 25 Source: MICS Tajikistan ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 40% - Pneumonia: 17% - Preterm: 12% - Asphyxia: 11% - Other: 24% - HIV/AIDS: 0% - Malaria: 0% - Measles: 0% - Injuries: 8% - Sepsis*: 8% - Congenital: 5% - Diphtheria: 1% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 15% - Indirect: 22% - Other direct: 17% - Abortion: 9% - Sepsis: 9% - Embolism: 11% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| MICS \| Other NS \| DHS \| \|------\|------\|----------\|-----\| \| 2000 \| 71 \| \| \| \| 2005 \| 77 \| \| \| \| 2007 \| 89 \| \| \| \| 2012 \| 79 \| \| \| Demand for family planning satisfied (%) 55 (2012) Antenatal care (4 or more visits, %) 49 (2007) Malaria during pregnancy - intermittent preventive treatment (%) C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine Postnatal visit for baby (within 2 days for home births, %) 54 (2012) Postnatal visit for mother (within 2 days for home births, %) 80 (2012) Women with low body mass index (<18.5 kg/m², %) 9 (2012) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| MICS \| Other \| DHS \| \|------\|------\|-------\|-----\| \| 2000 \| 29 \| 48 \| 60 \| \| 2005 \| 35 \| \| \| \| 2009 \| 73 \| \| \| \| 2012 \| 22 \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial Percent children < 5 years sleeping under ITNs \| Year \| MICS \| Other \| DHS \| \|------\|------\|-------\|-----\| \| 2005 \| 11 \| \| \| \| 2009 \| 1 \| \| \| \| 2012 \| 1 \| \| \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1995-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 33 \| 25 \| 11 \| \| 2012 \| 43 \| 77 \| 29 \| Improved sanitation coverage Percent of population by type of sanitation facility, 2012 - Improved facilities - Shared facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 10 \| 10 \| 10 \| \| 2012 \| 30 \| 10 \| 30 \| Source: WHO/UNICEF JMP 2014 ### POLICIES Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent Legal status of abortion (X of 5 circumstances) 5 (R,F) Midwives authorized for specific tasks (X of 7 tasks) Maternity protection (Convention 183) Partial Maternal deaths notification Yes Postnatal home visits in the first week after birth Yes Kangaroo Mother Care in facilities for low birthweight/preterm newborns - Antenatal corticosteroids as part of management of preterm labour - International Code of Marketing of Breastmilk Substitutes Partial Community treatment of pneumonia with antibiotics Yes Low osmolarity ORS and zinc for management of diarrhoea Yes ### SYSTEMS Costed national implementation plan(s) for: maternal, newborn and child health available Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) - Density of doctors, nurses and midwives (per 10,000 population) 63.8 (2011) National availability of Emergency Obstetric Care services (% of recommended minimum) 86 (2005) ### FINANCING Per capita total expenditure on health (int$) 129 (2012) General government expenditure on health as % of total government expenditure (%) 7 (2012) Out of pocket expenditure as % of total expenditure on health(%) 60 (2012) Reproductive, maternal, newborn and child health expenditure by source No Data ODA to child health per child (US$) 8 (2011) ODA to maternal and neonatal health per live birth (US$) 11 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|-------------\|------\| \| Total population (000) \| 47,783 \| 2013 \| \| Total under-five population (000) \| 8,487 \| 2013 \| \| Births (000) \| 1,898 \| 2012 \| \| Birth registration (%) \| 16 \| \| \| Total under-five deaths (000) \| 98 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 40 \| \| \| Neonatal mortality rate (per 1000 live births) \| 21 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 38 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 26 \| 2009 \| \| Total maternal deaths \| 7,900 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 44 \| 2013 \| \| Total fertility rate (per woman) \| 5.3 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 128 \| 2007 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 166 - 1995: 150 - 2000: 130 - 2005: 110 - 2010: 90 - 2015: 54 MDG Target: 55 Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 910 - 1995: 750 - 2000: 600 - 2005: 450 - 2010: 410 - 2015: 230 MDG Target** Source: MMIEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 58 \| \| Antenatal care (4+ visits) \| 43 \| \| Skilled attendant at delivery \| 49 \| \| Postnatal care \| 31 \| \| Exclusive breastfeeding \| 50 \| \| Measles \| 97 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1991-1992 DHS: 44 - 1996 DHS: 38 - 1999 Other NS: 36 - 2004-2005 DHS: 43 - 2010 DHS: 49 #### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| \|---------------------------------------------------------------------------\|-------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| 56 \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| 77 \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 58 \| 92 \| \| Antenatal care (1+ visit) \| 43 \| 90 \| \| Antenatal care (4+ visits) \| 38 \| 85 \| \| Skilled attendant at delivery \| 36 \| 82 \| \| Early initiation of breastfeeding \| 31 \| 80 \| \| ITN use among children <5 yrs \| 25 \| 75 \| \| DTP3 \| 43 \| 90 \| \| Measles \| 38 \| 85 \| \| Vitamin A (past 6 months) \| 25 \| 75 \| \| ORT & continued feeding \| 25 \| 75 \| \| Caseseeking for pneumonia \| 25 \| 75 \| Source: DHS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 92 - 1995: 92 - 2000: 92 - 2005: 92 - 2012: 92 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1991-1992 DHS: 65 - 1996 DHS: 70 - 1999 DHS: 68 - 2004-2005 DHS: 59 - 2010 DHS: 71 ### NUTRITION - Wasting prevalence (moderate and severe, %): 5 (2010) - Low birthweight incidence (moderate and severe, %): 8 (2010) #### Early initiation of breastfeeding Within 1 hr of birth, % - 1991-1992 DHS: 49 (2010) #### Introduction of solid, semi-solid/soft foods (%) - 1991-1992 DHS: 92 (2010) #### Vitamin A two dose coverage (%) - 1991-1992 DHS: 95 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1991-1992 DHS: 50 - 1996 DHS: 50 - 1999 DHS: 48 - 2004-2005 DHS: 44 - 2010 DHS: 43 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1991-1992 DHS: 23 - 1996 DHS: 29 - 1999 Other NS: 32 - 2004-2005 DHS: 41 - 2010 DHS: 50 ## Tanzania, United Republic of ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 40% - Pneumonia: 13% - Asphyxia: 13% - Preterm: 10% - Other: 17% - HIV/AIDS: 6% - Malaria: 10% - Measles: 6% - Diarrhoea: 5% - Congenital: 5% - Sepsis: 8% - Injuries: 6% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition. Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| \|------------\|-------\| \| 1991-1992 \| 62 \| \| 1996 \| 50 \| \| 1999 \| 49 \| \| 2004-2005 \| 78 \| \| 2007-2008 \| 76 \| \| 2010 \| 88 \| Demand for family planning satisfied (%) 58 (2010) Antenatal care (4 or more visits, %) 43 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 26 (2012) C-section rate (total, urban, rural; %) 5, 10, 3 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 88 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) 31 (2012) Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------------\|-------\| \| 1991-1992 \| 57 \| \| 1996 \| 48 \| \| 1999 \| 55 \| \| 2004-2005 \| 53 \| \| 2007-2008 \| 54 \| \| 2010 \| 50 \| \| 2012 \| 44 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| \|------------\|-------\| \| 1999 \| 2 \| \| 2004-2005 \| 16 \| \| 2007-2008 \| 26 \| \| 2010 \| 64 \| \| 2011-2012 \| 72 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 48 \| 30 \| 7 \| \| 2012 \| 61 \| 33 \| 9 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Unimproved facilities - Shared facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 6 \| 13 \| 4 \| \| 2012 \| 81 \| 24 \| 7 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 3 - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: No - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (x of 3): 3 (2013) - Newborn health (x of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 2.5 (2006) - National availability of Emergency Obstetric Care services (% of recommended minimum): 21 (2005) ### FINANCING - Per capita total expenditure on health (US$): 109 (2012) - General government expenditure on health as % of total government expenditure (%): 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 32 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 21 (2013) - ODA to maternal and neonatal health per live birth (US$): 45 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 6,643 \| 2013 \| \| Total under-five population (000) \| 1,069 \| 2013 \| \| Births (000) \| 245 \| 2012 \| \| Birth registration (%) \| 78 \| \| \| Total under-five deaths (000) \| 22 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 35 \| \| \| Neonatal mortality rate (per 1000 live births) \| 33 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 62 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 25 \| 2009 \| \| Total maternal deaths \| 1,100 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 46 \| 2013 \| \| Total fertility rate (per woman) \| 4.7 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 88 \| 2009 \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 143 - 1995: 120 - 2000: 100 - 2005: 80 - 2010: 60 - 2015: 48 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births** - 1990: 660 - 1995: 550 - 2000: 450 - 2005: 350 - 2010: 250 - 2015: 170 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 29 \| \| Antenatal care (4+ visits) \| 55 \| \| Skilled attendant at delivery \| 59 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 62 \| \| Measles \| 72 \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1998 DHS: 51 - 2000 MICS: 49 - 2003 Other NS: 61 - 2006 MICS: 62 - 2010 MICS: 59 #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 52 - 2011: 75 - 2012: 86 Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 29 \| 55 \| \| Antenatal care (1+ visit) \| 50 \| 70 \| \| Antenatal care (4+ visits) \| 30 \| 60 \| \| Skilled attendant at delivery \| 30 \| 60 \| \| Early initiation of breastfeeding \| 50 \| 70 \| \| ITN use among children <5 yrs \| 50 \| 70 \| \| DTP3 \| 50 \| 70 \| \| Measles \| 50 \| 70 \| \| Vitamin A (past 6 months) \| 50 \| 70 \| \| ORT & continued feeding \| 50 \| 70 \| \| Caseseeking for pneumonia \| 50 \| 70 \| Source: MICS 2010 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 80 - 1995: 60 - 2000: 40 - 2005: 60 - 2012: 84 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1998 DHS: 26 - 2000 MICS: 30 - 2006 MICS: 23–26 - 2010 MICS: 32–41 ### NUTRITION - Wasting prevalence (moderate and severe, %): 5 (2010) - Low birthweight incidence (moderate and severe, %): 11 (2010) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1988 DHS: 22 - 1996 MICS: 17 - 1998 DHS: 41 - 2006 MICS: 24 - 2008 Other NS: 33 - 2010 MICS: 30 #### Early initiation of breastfeeding (within 1 hr of birth, %): 46 (2010) #### Introduction of solid, semi-solid/soft foods (%): 44 (2010) #### Vitamin A two dose coverage (%): 64 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1988 DHS: 14 - 1998 DHS: 10 - 2000 MICS: 18 - 2006 MICS: 28 - 2008 Other: 48 - 2010 MICS: 62 ## Togo ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 35% - Pneumonia: 12% - Preterm: 10% - Asphyxia: 11% - Other: 24% - Congenital: 2% - Sepsis: 7% - HIV/AIDS: 1% - Malaria: 18% - Injuries: 5% - Measles: 1% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 29% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Regional estimates for Sub-Saharan Africa, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| Other NS \| MICS \| \|------\|-----\|------\|----------\|------\| \| 1988 \| 43 \| 82 \| 73 \| 85 \| \| 2000 \| 73 \| \| \| 84 \| \| 2003 \| \| \| \| 72 \| \| 2006 \| \| \| \| \| \| 2010 \| \| \| \| \| Demand for family planning satisfied (%) 29 (2010) Antenatal care (4 or more visits, %) 55 (2010) Malaria during pregnancy - intermittent preventive treatment (%) 50 (2012) C-section rate (total, urban, rural; %) 9, 16, 5 (2012) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 81 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 11 (1998) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| MICS \| MICS \| \|------\|-----\|------\|------\|------\| \| 1998 \| 17 \| 25 \| 13 \| 10 \| \| 2000 \| 22 \| 10 \| 24 \| 11 \| \| 2006 \| \| \| \| \| \| 2010 \| \| \| \| \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| MICS \| \|------\|------\| \| 2000 \| 2 \| \| 2006 \| 38 \| \| 2010 \| 57 \| Percent children < 5 years sleeping under ITNs \| Year \| MICS \| \|------\|------\| \| 2000 \| 2 \| \| 2006 \| 38 \| \| 2010 \| 57 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 44 \| 15 \| 5 \| \| 2012 \| 56 \| 20 \| 12 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 60 \| 25 \| 26 \| \| 2012 \| 53 \| 12 \| 74 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 2 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): Partial - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Partial - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 2 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 2 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 3.3 (2008) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): 75 (2012) - General government expenditure on health as % of total government expenditure (%): 15 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 41 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 21 (2013) - ODA to maternal and neonatal health per live birth (US$): 48 (2011) \| Indicator \| Value \| Year \| \|------------------------------------------------\|--------\|------\| \| Total population (000) \| 5,173 \| 2013 \| \| Total under-five population (000) \| 503 \| 2013 \| \| Births (000) \| 111 \| 2012 \| \| Birth registration (%) \| 96 \| \| \| Total under-five deaths (000) \| 6 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 41 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 22 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 45 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 13 \| 2009 \| \| Total maternal deaths \| 68 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 640 \| 2013 \| \| Total fertility rate (per woman) \| 2.4 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 21 \| 2006 \| ### Under-five mortality rate \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 90 \| \| 1995 \| 80 \| \| 2000 \| 70 \| \| 2005 \| 60 \| \| 2010 \| 50 \| \| 2015 \| 40 \| Source: IGME 2013 ### Maternal mortality ratio \| Year \| Deaths per 100,000 live births \| \|------\|-------------------------------\| \| 1990 \| 66 \| \| 1995 \| 60 \| \| 2000 \| 55 \| \| 2005 \| 50 \| \| 2010 \| 45 \| \| 2015 \| 40 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 83 \| \| Antenatal care (4+ visits) \| 83 \| \| Skilled attendant at delivery \| 100 \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 11 \| \| Measles \| 99 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition #### Skilled attendant at delivery \| Year \| Percent \| \|------\|---------\| \| 1996 \| 96 \| \| 2000 \| 97 \| \| 2006 \| 100 \| #### Prevention of mother-to-child transmission of HIV \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| Uncertainty range around the estimate \| \|-------------------------------------------------------------------------------------\|-----------------------------------------------------\|--------------------------------------\| \| No Data \| No Data \| No Data \| ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Careseeking for pneumonia \| \| \| No Data Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 80 \| \| 1995 \| 90 \| \| 2000 \| 100 \| \| 2005 \| 90 \| \| 2012 \| 97 \| Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 2000 \| 51 \| \| 2006 \| 83 \| ### NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percentage \| \|------\|------------\| \| 2000 \| 7 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percentage \| \|------\|------------\| \| 2006 \| 4 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percentage \| \|------\|------------\| \| 2006 \| 60 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percentage \| \|------\|------------\| \| 2005 \| 54 \| Vitamin A two dose coverage (%) \| Year \| Percentage \| \|------\|------------\| \| \| - \| #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percentage \| \|------\|------------\| \| 2000 \| 11 \| \| \| 28 \| #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percentage \| \|------\|------------\| \| 2000 \| 13 \| \| 2006 \| 11 \| Causes of under-five deaths, 2012 - Neonatal death: 41% - Pneumonia: 15% - Preterm: 15% - Asphyxia: 9% - Other: 27% - Congenital: 9% - Sepsis: 6% - Diarrhoea: 0% - Measles: 0% - Malaria: 0% - HIV/AIDS: 0% - Injuries: 7% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition. Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Haemorrhage: 23% - Hypertension: 15% - Indirect: 22% - Other direct: 17% - Abortion: 9% - Sepsis: 9% - Embolism: 11% Regional estimates for Caucasus and Central Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 2000 \| 98 \| 99 \| Demand for family planning satisfied (%) 83 (2000) Antenatal care (4 or more visits, %) 83 (2000) Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 3, 4, 2 (2002) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine - Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 10 (2000) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 2000 \| 47 \| 40 \| Very limited risk Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1995-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1995 \| 31 \| 17 \| 43 \| \| 2012 \| 29 \| 10 \| 46 \| Improved sanitation coverage** Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation No Data Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - - Legal status of abortion (X of 5 circumstances) 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks) - - Maternity protection (Convention 183) No - Maternal deaths notification Yes - Postnatal home visits in the first week after birth - - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - - Antenatal corticosteroids as part of management of preterm labour - - International Code of Marketing of Breastmilk Substitutes Yes - Community treatment of pneumonia with antibiotics - - Low osmolarity ORS and zinc for management of diarrhoea Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) - - Density of doctors, nurses and midwives (per 10,000 population) 132.2 (2002) - National availability of Emergency Obstetric Care services (% of recommended minimum) - ### FINANCING - Per capita total expenditure on health (int$) 209 (2012) - General government expenditure on health as % of total government expenditure (%) 9 (2012) - Out of pocket expenditure as % of total expenditure on health(%) 37 (2012) - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 2 (2013) - ODA to maternal and neonatal health per live birth (US$) 5 (2011) ## DEMOGRAPHICS \| Indicator \| Value \| \|------------------------------------------------\|--------\| \| Total population (000) \| 36,346 \| \| Total under-five population (000) \| 6,939 \| \| Births (000) \| 1,591 \| \| Birth registration (%) \| 30 \| \| Total under-five deaths (000) \| 103 \| \| Neonatal deaths: % of all under-5 deaths \| 33 \| \| Neonatal mortality rate (per 1000 live births) \| 23 \| \| Infant mortality rate (per 1000 live births) \| 45 \| \| Stillbirth rate (per 1000 total births) \| 25 \| \| Total maternal deaths \| 5,900 \| \| Lifetime risk of maternal death (1 in N) \| 44 \| \| Total fertility rate (per woman) \| 6.0 \| \| Adolescent birth rate (per 1000 girls) \| 146 \| ## UNDER-FIVE MORTALITY RATE \| Year \| Deaths per 1000 live births \| \|-----------\|-----------------------------\| \| 1990 \| 178 \| \| 1995 \| 150 \| \| 2000 \| 120 \| \| 2005 \| 100 \| \| 2010 \| 69 \| \| 2015 \| 59 \| Source: IGME 2013 ## MATERNAL MORTALITY RATIO \| Year \| Deaths per 100,000 live births \| \|-----------\|--------------------------------\| \| 1990 \| 780 \| \| 1995 \| 600 \| \| 2000 \| 400 \| \| 2005 \| 200 \| \| 2010 \| 150 \| \| 2015 \| 100 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 47 \| \| Antenatal care (4+ visits) \| 48 \| \| Skilled attendant at delivery \| 57 \| \| Postnatal care \| 33 \| \| Exclusive breastfeeding \| 62 \| \| Measles \| 82 \| Source: DHS, MICS, Other NS See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel \| Year \| Percent \| \|-----------\|---------\| \| 1988-1989 \| 38 \| \| 1995 \| 38 \| \| 2000-2001 \| 39 \| \| 2006 \| 42 \| \| 2011 \| 57 \| ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Year \| Percent \| \|-----------\|---------\| \| 2010 \| 42 \| \| 2011 \| 49 \| \| 2012 \| 72 \| Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 47 \| \| Antenatal care (1+ visit) \| 48 \| \| Antenatal care (4+ visits) \| 57 \| \| Skilled attendant at delivery \| 33 \| \| Early initiation of breastfeeding \| 62 \| \| ITN use among children <5 yrs \| 82 \| \| DTP3 \| 38 \| \| Measles \| 38 \| \| Vitamin A (past 6 months) \| 39 \| \| ORT & continued feeding \| 42 \| \| Caseseeking for pneumonia \| 57 \| Source: DHS 2011 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|-----------\|---------\| \| 1990 \| 40 \| \| 1995 \| 40 \| \| 2000 \| 40 \| \| 2005 \| 40 \| \| 2012 \| 40 \| Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|-----------\|---------\| \| 1995 \| 61 \| \| 2000-2001 \| 67 \| \| 2006 \| 73 \| \| 2011 \| 79 \| ## NUTRITION Wasting prevalence (moderate and severe, %) \| Year \| Percent \| \|-----------\|---------\| \| 2011 \| 5 \| Low birthweight incidence (moderate and severe, %) \| Year \| Percent \| \|-----------\|---------\| \| 2011 \| 12 \| Early initiation of breastfeeding (within 1 hr of birth, %) \| Year \| Percent \| \|-----------\|---------\| \| 2011 \| 53 \| Introduction of solid, semi-solid/soft foods (%) \| Year \| Percent \| \|-----------\|---------\| \| 2011 \| 67 \| Vitamin A two dose coverage (%) \| Year \| Percent \| \|-----------\|---------\| \| 2012 \| 70 \| ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|-----------\|---------\| \| 1988-1989 \| 48 \| \| 1995 \| 21 \| \| 2000-2001 \| 19 \| \| 2006 \| 16 \| \| 2011 \| 14 \| ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|-----------\|---------\| \| 1988-1989 \| 67 \| \| 1995 \| 57 \| \| 2000-2001 \| 63 \| \| 2006 \| 60 \| \| 2011 \| 62 \| ## Uganda ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 14% - Diarrhoea: 9% - Measles: 6% - Injuries: 6% - HIV/AIDS: 7% - Malaria: 13% - Other: 18% Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Intrapartum-related events Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| Total DHS \| \|------------\|-----------\| \| 1988–1989 \| 87 \| \| 1995 \| 91 \| \| 2000–2001 \| 92 \| \| 2006 \| 94 \| \| 2011 \| 93 \| Demand for family planning satisfied (%) 47 (2011) Antenatal care (4 or more visits, %) 48 (2011) Malaria during pregnancy - intermittent preventive treatment (%) 25 (2011) C-section rate (total, urban, rural; %) 5, 14, 4 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 85 (2012) Postnatal visit for baby (within 2 days for home births, %) 11 (2011) Postnatal visit for mother (within 2 days for home births, %) 33 (2011) Women with low body mass index (<18.5 kg/m², %) 10 (2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| Total DHS \| \|------------\|-----------\| \| 1995 \| 48 \| \| 2000–2001 \| 29 \| \| 2006 \| 34 \| \| 2011 \| 39 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| Total DHS \| \|------------\|-----------\| \| 2000–2001 \| 0 \| \| 2006 \| 10 \| \| 2009 \| 33 \| \| 2011 \| 43 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990–2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 41 \| 35 \| 23 \| \| 2012 \| 70 \| 71 \| 70 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990–2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 37 \| 34 \| 32 \| \| 2012 \| 40 \| 34 \| 34 \| ### POLICIES \| Policy \| Status \| \|------------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Partial \| \| Legal status of abortion (X of 5 circumstances) \| 3 (R,F) \| \| Midwives authorized for specific tasks (X of 7 tasks) \| 7 \| \| Maternity protection (Convention 183) \| No \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| Yes \| \| Antenatal corticosteroids as part of management of preterm labour \| No \| \| International Code of Marketing of Breastmilk Substitutes \| Yes \| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Status \| \|------------------------------------------------------------------------\|--------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Partial (2013) \| \| Life Saving Commodities in Essential Medicine List: \| \| \| Reproductive health (X of 3) \| 2 (2013) \| \| Maternal health (X of 3) \| 3 (2013) \| \| Newborn health (X of 4) \| 3 (2013) \| \| Child health (X of 3) \| 3 (2013) \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 14.2 (2005) \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| 34 (2003) \| ### FINANCING \| Financing \| Status \| \|--------------------------------------------------------------------------\|--------\| \| Per capita total expenditure on health (int$) \| 108 (2012) \| \| General government expenditure on health as % of total government expenditure (%) \| 10 (2012) \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 49 (2012) \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data \| \| ODA to child health per child (US$) \| 13 (2011) \| \| ODA to maternal and neonatal health per live birth (US$) \| 21 (2011) \| ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 28,541 \| 2013 \| \| Total under-five population (000) \| 2,989 \| 2013 \| \| Births (000) \| 623 \| 2012 \| \| Birth registration (%) \| 100 \| \| \| Total under-five deaths (000) \| 25 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| \| \| Neonatal mortality rate (per 1000 live births) \| 14 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 34 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 6 \| 2009 \| \| Total maternal deaths \| 220 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 1,100 \| 2013 \| \| Total fertility rate (per woman) \| 2.3 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 26 \| 2006 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 74 - 1995: 60 - 2000: 50 - 2005: 40 - 2010: 30 - 2015: 25 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 66 - 1995: 50 - 2000: 40 - 2005: 30 - 2010: 20 - 2015: 17 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 80% \| \| Antenatal care (4+ visits) \| 100% \| \| Skilled attendant at delivery \| 100% \| \| Postnatal care \| \| \| Exclusive breastfeeding \| 26% \| \| Measles \| 99% \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1996 DHS: 98% - 2000 MICS: 96% - 2006 MICS: 100% ### Prevention of mother-to-child transmission of HIV \| Indicator \| Value \| \|------------------------------------------------\|-------\| \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| - \| \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| - \| \| Uncertainty range around the estimate \| - \| Source: UNICEF/UNAIDS/WHO 2013 ## EQUITY ### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 80% \| 90% \| \| Antenatal care (1+ visit) \| 100% \| 100% \| \| Antenatal care (4+ visits) \| 100% \| 100% \| \| Skilled attendant at delivery \| 100% \| 100% \| \| Early initiation of breastfeeding \| 60% \| 70% \| \| ITN use among children <5 yrs \| 50% \| 60% \| \| DTP3 \| 90% \| 100% \| \| Measles \| 90% \| 100% \| \| Vitamin A (past 6 months) \| 50% \| 60% \| \| ORT & continued feeding \| 30% \| 40% \| \| Case-seeking for pneumonia \| 50% \| 60% \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 90% - 1995: 95% - 2000: 99% - 2005: 99% - 2012: 99% Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1996 DHS: 87% - 2006 MICS: 68% ## NUTRITION ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1996 DHS: 13%, 40% - 2002 DHS: 7%, 25% - 2006 MICS: 4%, 20% ### Early initiation of breastfeeding (within 1 hr of birth, %) - 2006: 67% ### Introduction of solid, semi-solid/soft foods (%) - 2006: 47% ### Vitamin A two dose coverage (%) - 2012: 99% ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1996 DHS: 3% - 2000 MICS: 16% - 2002 DHS: 19% - 2006 MICS: 26% ## Uzbekistan ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Pneumonia: 17% - Preterm: 11% - Neonatal death: 34% - Asphyxia: 7% - Other: 30% - Congenital: 6% - Sepsis: 5% - Measles: 0% - Diarrhoea: 0% - HIV/AIDS: 0% - Malaria: 0% - Injuries: 9% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half of child deaths are attributable to undernutrition. Source: WHO/CHERG 2014 Causes of maternal deaths, 2013 - Sepsis: 9% - Abortion: 5% - Other direct: 17% - Indirect: 22% - Embolism: 11% - Haemorrhage: 23% - Hypertension: 15% Regional estimates for Caucasus and Central Asia, 2013 Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| MICS \| \|------\|-----\|------\|------\| \| 1996 \| 95 \| 97 \| 99 \| Demand for family planning satisfied (%) 80 (1996) Antenatal care (4 or more visits, %) - Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) 3, 5, 2 (1996) Neonatal tetanus vaccine - Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) 10 (1996) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| MICS \| \|------\|-----\|------\|------\| \| 1996 \| 31 \| 33 \| 32 \| \| 2000 \| 28 \| 28 \| \| Very limited risk Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 57 \| 86 \| 37 \| \| 2012 \| 47 \| 55 \| 26 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 33 \| 11 \| 7 \| \| 2012 \| 40 \| 14 \| 8 \| No Data Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent - - Legal status of abortion (X of 5 circumstances) 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks) - - Maternity protection (Convention 183) Partial - Maternal deaths notification Yes - Postnatal home visits in the first week after birth Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns - - Antenatal corticosteroids as part of management of preterm labour - - International Code of Marketing of Breastmilk Substitutes - - Community treatment of pneumonia with antibiotics Yes - Low osmolarity ORS and zinc for management of diarrhoea Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available - - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3) - - Maternal health (X of 3) - - Newborn health (X of 4) - - Child health (X of 3) - - Density of doctors, nurses and midwives (per 10,000 population) 143.6 (2012) - National availability of Emergency Obstetric Care services (% of recommended minimum) - ### FINANCING - Per capita total expenditure on health (int$) 221 (2012) - General government expenditure on health as % of total government expenditure (%) 10 (2012) - Out of pocket expenditure as % of total expenditure on health(%) 44 (2012) - Reproductive, maternal, newborn and child health expenditure by source No Data - ODA to child health per child (US$) 6 (2013) - ODA to maternal and neonatal health per live birth (US$) 9 (2011) DEMOGRAPHICS - Total population (000): 90,796 (2013) - Total under-five population (000): 7,184 (2013) - Births (000): 1,440 (2012) - Birth registration (%): 95 (2012) - Total under-five deaths (000): 33 (2012) - Neonatal deaths: % of all under-5 deaths: 53 (2012) - Neonatal mortality rate (per 1000 live births): 12 (2012) - Infant mortality rate (per 1000 live births): 18 (2012) - Stillbirth rate (per 1000 total births): 13 (2009) - Total maternal deaths: 690 (2013) - Lifetime risk of maternal death (1 in N): 1,100 (2013) - Total fertility rate (per woman): 1.8 (2012) - Adolescent birth rate (per 1000 girls): 38 (2010) Under-five mortality rate - Deaths per 1000 live births \| Year \| Deaths per 1000 live births \| \|------\|-----------------------------\| \| 1990 \| 51 \| \| 1995 \| 45 \| \| 2000 \| 38 \| \| 2005 \| 30 \| \| 2010 \| 23 \| \| 2015 \| 17 \| Source: IGME 2013 Maternal mortality ratio - Deaths per 100,000 live births \| Year \| Deaths per 100,000 live births \| \|------\|--------------------------------\| \| 1990 \| 140 \| \| 1995 \| 110 \| \| 2000 \| 80 \| \| 2005 \| 60 \| \| 2010 \| 49 \| \| 2015 \| 35 \| Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. --- MATERNAL AND NEWBORN HEALTH Coverage along the continuum of care - Demand for family planning satisfied - Antenatal care (4+ visits): 60% - Skilled attendant at delivery: 93% - Postnatal care: 17% - Exclusive breastfeeding: 96% - Measles: 96% Skilled attendant at delivery - Percent live births attended by skilled health personnel \| Year \| Percent \| \|------\|---------\| \| 1997 \| 77 \| \| 2000 \| 70 \| \| 2002 \| 85 \| \| 2006 \| 88 \| \| 2011 \| 93 \| Source: DHS, MICS, Other NS Prevention of mother-to-child transmission of HIV - Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - Percent HIV+ pregnant women receiving ARVs for PMTCT - Uncertainty range around the estimate Source: UNICEF/UNAIDS/WHO 2013 --- EQUITY Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% (red circles) - Richest 20% (orange circles) - Demand for family planning satisfied - Antenatal care (1+ visit) - Antenatal care (4+ visits) - Skilled attendant at delivery - Early initiation of breastfeeding - ITN use among children <5 yrs - DTP3 - Measles - Vitamin A (past 6 months) - ORC & continued feeding - Caseseeking for pneumonia Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. Source: MICS 2011 --- CHILD HEALTH Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine \| Year \| Percent \| \|------\|---------\| \| 1990 \| 97 \| \| 1995 \| 97 \| \| 2000 \| 96 \| \| 2005 \| 96 \| \| 2012 \| 96 \| Source: WHO/UNICEF 2013 Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics \| Year \| Percent \| \|------\|---------\| \| 1997 \| 69 \| \| 2000 \| 60 \| \| 2002 \| 71 \| \| 2006 \| 83 \| \| 2011 \| 73 \| \| 2011 \| 68 \| Source: DHS, MICS --- NUTRITION - Wasting prevalence (moderate and severe, %): 4 (2011) - Low birthweight incidence (moderate and severe, %): 5 (2011) - Early initiation of breastfeeding (within 1 hr of birth, %): 40 (2011) - Introduction of solid, semi-solid/soft foods (%): 50 (2011) - Vitamin A two dose coverage (%): 98 (2012) Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted \| Year \| Percent \| \|------\|---------\| \| 1987-1989 \| 41 \| \| 1994 \| 41 \| \| 2000 \| 27 \| \| 2004 \| 24 \| \| 2008 \| 20 \| \| 2011 \| 12 \| Source: Other NS, MICS Exclusive breastfeeding** Percent of infants <6 months exclusively breastfed \| Year \| Percent \| \|------\|---------\| \| 1997 \| 17 \| \| 2002 \| 15 \| \| 2005 \| 12 \| \| 2006 \| 17 \| \| 2011 \| 17 \| Source: DHS, MICS ## DEMOGRAPHICS ### Causes of under-five deaths, 2012 - Neonatal death: 54% - Preterm: 20% - Asphyxia: 7% - Other: 6% - Sepsis: 5% - Congenital: 13% - Other: 24% - Measles: 2% - Diarrhoea: 7% - Injuries: 4% - HIV/AIDS: 1% - Malaria: 0% Intrapartum-related events Sepsis/ Tetanus/ Meningitis/ Encephalitis Globally nearly half child deaths are attributable to undernutrition Source: WHO/CHERG 2014 ### Causes of maternal deaths, 2013 - Haemorrhage: 30% - Hypertension: 15% - Indirect: 17% - Other direct: 14% - Sepsis: 6% - Embolism: 12% - Abortion: 7% Regional estimates for South-eastern Asia, 2013 Source: WHO 2014 ## MATERNAL AND NEWBORN HEALTH ### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1997 \| 71 \| 68 \| \| 2000 \| 86 \| 81 \| \| 2002 \| 91 \| 94 \| Demand for family planning satisfied (%) 95 (2011) Antenatal care (4 or more visits, %) 60 (2011) Malaria during pregnancy - intermittent preventive treatment (%) 1 (2006) C-section rate (total, urban, rural; %) 20, 31, 16 (2011) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 91 (2012) Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) - ## CHILD HEALTH ### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1997 \| 40 \| 24 \| \| 2000 \| 11 \| 40 \| \| 2002 \| 65 \| 26 \| \| 2006 \| 57 \| 47 \| ### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial \| Year \| MICS \| \|------\|------\| \| 2000 \| 16 \| \| 2005 \| 13 \| \| 2011 \| 9 \| Percent children < 5 years sleeping under ITNs \| Year \| MICS \| \|------\|------\| \| 2000 \| 16 \| \| 2005 \| 13 \| \| 2011 \| 9 \| ## WATER AND SANITATION ### Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 53 \| 22 \| 9 \| \| 2012 \| 69 \| 43 \| 26 \| ### Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 37 \| 22 \| 19 \| \| 2012 \| 64 \| 24 \| 26 \| Source: WHO/UNICEF JMP 2014 ## POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Yes - Legal status of abortion (X of 5 circumstances): 5 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: Yes - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ## SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Partial (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): - - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 23.0 (2011) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ## FINANCING - Per capita total expenditure on health (int$): 233 (2012) - General government expenditure on health as % of total government expenditure (%): 9 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 49 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 9 (2011) - ODA to maternal and neonatal health per live birth (US$): 33 (2011) \| Metric \| Value \| \|---------------------------------------------\|-----------\| \| Total population (000) \| 23,852 \| \| Total under-five population (000) \| 3,397 \| \| Births (000) \| 752 \| \| Birth registration (%) \| 17 \| \| Total under-five deaths (000) \| 43 \| \| Neonatal deaths: % of all under-5 deaths \| 45 \| \| Neonatal mortality rate (per 1000 live births)\| 27 \| \| Infant mortality rate (per 1000 live births)\| 46 \| \| Stillbirth rate (per 1000 total births) \| 23 \| \| Total maternal deaths \| 2,100 \| \| Lifetime risk of maternal death (1 in N) \| 88 \| \| Total fertility rate (per woman) \| 4.2 \| \| Adolescent birth rate (per 1000 girls) \| 80 \| ### UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 125 - 1995: 100 - 2000: 80 - 2005: 60 - 2010: 42 - 2015: MDG Target Source: IGME 2013 ### MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 460 - 1995: 350 - 2000: 270 - 2005: 120 - 2010: MDG Target - 2015*: MDG Target Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| Percentage \| \|----------------------------------------------\|------------\| \| Demand for family planning satisfied \| 54 \| \| Antenatal care (4+ visits) \| 14 \| \| Skilled attendant at delivery \| 36 \| \| Postnatal care \| 71 \| \| Exclusive breastfeeding \| 12 \| \| Measles \| 71 \| * See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1991-1992: 16 DHS - 1997: 22 DHS - 2003: 27 Other NS - 2006: 36 MICS #### Prevention of mother-to-child transmission of HIV \| Year \| Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) \| Percent HIV+ pregnant women receiving ARVs for PMTCT \| \|------\|----------------------------------------------------------------------------------\|-----------------------------------------------------\| \| 2010 \| - \| - \| \| 2011 \| - \| - \| \| 2012 \| - \| - \| Source: UNICEF/UNAIDS/WHO 2013 ### EQUITY #### Socioeconomic inequities in coverage \| Household wealth quintile \| Poorest 20% \| Richest 20% \| \|---------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| 54 \| 71 \| \| Antenatal care (1+ visit) \| 14 \| 36 \| \| Antenatal care (4+ visits) \| 36 \| 71 \| \| Skilled attendant at delivery \| 36 \| 71 \| \| Early initiation of breastfeeding \| 71 \| 71 \| \| ITN use among children <5 yrs \| 71 \| 71 \| \| DTP3 \| 71 \| 71 \| \| Measles \| 71 \| 71 \| \| Vitamin A (past 6 months) \| 71 \| 71 \| \| ORT & continued feeding \| 71 \| 71 \| \| Caseseeking for pneumonia \| 71 \| 71 \| Source: MICS 2006 Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 82 - 1995: 82 - 2000: 71 - 2005: 71 - 2012: 23 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1991-1992: 28 DHS - 1997: 32 DHS - 2003: 47 Other NS - 2006: 44 MICS ### NUTRITION - Wasting prevalence (moderate and severe, %): 13 (2011) - Low birthweight incidence (moderate and severe, %): 32 (1997) #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1991-1992: 52 Other NS - 1996: 50 MICS - 1997: 48 DHS - 2003: 43 Other NS - 2011: 36 Other NS #### Early initiation of breastfeeding (within 1 hr of birth, %): 30 (2006) #### Introduction of solid, semi-solid/soft foods (%): 76 (2003) #### Vitamin A two dose coverage (%): 11 (2012) #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1991-1992: 13 DHS - 1997: 18 DHS - 2003: 12 Other NS ## Yemen ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 45% - Pneumonia: 16% - Preterm: 14% - Asphyxia: 13% - Other: 19% - HIV/AIDS: 0% - Malaria: 1% - Injuries: 7% - Measles: 1% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 31% - Indirect: 23% - Hypertension: 13% - Sepsis: 5% - Embolism: 9% - Other direct: 16% - Abortion: 3% ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| Other \| MICS \| \|------\|-----\|-------\|------\| \| 1991-1992 \| 26 \| 34 \| 41 \| \| 1997 \| 34 \| 41 \| 47 \| Demand for family planning satisfied (%) (2006) 54 Antenatal care (4 or more visits, %) (2003) 14 Malaria during pregnancy - intermittent preventive treatment (%) - C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 9, -, - Neonatal tetanus vaccine (2012) 66 Postnatal visit for baby (within 2 days for home births, %) - Postnatal visit for mother (within 2 days for home births, %) - Women with low body mass index (<18.5 kg/m², %) (1997) 25 ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| MICS \| \|------\|-----\|------\| \| 1991-1992 \| 26 \| 48 \| \| 1997 \| 32 \| 33 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Unimproved - Surface water \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 27 \| 39 \| 28 \| \| 2012 \| 40 \| 84 \| 41 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 2 \| 31 \| 44 \| \| 2012 \| 34 \| 70 \| 54 \| ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: Partial - Legal status of abortion (X of 5 circumstances): 1 - Midwives authorized for specific tasks (X of 7 tasks): - - Maternity protection (Convention 183): No - Maternal deaths notification: No - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: Yes - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 0 (2013) - Maternal health (X of 3): 2 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 8.7 (2010) - National availability of Emergency Obstetric Care services (% of recommended minimum): 14 (2005) ### FINANCING - Per capita total expenditure on health (int$): 118 (2012) - General government expenditure on health as % of total government expenditure (%): 4 (2012) - Out of pocket expenditure as % of total expenditure on health(%): 72 (2012) - Reproductive, maternal, newborn and child health expenditure by source: No Data - ODA to child health per child (US$): 8 (2011) - ODA to maternal and neonatal health per live birth (US$): 11 (2011) Note: See annexes for additional information on the indicators above. \| Indicator \| 2013 \| 2012 \| \|------------------------------------------------\|----------\|----------\| \| Total population (000) \| 14,075 \| \| \| Total under-five population (000) \| 2,566 \| \| \| Births (000) \| 608 \| \| \| Birth registration (%) \| 14 \| \| \| Total under-five deaths (000) \| 50 \| \| \| Neonatal deaths: % of all under-5 deaths \| 34 \| \| \| Neonatal mortality rate (per 1000 live births) \| 29 \| \| \| Infant mortality rate (per 1000 live births) \| 56 \| \| \| Stillbirth rate (per 1000 total births) \| 26 \| \| \| Total maternal deaths \| 1,800 \| \| \| Lifetime risk of maternal death (1 in N) \| 59 \| \| \| Total fertility rate (per woman) \| 5.7 \| \| \| Adolescent birth rate (per 1000 girls) \| 151 \| \| ### Under-five mortality rate Deaths per 1000 live births - 1990: 200 - 1995: 192 - 2000: 150 - 2005: 100 - 2010: 89 - 2015: 64 Source: IGME 2013 ### Maternal mortality ratio Deaths per 100,000 live births - 1990: 580 - 1995: 560 - 2000: 420 - 2005: 280 - 2010: 150 - 2015: MDG Target Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ### MATERNAL AND NEWBORN HEALTH #### Coverage along the continuum of care \| Service \| 2013 \| 2012 \| \|----------------------------------------------\|----------\|----------\| \| Demand for family planning satisfied \| 61 \| \| \| Antenatal care (4+ visits) \| 60 \| \| \| Skilled attendant at delivery \| 47 \| \| \| Postnatal care \| 39 \| \| \| Exclusive breastfeeding \| 61 \| \| \| Measles \| 83 \| \| See Annex/website for indicator definition #### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1992 DHS: 51 - 1996 DHS: 47 - 1999 MICS: 47 - 2001-2002 DHS: 43 - 2007 DHS: 47 #### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 74 - 2011: 90 - 2012: >95 Percent HIV+ pregnant women receiving ARVs for PMTCT - 2010: 74 - 2011: 90 - 2012: >95 Uncertainty range around the estimate ### EQUITY #### Socioeconomic inequities in coverage Household wealth quintile: Poorest 20% vs Richest 20% \| Service \| Poorest 20% \| Richest 20% \| \|----------------------------------------------\|-------------\|-------------\| \| Demand for family planning satisfied \| \| \| \| Antenatal care (1+ visit) \| \| \| \| Antenatal care (4+ visits) \| \| \| \| Skilled attendant at delivery \| \| \| \| Early initiation of breastfeeding \| \| \| \| ITN use among children <5 yrs \| \| \| \| DTP3 \| \| \| \| Measles \| \| \| \| Vitamin A (past 6 months) \| \| \| \| ORT & continued feeding \| \| \| \| Caseseeking for pneumonia \| \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ### CHILD HEALTH #### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 83 - 1995: 83 - 2000: 83 - 2005: 83 - 2012: 78 Source: WHO/UNICEF 2013 #### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 1992 DHS: 62, 14 - 1996 DHS: 71, 14 - 2001-2002 DHS: 69, 14 - 2007 DHS: 68, 14 ### NUTRITION Wasting prevalence (moderate and severe, %): 6 (2007) Low birthweight incidence (moderate and severe, %): 11 (2007) Early initiation of breastfeeding (within 1 hr of birth, %): 57 (2007) Introduction of solid, semi-solid/soft foods (%): 94 (2007) Vitamin A two dose coverage (%): - #### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1992 DHS: 21, 46 - 1996 DHS: 20, 49 - 1999 MICS: 20, 58 - 2001-2002 DHS: 23, 53 - 2007 DHS: 15, 46 #### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1992 DHS: 10 - 1996 DHS: 19 - 1999 MICS: 27 - 2001-2002 DHS: 40 - 2007 DHS: 61 Zambia ### DEMOGRAPHICS #### Causes of under-five deaths, 2012 - Neonatal death: 34% - Pneumonia: 13% - Preterm: 10% - Asphyxia: 11% - Other: 16% - HIV/AIDS: 6% - Malaria: 16% - Injuries: 5% - Measles: 1% - Sepsis: 7% - Congenital: 2% - Diarrhoea: 9% Source: WHO/CHERG 2014 #### Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Embolism: 2% Source: WHO 2014 ### MATERNAL AND NEWBORN HEALTH #### Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| MICS \| 2001-2002 \| 2007 \| \|------\|-----\|------\|-----------\|------\| \| 1992 \| 92 \| \| \| \| \| 1996 \| 96 \| \| \| \| \| 1999 \| 83 \| \| \| \| \| 2001-2002 \| 93 \| \| \| \| \| 2007 \| 94 \| \| \| \| #### Demand for family planning satisfied (%) 61 (2007) #### Antenatal care (4 or more visits, %) 60 (2007) #### Malaria during pregnancy - intermittent preventive treatment (%) 69 (2012) #### C-section rate (total, urban, rural; %) (Minimum target is 5% and maximum target is 15%) 3, 6, 2 (2007) #### Neonatal tetanus vaccine 81 (2012) #### Postnatal visit for baby (within 2 days for home births, %) - #### Postnatal visit for mother (within 2 days for home births, %) 39 (2007) #### Women with low body mass index (<18.5 kg/m², %) - ### CHILD HEALTH #### Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - Receiving oral rehydration therapy/increased fluids with continued feeding - Treated with ORS \| Year \| DHS \| 2001-2002 \| 2007 \| \|------\|-----\|-----------\|------\| \| 1992 \| 53 \| \| \| \| 1996 \| 54 \| \| \| \| 2001 \| 48 \| \| \| \| 2002 \| 53 \| \| \| \| 2007 \| 56 \| \| \| #### Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| Other NS \| 2008 \| Other NS \| 2010 \| \|------\|-----\|----------\|------\|----------\|------\| \| 1999 \| 1 \| \| \| \| \| \| 2001-2002 \| 7 \| \| \| \| \| \| 2006 \| 23 \| \| \| \| \| \| 2007 \| 29 \| \| \| \| \| \| 2008 \| 41 \| \| \| \| \| \| 2010 \| 50 \| \| \| \| \| ### WATER AND SANITATION #### Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 29 \| 32 \| 20 \| \| 2012 \| 48 \| 41 \| 15 \| #### Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Unimproved facilities - Open defecation \| Year \| Total \| Urban \| Rural \| \|------\|-------\|-------\|-------\| \| 1990 \| 14 \| 19 \| 26 \| \| 2012 \| 23 \| 27 \| 16 \| Source: WHO/UNICEF JMP 2014 ### POLICIES \| Policy \| Status \| \|------------------------------------------------------------------------\|--------\| \| Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent \| Partial \| \| Legal status of abortion (X of 5 circumstances) \| 4 (R,F) \| \| Midwives authorized for specific tasks (X of 7 tasks) \| 7 \| \| Maternity protection (Convention 183) \| Partial \| \| Maternal deaths notification \| Yes \| \| Postnatal home visits in the first week after birth \| Yes \| \| Kangaroo Mother Care in facilities for low birthweight/preterm newborns \| No \| \| Antenatal corticosteroids as part of management of preterm labour \| - \| \| International Code of Marketing of Breastmilk Substitutes \| Yes \| \| Community treatment of pneumonia with antibiotics \| Yes \| \| Low osmolarity ORS and zinc for management of diarrhoea \| Yes \| ### SYSTEMS \| System \| Status \| Year \| \|----------------------------------------------------------------------\|--------\|------\| \| Costed national implementation plan(s) for: maternal, newborn and child health available \| Yes \| 2013 \| \| Life Saving Commodities in Essential Medicine List: \| \| \| \| Reproductive health (X of 3) \| 3 \| 2013 \| \| Maternal health (X of 3) \| 3 \| 2013 \| \| Newborn health (X of 4) \| 3 \| 2013 \| \| Child health (X of 3) \| 3 \| 2013 \| \| Density of doctors, nurses and midwives (per 10,000 population) \| 8.5 \| 2010 \| \| National availability of Emergency Obstetric Care services (% of recommended minimum) \| 41 \| 2005 \| ### FINANCING \| Financing \| Status \| Year \| \|--------------------------------------------------------------------------\|--------\|------\| \| Per capita total expenditure on health (int$) \| 112 \| 2012 \| \| General government expenditure on health as % of total government expenditure (%) \| 16 \| 2012 \| \| Out of pocket expenditure as % of total expenditure on health(%) \| 24 \| 2012 \| \| Reproductive, maternal, newborn and child health expenditure by source \| No Data\| \| \| ODA to child health per child (US$) \| 43 \| 2011 \| \| ODA to maternal and neonatal health per live birth (US$) \| 114 \| 2011 \| ## DEMOGRAPHICS \| Indicator \| Value \| Year \| \|------------------------------------------------\|-----------\|------\| \| Total population (000) \| 13,724 \| 2013 \| \| Total under-five population (000) \| 2,010 \| 2013 \| \| Births (000) \| 439 \| 2012 \| \| Birth registration (%) \| 49 \| 2010-2011 \| \| Total under-five deaths (000) \| 39 \| 2012 \| \| Neonatal deaths: % of all under-5 deaths \| 44 \| 2012 \| \| Neonatal mortality rate (per 1000 live births) \| 39 \| 2012 \| \| Infant mortality rate (per 1000 live births) \| 56 \| 2012 \| \| Stillbirth rate (per 1000 total births) \| 20 \| 2009 \| \| Total maternal deaths \| 2,100 \| 2013 \| \| Lifetime risk of maternal death (1 in N) \| 53 \| 2013 \| \| Total fertility rate (per woman) \| 3.6 \| 2012 \| \| Adolescent birth rate (per 1000 girls) \| 112 \| 2008 \| ## UNDER-FIVE MORTALITY RATE Deaths per 1000 live births - 1990: 74 - 1995: 70 - 2000: 69 - 2005: 68 - 2010: 66 - 2015: 25 Source: IGME 2013 ## MATERNAL MORTALITY RATIO Deaths per 100,000 live births - 1990: 520 - 1995: 550 - 2000: 600 - 2005: 700 - 2010: 470 - 2015: 130 Source: MMEIG 2014 Note: MDG target calculated by Countdown to 2015. ## MATERNAL AND NEWBORN HEALTH ### Coverage along the continuum of care \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| 80 \| \| Antenatal care (4+ visits) \| 65 \| \| Skilled attendant at delivery \| 65 \| \| Postnatal care \| 27 \| \| Exclusive breastfeeding \| 31 \| \| Measles \| 90 \| See Annex/website for indicator definition ### Skilled attendant at delivery Percent live births attended by skilled health personnel - 1988 DHS: 70 - 1994 DHS: 69 - 1999 DHS: 73 - 2005-2006 DHS: 69 - 2010-2011 DHS: 66 ### Prevention of mother-to-child transmission of HIV Eligible HIV+ pregnant women receiving ART for their own health (% of total ARVs) - 2010: 31 - 2011: 53 - 2012: 82 ## EQUITY ### Socioeconomic inequities in coverage Household wealth quintile: - Poorest 20% - Richest 20% \| Service \| Coverage \| \|----------------------------------------------\|----------\| \| Demand for family planning satisfied \| \| \| Antenatal care (1+ visit) \| \| \| Antenatal care (4+ visits) \| \| \| Skilled attendant at delivery \| \| \| Early initiation of breastfeeding \| \| \| ITN use among children <5 yrs \| \| \| DTP3 \| \| \| Measles \| \| \| Vitamin A (past 6 months) \| \| \| ORT & continued feeding \| \| \| Caseseeking for pneumonia \| \| Coverage levels are shown for the poorest 20% (red circles) and the richest 20% (orange circles). The longer the line between the two groups, the greater the inequality. These estimates may differ from other charts due to differences in data sources. ## CHILD HEALTH ### Immunization Percent of children immunized: - against measles - with 3 doses DTP - with 3 doses Hib - with rotavirus vaccine - with 3 doses pneumococcal conjugate vaccine - 1990: 90 - 1995: 80 - 2000: 70 - 2005: 60 - 2012: 89 Source: WHO/UNICEF 2013 ### Pneumonia treatment Percent of children <5 years with symptoms of pneumonia: - taken to appropriate health provider - receiving antibiotics - 2005-2006 DHS: 25 - 2009 Other NS: 43 - 2010-2011 DHS: 48 ## NUTRITION Wasting prevalence (moderate and severe, %): 3 (2010-2011) Low birthweight incidence (moderate and severe, %): 11 (2010-2011) Early initiation of breastfeeding (within 1 hr of birth, %): 65 (2010-2011) Introduction of solid, semi-solid/soft foods (%): 86 (2010-2011) Vitamin A two dose coverage (%): 61 (2012) ### Underweight and stunting prevalence Percent of children <5 years who are moderately or severely: - underweight - stunted - 1988 DHS: 31 - 1994 DHS: 29 - 1999 DHS: 34 - 2005-2006 DHS: 36 - 2010-2011 DHS: 32 ### Exclusive breastfeeding Percent of infants <6 months exclusively breastfed - 1988 DHS: 10 - 1994 DHS: 11 - 1999 DHS: 32 - 2005-2006 DHS: 22 - 2010-2011 DHS: 31 ## Zimbabwe ### DEMOGRAPHICS Causes of under-five deaths, 2012 - Neonatal death: 44% - Preterm: 14% - Asphyxia: 13% - Other: 18% - HIV/AIDS: 9% - Malaria: 1% - Injuries: 5% - Measles: 1% - Diarrhoea: 1% Intrapartum-related events Causes of maternal deaths, 2013 - Haemorrhage: 25% - Hypertension: 16% - Indirect: 29% - Other direct: 9% - Abortion: 10% - Sepsis: 10% - Embolism: 2% Source: WHO/CHERG 2014 ### MATERNAL AND NEWBORN HEALTH Antenatal care Percent women aged 15–49 years attended at least once by a skilled health provider during pregnancy. \| Year \| DHS \| \|------------\|-------\| \| 1988 \| 91 \| \| 1994 \| 93 \| \| 1999 \| 93 \| \| 2005-2006 \| 94 \| \| 2010-2011 \| 90 \| Demand for family planning satisfied (%) 80 (2010-2011) Antenatal care (4 or more visits, %) 65 (2010-2011) Malaria during pregnancy - intermittent preventive treatment (%) 7 (2010-2011) C-section rate (total, urban, rural; %) (5, 8, 3) (Minimum target is 5% and maximum target is 15%) Neonatal tetanus vaccine 66 (2012) Postnatal visit for baby (within 2 days for home births, %) 12 (2010-2011) Postnatal visit for mother (within 2 days for home births, %) 27 (2010-2011) Women with low body mass index (<18.5 kg/m², %) 6 (2010-2011) ### CHILD HEALTH Diarrhoeal disease treatment Percent of children <5 years with diarrhoea: - receiving oral rehydration therapy/increased fluids with continued feeding - treated with ORS \| Year \| DHS \| \|------------\|-------\| \| 1994 \| 79 \| \| 2005-2006 \| 47 \| \| 2009 \| 6 \| \| 2010-2011 \| 35 \| \| \| 32 \| \| \| 46 \| \| \| 21 \| Malaria prevention and treatment Percent children receiving first line treatment among those receiving any antimalarial - Percent children < 5 years sleeping under ITNs \| Year \| DHS \| \|------------\|-------\| \| 2005-2006 \| 3 \| \| 2009 \| 17 \| \| 2010-2011 \| 10 \| ### WATER AND SANITATION Improved drinking water coverage Percent of population by type of drinking water source, 1990-2012 - Piped on premises - Other improved - Surface water - Unimproved \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 46 \| 97 \| 79 \| \| 2012 \| 63 \| 64 \| 63 \| Improved sanitation coverage Percent of population by type of sanitation facility, 1990-2012 - Improved facilities - Shared facilities - Open defecation - Unimproved facilities \| Year \| Total \| Urban \| Rural \| \|------------\|-------\|-------\|-------\| \| 1990 \| 33 \| 25 \| 46 \| \| 2012 \| 40 \| 44 \| 40 \| Source: WHO/UNICEF JMP 2014 ### POLICIES - Laws or regulations that allow adolescents to access contraceptives without parental or spousal consent: No - Legal status of abortion (X of 5 circumstances): 2 (R,F) - Midwives authorized for specific tasks (X of 7 tasks): 7 - Maternity protection (Convention 183): No - Maternal deaths notification: Yes - Postnatal home visits in the first week after birth: Yes - Kangaroo Mother Care in facilities for low birthweight/preterm newborns: No - Antenatal corticosteroids as part of management of preterm labour: Yes - International Code of Marketing of Breastmilk Substitutes: Yes - Community treatment of pneumonia with antibiotics: No - Low osmolarity ORS and zinc for management of diarrhoea: Yes ### SYSTEMS - Costed national implementation plan(s) for: maternal, newborn and child health available: Yes (2013) - Life Saving Commodities in Essential Medicine List: - Reproductive health (X of 3): 3 (2013) - Maternal health (X of 3): 3 (2013) - Newborn health (X of 4): 3 (2013) - Child health (X of 3): 3 (2013) - Density of doctors, nurses and midwives (per 10,000 population): 13.1 (2009) - National availability of Emergency Obstetric Care services (% of recommended minimum): - ### FINANCING - Per capita total expenditure on health (int$): - - General government expenditure on health as % of total government expenditure (%): - - Out of pocket expenditure as % of total expenditure on health(%): - - Reproductive, maternal, newborn and child health expenditure by source: No Data - 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Available online at: https://researchsynergy.org/ijeiece/ International Journal of Emerging Issues in Early Childhood Education (IJEIECE) Volume 3 Number 2 (2021): 28-41 ISSN 2685-4074 (Online) \| 2655-9986 (Print) Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Speaking and Listening: An Evidence in Oyo State Nigeria. Oluyemisi Majebi 1 , Esther Oduolowu 2 1Early Childhood and Educational Foundations, Nigeria 2Sokoto State University, Nigeria Abstract The study examined the impact of culturally based Instructional strategy (indigenous songs, rhymes, games, stories, language of the immediate environment, and instructional materials) on pre-primary school children's cognitive competence with special attention on problem-solving, speaking, and listening skills. Socio-cultural theory provided the framework, while pretest-posttest control group quasi-experimental design was adopted. 74 children (44 males and 30 females) with a mean age of 5.61 from four pre-primary schools (two public and private schools) were purposively selected from two local government areas and randomized into CIBS and conventional groups, respectively. Children's Cognitive Competency Rating Scale (r = 0.89) and CBIS Instructional Guide were the instruments used to collect data for the study. Paired sample t-test and Analysis of covariance (ANCOVA) were used to analyze the data. There was a significant main effect of treatment on children's cognitive competence (F(1,65) = 10.31; partial ῆ 2 = 0.14). CIBS was found to be potent in enhancing pre-primary school children's cognitive competence, especially in the area of problemsolving, speaking, and listening skills. Teaching and learning activities at the pre-primary school level should employ a culturally-based instructional strategy. Keywords: Culturally-based instructional strategy, cognitive competence, problem-solving, speaking and listening skills. This is an open access article under the CC-BY-NC license. INTRODUCTION So much preference for foreign educational materials and philosophy in Nigeria is exhibited in every education segment, ranging from curriculum to instructional strategy. The classrooms, especially the preschool classes, depend largely on instructional strategies that are Euro-Western orientated. Most of the strategies adopted during the teaching and learning activities at this level are less culturally relevant. These have been associated with the non-relevance of such educational attainment to the immediate environment because culture plays a prominent role in the teaching and learning process. Research evidence from descriptive and experimental studies, both local and international, have linked meaningful learning with culture. Berk and Winsler (2002) and Darling-Hammond, Austin, Lit, Nasir, Moll, and Ladson Billings (2008) claim that human beings are cultural animals; they are products of their cultural upbringing and cultural environments. Gay (2000), Rogoff (2003), Obanya (2007), Ritterhouse (2007), Fries-Gaither (2009), Chartock (2010), and Gwanfogbe (2011) assert that the teaching and learning process has its root in culture and culture is central to learning. This implies that the culture of the people cannot be ignored in the teaching and learning process specifically for effectiveness and meaningfulness. It has a strong influence on educational practices, especially how people teach and how they learn. Culture influences how people process learning, solve International Journal of Emerging Issues in Early Childhood Education (IJEIECE) Vol. 3 (2), 28-41 Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Speaking and Listening: An Evidence in Oyo State Nigeria. Oluyemisi Majebi, Esther Oduolowu problems and teach (Saifer, Edwards, Elli, Lena Ko, Stuczynski, Dorfman, and Kirkham 2005). It produces the needed content for the educational curriculum and plays an active role in facilitating effective learning. It also has a strong link with the understanding of people's learning styles. Hills (2012) asserts that understanding the culture of a society is the key to understanding the way people learn. Thus, the instructional strategy to be adopted in the course of teaching ought to have a base in the culture of the immediate society since culture, education, and learning are interrelated (Azubuike 2013). The early years pose a good chance of introducing a strategy that is culturally based to children. LITERATURE REVIEW The early years, if properly handled, have been confirmed to lay a solid foundation for the holistic development of the child, cognitive competence inclusive. Cognitive competence is usually inferred from children's academic excellence, motor activities, communication, or social behaviors during their learning, play, and daily activities. As expressed by UNESCO (2003), cognitive competence is learning to know, which implies learning how to learn by developing one's concentration, memory skills, and ability to think. Scrimsher and Tudge (2003) explain cognitive competence from social and cultural points of view. It is social because children learn through interactions with others and require assistance from others to learn what they need to know and culture because what children need to know is determined by the culture of their environment. Michelon (2006) describes it as a competence that has more to do with the mechanisms of how we learn, remember, solve problems, and pay attention. It can be said summarily that cognitive competence is demonstrated in performing tasks that involve reasoning, remembering, adapting, transferring, and applying wisdom to adequately proffer a solution to the problem at hand. All these components have their root in the culture of people. Vygotsky's assertion says that tools of intellectual adaptation are available in each culture to help children develop adaptive thinking and problem-solving strategies (Wang, Ceci, Williams, and Kopko, 2004). Thus, points to the fact that there is a strong connection between the cognitive competence of the child and his/her culture. This means that the development of cognitive competence might not be culturally neutral. The former can be strengthened during the early years when teaching and learning activities employ culturally-based instructional strategies. This is why Butler (2011) affirms that culture plays a role in conveying and receiving information and shaping an individual's thinking process. Wang et al. (2004) assert that people in different cultures have been shown to possess different cognitive competence unique to their living environment. And most times, this type of competency has been found to be beneficial to the environment. Neglecting culture and culturally based instruction strategy in the process of acquiring this competence might affect children's acquisition of necessary skills that can make them relevant in their immediate environment. Cognitive competence involves so many skills; this study focuses on problem-solving, speaking, and listening skills. These were given consideration because they are frequently used in day-to-day activities and can easily be translated into developing other skills needed to make a meaningful contribution to one's immediate environment. Problems are part of everyday life and can be handled differently depending on what the situation presents and the skill that the person involved possesses. Problemsolving skills can be explained as analyzing a situation and forming and applying a workable solution to arrive at an expected solution. It could also mean staying on a difficult task and applying different tactics or strategies until an expected result is achieved. Mayer and Wittrock (2009) describe problem-solving as a cognitive process directed at transforming a problem from the given state to the goal state when the problem solver is not immediately aware of a International Journal of Emerging Issues in Early Childhood Education (IJEIECE) Vol. 3 (2), 28-41 Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Speaking and Listening: An Evidence in Oyo State Nigeria. Oluyemisi Majebi, Esther Oduolowu solution method. It thus means, developing a problem-solving skill goes beyond supplying an answer to an exercise in the classroom; it includes searching for or exploring every possible means to finding solutions to a problem. Previous knowledge gained can also be transferred to solve a problem at hand. Some of the subsets of problem-solving might be employed to achieve these. According to Mayer and Wittrock (2009), these subsets of problem-solving skills include abilities to reason, make decisions, think critically, and creatively. All these are required to be able to provide a solution to a problem. Meanwhile, Oduolowu (1998) had earlier pointed out that the conscious development of the cognitive skill, especially the problem-solving skill, is still alien to the primary school system in Nigeria. This author made this assertion because most of the children's activities are paper-pencil based. Activities that can consciously prompt problem-solving skills are not organized for children during the teaching and learning activities. The problem still persists, and the pre-primary school level is not left out of this situation. Salami (2014) established that majority of children's classroom activities are still paper-pencil based. This might be one of the possible factors responsible for poor performance in Mathematics in Nigeria. Children's poor performance in problem-solving has been linked with poor performance in mathematics (Salami, 2014). An instructional strategy that is culturally based possesses diverse culturally relevant activities that can be used to engage children in meaningful problem-solving activities. Closely related to problem-solving skills are speaking and listening skills. Children that possess good listening and speaking skills may likely stand a higher chance of exhibiting problem-solving skills. They might be able to ask questions related to the task at hand and listen to instructions from others. They might be able to discuss the problem encountered and the process of solving it. Speaking and Listening skills are part of the indices of cognitive competence. They are two sides of a coin in communication skills, they are interrelated; speaking skill is the ability to make an expression known through the use of verbal symbols or sign while listening is the ability to receive and decode the expression. Speaking is an expressive language skill in which the speaker uses verbal symbols to communicate (Oduolowu and Amosun, 2010). It was also described as the process of building and sharing the message through the use of verbal and non-verbal symbols in a variety of contexts (Šolcová, 2011). Speaking can then be described as a verbal or signal expression of one's thinking, emotion, and relationship with others. It plays a significant role in the dissemination of information and ideas. Listening is as important as what is being said (speaking). Hearing is often mistaken as listening; the two differ. Thus, hearing precedes listening. Listening skill involves the ability to hear what people are saying accurately, respond promptly and relay it precisely if necessary. According to Okoro (2006), listening involves the ability to encode and decode a heard message. Jalongo (2008) describes it as the process of taking in information through the sense of hearing and making meaning from what is being heard. Oduolowu and Amosun (2010) conceive listening as the ability to select sound information that one wants to hear in order to perceive it in a clear and organized fashion. Listening skill is an important aspect of the cognitive development of children. Brown (2012) observes that developing good listening skills will help children to cope with the academic demands of school. Children who are active listeners can incorporate the things they hear faster in their framework of knowledge than their more passive counterparts. They can also exhibit better concentration and memory when they develop good listening skills (Tramel, 2011). The culturally-based instructional strategy has different activities that can enhance these skills in children. Some of which include storytelling, singing, and recitation of rhymes which were adopted in this study. Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Oluyemisi Majebi, Esther Oduolowu Speaking and Listening: An Evidence in Oyo State Nigeria. Despite the relevance of speaking and listening skills to children's learning, researchers have established that little or no attention is devoted to these skills in the classroom. Oduolowu and Amosun (2010) observe that these two skills have suffered neglect and are taught least often in the classroom. Also, most of the practices in Nigeria's pre-primary and primary classrooms are not conscious of the influence of culture on the development of children's cognitive competence, especially in problem-solving, speaking, and listening skills. These aspects of a child's development were not handled with negligence in the cultural practice of the people. Children were engaged in activities such as storytelling, indigenous games, rhymes, tongue-twisting, proverbs, among others, to enhance their intellectual development. However, reports from different studies have revealed that these multidimensional practices are fading out gradually, and the results are obvious in the products. For instance, Fakeye (2010) reports that teaching and learning activities are being carried out at the early childhood level using English as a medium of instruction. Roy-Omoni (2010) notes that children in their formative years are denied the teaching and learning through their mother tongue, contrary to the recommendation from the national policy on education in Nigeria. The local language has become outmoded and displaced in the teaching and learning process (Obioha 2010). Salami and Oyaremi 2012; Akinwale (2013) note that African children are exposed to games, toys, songs, nursery rhymes that have no direct relationship with what the growing children are likely to encounter in their immediate environments. Also, most of the teaching materials are imported. Ekukinam (2012). The need to bring all these valued ways of effective teaching and learning activities back into the educational system calls for an instructional strategy that acknowledges the relevance of culture in developing cognitive competencies. Giving culture its due recognition in education, especially in classroom teaching and learning activities, is the root of culturally-based instructional strategy (CBIS). Culturally-based instructional strategy, in this context, is originally known as culturally responsive classroom practices. It was created by Gloria LadsonBillings to describe a pedagogy that empowers children intellectually, socially, emotionally, and politically by using cultural referents to impart knowledge, skills, attitudes, and values. It utilises the pupils' backgrounds, knowledge, and experiences to inform the teacher's lessons and methodology (Coffey 2008). CBIS is described as the instructional strategy that is grounded in an understanding of the role of culture in the teaching and learning process (Underwood, 2009). Alaska Native Knowledge Network (1998) views the strategy as a way of shifting the focus in the curriculum from teaching/learning about cultural values as another subject to teaching/learning through the local culture as a foundation for all educational activities. A culturally-based instructional strategy is a form of strategy that employs the indigenous process and activity to facilitate meaningful and effective teaching and learning in the classroom. It gives adequate attention to the relevance of indigenous songs, stories, games, rhymes, the language of the immediate environment, and materials found in the immediate environment on achieving meaningful teaching and learning. And also help to equip the children from the society to improve the society. It engages practices that are culturally, developmentally, contextually, and child's friendly in the classroom to achieve holistic development of the child. CBIS is a form of teaching based on the assumption that children's academic achievement can be improved when knowledge and skills are presented in ways that are consistent with their cultural frame of reference (Gay, 2000). Gay (2000) and King (2012) note that CBIS recognizes that pupils learn in many different ways. These practices maintain that varied instructional techniques are a critical part of teaching responsively. Dawes and Biersteker (2011) see a culturally-based instructional strategy that encourages Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Oluyemisi Majebi, Esther Oduolowu Speaking and Listening: An Evidence in Oyo State Nigeria. children's total engagement in learning through participation and interaction in activities. The literature revealed that the strategy is dynamic and is not characterised by the classroom's routines and rituals. Each theme or topic taught is backed up with relevant indigenous stories, rhyme, and songs. CulturallyBased Instructional Strategy (CBIS) emphasises a learner-center strategy where children are exposed to opportunities and activities to express themselves verbally or non-verbally through indigenous stories, games, rhymes, and songs. These indigenous games and songs have their own effects on children's holistic development. Durojaiye (1977) had earlier submitted that when the traditional games are used in nursery schools, it is a way of giving children a chance to learn and pass on to the next generation what has been taken away from their background traditional. A substantial number of findings from experimental studies from Western countries on culturally-based instructional strategy has revealed that any culturally appropriate strategy has a positive impact on students' learning outcomes. The strategy is effective in increasing students' achievement in any subject area (Moyo 2009; Underwood 2009; Peterek, 2009; Thompson, 2010; Hills, 2012; Mayfield, 2012; Thoms 2014; Paulk, Martinez and Lambeth 2014). It ensures academic success and could also enhance the acquisition of cognitive competence because this strategy, according to Erickson (2010), is rooted in the belief that everything in education relates to culture, its acquisition, transmission, and intervention. All learning is mediated by culture. This means that if culture is neglected in education, it might not yield the expected result. If it is a good one, education must be rooted in and guided by the culture of the society concerned. The study is hinged on Socio-cultural Theory. Lev Vgyotsky propounded this theory in 1978. The theory acknowledges the relevance of culture on the process of knowing (Kanselaar, 2002; McLeod, 2018). It believes that people are products of their social and cultural environment. According to Ellig & Holmes (2011), Vygotsky believed that community plays an influential role in the importance of making meaning essentially, learning. The theory believes that a child's learning cannot be separated from the child's cultural background because culture determines how he or she relates with others, learn and think. This theory is relevant to this study because it acknowledges the relevance of culture in the teaching and learning processes by establishing a link between culture and the child's cognitive development. This study, therefore, considered enhancing the pre-primary school children's cognitive competence (problem-solving, speaking, and listening skills) through culturally-based instructional strategy (indigenous songs, rhymes, games, stories, language of the immediate environment, and local materials) in Oyo State, Nigeria RESEARCH METHODS Research question The research question was stated as follows to guide the study Is there a difference before and after the treatment in children's cognitive competence in problem- solving, listening, and speaking? Hypothesis H01: There is no significant main effect of treatment on children's cognitive competence Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Speaking and Listening: An Evidence in Oyo State Nigeria. Oluyemisi Majebi, Esther Oduolowu Research Design The study used the pretest-posttest control group quasi-experimental research design to determine the impact of the treatment on pupils' cognitive competence. Pretest-posttest control group design is the type of quasi-experimental design in which the cognitive competence of the participants in the research is measured before and after the treatment in both the experimental and the control groups. This study observed how well the pre-primary school children exhibited the problem-solving, listening, and speaking skills of cognitive competence before as well as post-treatment. This was to ascertain that the groups were almost the same or significantly different in the exhibition of skills before treatment and to determine the extent to which the participants were knowledgeable about the content before and the shift in their knowledge after the experiment. In the end, that it may be justified that the post-competence of the preprimary school children is the result of the treatment, there must be a control group. The research design is schematically represented thus: O 1 X 1 O 2 - E (Experimental Group) O 3 X 2 O 4 - C (Control Group) Where O1, 03 represent pretest measures and O2 and 04 represent posttest measures for experimental and control groups, respectively. X1 represents culturally-based instructional strategy (Experimental group) X2 represents conventional instructional strategy (Control Group) Research Participants Two local government areas (LGAs) (Ibadan North and Ibadan North-East) and two pre-primary schools (one public and one private) were purposively selected from each of the LGAs based on their willingness to participate in the study. An intact class of Nursery III children was selected per school and randomized into CIBS and conventional groups. A total of 74 pre-primary school children (44 males and 30 females) with a mean age of 5.61 participated in the study. There were 37 children in each of the groups. Data collection The study was carried out in three stages: the training of research assistants/administration of pretest, implementation of the treatment, and administration of posttest. The procedure lasted for ten weeks in the selected schools. The pre-primary school children in the experimental group were exposed to culturally-based instructional strategy (CBIS), which comprises methodology (indigenous songs, rhymes, games, and stories), medium of instruction (language of the immediate environment -Yoruba), and indigenous materials (such as beads of different colors, dry seeds, cowries to develop the skills. All these were used to expose children to hands-on activities that involve counting, grouping, sorting, and matching. Posters that contained Yorùbá numbers and alphabet with relevant pictures were made available to them to engage in making word-picture albums and word-formation. They also engaged in fixing puzzles, counting, grouping, sorting, and matching indigenous objects, and threading beads for problem-solving. Relevant indigenous stories, rhymes, and game songs were used to facilitate the acquisition of the skill of listening and speaking skills. The pre-primary school children in the control group were exposed to the conventional instructional strategy (CIS). Researchers have established this strategy to be dominated by Western-oriented activities, such as foreign songs, rhymes, and games language. English was the medium of instruction adopted for the conventional group. Afterward, the posttest was administered to the two groups by the tenth week of the study. The instruments used were the Children's cognitive Competence Rating Scale (r = 0.89) and CIBS Instructional Guide. Compiled Relevant Indigenous Rhymes, Songs, and Games, Children's Indigenous Picture Storybook, Pictorial Charts on Indigenous Numbers and Alphabets. Data analysis Data were analysed using Paired sample t-test and Analysis of covariance. Paired t-test was used to show the difference between pretest and posttest scores of children. In contrast, Analysis of Covariance was used to control the effect of the extraneous variables in the study. FINDINGS AND DISCUSSION Research Question: 1. Is there a difference before and after the treatment in children's cognitive competence in problemsolving, listening, and speaking? Table 1. Summary of paired t-test analysis showing the difference between pre and post scores of the children in cognitive competence Table 1 reveals that there was a difference between the mean scores of problem-solving skills at the pretest (18.08) and the posttest (30.03) of the thirty-seven (37) children in the experimental group that were exposed to the treatment. This difference was significant (t = 9.32; df = 36;). The mean scores of listening skills at the pretest (8.68) differs from the posttest (23.62) of the children exposed to treatment. This difference was significant (t = 13.05; df = 36;). The mean score of speaking skill at pretest (7.81) differs from the posttest (24.81) of the children exposed to treatment. It was significant (t = 15.04; df = 36;). International Journal of Emerging Issues in Early Childhood Education (IJEIECE) Vol. 3 (2), 28-41 Oluyemisi Majebi, Esther Oduolowu Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Speaking and Listening: An Evidence in Oyo State Nigeria. Hypothesis H01: There is no significant main effect of treatment on children's cognitive competence Table 2: Summary of Analysis of Covariance (ANCOVA) on Cognitive Competence of Children Dependent Variable: post-conquest * denotes significant difference at 0.05 level of significant a. R Squared = .405 (Adjusted R Squared = .332) Table 2 indicates that there was a significant main effect of treatment on children's cognitive competence (F(1,65) = 10.31; partial; ῆ 2 = 0.14). Therefore, H01 was rejected. The effect size was 14%. Table 3 presents the magnitude of performance across the groups. Table 3: Estimated Marginal Means on Cognitive Competence of Children International Journal of Emerging Issues in Early Childhood Education (IJEIECE) Vol. 3 (2), 28-41 Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Speaking and Listening: An Evidence in Oyo State Nigeria. Oluyemisi Majebi, Esther Oduolowu Table 3 shows the competent cognitive scores of the two groups of children. Out of a maximum mark of 99, the mean score of children in the control group was 69.02 (69.72%), while that of the children in the experimental group was 86.18 (87.05%). This implies that those exposed to CBIS exhibited significantly better cognitive competence in problem-solving, speaking, and listening skills than those exposed to conventional strategy. DISCUSSION Point 1: The study's finding reveals that there was a significant main effect of treatment (culturally-based Instructional Strategy) on pre-primary school children's cognitive competence (problem-solving, speaking, and listening skills). It simply means that the children exposed to CBIS gained more in the skills of cognitive competence than those exposed to conventional instructional strategy (CIS). This effectiveness corroborates the findings of different experimental studies that have been carried out on CBIS, such as Moyo (2009), Underwood (2009), Peterek (2009), Hills (2012), Mayfield (2012), Thoms (2014), Paulk, Martinez, and Lambeth (2014). These scholars confirmed that the strategy is effective in increasing student achievement in any subject area. It is also in line with the submission of Gay (2000) that all students will perform better on multiple measures of achievement when teaching is filtered through their own cultural experiences. Point 2: The language of the medium of instruction - Yoruba adopted in this study as contrary to the conventional medium of instruction – English language at the pre-primary school level is also believed to have a significant effect on the acquisition of cognitive competence. The Six-Year Yoruba Medium Primary Project by Fafunwa, as reported by Agbedo, Abata-Ahura, Krisagbedo, and Edward (2012), demonstrated that a full six-year primary education in the mother tongue with the L2 taught as a subject was not only viable but gave better results than all-English schooling. Oribabor and Adeshina (2013) also confirmed that the use of the Yoruba language as a medium of instruction aided learning better than the foreign language. Point 3: The indigenous materials used during the experiment also attracted children's attention and encouraged children's active involvement during the teaching and learning activities because some of them were new in the classroom. As identified by Yitbarek (2012), using indigenous materials makes teachers and learners aware of the resources to be found in their environment and stimulates creativity to use them. This could be one of the reasons why the Rivers Readers Project (nd) suggested that materials in the mother tongue of reasonable quality could be developed and utilized during the course of teaching and learning. Point 4: The components of cognitive competence (problem-solving, listening, and speaking) selected for this study were also examined separately before and after the treatment. The results revealed that the pre-primary school children were exposed to the culturally-based instructional strategy with respect to the series of activities, such as the use of indigenous stories, rhymes, games-songs, materials, and language International Journal of Emerging Issues in Early Childhood Education (IJEIECE) Vol. 3 (2), 28-41 Speaking and Listening: An Evidence in Oyo State Nigeria. Correlational Study of Culturally-Based Instructional Strategy and Cognitive Competencies on Problem Solving, Oluyemisi Majebi, Esther Oduolowu of the immediate environment exhibited higher skills of problem-solving, listening and speaking after the treatment. There was a difference between the mean scores of problem-solving skills before and after the children were exposed to treatment. This difference was significant. This might be because children were not limited to their conventional strategy of just providing answers to certain exercises; they were engaged with indigenous materials and various problem-solving activities such as counting, sorting, matching, grouping, fixing of puzzles, and word formation. This finding is in agreement with Deak (2000), who exposed pre-primary school children to a series of activities to develop problem-solving skills. The experiment yielded tremendous results: children were able to search for information to solve problems, and they could match familiar words. Mugweni, Mutereri, and Ganga (2012) assert that extensive involvement in traditional games and socio-dramatic play has been seen to improve children's memory and cognitive perspective-taking abilities. Likewise, there was a difference between the mean score of listening skills before and after exposing the children to the treatment. Indigenous stories, songs, and rhyme were employed to facilitate this skill in pre-primary school children exposed to the treatment. This difference was shown to be significant. This finding also corroborates the finding of an experimental study carried out by Oduolowu and Akintemi (2014) that indigenous storytelling facilitated listening skills. Also, there was a difference between the mean score of the speaking skill before and after exposing the children to the treatment. This difference was significant. This means that indigenous stories, songs, rhymes, games, materials, and language of the immediate environment significantly affected the selected components of cognitive competence of the pre-primary school children after the treatment. CONCLUSION Based on the findings of this study, it can be concluded that culturally-based instructional strategy (CBIS) is better than the conventional instructional strategy that has dominated pre-primary school classrooms in Nigeria. The children exposed to CBIS gained more in the skills of cognitive competence than those exposed to conventional instructional strategy (CIS). They exhibited higher competence in problemsolving, listening, and speaking skills. Adopting CBIS exposes children to indigenous ways of learning that allow them to be actively involved in teaching and learning activities. Limitation and Further Research Getting the relevant indigenous songs, games, play, and materials relevant to the topic treated almost hindered the implementation of the experiment. Most of the indigenous ways of teaching are gradually going into extinction. Further studies on culturally-based instructional strategy should not be restricted to an aspect of the child's development (cognitive) but should be extended to cover the holistic development of children; none of the domains should be neglected or given more attention than the other. 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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 14A Proxy Statement Pursuant to Section 14(a) of the Securities Exchange Act of 1934 (Amendment No. ) Filed by the Registrant þ Filed by a Party other than the Registrant ☐ Check the appropriate box: ☐ Preliminary Proxy Statement ☐ Confidential, for Use of the Commission Only (as permitted by Rule 14a-6(e)(2)) þ Definitive Proxy Statement ☐ Definitive Additional Materials ☐ Soliciting Material under §240.14a-12 PTC Therapeutics, Inc. (Name of Registrant as Specified In Its Charter) (Name of Person(s) Filing Proxy Statement, if other than the Registrant) Payment of Filing Fee (Check the appropriate box): þ No fee required. ☐ Fee computed on table below per Exchange Act Rules 14a-6(i)(1) and 0-11. 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(1) Amount Previously Paid: (2) Form, Schedule or Registration Statement No.: (3) Filing Party: (4) Date Filed: April 30, 2018 Dear Stockholder: You are cordially invited to attend the 2018 Annual Meeting of Stockholders of PTC Therapeutics, Inc., on Wednesday, June 13, 2018 at 9:00 a.m., Eastern Time. The Annual Meeting will be held at the Embassy Suites, located at 121 Centennial Ave. in Piscataway Township, New Jersey. The attached Notice of the Annual Meeting and proxy statement provide important information about the Annual Meeting and will serve as your guide to the business to be conducted at the meeting. Your vote is very important to us. We urge you to read the accompanying materials regarding the matters to be voted on at the Annual Meeting and to submit your voting instructions by proxy. Our Board of Directors recommends that you vote "for" each of the proposals listed on the attached Notice. You may submit your proxy by Internet, by telephone or by requesting a printed copy of the proxy materials and using the enclosed proxy card. If you submit your proxy before the meeting but later decide to attend the Annual Meeting in person, you may still vote in person at the Annual Meeting. On behalf of our Board of Directors, management and all of our employees, I thank you for your continuing support and confidence. Sincerely, Stuart W. Peltz, Ph.D. Chief Executive Officer PTC Therapeutics, Inc. 100 Corporate Court South Plainfield, New Jersey 07080 PTC Therapeutics, Inc. 100 Corporate Court South Plainfield, New Jersey 07080 NOTICE OF ANNUAL MEETING OF STOCKHOLDERS To be held on June 13, 2018 To the Stockholders of PTC Therapeutics, Inc.: This proxy statement contains information about the 2018 Annual Meeting of Stockholders of PTC Therapeutics, Inc., which we refer to as the Annual Meeting. The Annual Meeting will be held on Wednesday, June 13, 2018 at 9:00 a.m., Eastern Time, at the Embassy Suites, located at 121 Centennial Ave. in Piscataway Township, New Jersey. At the Annual Meeting, stockholders will consider and act upon the following matters: 1. To elect the two Class II director nominees nominated by our Board of Directors and named in the proxy statement, each to serve for a term ending in 2021, or until his successor has been duly elected and qualified; 2. To ratify the appointment of Ernst & Young LLP, a registered public accounting firm, as our independent registered public accounting firm for the fiscal year ending December 31, 2018; 3. To hold an advisory vote to approve named executive officer compensation; and 4. To transact such other business as may properly come before the Annual Meeting or any adjournment or postponement thereof. Instead of mailing a printed copy of our proxy materials to all of our stockholders, we provide access to these materials via the Internet. This reduces the amount of paper necessary to produce these materials as well as the costs associated with mailing these materials to all stockholders. Accordingly, on or about April 30, 2018, we will begin mailing a Notice of Internet Availability of Proxy Materials, or Notice, to stockholders of record at the close of business on April 20, 2018, the record date for the Annual Meeting, and will post our proxy materials on the website referenced in the Notice. As more fully described in the Notice, stockholders may choose to access our proxy materials on the website referred to in the Notice or may request to receive a printed set of our proxy materials. If you are a stockholder of record, we encourage you to vote in one of the following ways: * Vote over the Internet, by going to www.proxyvote.com (have your Notice or proxy card in hand when you access the website); * Vote by Telephone , by calling the toll-free number (800) 690-6903 (have your Notice or proxy card in hand when you call); or * Vote by Mail, if you received (or requested and received) a printed copy of the proxy materials, by returning the enclosed proxy card (signed and dated) in the envelope provided. If your shares are held in "street name," meaning that they are held for your account by a broker or other nominee, you will receive instructions from the holder of record that you must follow for your shares to be voted. Whether or not you plan to attend the Annual Meeting in person, we urge you to take the time to vote your shares. By Order of the Board of Directors, Megan Sniecinski Secretary April 30, 2018 TABLE OF CONTENTS PTC Therapeutics, Inc. 100 Corporate Court South Plainfield, New Jersey 07080 PROXY STATEMENT FOR THE ANNUAL MEETING OF STOCKHOLDERS To be held on June 13, 2018 These proxy materials are being furnished in connection with the solicitation of proxies by our Board of Directors for use at the 2018 Annual Meeting to be held on Wednesday, June 13, 2018 at 9:00 a.m., Eastern Time, at the Embassy Suites, located at 121 Centennial Ave. in Piscataway Township, New Jersey, and at any adjournment or postponement thereof. All proxies will be voted in accordance with the instructions contained in those proxies. If no choice is specified, the proxies will be voted "for" each of the director nominees and "for" each of the proposals set forth in the accompanying Notice of Annual Meeting of Stockholders. You may revoke your proxy at any time before it is exercised at the meeting by giving our Secretary written notice to that effect. The Notice of Annual Meeting and proxy statement are first being mailed and/or made available to stockholders on or about April 30, 2018 in conjunction with the delivery of our 2017 Annual Report to Stockholders. In this proxy statement, unless expressly stated otherwise or the context otherwise requires, the use of "PTC," "the Company," "our," "we" or "us" refers to PTC Therapeutics, Inc., and its subsidiaries. Certain information contained in this proxy statement relating to the occupations and security holdings of our directors and officers is based upon information received from the individual directors and officers. Whether or not you expect to attend the Annual Meeting in person, please vote as promptly as possible to ensure your representation and the presence of a quorum at the Annual Meeting. You may vote your shares on the Internet by visiting www.proxyvote.com or by telephone by calling 1-800-690-6903 and following the recorded instructions, by requesting a printed copy of the proxy materials and using the enclosed proxy card or by voting in person at the Annual Meeting. Your proxy is revocable in accordance with the procedures set forth in this proxy statement. Important Notice Regarding Availability of Proxy Materials for the 2018 Annual Meeting of Stockholders on June 13, 2018 This proxy statement and the 2017 Annual Report to Stockholders are available for viewing, printing and downloading at: http://ir.ptcbio.com/annualmeetingmaterials All website addresses given in this proxy statement are for information only and are not intended to be an active link or to incorporate any website information into this document. 1 IMPORTANT INFORMATION ABOUT THE ANNUAL MEETING AND VOTING Q. Why did I receive these proxy materials? A. We are providing these proxy materials to you in connection with the solicitation by our Board of Directors, or Board, of proxies to be voted at our Annual Meeting to be held at the Embassy Suites, located at 121 Centennial Ave. in Piscataway Township, New Jersey on Wednesday, June 13, 2018 at 9:00 a.m., Eastern Time. At the Annual Meeting, our stockholders will consider and vote on the matters described in this proxy statement. As of the date of this proxy statement, we are not aware of any business to come before the meeting other than the matters described herein. The Notice of Annual Meeting, proxy statement, and voting instructions, together with our 2017 Annual Report, will be made available to each stockholder entitled to vote starting on or about April 30, 2018. These materials are available for viewing, printing and downloading on the Internet at www.proxyvote.com. Q. Who can vote at the Annual Meeting? A. Our Board has fixed April 20, 2018 as the record date for the Annual Meeting. If you were a stockholder of record on the record date, you are entitled to vote (in person or by proxy) all of the shares that you held on that date at the Annual Meeting and at any postponement or adjournment thereof. On the record date, we had 46,411,985 shares of our common stock outstanding. Each share of common stock entitles its holder to one vote per share. Holders of common stock do not have cumulative voting rights. Q. How do I vote? A. If you are a stockholder of record, meaning that your shares are registered directly in your name, you may vote: (1) Over the Internet: Go to www.proxyvote.com. Use the vote control number printed on your Notice (or your proxy card or voting instruction card) to access your account and vote your shares. You must specify how you want your shares voted or your Internet vote cannot be completed and you will receive an error message. Your shares will be voted according to your instructions. You must submit your Internet proxy before 11:59 p.m., Eastern Time, on June 12, 2018, the day before the Annual Meeting, for your proxy to be valid and your vote to count. If you choose to vote over the Internet, you do not have to return a proxy card (or voting instruction card). 2 (2) By Telephone: Call 1-800-690-6903, toll free from the United States, Canada and Puerto Rico, and follow the recorded instructions. You will need to have the Notice (or your proxy card or voting instruction card) in hand when you call. You must specify how you want your shares voted and confirm your vote at the end of the call or your telephone vote cannot be completed. Your shares will be voted according to your instructions. You must submit your telephonic proxy before 11:59 p.m., Eastern Time, on June 12, 2018, the day before the Annual Meeting, for your proxy to be valid and your vote to count. If you choose to vote by telephone, you do not have to return the proxy card (or voting instruction card). (3) By Mail: If you received a printed copy of the proxy materials, complete and sign your enclosed proxy card and mail it in the enclosed postage prepaid envelope. Your shares will be voted according to your instructions. Broadridge must receive the proxy card by June 12, 2018, the day before the Annual Meeting, for your proxy to be valid and your vote to count. If you sign and return your proxy card but do not specify how you want your shares voted, they will be voted as recommended by our Board. (4) In Person at the Meeting: If you attend the Annual Meeting, you may deliver your completed proxy card in person or you may vote by completing a ballot, which we will provide to you at the meeting. If your shares are held in "street name," meaning they are held for your account by a broker, bank, trust or other nominee or custodian, then you are considered the beneficial owner of those shares, and you may vote: (1) Over the Internet or by Telephone: You will receive instructions from your broker or other nominee if they permit Internet or telephone voting. You should follow those instructions. (2) By Mail: You will receive instructions from your broker or other nominee explaining how you can vote your shares by mail. You should follow those instructions. (3) In Person at the Meeting: Contact your broker or other nominee who holds your shares to obtain a broker's proxy and bring it with you to the Annual Meeting. A broker's proxy is not the form of proxy enclosed with this proxy statement. You will not be able to vote shares you hold in street name in person at the Annual Meeting unless you have a proxy from your broker or other nominee issued in your name giving you the right to vote your shares. If you hold your shares of our common stock in multiple accounts, you should vote your shares as described above for each set of proxy materials you receive. Q. Can I change or revoke my vote? Q. Will my shares be voted if I do not return my proxy? A. If your shares are registered directly in your name, you may revoke your proxy and change your vote at any time before the Annual Meeting. To do so, you must do one of the following: (1) Vote over the Internet or by telephone as instructed above. Only your latest Internet or telephone vote is counted. You may not change your vote over the Internet or by telephone after 11:59 p.m., Eastern Time, on June 12, 2018. (2) Sign a new proxy and submit it as instructed above. Only your latest dated proxy, received by Broadridge not later than June 12, 2018, will be counted. (3) Attend the Annual Meeting, request that your proxy be revoked and vote in person as instructed above. Attending the Annual Meeting will not revoke your Internet vote, telephone vote or proxy, as the case may be, unless you specifically request it. If your shares are held in street name, you may submit new voting instructions by contacting your broker or other nominee. You may also vote in person at the Annual Meeting if you obtain a broker's proxy as described in the answer above. A. If your shares are registered directly in your name, your shares will not be voted if you do not vote over the Internet, by telephone, by returning your proxy or by ballot at the Annual Meeting. If your shares are held in street name, your broker or other nominee may, under certain circumstances, vote your shares if you do not timely return your proxy. Brokers can vote their customers' unvoted shares on discretionary matters but cannot vote such shares on non-discretionary matters. If you do not timely return a proxy to your broker to vote your shares, your broker may, on discretionary matters, either vote your shares or leave your shares unvoted. The ratification of the appointment of our independent registered public accounting firm (Proposal 2) is a discretionary matter. The election of directors (Proposal 1) and the advisory vote to approve named executive officer compensation (Proposal 3) are each non-discretionary matters. If your shares are held in street name and you do not vote your shares, your broker or other nominee cannot vote your shares on Proposals 1 or 3. Shares held in street name by brokers or nominees who indicate on their proxies that they do not have authority to vote the shares on Proposals 1 or 3 will not be counted as votes FOR or WITHHELD from any director nominee, with respect to Proposal 1, or FOR or AGAINST Proposal 3 and will be treated as "broker non-votes." Broker non-votes will have no effect on the voting on Proposals 1, 2 or 3. We encourage you to provide voting instructions to your broker or other nominee by giving your proxy to them. This ensures that your shares will be voted at the Annual Meeting according to your instructions. Q. How many shares must be present to hold the Annual Meeting? Q. What vote is required to approve each proposal and how are votes counted? A. The holders of a majority in voting power of the common stock issued, outstanding and entitled to vote at the meeting must be present to hold the Annual Meeting and conduct business. This is called a quorum. For purposes of determining whether a quorum exists, we count as "present" any shares that are voted over the Internet, by telephone, by completing and submitting a proxy or that are represented in person at the meeting. Abstentions and broker non-votes will be counted for the purposes of establishing a quorum at the meeting. If a quorum is not present, we expect to adjourn the Annual Meeting until we obtain a quorum. A. Proposal 1—Election of Two Class II Directors The two director nominees receiving the highest number of votes FOR election will be elected as directors. This is called a plurality. Proposal 1 is a non-discretionary matter. With respect to Proposal 1, you may: * vote FOR all director nominees; * vote FOR one or more director nominee(s) and WITHHOLD your vote from the other director nominee(s); or * WITHHOLD your vote from all director nominees. Votes that are withheld will not be included in the vote tally for the election of directors and will not affect the results of the vote. Proposal 2—Ratification of Appointment of Independent Registered Public Accounting Firm To approve Proposal 2, stockholders holding a majority of the votes cast on the matter must vote FOR the proposal. Proposal 2 is a discretionary matter. If your shares are held in street name and you do not vote your shares, your broker or other nominee may vote your unvoted shares on Proposal 2. If you vote to ABSTAIN on Proposal 2, your shares will not be voted FOR or AGAINST the proposal and will also not be counted as votes cast or shares voting on the proposal. Voting to ABSTAIN will have no effect on the voting on Proposal 2. Proposal 3—Advisory Vote to Approve Named Executive Officer Compensation Proposal 3 asks for a non-binding, advisory vote, so there is no "required vote" that would constitute approval. Proposal 3 is a non-discretionary matter. We value the opinions expressed by our stockholders in this advisory vote, and our Compensation Committee, which is responsible for overseeing and administering our executive compensation programs, will consider the outcome of the vote when designing our compensation programs and making future compensation decisions for our named executive officers. If you vote to ABSTAIN on Proposal 3, your shares will not be voted FOR or AGAINST the proposal and will also not be counted as votes cast or shares voting on the proposal. Voting to ABSTAIN will have no effect on the voting on Proposal 3. Q. Are there other matters to be voted on at the Annual Meeting? A. We do not know of any matters that may come before the Annual Meeting other than the matters listed in the accompanying Notice of Annual Meeting of Stockholders. If any other matters are properly presented at the Annual Meeting, the persons named in the accompanying proxy intend to vote, or otherwise act, in accordance with their judgment on the matter. Q. Who may attend the Annual Meeting? A. All stockholders of record on our books at the close of business on April 20, 2018, the record date for the Annual Meeting, may attend the meeting. To gain admission, record holders will need a valid picture identification or other proof that you are a stockholder of record of our shares as of the record date. If your shares are held in a bank or brokerage account, a recent bank or brokerage statement showing that you owned shares on the record date will be required for admission. To obtain directions to attend the Annual Meeting and vote in person, please contact Investor Relations by sending an email to: email@example.com. Q. Where can I find the voting results? A. We will report the voting results in a Current Report on Form 8-K within four business days following the adjournment of the Annual Meeting. Q. What are the costs of soliciting these proxies? A. We will bear the cost of soliciting proxies. In addition to these proxy materials, our directors, officers and employees may solicit proxies without additional compensation. We do not currently plan to hire a proxy solicitor to help us solicit proxies from brokers and other nominees, although we reserve the right to do so. We may reimburse brokers or persons holding stock in their names, or in the names of their nominees, for their expenses in sending proxies and proxy material to beneficial owners. 6 CORPORATE GOVERNANCE Our Board believes that good corporate governance is important to ensure that our Company is managed for the long-term benefit of our stockholders. This section describes key corporate governance guidelines and practices that we have adopted to further this goal. Complete copies of the committee charters, Code of Business Conduct and Ethics and Corporate Governance Guidelines described below are available on the Corporate Governance page of the Investors section of our website, www.ptcbio.com. Alternatively, you can request a copy of any of these documents by writing to our Vice President, Corporate Communications, PTC Therapeutics, Inc., 100 Corporate Court, South Plainfield, New Jersey 07080. Code of Business Conduct and Ethics We have adopted a written Code of Business Conduct and Ethics, which is a code of ethics that applies to our directors, officers and employees, including our principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions. We have posted a current copy of the Code of Business Conduct and Ethics on the Corporate Governance page of the Investors section of our website, www.ptcbio.com. In addition, we intend to post on our website all disclosures that are required by law or Nasdaq's listing standards concerning any amendments to, or waivers from, any provision of the Code of Business Conduct and Ethics. Corporate Governance Guidelines Our Board has adopted Corporate Governance Guidelines to assist it in the exercise of its duties and responsibilities and to serve the best interests of our Company and our stockholders. We have posted a current copy of the Corporate Governance Guidelines on the Corporate Governance page of the Investors section of our website, www.ptcbio.com. These principles, which provide a framework for the conduct of our Board's business, provide that: * the principal responsibility of the directors is to oversee our management and to hold our management accountable for the pursuit of our corporate objectives; * a majority of the members of our Board shall be independent directors; * the independent directors meet regularly in executive session; * directors have full and free access to management and, as necessary and appropriate, independent advisors; * new directors participate in an orientation program and all directors are encouraged to attend director education programs; and * at least annually, our Board and its committees will conduct a self-evaluation to determine whether they are functioning effectively. Director Independence Our Board has determined that all of our directors and director nominees, other than Dr. Peltz, our Chief Executive Officer, are independent as defined under applicable Nasdaq rules. In making such determination, our Board considered the relationships that each such person has with our Company and all other facts and circumstances that our Board deemed relevant in determining independence, including beneficial ownership of our common stock by our non-employee directors. Director Nominations Process Our Nominating and Corporate Governance Committee is responsible for identifying individuals qualified to serve as directors, consistent with criteria approved by our Board, and recommending the persons to be nominated for election as directors. The process followed by our Nominating and Corporate Governance Committee to identify and evaluate director candidates includes requests to members of our Board, search firms and others for recommendations, meetings from time to time to evaluate biographical information and background material relating to potential candidates and interviews of selected candidates by members of our Nominating and Corporate Governance Committee and our Board. Criteria and Diversity 7 In considering whether to recommend any particular candidate for inclusion in our Board's slate of recommended director nominees, our Nominating and Corporate Governance Committee applies the criteria specified in our Corporate Governance Guidelines. These criteria include the candidate's integrity, business acumen, knowledge of our business and industry, experience, diligence, conflicts of interest with us, and ability to act in the interests of stockholders. Our Nominating and Corporate Governance Committee does not assign specific weight to particular criteria and no particular criterion is a prerequisite for any prospective director nominee. Our Board does not have a formal policy with respect to diversity, but our Corporate Governance Guidelines provide that an objective of Board composition is to bring to our Company a variety of perspectives and skills derived from high quality business and professional experience. Our Board recognizes its responsibility to ensure that director nominees possess appropriate qualifications and reflect a reasonable diversity of personal and professional experience, skills, backgrounds and perspectives. We believe that the backgrounds and qualifications of our directors, considered as a group, should provide a composite mix of experience, knowledge and abilities that will allow our Board to promote our strategic objectives and to fulfill its responsibilities to our stockholders. The director biographies presented under "Proposal 1: Election of Directors" indicate each director nominee's experience, qualifications, attributes and skills that led our Board to conclude that he should be nominated to serve as a member of our Board or, in the case of our continuing directors, that he or she is qualified to serve on our Board. Our Board believes that each of the director nominees and continuing directors has had substantial achievement in his or her professional and personal pursuits, and possesses the background, talents and experience that our Board desires and that will contribute to the best interests of our Company and to long-term stockholder value. Stockholder Nominations Stockholders may recommend individuals to our Nominating and Corporate Governance Committee for consideration as potential director candidates by submitting their names, together with appropriate biographical information and background materials as of the date such recommendation is made, to our Nominating and Corporate Governance Committee, c/o Secretary, PTC Therapeutics, Inc., 100 Corporate Court, South Plainfield, New Jersey 07080. Assuming that appropriate biographical and background material has been provided on a timely basis, our Nominating and Corporate Governance Committee will evaluate stockholder-recommended candidates by following substantially the same process, and applying substantially the same criteria, as it follows for candidates submitted by others. Stockholders also have the right under our bylaws to directly nominate director candidates, without any action or recommendation on the part of our Nominating and Corporate Governance Committee or our Board, by following the procedures set forth under "Stockholder Proposals and Nominations for Director." Board Meeting and Annual Meeting Attendance Our Board held 13 meetings during 2017. During 2017, each of our directors attended at least 75% of the Board meetings and the meetings of the committees on which such director then served, other than Dr. Jacobson and Dr. Steele. Due to unavoidable prior obligations, Drs. Jacobson and Steele were unable to attend several special meetings of the Board that were called on short notice and as a result attended 69% and 70%, respectively, of the aggregate number of our Board meetings and the meetings of the committees upon which they served in 2017, as applicable. Notwithstanding their attendance record at formal board meetings during 2017, Drs. Jacobson and Steele have been consistently available to our Board and management for regular consultations on matters critical to our success, in particular those related to their areas of expertise as leaders in the life sciences and health industries. The Board believes that Dr. Steele's contributions to the Board and the Company have been significant and that his re-election to the Board is in the best interests of the Company and its stockholders due to his extensive experience in our industry. Our Corporate Governance Guidelines provide that our directors are expected to attend the Annual Meeting. Eight of our then ten directors attended our 2017 annual meeting of stockholders. Board Leadership Structure The positions of Chair of the Board and Chief Executive Officer are currently separate. Mr. Schmertzler serves as our Chair of the Board and Dr. Peltz serves as our Chief Executive Officer. This leadership structure allows our Chief Executive Officer to focus on our day-to-day business and allows our Chair of the Board to lead our Board in its fundamental role of providing advice to and independent oversight of management. Our Board recognizes the time, effort and energy that our Chief Executive Officer must devote to his position, as well as the commitment required by Mr. Schmertzler to serve as our Chair of the Board, particularly as our Board's oversight responsibilities continue to grow. Our Board also believes that this structure ensures a greater role for the independent directors in the oversight of our Company and active participation of the independent directors in setting agendas and establishing priorities and procedures for the work of our Board. Our bylaws do not require the position of Chair of our Board and Chief Executive Officer to be separate. Our Board believes that its leadership structure demonstrates our commitment to good corporate governance, and is appropriate at present because it strikes an effective balance between strategy development, independent leadership and management oversight. Our Board believes its leadership structure positively affects its administration of its risk oversight function. Board Committees Our Board has established three standing committees: our Audit Committee, our Compensation Committee and our Nominating and Corporate Governance Committee. Each of these committees operates under a charter that has been approved by our Board. Each committee's charter is posted on the Corporate Governance page of the Investors section of our website, www.ptcbio.com. Our Board has determined that all of the members of each of its three committees are independent as defined under applicable Nasdaq rules, including, in the case of all members of our Audit Committee, the independence requirements contemplated by Rule 10A-3 under the Securities Exchange Act of 1934, as amended, or the Exchange Act, and, in the case of all members of our Compensation Committee, the independence requirements contemplated by Rule 10C-1 under the Exchange Act. Audit Committee The members of our Audit Committee are Mr. Southwell, Ms. Svoronos and Dr. Zeldis. Mr. Southwell is the current chair of our Audit Committee. Our Audit Committee held six meetings in 2017. Our Audit Committee's responsibilities include: * appointing, approving the compensation of, and assessing the independence of our registered public accounting firm; * overseeing the work of our independent registered public accounting firm, including through the receipt and consideration of reports from such firm; * reviewing and discussing with management and our independent registered public accounting firm our annual and quarterly financial statements and related disclosures; * monitoring our internal control over financial reporting, disclosure controls and procedures and code of business conduct and ethics; * overseeing our internal audit function; * overseeing our risk assessment and risk management policies; * establishing policies regarding hiring employees from our independent registered public accounting firm and procedures for the receipt and retention of accounting related complaints and concerns; * meeting independently with our internal auditing staff, our independent registered public accounting firm and management; * reviewing and approving or ratifying any related person transactions; and * preparing the audit committee report required by Securities and Exchange Commission, or SEC, rules. Our Board has determined that Mr. Southwell and Ms. Svoronos are "audit committee financial experts" as defined in applicable SEC rules. Compensation Committee The members of our Compensation Committee are Messrs. Schmertzler and Southwell and Dr. Steele. Mr. Schmertzler chairs our Compensation Committee. Our Compensation Committee held ten meetings in 2017. Our Compensation Committee's responsibilities include: * reviewing and approving, or making recommendations to our Board with respect to, the compensation of our Chief Executive Officer and our other executive officers; * overseeing an evaluation of our senior executives; * overseeing and administering our cash and equity incentive plans; and * reviewing and making recommendations to our Board with respect to director compensation. Compensation Processes and Procedures Our Compensation Committee makes all compensation decisions regarding our Chief Executive Officer and each of his direct reports, including salary, annual cash incentive compensation and long-term equity compensation (or, when the Committee deems it appropriate, makes recommendations concerning such matters to our Board). If the Compensation Committee deems it appropriate, it may delegate any of its responsibilities to one or more Compensation Committee members or subcommittees. Our Compensation Committee relies on management for legal, tax, compliance, finance and human resource recommendations, data and analysis for the design and administration of the compensation and benefits programs for our executive officers. As a result, our Chief Executive Officer, Principal Financial Officer, Senior Vice President, Human Resources & Administration, and Executive Vice President & Chief Legal Officer generally attend Compensation Committee meetings upon the invitation of the Committee. The Compensation Committee also establishes, with input from the Chief Executive Officer and other members of the executive team, the corporate goals applicable to our annual cash incentive awards. On an annual basis our Chief Executive Officer meets with the executive officers to discuss the Company's accomplishments as well as the individual officer's performance and contributions over the year. Based on these discussions and input from others within PTC, our Chief Executive Officer, with respect to each executive officer other than himself, prepares an evaluation of the executive officer as to the level of contribution made to the management and success of our Company. In addition, our Chief Executive Officer, with the participation of other members of senior management, prepares information concerning the Company's achievements and our performance against corporate goals during the fiscal year. The Compensation Committee is presented with this information and the Chief Executive Officer's recommendations with respect to each executive officer, other than himself, as to each element of compensation. The Chief Executive Officer's recommendations, information concerning the Company's performance over the applicable fiscal period, expectations concerning performance in the coming year, and advice and information from its independent compensation consultant are all taken into account by the Compensation Committee when it makes final determinations on executive compensation matters. Our Chief Executive Officer's performance and salary, annual cash incentive compensation and long-term equity compensation are discussed by the Compensation Committee in executive session, with advice and participation from the Compensation Committee's independent compensation consultant as requested by the Compensation Committee. Our Chief Executive Officer does not participate in decisions regarding his own compensation. For additional information concerning our executive compensation program, see Compensation Discussion and Analysis on page 25. Our Compensation Committee has delegated to the Chief Executive Officer limited authority to make stock option grants to non-Section 16 officers. Any such awards must be reported to our Compensation Committee at its next meeting. During 2017, our Chief Executive Officer did not make any grants pursuant to this delegated authority. Role of Independent Compensation Consultants Our Compensation Committee may, in its sole discretion, retain or obtain the advice of one or more compensation consultants. In 2017, our Compensation Committee engaged Frederic W. Cook & Co., Inc., or FW Cook, as its independent compensation consultant, to provide comparative data on executive compensation practices in our industry, to assist the Compensation Committee in developing an appropriate list of peer companies against which to conduct compensation benchmarking, and to advise on our executive compensation program generally. The Compensation Committee also engaged FW Cook for recommendations and review of non-employee director compensation in 2017. Although our Compensation Committee considers the advice and recommendations of independent compensation consultants as to our executive compensation program, our Compensation Committee ultimately makes its own decisions about these matters. In the future, we expect that our Compensation Committee will continue to engage independent compensation consultants to provide additional guidance on our executive compensation programs and to conduct further competitive benchmarking against a peer group of publicly traded companies. The Compensation Committee has reviewed information regarding the independence and potential conflicts of interest of FW Cook during 2017 and 2018, taking into account, among other things, the factors set forth in the Nasdaq listing standards. Based on such reviews, the Compensation Committee concluded that the engagement of FW Cook did not raise any conflict of interest. FW Cook did not provide services to the Company outside of services provided at the request of the Compensation Committee in 2017. Nominating and Corporate Governance Committee The members of our Nominating and Corporate Governance Committee are Dr. Zeldis and Mr. Schmertzler. Mr. Schmertzler chairs our Nominating and Corporate Governance Committee. Our Nominating and Corporate Governance Committee held one meeting in 2017. Our Nominating and Corporate Governance Committee's responsibilities include: * identifying individuals qualified to become members of our Board; * recommending to our Board the persons to be nominated for election as directors and to each of our Board's committees; * reviewing and making recommendations to our Board with respect to our board leadership structure; * reviewing and making recommendations to our Board with respect to management succession planning; * developing and recommending to our Board corporate governance principles; and * overseeing a periodic evaluation of our Board. Risk Oversight Risk is inherent with every business and how well a business manages risk can ultimately determine its success. We face a number of risks, including those described under "Risk Factors" in our Annual Report on Form 10-K for the fiscal year ended December 31, 2017, and those described in our Quarterly Reports on Form 10-Q and our Current Reports on Form 8-K. Our Board is actively involved in oversight of risks that could affect us. Role of Our Board in Management of Risk Our Board administers its risk oversight function directly and through its Audit Committee and receives regular reports from members of senior management, including our Chief Executive Officer, Principal Financial Officer and Chief Legal Officer, on areas of material risk to our Company, including operational, financial, legal and regulatory, and strategic and reputational risks and has direct access to our Senior Vice President, Business Operations, our Senior Vice President, Quality Assurance and our Senior Vice President, Global Regulatory Affairs. As part of its charter, our Audit Committee regularly discusses with management our major risk exposures, their potential financial impact on our Company and the steps we take to manage them. Our Board believes that full and open communication between our management and our Board is essential for effective risk management and oversight. In addition, our Compensation Committee assists our Board in fulfilling its oversight responsibilities with respect to the management and risks arising from our compensation policies and programs. Our Nominating and Corporate Governance Committee assists our Board in fulfilling its oversight responsibilities with respect to the management of risks associated with board organization, membership and structure, succession planning for our directors and executive officers and corporate governance. Communicating with our Directors Our Board will give appropriate attention to written communications that are submitted by stockholders, and will respond if and as appropriate. Our Chair of the Board and the Chair of our Nominating and Corporate Governance Committee, with the assistance of our Chief Legal Officer and Vice President, Corporate Communications, are primarily responsible for monitoring communications from stockholders and for providing copies or summaries to the other directors as they consider appropriate. Communications are forwarded to all directors if they relate to important substantive matters. In general, communications relating to corporate governance and corporate strategy are more likely to be forwarded than communications relating to ordinary business affairs, personal grievances and matters that are duplicative communications. Items that are unrelated to the duties and responsibilities of the Board may be excluded or redirected, as appropriate, such as business solicitations, job inquiries or advertisements, mass mailings, new product suggestions, or communications that have no rational relevance to our business or operations. In addition, material that is unduly hostile, threatening or similarly unsuitable will be excluded; however, any communication will be made available to any director upon her or his request. Stockholders who wish to send communications on any topic to our Board should address such communications to the Board of Directors c/o PTC Therapeutics, Inc., 100 Corporate Court, South Plainfield, New Jersey 07080, Attn: Secretary. Compensation Committee Interlocks and Insider Participation Messrs. Schmertzler and Southwell and Dr. Steele served as members of the Compensation Committee during the last completed fiscal year. None of our executive officers serves as a member of the board of directors or compensation committee, or other committee serving an equivalent function, of any other entity that has one or more of its executive officers serving as a member of our Board or our Compensation Committee. None of the members of our Compensation Committee is, or has ever been, an officer or employee of PTC. Policies and Procedures for Related Person Transactions Our Board has adopted a written related person policy, which sets forth our policies and procedures for the review of any transaction, arrangement or relationship in which PTC is a participant, the amount involved exceeds $120,000 and one of our executive officers, directors, director nominees or 5% stockholders, or their immediate family members, each of whom we refer to as a "related person," has a direct or indirect material interest. If a related person proposes to enter into such a transaction, arrangement or relationship, which we refer to as a "related person transaction," the related person must report the proposed related person transaction to our Chief Legal Officer. Our related person policy calls for the proposed related person transaction to be reviewed and, if deemed appropriate, approved by our Audit Committee. Whenever practicable, the reporting, review and approval will occur prior to entry into the transaction. If advance review and approval is not practicable, the Audit Committee will review, and, in its discretion, may ratify the related person transaction. Our related person policy also permits the Chair of our Audit Committee to review and, if deemed appropriate, approve proposed related person transactions that arise between Audit Committee meetings, subject to ratification by the Audit Committee at its next meeting. Any related person transactions that are ongoing in nature will be reviewed annually. A related person transaction reviewed under the policy will be considered approved or ratified if it is authorized by our Audit Committee after full disclosure of the related person's interest in the transaction. As appropriate for the circumstances, the Audit Committee will review and consider: * the related person's interest in the related person transaction; * the approximate dollar value of the amount involved in the related person transaction; * the approximate dollar value of the amount of the related person's interest in the transaction without regard to the amount of any profit or loss; * whether the transaction was undertaken in the ordinary course of our business; * whether the terms of the transaction are no less favorable to us than terms that could have been reached with an unrelated third party; * the purpose of, and the potential benefits to us of, the transaction; and * any other information regarding the related person transaction or the related person in the context of the proposed transaction that would be material to investors in light of the circumstances of the particular transaction. Our Audit Committee may approve or ratify the transaction only if the Audit Committee determines that, under all of the circumstances, the transaction is in our best interests. The Audit Committee may impose any conditions on the related person transaction that it deems appropriate. In addition to the transactions that are excluded by the instructions to the SEC's related person transaction disclosure rule, our Board has determined that the following transactions do not create a material direct or indirect interest on behalf of related persons and, therefore, are not related person transactions for purposes of this policy: * interests arising solely from the related person's position as an executive officer of another entity (whether or not the person is also a director of such entity) that is a participant in the transaction, where (a) the related person and all other related persons own in the aggregate less than a 10% equity interest in such entity, (b) the related person and his or her immediate family members are not involved in the negotiation of the terms of the transaction and do not receive any special benefits as a result of the transaction and (c) the amount involved in the transaction is less than the greater of $200,000 or 5% of the annual gross revenues of the company receiving payment under the transaction; and * a transaction that is specifically contemplated by provisions of our certificate of incorporation or our bylaws. Our related person policy provides that transactions involving compensation of executive officers shall be reviewed and approved by our Compensation Committee in the manner specified in its charter. All of the transactions discussed below under the heading "Related Person Transactions" that occurred during 2017 were reviewed and approved by our Audit Committee or, with respect to compensation matters, our Compensation Committee, in each case in accordance with our policy. Related Person Transactions Since January 1, 2017, we have engaged in the following transactions in which our directors, executive officers and holders of more than 5% of our voting securities, and affiliates of our directors, executive officers and holders of more than 5% of our voting securities may have a direct or indirect material interest. We believe that all of these transactions were on terms as favorable to us as could have been obtained from unrelated third parties. Familial Relationship Jane (Zheng) Yang Almstead, the wife of Neil Almstead, our Executive Vice President, Research, Pharmaceutical Operations and Technology, is employed by us as a Senior Manager, BioAnalytical; Joeli Mansim, the wife of Marcio Souza, our Chief Operating Officer, is employed by the Company as Senior Director, Business Operations LATAM; and Ellen Welch, Ph.D., the domestic partner of Stuart W. Peltz, our Chief Executive Officer, is employed by us as Senior Vice President, Genetic Disorders & Translational Medicine. For their services to PTC during fiscal 2017, these employees received compensation of $161,587 to $559,117, comprised of base salary and non-equity incentive compensation (paid in fiscal 2018 based on 2017 performance), equity awards in the form of stock options and restricted stock units (based on the grant-date fair value), vested stock appreciation rights, company 401(k) matching contributions, and with respect to Ms. Mansim, a bonus award. These amounts reflect the full grant-date fair value of equity compensation awarded in 2017 (computed in accordance with the provisions of ASC 718), and do not represent the actual value realized by the employee during the year. Each of these individuals participated in our benefit programs generally available to U.S. employees during 2017. Neither Dr. Peltz, Dr. Almstead nor Mr. Souza participate in the compensation decisions regarding their family members, and we believe that the compensation paid to Ms. Almstead, Ms. Mansim and Dr. Welch is fair and commensurate with what their compensation would be if they had no relationship to an executive officer of the Company. During 2017, our IT, human resources and finance departments each engaged RSM US LLP, a provider of audit, tax and consulting services, for IT and tax services and audit services with respect to our 401(k) plan for aggregate fees of approximately $431,000. Dr. Peltz's brother is a principal in a different business unit at RSM, and we have been advised that he does not receive a direct economic benefit from these service agreements. We have, and anticipate that we will continue to, engage RSM for these types of services during 2018. We believe that the fees paid are fair and have been unaffected by this relationship. Indemnification Agreements Our restated certificate of incorporation, or certificate of incorporation, provides that we will indemnify our directors and officers to the fullest extent permitted by Delaware law. In addition, we have entered into indemnification agreements with our directors and executive officers. These indemnification agreements may require us, among other things, to indemnify each such director and executive officer for some expenses, including attorneys' fees, judgments, fines and settlement amounts incurred by him or her in any action or proceeding arising out of his or her service as one of our directors and/or executive officers. Consulting Agreements In conjunction with his resignation from the Company as an employee, our former Chief Commercial Officer, Mark Rothera, entered into a consulting agreement with the Company effective as of August 10, 2017, with a term continuing through September 30, 2018. For a discussion of the terms of the consulting agreement, please see "Consulting Agreements" on page 41. PRINCIPAL STOCKHOLDERS The following table sets forth information, to the extent known by us or ascertainable from public filings, with respect to the beneficial ownership of our common stock as of April 20, 2018, except as otherwise indicated in the table below, by each of our directors and director nominees; each of our named executive officers; all of our directors, director nominees and executive officers as a group; and each person, or group of affiliated persons, who is known by us to beneficially own more than 5% of our common stock. The column entitled "Percentage of shares beneficially owned" is based on a total of 46,411,985 shares of our common stock outstanding as of April 20, 2018. Beneficial ownership is determined in accordance with the rules and regulations of the SEC and includes voting or investment power with respect to our common stock. Shares of our common stock subject to options or warrants that are currently exercisable or exercisable within 60 days of April 20, 2018 are considered outstanding and beneficially owned by the person holding the options or warrants for the purpose of calculating the percentage ownership of that person but not for the purpose of calculating the percentage ownership of any other person. Except as otherwise noted, the persons and entities in this table have sole voting and investing power with respect to all of the shares of our common stock beneficially owned by them, subject to community property laws, where applicable. Except as otherwise indicated in the table below, addresses of named beneficial owners are in care of PTC Therapeutics Inc., 100 Corporate Court, South Plainfield, New Jersey 07080. _______________________________________________________________________________ * Less than one percent. (1) Consists of (a) 1,047,410 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; (b) 16,200 shares of restricted common stock; and (c) 10,446 shares of common stock. As of April 20, 2017, Dr. Peltz held an aggregate of 1,466,847 vested and unvested stock options to purchase an equal number of shares of our common stock. (2) Consists of (a) 209,167 shares of common stock underlying options held by Dr. Almstead that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; (b) 4,500 shares of restricted common stock held by Dr. Almstead; (c) 12,654 shares of common stock held directly by Dr. Almstead; (d) 3,001 shares of common stock underlying options held by Dr. Almstead's spouse that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; and (e) 3,336 shares of common stock held by Dr. Almstead's spouse. Dr. Almstead disclaims beneficial ownership of the shares held by his spouse. (3) Consists of (a) 264,105 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; (b) 6,750 shares of restricted common stock; and (c) 22,059 shares of common stock. (4) Consists of (a) 115,332 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; and (b) 6,848 shares of common stock. (5) Consists of (a) 68,645 shares of common stock underlying options held by Mr. Souza that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; (b) 33,000 shares of restricted common stock held by Mr. Souza; (c) 35,232 shares of common stock held directly by Mr. Souza; (d) 2,500 shares of common stock underlying options held by Mr. Souza's spouse that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; and (e) 663 shares of common stock held by Mr. Souza's spouse. Mr. Souza disclaims beneficial ownership of the shares held by his spouse. (6) Consists of (a) 46,391 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; and (b) 3,735 shares of common stock. (7) Consists of (a) 1,320,369 shares of common stock held by Section Six Partners, L.P., of which Mr. Schmertzler is a general partner; (b) 104,950 shares of common stock underlying options held by Mr. Schmertzler that are exercisable as of April 20, 2017 or will become exercisable within 60 days after such date; and (c) 86,766 shares of common stock held directly by Mr. Schmertzler. (8) Consists of 67,256 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date. (9) Consists of 49,833 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date. (10) Consists of (a) 31,166 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date; and (b) 25,000 shares of common stock. (11) Consists of 61,833 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days of such date. (12) Consists of (a) 2,071,589 shares of common stock underlying options that are exercisable as of April 20, 2018 or will become exercisable within 60 days after such date; (b) 60,450 shares of restricted common stock; and (c) 1,527,108 shares of common stock. (13) The address for Scopia Capital Management LP, or Scopia, is 152 West 57th Street, 33rd Floor, New York, NY 10019. As of March 31, 2018, consists of 5,914,052 shares of common stock held by Scopia and its affiliates, of which Scopia has shared voting power over 5,914,052 shares and shared dispositive power over 5,914,052 shares. The information contained in this footnote and the table above has been included solely in reliance upon, and without independent investigation of, the disclosures by Scopia that are contained in a Schedule 13G/A filed with the SEC on April 10, 2018. (14) The address for RTW Investments, LP, or RTW, is 250 West 55th Street, 16th Floor, Suite A, New York, NY 10019. As of December 31, 2017, consists of 4,130,115 shares of common stock held by RTW and its affiliates, of which RTW has shared voting power over 4,130,115 shares and shared dispositive power over 4,130,115 shares. The information contained in this footnote and the table above has been included solely in reliance upon, and without independent investigation of, the disclosures by RTW that are contained in a Schedule 13G/A filed with the SEC on February 14, 2018. (15) The address for BlackRock, Inc., or BlackRock, is 55 East 52nd Street, New York, NY 10022. As of December 31, 2017, consists of 3,093,399 shares of common stock held by BlackRock and its affiliates, of which BlackRock has sole voting power over 3,030,308 shares and sole dispositive power over 3,093,399 shares. The information contained in this footnote and the table above has been included solely in reliance upon, and without independent investigation of, the disclosures by BlackRock that are contained in a Schedule 13G/A filed with the SEC on January 29, 2018. (16) The address for The Vanguard Group, Inc., or Vanguard, is 100 Vanguard Blvd., Malvern, PA 19355. As of December 31, 2017, consists of 2,775,655 shares of common stock held by Vanguard and its affiliates. Sole voting power is held for 70,870 shares, shared voting power is held for 2,600 shares, sole dispositive power is held for 2,705,685 shares and shared dispositive power is held for 69,970 shares. The information contained in this footnote and the table above has been included solely in reliance upon, and without independent investigation of, the disclosures by Vanguard that are contained in a Schedule 13G filed with the SEC on February 9, 2018. (17) The address for State Street Corporation, or State Street, is 1 Lincoln Street, Boston, MA 02111. As of December 31, 2017, consists of 2,724,415 shares of common stock held by State Street and its affiliates, of which State Street has shared voting power over 2,724,415 shares and shared dispositive power over 2,724,415 shares. The information contained in this footnote and the table above has been included solely in reliance upon, and without independent investigation of, the disclosures by State Street that are contained in a Schedule 13G filed with the SEC on February 14, 2018. (18) The address for D. E. Shaw & Co., L.P., or DE Shaw, is 1166 Avenue of Americas, 9th Floor, New York, NY 10036. As of December 31, 2017, consists of 2,608,432 shares of common stock held by DE Shaw and its affiliates, of which DE Shaw has shared voting power over 2,499,607 shares and shared dispositive power over 2,608,432 shares. The information contained in this footnote and the table above has been included solely in reliance upon, and without independent investigation of, the disclosures by DE Shaw that are contained in a Schedule 13G/A filed with the SEC on February 14, 2018. (19) The address for Boxer Capital, LLC, or Boxer, is 11682 El Camino Real, Suite 320, San Diego CA 92130. As of February 14, 2018, consists of 2,600,000 shares of common stock held by Boxer and its affiliates, of which Boxer has shared voting power over 2,600,000 shares and shared dispositive power over 2,600,000 shares. The information contained in this footnote and the table above has been included solely in reliance upon, and without independent investigation of, the disclosures by Boxer that are contained in a Schedule 13G/A filed with the SEC on February 26, 2018. SECTION 16(A) BENEFICIAL OWNERSHIP REPORTING COMPLIANCE Section 16(a) of the Exchange Act requires our directors and executive officers and beneficial owners of more than 10% of our common stock to file reports of ownership and changes of ownership with the SEC on Forms 3, 4 and 5. The SEC has designated specific deadlines for these reports and we must identify in this proxy statement those persons who did not file these reports when due. We believe that during 2017 our directors, executive officers and beneficial owners of more than 10% of our common stock timely complied with all applicable filing requirements, with the exception of the late filing of a Form 4 by two days due to filing agent technical issues by Mr. Southwell. The late Form 4 reported the annual grant of stock options to Mr. Southwell. In making these disclosures, we relied solely on a review of copies of such reports filed with the SEC and furnished to us, and written representations that no other reports were required. PROPOSAL 1: ELECTION OF DIRECTORS Information Regarding Directors and Director Nominees Board Composition We currently have a classified board of directors consisting of three classes: Class I, Class II, and Class III. The terms of service of the three classes are staggered so that the term of one class expires each year. At each annual meeting of stockholders, directors are elected for a full term of three years to continue in office or to succeed those directors whose terms are expiring. Our directors hold office until their successors have been elected and qualified, or until the earlier of their resignation or removal. Our certificate of incorporation and bylaws provide that the authorized number of directors may be changed only by resolution of our Board; that our directors may be removed only for cause by the affirmative vote of the holders of at least 75% of the votes entitled to be cast in an annual election of directors; and that any vacancy on our Board, including a vacancy resulting from an enlargement of our Board, may be filled only by vote of a majority of our directors then in office. Our Board is authorized to have ten directors and currently consists of seven directors, two Class I directors, two Class II directors, and three Class III directors with each class having one vacancy. There are no family relationships between or among any of our executive officers, directors or director nominees. The principal occupation and employment during the past five years of each of our directors and director nominees was carried on, in each case except as specifically identified below, with a corporation or organization that is not a parent, subsidiary or other affiliate of us. There is no arrangement or understanding between any of our directors or director nominees and any other person or persons pursuant to which he was or is to be selected as a director or director nominee. Director Nominees At the Annual Meeting, stockholders will be asked to consider the election of Michael Schmertzler and Glenn D. Steele Jr., M.D., Ph.D. Upon the recommendation of our Nominating and Corporate Governance Committee, our Board has nominated Mr. Schmertzler and Dr. Steele for election at the Annual Meeting as Class II directors, each to serve until 2021. In June 2017, one of our then Class II directors, Adam Koppel, resigned from the Board leaving a Class II seat vacant. Our Board is not nominating a nominee to fill the vacancy in this election cycle, and the seat will remain vacant until filled by our Board in accordance with our certificate of incorporation and bylaws. Each of Mr. Schmertzler and Dr. Steele, our director nominees, has indicated his willingness to serve on our Board, if elected. If either director nominee should be unable to serve, the person acting under the proxy may vote the proxy for a substitute director nominee designated by our Board. We do not contemplate that either of our director nominees will be unable to serve if elected. Unless otherwise instructed in the proxy, all proxies will be voted "FOR" the election of each of the director nominees identified above to a three-year term ending in 2021, each such director nominee to hold office until his successor has been duly elected and qualified. A plurality of the voting power of the shares of common stock present in person or represented by proxy at the Annual Meeting and entitled to vote is required to elect each director nominee as a director. Our Board Recommends that You Vote "FOR" the Election of Michael Schmertzler and Glenn D. Steele Biographical Information The following table and biographical descriptions provide information as of April 20, 2018 relating to each director nominee and each director continuing in office, including age and period of service as a director of our Company; committee memberships; business experience during the past five years, including directorships at other public companies; community activities; and the other experience, qualifications, attributes or skills that led our Board to conclude that such director should serve as a director of PTC. Class II Director nominees to be elected at the Annual Meeting (current terms expiring in 2018) Name Age Board Tenure, Principal Occupation, Other Business Experience During the Past Five Years and Other Directorships Michael Schmertzler Chair of the Board Compensation Committee Nominating and Corporate Governance Committee Glenn D. Steele Jr., M.D., Ph.D. Compensation Committee 66 73 Mr. Schmertzler has served as a member of our Board since 2001 and as Chair of our Board since 2004. From 2001 to 2015, Mr. Schmertzler served as a Managing Director of Aries Advisors, LLC, the subadvisor to Credit Suisse First Boston Equity Partners, L.P., a private equity fund, and the Chair of the investment committee of Credit Suisse First Boston Equity Partners, L.P. From 1997 to 2001, Mr. Schmertzler was Co-Head of United States and Canadian Private Equity at Credit Suisse First Boston, an investment banking firm. Prior to 1997, Mr. Schmertzler held various management positions with Morgan Stanley and its affiliates, including President of Morgan Stanley Leveraged Capital Funds and head of Morgan Stanley's biotechnology pharmaceuticals group, and was Managing Director and Chief Financial Officer of Lehman Brothers Kuhn Loeb and Head of International Sales and Trading and Investment Banking at its successor, Lehman Brothers, both investment banking firms. Mr. Schmertzler is currently a director of Lehman Commercial Paper Incorporated, a liquidating post-bankruptcy subsidiary of Lehman Brothers Holdings, Incorporated. Mr. Schmertzler served as a director of our UK subsidiary until February 2016. Since 2008, he has been an Adjunct Professor and Lecturer at Yale University. Mr. Schmertzler received a B.A. from Yale College in Molecular Biophysics and Biochemistry, History and City Planning and an M.B.A. from the Harvard Business School. We believe that Mr. Schmertzler is qualified to serve on our Board due to his extensive experience as an investment banking and financial professional, his extensive personal knowledge of our industry and his many years of service as one of our directors. Dr. Steele has served as a member of our Board since 2015. Dr. Steele has served as the Chairman of xG Health Solutions, a health care redesign and optimization company affiliated with Geisinger Health System, since 2013. From 2001 until 2015, Dr. Steele served as President and Chief Executive Officer of Geisinger Health System, an integrated health services organization in central and northeastern Pennsylvania. Dr. Steele previously served as the dean of the Biological Sciences Division and the Pritzker School of Medicine and vice president for medical affairs at the University of Chicago, as well as the Richard T. Crane Professor in the Department of Surgery. Prior to that, he was the William V. McDermott Professor of Surgery at Harvard Medical School, president and chief executive officer of Deaconess Professional Practice Group, Boston, MA, and chairman of the department of surgery at New England Deaconess Hospital (Boston, MA). Dr. Steele serves on the board of directors of Wellcare Health Plans Inc., a NYSE-listed managed care company, and served as a director of CEPHEID, a Nasdaq-listed molecular diagnostics company, from 2011 to 2016 as well as Weis Markets Inc., a NYSE-listed supermarket chain, from 2009 to 2015. We believe that Dr. Steele is qualified to serve on our Board because of his leadership and business experience, extensive experience in the health care industry, and his service on the boards of directors of other public companies. Class III Directors (terms expiring in 2019) Name Age Allan Jacobson, Ph.D. Director David P. Southwell Audit Committee Compensation Committee Dawn Svoronos Audit Committee 72 57 64 Board Tenure, Principal Occupation, Other Business Experience During the Past Five Years and Other Directorships Dr. Jacobson is a co-founder of PTC Therapeutics, Inc., and has served as a member of our Board since our inception in 1998, and previously served as Chairman of our Board from 1998 to 2004. Since 2000, Dr. Jacobson has served as Chairman of our scientific advisory board. Since 1994, Dr. Jacobson has been the Chairman of the Department of Microbiology and Physiological Systems at the University of Massachusetts Medical School. In 1982, Dr. Jacobson co-founded Applied bioTechnology, Inc., a biotechnology company, and served as its chairman until its sale in 1991. From 1987 to 1990, Dr. Jacobson served as special limited partner at Euclid Partners, a venture capital firm. Dr. Jacobson received a Ph.D. from Brandeis University in 1971, has authored over 100 publications in the field of post-transcriptional control processes and is an elected member of the American Academy of Microbiology. We believe that Dr. Jacobson is qualified to serve on our Board because of his service as one of our directors since our inception, his knowledge of our Company and his extensive experience as a founder and leader of new businesses in the life science industry. Mr. Southwell has served as a member of our Board since 2005. From 2014 to January 2018, he served as the President and Chief Executive Officer, and a member of the board of directors, of Inotek Pharmaceuticals, Inc., a biotechnology company, prior to its acquisition by Rocket Pharmaceuticals, Inc. From March 2010 to September 2012, Mr. Southwell served as the Executive Vice President and Chief Financial Officer, and from 2008 to 2010 served as a member of the board of directors, of Human Genome Sciences, Inc., a biopharmaceutical company. Prior to joining Human Genome Sciences, he served as Executive Vice President and Chief Financial Officer of Sepracor, Inc., a research-based pharmaceutical company, from June 1994 to March 2008, and as Sepracor's Senior Vice President and Chief Financial Officer, from 1994 to 1995. From August 1988 until 1994, Mr. Southwell was associated with Lehman Brothers Inc., a securities firm, in various positions within the investment banking division. Since 2018, Mr. Southwell has served as a director for Rocket Pharmaceuticals, Inc. and Spero Therapeutics, Inc., both Nasdaq-listed biotechnology companies. During 2016, Mr. Southwell served as a director of inVentive Health, Inc., a contract research organization prior to its recapitalization in late 2016. From 2007 to 2016, Mr. Southwell served on the board of directors of THL Credit, Inc., a Nasdaq-listed business development company under the Investment Company Act of 1940. Mr. Southwell received a B.A. from Rice University and an M.B.A. from the Tuck School of Business at Dartmouth College, where he currently serves as a member of the Board of Overseers. We believe that Mr. Southwell is qualified to serve on our Board because of his extensive executive leadership experience and knowledge of our industry. Ms. Svoronos has served as a member of our Board since 2016. Ms. Svoronos has more than 30 years of experience in the pharmaceutical industry, including extensive commercial work with the multinational pharmaceutical company Merck & Co. Inc., where she held roles of increasing seniority over 23 years of service. Prior to her retirement from Merck in 2011, Ms. Svoronos most recently served as President of Merck in Europe/Canada from 2009 to 2011, President of Merck in Canada from 2006 to 2009, and Vice-President of Merck for Asia Pacific from 2005 to 2006. Ms. Svoronos has served on the board of directors of Xenon Pharmaceuticals, Inc., a Nasdaq-listed biopharmaceutical company, since 2016, and on the board of directors of Theratechnologies, Inc., a specialty pharmaceutical company that trades on the Toronto Stock Exchange, since 2013. Previously, Ms. Svoronos served on the board of directors of Medivation, Inc., a Nasdaq-listed biopharmaceutical company, from 2013 until its acquisition in 2016. Ms. Svoronos is also a member of the board of directors of AgNovos Healthcare Company, a privately held organization, and West Island (Montreal) Palliative Care Residence, ad not-for-profit organization. We believe that Ms. Svoronos is qualified to serve on our Board because of her extensive experience in commercialization of pharmaceutical products, including her substantial ex-U.S. commercialization expertise as well as her leadership experience and her service on the boards of directors of other public companies. Class I Directors (terms expiring in 2020) Name Stuart W. Peltz, Ph.D. Chief Executive Officer and Director Jerome B. Zeldis, M.D., Ph.D. Audit Committee Nominating and Corporate Governance Committee Age 58 68 Board Tenure, Principal Occupation, Other Business Experience During the Past Five Years and Other Directorships Dr. Peltz is a co-founder of PTC Therapeutics, Inc., and has served as our Chief Executive Officer and a member of our Board since our inception in 1998. He also serves as a director of PTC Therapeutics International Limited, our international headquarters and indirect wholly-owned subsidiary, and as a director of one of our international subsidiary boards. Dr. Peltz is a recognized scientific leader in RNA biology in the area of post-transcriptional control processes involving mRNA turnover and translation, with more than 30 years of research and over 100 publications in this area. Prior to founding PTC, Dr. Peltz was a Professor in the Department of Molecular Genetics & Microbiology at the Robert Wood Johnson Medical School, Rutgers University. Dr. Peltz previously served as a board member of the BioNJ Board of Trustees from 2005 to 2017, including as its Chairman from 2014 to 2016. Dr. Peltz has received a number of business and scientific awards, including election as a Fellow of the American Academy for the Advancement of Science in 2010, recipient of the Dr. Sol J. Barer Award for Vision Innovation and Leadership in 2014 and recognition as PharmaVoice's 100 Most Inspiring People in 2009. He served as a member of the board of directors for the Biotechnology Industry Organization (BIO) from 2010 to 2015, including being on BIO's Emerging Companies Section Governing Board. Dr. Peltz received a Ph.D. from the McArdle Laboratory for Cancer Research at the University of Wisconsin. We believe that Dr. Peltz is qualified to serve on our Board because of his extensive executive leadership experience, many years of service as one of our directors and our Chief Executive Officer and extensive knowledge of our Company and industry. Dr. Zeldis has served as a member of our Board since September 2012. Dr. Zeldis currently serves as the Chief Medical Officer of Sorrento Therapeutics, Inc., a public clinical-stage biopharmaceutical company. Prior to joining Sorrento in August 2016, Dr. Zeldis served as Chief Executive Officer of Celgene Global Health and the Chief Medical Officer of Celgene Corporation, a public biopharmaceutical company, where he had been employed since 1997. He previously served as Celgene's Senior Vice President of Clinical Research and Medical Affairs. Previously, Dr. Zeldis served as Assistant Professor of Medicine at Harvard Medical School, Associate Professor of Medicine at University of California, Davis, Clinical Associate Professor of Medicine at Cornell Medical School, and Professor of Clinical Medicine at the Robert Wood Johnson Medical School. Dr. Zeldis received an A.B. and M.S. from Brown University and a M.Phil., M.D. and Ph.D. in Molecular Biophysics and Biochemistry (immunochemistry) from Yale University. Dr. Zeldis serves on the board of directors of several public companies, including, since 2011, Soligenix, Inc., a biopharmaceutical company listed on Nasdaq in December 2016; since 2012, Alliqua BioMedical, Inc., a Nasdaq-listed biomedical company; since 2015, BioSig Technologies, Inc., a medical device company traded on the OTCQB; and, since 2016, MetaStat, Inc., a molecular diagnostic company traded on the OTCQB. We believe that Dr. Zeldis is qualified to serve on our Board because of his executive leadership experience, his knowledge of the biopharmaceutical industry, his extensive role in drug development and clinical studies as well as his directorships in other life science companies. 21 PROPOSAL 2: RATIFICATION OF SELECTION OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM Our Audit Committee has appointed the firm of Ernst & Young LLP, an independent registered public accounting firm, to audit our books, records and accounts for the fiscal year ending December 31, 2018. This appointment is being presented to the stockholders for ratification at the Annual Meeting. Ernst & Young LLP has served as our auditor consecutively since 2010, and has served as our independent registered public accounting firm beginning in connection with our initial public offering in 2013. Ernst & Young LLP has no direct or indirect material financial interest in our Company or our subsidiaries. Representatives of Ernst & Young LLP are expected to be present at the Annual Meeting and will be given the opportunity to make a statement on the firm's behalf if they so desire. The representatives also will be available to respond to appropriate questions. Our Audit Committee is solely responsible for selecting our independent registered public accounting firm for 2018. Although we are not required to submit the appointment to a vote of the stockholders, our Board believes that it is appropriate as a matter of good corporate governance to request that the stockholders ratify the appointment of Ernst & Young LLP as our independent registered public accounting firm. If the stockholders do not ratify the appointment, our Audit Committee will investigate the reasons for stockholder rejection and may reconsider its appointment of Ernst & Young LLP as our independent registered public accounting firm for 2018 and may appoint another independent registered public accounting firm. Even if the appointment is ratified, our Audit Committee in their discretion may direct the appointment of a different independent registered public accounting firm at any time during the year if they determine that such a change would be in the best interests of our Company and our stockholders. A majority of the voting power of the shares of common stock cast on this matter is required to approve this proposal. Unless otherwise instructed in the proxy, all proxies will be voted "FOR" the ratification of Ernst & Young LLP. Our Board Recommends that You Vote "FOR" the Ratification of Ernst & Young LLP as our Independent Registered Public Accounting Firm for the Fiscal Year Ending December 31, 2018. Fees Paid to Independent Registered Public Accounting Firm The following table sets forth the fees incurred for services performed by Ernst & Young LLP during fiscal years 2017 and 2016: _______________________________________________________________________________ (1) "Audit Fees" represent fees for the respective fiscal year for professional services for the audit of our annual financial statements, the review of financial statements included in our quarterly financial statements, accounting consultations, and other services that are normally provided by the independent registered public accounting firm in connection with other statutory or regulatory requirements including, services rendered relating to our registration statement filings with the SEC and services rendered in connection with the audit of the Company's internal control over financial reporting in accordance with Section 404 of the Sarbanes-Oxley Act. (2) "Tax Fees" is primarily for services rendered in connection with international tax matters, including services rendered for tax compliance and tax advice. (3) This category consists of fees for any other products or services provided by Ernst & Young LLP not described above. The services for fees in 2017 and 2016 under this category are related to licensed accounting research software. Our Audit Committee determined that the provision of the non-audit services by Ernst & Young LLP described above is compatible with maintaining Ernst & Young LLP's independence. Audit Committee Pre-Approval Policy and Procedures Our Audit Committee as a whole, or through its Chair, pre-approves all audit and non-audit services (including fees) to be provided by the independent registered public accounting firm. Our Audit Committee has delegated to the Chair of our Audit Committee the authority to pre-approve non-audit services not prohibited by law to be performed by Ernst & Young LLP and associated fees, provided that the Chair of our Audit Committee reports any decisions to pre-approve such services and fees to the full Audit Committee at its next regular meeting. All services provided by Ernst & Young LLP during 2017 and 2016 were pre-approved by the Audit Committee. REPORT OF THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS The Audit Committee has reviewed and discussed the audited financial statements of PTC Therapeutics, Inc. for the fiscal year ended December 31, 2017 with management. The Audit Committee has discussed with Ernst & Young LLP, our independent registered public accounting firm, the matters required to be discussed by Auditing Standard No. 1301, Communications with Audit Committees, as modified or supplemented, as adopted by the Public Company Accounting Oversight Board. The Audit Committee has received the written disclosures and the letter from Ernst & Young LLP required by applicable requirements of the Public Company Accounting Oversight Board regarding Ernst & Young LLP's communications with the Audit Committee concerning independence, and has discussed Ernst & Young LLP's independence from us with Ernst & Young LLP. Based on the review and discussions referred to in the foregoing paragraphs, the Audit Committee recommended to the Board that the audited financial statements as of and for the year ended December 31, 2017 be included in the Company's Annual Report on Form 10-K for the fiscal year ended December 31, 2017. By the Audit Committee of the Board of Directors of PTC Therapeutics, Inc. David P. Southwell, Chair Dawn Svoronos Jerome B. Zeldis, M.D., Ph.D. EXECUTIVE OFFICERS The following table and biographical descriptions provide information as of April 20, 2018 relating to each of our executive officers, other than Dr. Peltz, who also serves as a director of the Company. Dr. Peltz's biographical information is presented above in this proxy statement under the heading "Proposal 1: Election of Directors—Biographical Information." Name Age Board Tenure, Principal Occupation, Other Business Experience During the Past Five Years and Other Directorships Neil Almstead, Ph.D. Executive Vice President, Research, Pharmaceutical Operations & Technology Mark E. Boulding Executive Vice President and Chief Legal Officer Christine Utter Principal Financial Officer and Treasurer Marcio Souza Chief Operating Officer 51 Dr. Almstead has served as our Executive Vice President, Research, Pharmaceutical Operations and Technology since January 2015. Dr. Almstead has been employed with PTC since 2000. He served as our Senior Vice President, Research and CMC from July 2008 to December 2014 and Senior Vice President, Chemistry and CMC from January 2007 to June 2008. Prior to joining PTC, Dr. Almstead served as Project Manager at Procter & Gamble Company, a publicly traded consumer products company. Dr. Almstead has co-authored more than 75 publications and patents pertaining to the design and synthesis of lead candidate compounds for genetic disorders, oncology and inflammatory diseases. Dr. Almstead received a B.S. from Clarkson University and a Ph.D. in Organic Chemistry from the University of Illinois at Urbana-Champaign. 57 Mr. Boulding has served as our Executive Vice President and Chief Legal Officer since March 2012, and previously served as our Senior Vice President and General Counsel from April 2002 to February 2012 and our Corporate Secretary from 2002 to 2017. He also serves as a director of one and as cosecretary of two subsidiaries of PTC. Prior to joining us, Mr. Boulding served as General Counsel, Executive Vice President and Secretary of MedicaLogic/Medscape, Inc., a provider of digital health records software and healthcare information, from May 2000 to April 2002. From June 1999 to May 2000, Mr. Boulding served as the General Counsel, Vice President and Secretary of Medscape, Inc., a provider of online health information and education. Mr. Boulding previously was a partner in two Washington, D.C.-based law firms. Mr. Boulding received a J.D. from the University of Michigan and a B.A. from Yale College. 40 Ms. Utter has served as our Principal Financial Officer since June 2017. Ms. Utter joined the Company in 2010 as the Assistant Controller and became Senior Vice President, Finance, in January 2017. From 2005 until 2009, Ms. Utter was the Assistant Corporate Controller of Barrier Therapeutics, a pharmaceutical company. Prior to 2005, Ms. Utter held positions as a financial analyst at Engelhard Corporation and as an auditor at both Ernst & Young LLP and Arthur Andersen. Ms. Utter holds a B.S. in accounting from The College of New Jersey, and is a certified public accountant. 39 Mr. Souza has served as our Chief Operating Officer since June 2017. Mr. Souza joined the Company in July 2014 as Vice President of Global Marketing and became Senior Vice President, Head of Global Product Strategy, in June 2016. From October 2012 until July 2014, he was the Executive Director of Marketing for NPS Pharmaceuticals, a biopharmaceutical company. From 2007 until 2012, he worked for Shire HGT, a biopharmaceutical company, in various positions of increasing responsibility in Latin America, the United States, and Switzerland, most recently as Senior Director, Global Commercial. Mr. Souza holds a pharmacy and biochemistry degree from University of Sao Paulo and has received his MBA from Fundacao Dom Cabral in Brazil. There are no family relationships between or among any of our executive officers or directors. There is no arrangement or understanding between any of our executive officers and any other person or persons pursuant to which he was or is to be selected as an executive officer. EXECUTIVE COMPENSATION This section describes the material elements of compensation awarded to, earned by or paid to our named executive officers, who, for fiscal year 2017, are: * Stuart W. Peltz, Ph.D., Chief Executive Officer; * Christine Utter, Principal Financial Officer and Treasurer * Neil Almstead, Ph.D., Executive Vice President, Research, Pharmaceutical Operations & Technology; * Mark E. Boulding, Executive Vice President and Chief Legal Officer; and * Marcio Souza, Chief Operating Officer. In addition, our named executive officers for fiscal year 2017 included Shane Kovacs and Mark Rothera, each of whom resigned from the Company as an employee during fiscal year 2017. Mr. Kovacs stepped down as Executive Vice President, Chief Financial Officer and Head of Corporate Development and ceased to be an executive officer effective as of May 31, 2017. Mr. Rothera stepped down as Chief Commercial Officer and ceased to be an executive officer effective as of August 9, 2017. Mr. Rothera continues to provide services to the Company as a consultant. Additionally, this section discusses the principles underlying our decisions with respect to the compensation of our named executive officers and the most important factors relevant to an analysis of these decisions, as well as qualitative information regarding the manner and context in which compensation is awarded to and earned by our named executive officers, and is intended to provide context for the data presented in the tables and narrative that follow. Compensation Discussion and Analysis Executive Summary Our executive compensation program is intended to be competitive with our peers and to motivate our executive team to achieve our short- and longterm strategy for creating stockholder value. Our executive compensation program consists of three primary elements: base salary, annual cash incentive and annual equity award. In 2017, the total compensation we paid out to our Chief Executive Officer, as reported in Summary Compensation Table on page 37, was below the median of our 2016 peer group based on the peer data available. Additionally, the total compensation paid to our Chief Executive Officer in 2017 was approximately 50% less than that his total compensation in 2016, recognizing that our stock price was considerably lower when 2017 equity grants were made in January 2017 as compared to the stock price in January 2016 when the 2016 equity grants were made. Total compensation, as reported in Summary Compensation Table on page 37, was lower in 2017 than in 2016 for all named executive officers who were named executive officers for both years. All named executive officers had 2017 total compensation that was below our 2016 peer group median. 2017 Say on Pay Vote Pursuant to Section 14A of the Exchange Act, at our 2017 annual meeting of stockholders, our stockholders voted, in an advisory manner, on a proposal to approve our named executive officers' compensation, which is commonly referred to as the "say-on-pay" vote. The 2017 say-on-pay vote was approved by our stockholders, with approximately 95.2% of the votes cast in favor of the overall compensation of our named executive officers, including related compensation philosophy, policies and practices. We were pleased with the continued strong support from our stockholders, which we believe resulted from changes we made to our executive compensation program over the past several years, and we will continue to evaluate our executive compensation program going forward. As previously disclosed, in an effort to continue to improve our governance and compensation practices, in December 2016, our Compensation Committee recommended, and our Board adopted, Executive and Director Stock Ownership Guidelines. These guidelines, which are described in more detail on page 35, require our Chief Executive Officer to hold shares of our common stock equal to three times, and each other executive officer to hold shares of our common stock equal to one time, his or her three-year average cash compensation. Directors are required to hold common stock equal to three times their average cash retainer. The guidelines require compliance within five years from adoption of the guidelines. In addition, the Compensation Committee formally adopted a cap to awards under our annual incentive program, limiting the maximum 25 achievable award for executive officers to two times target, as further described under "Mechanics of annual cash incentive program" on page 30. Executive Compensation Objectives and Philosophy Our compensation policies and programs are intended to: * drive the achievement of key corporate milestones and the execution of our long-term growth strategy by placing a significant portion of named executive officer compensation "at risk", * attract and retain well-qualified executive management, and * align the interests of our executive officers and long-term stockholders. "At-risk" compensation drives executive focus on achievement of our short- and long-term goals. Under our executive compensation program, a significant portion (70.5% and 57.5%, respectively) of our Chief Executive Officer's and other named executive officers' (for those who were named executive officers for the full year) primary compensation elements in 2017 (comprised of base salary, annual cash incentive at target, and the grant date fair market value of the equity award) were variable based on performance and/or our stock price, as shown below: Primary compensation elements in 2017 (base salary, annual cash incentive at target, and stock option award) The variable portion of our primary compensation was lower in 2017 than in 2016 due to the lower fair market value of the 2017 equity awards compared to the 2016 equity awards, while cash compensation in 2017 remained relatively in line with 2016 cash compensation. We believe that our annual cash incentive program contributes to the achievement of key short-term goals that drive the success of our long-term growth strategy. Our Compensation Committee works with management to establish corporate objectives under our annual cash incentive program that highlight the Company's top strategic goals and provide appropriate motivation toward the achievement of significant milestones that we believe directly correlate to the long-term enhancement of stockholder value. In addition, since becoming a public company in June 2013, our executive compensation program has included an annual equity award that vests over a period of four years, traditionally in the form of stock options and, in 2017, restricted stock. Equity awards are made at the start of the new year, which is after performance results for the previous year are known and before the results for the new year. The January 2017 grant was influenced by our company's performance in 2016 and represented a 63.7% decline in grant date fair market value compared to the January 2016 grant to our Chief Executive Officer. The equity awards granted in 2015 and 2016 were comprised solely of stock options and, in 2017, were comprised of stock options and restricted stock. Our Compensation Committee utilizes stock option awards to encourage the execution of our long-term growth strategy as these equity awards only provide value to the named executive officers if our stock price increases after the grants are made and the applicable award has vested, although, we do not believe that our performance can be evaluated accurately by simply reviewing our stock price on any particular trading day. We do not maintain an executive perquisite program or any guaranteed or funded retirement plan benefits other than a matching contribution under our 401(k) savings and retirement plan that we make available to all employees. Attract and retain well-qualified executive management. We believe the Company's growth and success can only be achieved with the valuable contributions of our employees, as led by our executive officers. Our Compensation Committee regularly works with an independent compensation consultant to understand the competitive landscape and design a compensation program intended to attract, engage and retain high caliber, talented executives capable of executing on our short- and long-term growth strategy. For compensation in 2017, our Compensation Committee utilized data from a peer group developed with the assistance of its independent compensation consultant as one tool to assist the Compensation Committee with respect to competitive positioning and internal parity for base salary, bonus target under our annual incentive program, and equity awards. Peer group data is viewed as a reference point in making compensation decisions, but the Compensation Committee does not target a particular competitive level or utilize peer data in a formulaic manner. As a result, individual pay levels vary based on individual experience, scope of responsibilities, past performance and expectations with respect to future performance and future leadership potential. Strengthen the alignment of the interests of our executive officers and stockholders. A stock option only has value if our stock price increases above the option exercise price and such increased value is maintained through the vesting and exercise date. The Compensation Committee believes that this form of equity award is most effective at rewarding successful execution of our long-term growth strategy and has historically relied primarily on granting stock option equity awards to our named executive officers. Peer Group Composition General. Our Compensation Committee uses peer group benchmark information developed in coordination with an independent compensation consultant to assist it in understanding the range of base salary, target annual incentive compensation, and equity grant levels offered for comparable roles at peer companies. On a regular basis, our Compensation Committee considers the relevance of its compensation peer group based on the Company's current stage of development, market cap and size. Analysis of the level and types of compensation our peer group companies offer for positions similar to those of our named executive officers is only one factor taken into account by the Compensation Committee when determining executive compensation. When establishing executive compensation, our Compensation Committee also considers the performance of the Company and each named executive officer's individual performance over the past year, their contributions to the execution of the Company's short-term goals and long-term strategy, the Board's expectations of performance against key strategic, financial and operational objectives in the coming year, the long-term retention of the named executive officer, and demonstration of executive leadership at PTC as well as matters of internal parity. 2016 Peer Group. Our Compensation Committee retained Frederic W. Cook & Co., or FW Cook, as its independent compensation consultant in 2016 and directed FW Cook to assist it in the development of a reference peer group, which we refer to as the 2016 peer group, for compensation decisions to be made effective in January 2017, including 2017 base salary revisions, annual cash incentive targets, and the annual equity awards granted on January 3, 2017. In developing the 2016 peer group, the Compensation Committee sought to reduce the market cap range utilized when creating its 2015 peer group, with the revised median market cap set at approximately $640 million at the time reviewed. PTC's market cap was near the 35th percentile of the revised peer group members. Celldex, Halozyme, Novavax, Pacira and Tesaro were removed from the peer group as a result of this downward market cap adjustment. At the time of its development, slightly more than half of the peer group was commercial in some manner. PTC's employee count was consistent with the commercial-stage members of the peer group. The 2016 peer group consisted of: Achillion Pharmaceuticals, Inc. Acorda Therapeutics, Inc. Aegerion Pharmaceuticals, Inc. Agenus, Inc. Alimera Sciences, Inc.* Amicus Therapeutics, Inc. Arena Pharmaceuticals, Inc. Ariad Pharmaceuticals Inc. Cempra, Inc. Cytokinetics, Inc.* ImmunoGen, Inc. Inovio Pharmaceuticals, Inc. Insmed Incorporated* Ironwood Pharmaceuticals, Inc. Merrimack Pharmaceuticals, Inc. Momenta Pharmaceuticals, Inc.* Nektar Therapeutics Rigel Pharmaceuticals, Inc.* Sangamo BioSciences, Inc.* Sarepta Therapeutics, Inc. Synergy Pharmaceuticals TG Therapeutics Vanda Pharmaceuticals Inc.* _______________________________________________________________________________ * New peer group member in 2016 2017 Peer Group. In 2017, FW Cook assisted the Compensation Committee in its review and revision of the 2016 peer group to be utilized by the Compensation Committee for compensation decisions to be made effective in January 2018, including 2018 base salary revisions, annual cash incentive targets for 2018, and the annual equity awards granted on January 3, 2018. In developing this revised 2017 peer group, which we refer to as the 2017 peer group, the Compensation Committee selected companies within what it considers an appropriate market cap range, that have at least one commercial product and are headquartered on the east coast of the United States to align cost-of-living and labor talent market considerations. The market cap range for the 2017 peer group had a median market cap of approximately $843 million at the time reviewed. PTC's market cap was near the 45th percentile of the revised peer group. Achillion, Cempra, Inovio Pharmaceuticals, Insmed and Merrimack Pharmaceuticals were removed from the peer group because they were not commercial-stage companies at the time of review. Alimera was removed from the peer group because its market cap was outside of our market cap range. Agenus, Arena Pharmaceuticals, Cytokinetics, Rigel Pharmaceuticals, Sangamo Pharmaceuticals and TG Therapeutics were removed from the peer group because their respective market caps were outside of our market cap range and they were not commercial-stage companies at the time of review. Nektar was removed due to its geographic location. Aegerion and Ariad were removed from the peer group because they had been acquired. PTC's employee population was approximately 14% higher than the median of the peer group. The 2017 peer group consisted of: Acorda Therapeutics, Inc. AMAG Pharmaceuticals, Inc.* Amarin Corporation plc* Amicus Therapeutics, Inc. ImmunoGen, Inc. Ironwood Pharmaceuticals, Inc. Keryx Biopharmaceuticals, Inc.* Medicines Company* Momenta Pharmaceuticals, Inc. Radius Health, Inc.* Sarepta Therapeutics, Inc. Sucampo Pharmaceuticals, Inc.* Synergy Pharmaceuticals, Inc. Vanda Pharmaceuticals Inc. _______________________________________________________________________________ * New peer group member in 2017 Individual and Company Performance When making annual compensation determinations, the Compensation Committee considers each named executive officer's individual performance over the past year, their contributions to the execution of the Company's short-term goals and long-term strategy, the Board's expectations of performance against key strategic, financial and operational objectives in the coming year, and demonstration of executive leadership at PTC. Individual performance is used together with other information resources to assist in a holistic evaluation of executive compensation. In connection with the close of each fiscal year, our Compensation Committee considers PTC's performance against the objectives and metrics established for that fiscal year and assigns a corporate rating value, defined as a percentage against goals, to corporate performance based on their assessment of results. This corporate rating is applied, together with the individual performance modifier described below, to determine the amounts earned by each named executive officer under the annual incentive program for the last closed (or closing) fiscal year. Awards under the 2017 annual incentive program were finalized in January 2018 based on the Compensation Committee's assessment of individual and PTC performance during 2017. While individual performance is considered in connection with all aspects of executive compensation, the individual performance modifier only directly impacts the value of cash incentive compensation received by our named executive officers under our annual incentive program. Quantitative weight is assigned to individual performance in the form of an individual performance modifier, which, for 2017 compensation, could range from 1.08, for top performers, to 1.0, for employees who consistently deliver on their position requirements and expectations. Performance below these levels can result in the application of an individual performance modifier that is less than 1.0, reducing the annual incentive award below target. Our Compensation Committee generally considers Dr. Peltz's assessment of each named executive officer's performance, other than himself, during the fourth quarter of the fiscal year at the same time that it considers the Company's performance against the corporate goals established by the Compensation Committee and Dr. Peltz's performance for the applicable year. As our Chief Executive Officer, Dr. Peltz has overall responsibility for our business strategy, operations and corporate vision and our Compensation Committee generally assesses his performance in the context of the execution of our business strategy and the performance of the Company as a whole over the applicable year. As a result, our Compensation Committee considers individual and PTC performance during the closing fiscal year as well as expectations for individual and PTC performance during the coming year when setting base salary, target annual cash incentive opportunity and annual equity awards that will become effective in January of the coming year. For example, 2017 base salary increases and annual equity awards were considered in late 2016 and set early in 2017 after considering Company and individual performance in 2016. At the same time, our Compensation Committee considered the demands that would be placed on our executive team in order to execute on our strategic goals in 2017. For a discussion of the Compensation Committee's assessment of individual and corporate performance in 2017, which directly impacted annual cash incentive awards for 2017, see "Annual cash incentive program" on page 30. For information concerning individual and corporate performance in 2016, which directly impacted 2017 base salary and equity award, see "Base salary" below. Elements of Executive Compensation The material elements of compensation and the periods of time in which our Compensation Committee made determinations with respect to each element for 2017 were as follows: Element of compensation 2017 compensation determinations finalized in... In addition, each named executive officer is entitled to severance payments and other benefits if his employment is terminated under the circumstances specified in his or her employment agreement and is entitled to participate in the benefit programs made available to all employees, such as health, life and disability insurance, the PTC 401(k) savings and retirement plan, and the 2016 Employee Stock Purchase Plan. Base salary. Base salary is designed to attract, motivate and retain qualified employees by providing a consistent cash flow throughout the year as compensation for performance of day-to-day responsibilities. The responsibilities of the position; background and experience; individual, team, and corporate performance and contribution; market competitive conditions; and other factors described below are taken into account by the Compensation Committee when determining this component of compensation. Fiscal 2017 base salary determinations. Base salary determinations for 2017 were discussed in December 2016 and set in January 2017. Our Compensation Committee set 2017 base salary increases at 3%, budgeted for cost of living adjustments, for each named executive officer who was an executive officer at the time of the determination. This increase in budget for the named executive officers was less than the budgeted rate of salary increases for the rest of the Company, reflecting our desire to emphasize performance based compensation for officers. Due primarily to the Compensation Committee's revisions to our 2016 peer group, which reduced the market cap size of the companies included in our peer group, the base salary levels for each named executive officer position against our 2016 peer group were in the 40th to 60th percentile, except with respect to Mr. Rothera, our former Chief Commercial Officer, whose base salary was in the 70th percentile. The Compensation Committee considered, with the assistance of FW Cook, that the CEO had total target cash compensation (consisting of base salary plus annual incentive award at target), at or below the 2016 peer group median. In setting 2017 base salaries, Dr. Peltz's assessment of each named executive officer's individual contributions to PTC's performance in 2016 and our Compensation Committee's assessment of individual and Company performance in 2016 were also considered. The specific performance factors taken into account by the Compensation Committee for each named executive officer are set forth in last year's proxy statement in the discussion of individual performance in 2016. For the corporate performance in 2016, our Compensation Committee considered in a positive light PTC's execution of its commercial strategy during 2016, while it also took into account setbacks in other clinical programs. Tabular presentation of base salary adjustments in 2017. The table below sets forth our named executive officers salaries, as determined by our Compensation Committee for fiscal year 2017: Base salary reflects new base salary following mid-year promotion. Increase was given in line with all promotion and new-hire salary increases and was paid on a pro-rated basis. Annual cash incentive program. Our annual cash incentive program is intended to motivate and reward our named executive officers to achieve and exceed annual goals and milestones that are expected to advance our long-term growth strategy. Both pre-established corporate goals and individual contributions toward these goals factor into the amount earned under the program. The corporate goals established under the program are tied to PTC's operating plan for the applicable year and have typically been focused on the achievement of specific research, clinical, regulatory, commercial, financial, compliance or operational milestones developed in collaboration with our Compensation Committee. Generally, our Compensation Committee also establishes one or more "stretch goals" that are expected to be more difficult to achieve within the one-year timeframe of the program and could, based on the outcome of other performance metrics, drive the company performance rating above target. Because the goals are intended to be consistent with our shortand long-term strategic priorities, we believe their achievement is conducive to the creation of stockholder value. Mechanics of annual cash incentive program. Each named executive officer has the potential to realize, at target, a pre-established value tied to a percentage of their salary. For 2017, the target annual cash incentive for Dr. Peltz and all other named executive officers remained unchanged from the level established in their respective employment agreements. Pursuant to his employment agreement with us, Dr. Peltz is eligible to earn, at target, an amount equal to 50% of his base salary and pursuant to his or her employment agreement with us, each other current named executive officer is eligible to earn, at target, an amount equal to 40% of his or her base salary. In connection with the close of each fiscal year, our Compensation Committee considers PTC's performance against the objectives and metrics established for that fiscal year and assigns a value, defined as a percentage against goals, to corporate performance based on the committee's assessment of results. Beginning in 2016, the Compensation Committee capped the amounts that could be achieved under the corporate performance segment of the annual incentive program to two times target. This limit may not be adjusted upward for individual performance. The program permits the exercise of both negative and positive discretion based on our Compensation Committee's view of overall corporate performance during the year (subject to the maximum award cap). However, historical corporate performance payouts under the annual cash incentive program in the last six years have ranged from a low of 75% to a high of 150%, in each case subject to upward or downward adjustment based on the individual officer's performance modifier. Individual performance is considered in the manner described under "Individual and Company Performance" on page 28, with a maximum quantitative modifier for potential awards based on 2017 performance of up to 1.08. Downward adjustments made to any executive officer's individual performance modifier may be used to make a corresponding upward adjustment to another executive officer's individual performance modifier, although no such adjustment effecting a named executive officer was made to 2017 annual incentive awards. The combination of corporate and individual performance is applied using the following formula: Modifier Potential award under annual cash incentive program. As part of its annual review of the executive compensation program, our Compensation Committee considers the potential value that could be earned by each named executive officer under the annual incentive program. Our Compensation Committee caps the amounts that could be achieved under the corporate performance segment of the annual incentive program to two times target. This limit may not be adjusted upward by the individual performance modifier. In making its determination not to increase annual incentive target percentages for any named executive officer under the 2017 annual incentive program, the Compensation Committee, with the assistance of its independent compensation consultant, considered that target annual cash incentive awards were generally consistent with those of our 2016 peer group, except for our CEO, Dr. Peltz, who had a target annual cash incentive award and target cash compensation that was below the median. Company goals and results under the 2017 annual incentive program. The core performance objectives established by our Compensation Committee for 2017, and our performance under such metrics, were as follows: Expand patient access to grow commercial opportunity for Translarna for the treatment of nonsense mutation Duchenne muscular dystrophy (nmDMD). In order to assess achievement of this goal, two primary metrics were established. The first metric required PTC to meet or exceed its external guidance of revenues between $105 and $125 million for 2017 using the budgeted exchange rates approved by the Board at the beginning of 2017. This goal was achieved and exceeded at the budgeted exchange rate (with $145.2 million in 2017 net sales). The second metric required execution on activities by the Company to pursue market and label expansion, including specific, related clinical goals, which were partially achieved. Manage operating expenses to support long-term growth of the Company. This goal was satisfied based upon achievement of PTC operating within the Board-approved budget for 2017. Advance regulatory strategy for Translarna for the treatment of nmDMD in the United States. This goal related to the execution of PTC's regulatory strategy to submit a new drug application, or NDA, for Translarna for the treatment of nmDMD with the United States Food and Drug Administration, or FDA via the FDA's file over protest regulations and pursue a full and fair review of the NDA with a positive advisory committee vote. This goal was partially achieved, as while the NDA was filed over protest and the FDA granted a standard review of the NDA and scheduled an advisory committee, the advisory committee's vote was not positive. Advance regulatory strategy for Translarna for the treatment of nmDMD in the European Union. This goal was achieved as Study 041 was initiated, allowing Translarna to maintain its EMA conditional approval. Advance nonsense mutation cystic fibrosis, or nmCF, program. This goal was not achieved as PTC announced negative results for ACT CF, its Phase 3 clinical trial for Translarna in nmCF and discontinued its clinical development of Translarna for nmCF. Advance Translarna life-cycle management program. Achievement of this goal required achievement of at least one program deliverable related to advancements in PTC's programs to pursue additional indications for Translarna. This goal was not achieved. Advance research and development programs to expand PTC's clinical pipeline. The metrics established to measure this goal related to activities to advance PTC's pipeline programs, including its oncology program and earlier stage programs, which were achieved. Advance spinal muscular atrophy, or SMA, program, a joint collaboration with F. Hoffman-La Roche Ltd and Hoffman-La Roche Inc., or Roche, and the Spinal Muscular Atrophy Foundation. This goal was achieved as the Sunfish study transitioned into the pivotal second part of its study, which triggered a $20 million milestone payment to us from Roche Develop organization, leadership and capabilities to support long term growth consistent with PTC's cause, culture and mission. Successfully reorganized senior management, including internal promotions to senior management, as well as structured team development activities, leadership coaching, and employee engagement on how to preserve PTC's culture during a period of challenges and changes to achieve this leadership and organizational goal in 2017. The "stretch goals" approved by the Compensation Committee were not achieved in 2017. These goals were linked to (i) FDA approval of Translarna for the treatment of nmDMD in the United States, for which the FDA issued a Complete Response Letter stating that it was unable to approve the Translarna NDA in its current form, and (ii) EMA approval of Translarna for the treatment of nmCF in the European Union, for which we discontinued clinical development in 2017. The recommendations of our Chief Executive Officer, who, with input from the other named executive officers, assessed PTC's performance against corporate goals for 2017, were also considered. As part of the assessment, the Compensation Committee also took into consideration the acquisition, integration and successful commercial launch of Emflaza in the United States. Since the acquisition of Emflaza occurred mid-year, it was not included as an initial formal goal for 2017. However, given the impact the Emflaza acquisition had in evaluating PTC's overall 2017 success, and the strategic importance of Emflaza to PTC's long-term success, the Compensation Committee considered it in assessing 2017 performance. In January 2018, our Compensation Committee finalized its determination that 2017 performance against the overall corporate objectives, goals and metrics warranted a corporate rating of 95% for the named executive officers. Individual performance in 2017. For individual performance in 2017, excluding those named executive officers who ceased to be employees during 2017, our Compensation Committee considered the following key accomplishments and contributions by individual named executive officers during 2017 and Dr. Peltz's recommendations with respect to performance ratings for all named executive officers, other than himself: Name/Rating Key performance factors in 2017 Stuart Peltz Christine Utter Neil Almstead Mark Boulding Marcio Souza Key contributions: strategy, leadership, vision, execution * Oversaw all critical aspects of PTC business and operations via active supervision of direct reports * Oversaw all critical aspects of the acquisition, integration, and implementation of Emflaza * Key contributions: led growing global finance team in support of all finance-related activities (revenue, tax, debt and cash management) * Key role in leading all financial aspects of the closing and implementation of the Emflaza acquisition including revenue recognition * Managed corporate expenses in 2017 within Board-approved budget * Streamlined quarterly close process to enable the acceleration of quarterly earnings calls * Key contributions: research, supply chain, manufacturing * Key role in advancement of drug candidate development and exploration of new lines of research for pre-clinical stage programs * Supported advancement of oncology program * Active management of manufacturing activities for Translarna clinical and commercial programs * Key in building Global Supply Chain capabilities, including expansion of international operations in Ireland * Key in building supply chain capabilities, for the introduction of Emflaza in the United States. * Managed PTC portfolio of research projects * Key contributions: corporate strategy, legal, compliance, quality assurance * Continued to execute corporate global strategy for multiple teams, including legal, compliance, and quality assurance * Key contributor to Emflaza negotiating team including lead role in negotiating all transaction documentation and key amendments resulting in a timely closing * Key advisor in continued global expansion of Translarna, especially in connection with negotiations and litigation with respect to market access * Key contributor in supporting FDA appeal and file over protest processes for Translarna for nmDMD in the United States * Oversight of quality function, including successful FDA inspection of PTC * Provided strategic support to critical corporate, clinical and commercial matters * Key contributions: corporate strategy, commercial, marketing, patient outreach * Delivered 2017 revenue above external guidance * Oversaw all aspects of the successful commercial launch of Emflaza * Continued expansion of global commercial footprint * Played significant role in initiation of Study 041 for Translarna to maintain EMA conditional approval * Key role in all regulatory processes and communications with FDA including file over protest, advisory committee hearing and appeal to Complete Response Letter * Oversaw critical patient initiatives, including global patient advocacy and other projects Amounts earned under 2017 annual incentive program. Our named executive officers earned the amounts set forth in the table below based on our Compensation Committee's determinations with respect to PTC's corporate rating and individual performance modifiers under the 2017 annual cash incentive program: 2017 corporate rating and Mark Rothera and Shane Kovacs were not eligible to receive awards for 2017 under our annual cash incentive program in light of their mid-year departures. Annual equity award. A significant portion of our executive compensation program in 2017 and in prior years has been in the form of an annual equity award that vests over a four-year period. The "Stock Award" and "Option Award" columns of our Summary Compensation Table set forth the full grant date fair value of the restricted stock award and stock option award, respectively, granted to each named executive officer in January 2017, calculated in accordance with the provisions of Financial Accounting Standards Board Accounting Standard Codification, Topic 718. These amounts do not represent the actual value realized by the named executive officers in 2017; in fact, no portion of the applicable stock option awards vested until January 2018. A stock option only has value if our stock price increases above the exercise price of the stock option and such value is maintained through the applicable vesting and exercise date. Our Compensation Committee views time-vested stock option awards as an important tool to align the interests of our named executive officers with the interests of our stockholders and believes that this form of equity is most effective at rewarding successful execution of our long-term growth strategy. The time vesting feature of the annual equity award, for both the stock option and restricted stock portion, is also intended to serve as a meaningful executive retention device. In determining the size of the annual equity awards granted to our named executive officers, our Compensation Committee considers PTC's performance during the year prior to grant, the individual's key contributions to our execution of our short- and long-term goals during that year, as well as expectations for the Company's and the individual's performance in the new year, including their potential for enhancing the long-term creation of value for our stockholders. Our Compensation Committee also considers the advice of its independent compensation consultant, including information regarding comparative stock ownership of, and equity awards received by, the executives in our peer group and our industry. Our Compensation Committee also considers matters of internal pay equity as well as individual expectations based on historic Company practices. In addition, Dr. Peltz provides his recommendations to our Compensation Committee for each named executive officer other than himself. Timing, pricing, material terms, of other matters related to equity awards. All grants to our named executive officers must be approved by our Compensation Committee. Annual equity awards are generally granted at predetermined meetings of the Compensation Committee, which have historically been in January. The annual equity awards granted in 2015, 2016 and 2017 were made on the first trading day of the respective year, and consider the prior year's performance more than the current year, because the Committee does not know the results of the coming year at the time of grant. As a result, performance in the previous year is a key factor in determining the grant amount. Specifically, the equity awards granted in January 2017, which are disclosed in the Summary Compensation Table, were impacted by our Compensation Committee's assessment of 2016 performance and expectations for 2017. Our Compensation Committee's assessment of 2017 performance and expectations for 2018 impacted the equity awards granted in January 2018, which will be discussed in next year's Summary Compensation Table. As noted in the "Tabular presentation of annual equity awards in 2017", the grant date fair market value of equity awards made to our named executive officers in 2017 substantially decreased from the value of such awards in 2016. The exercise price for annual stock option awards is set at the closing price of PTC's common stock on the date of the grant. Annual stock option awards granted to employees, including our named executive officers, since our initial public offering have vested over a four-year period, with 25% of the shares underlying such options generally vesting one year after grant and 6.25% of the shares vesting at the end of each successive three month period thereafter. The restricted stock awards granted to our named executive officers in 2017 vest over a four-year period, with 25% of the shares vesting one year after grant, and an additional 25% of the shares vesting annually thereafter. Fiscal 2017 equity award determinations. In establishing equity awards for 2017 in January 2017, our Compensation Committee considered that the exercise price of each stock option award granted to the named executive officers since PTC's initial public offering was above PTC's then-current common stock price. In addition, the Compensation Committee considered, in consultation with its independent compensation consultant, that the "in the money value" to the named executive officers with respect to all outstanding stock option awards was considerably below the median of the 2016 peer group and that approximately half of the commercial members of the 2016 peer group awarded time-based restricted shares to their executive teams as retention incentives. As the stock option awards alone were at risk of not fulfilling one of the primary objectives of PTC's compensation program - to attract and retain wellqualified executive management - to the satisfaction of our Compensation Committee, it determined to award 30% of the value of the 2017 equity awards to named executive officers as restricted stock with time-based vesting in equal annual installments over four years. The number of shares granted as restricted stock awards, as compared to stock option awards, reflects the difference in value between the stock options and restricted stock awards granted to the named executive officers. Although most prior option awards were underwater as of the grant date of the 2017 equity awards, the grants made to the named executive officers in 2017 were not made at larger than normal levels. Further, the grant date fair value of equity awards provided in 2017 to all of the named executive officers, as reported in the Summary Compensation Table and consisting of both options and restricted stock awards, was below the median of the 2016 peer group. The grant date fair value of equity awards provided to each of then current named executive officers in 2017 was at least 60% less than the grant date fair value of each then current named executive officer's equity awards in 2016, with the CEO's grant value reduced by approximately 64% compared to 2016. Our Compensation Committee believes that the addition of restricted stock awards to the 2017 compensation program provides an effective tool for motivating and retaining our executive officers, especially in conjunction with the grant of stock options. We believe that the stock ownership opportunities afforded by the restricted stock awards, when paired with PTC's stock ownership guidelines (discussed on page 35), align the interests of our executive officers and stockholders. With the assistance of its independent compensation consultant, our Compensation Committee determined an aggregate share pool to be allocated to equity awards made in 2017, which was determined by reference to the median average equity pools utilized by the 2016 peer group over the prior three years for the grant of awards to named executive officers. In allocating equity awards among the named executive officers, our Compensation Committee considered individual performance in the context of both PTC's achievements during 2016, as described under "Annual cash incentive program" beginning on page 30 as well as Dr. Peltz's assessment and recommendations for each of the named executive officers. Based on its analysis of performance in 2016, the advice of its independent compensation consultant, and the recommendations of Dr. Peltz, our Compensation Committee elected to allocate a median portion of the share pool to each named executive officer, except with respect to Mr. Rothera, who was allocated an award approximating the 75th percentile of the 2016 peer group in recognition of his significant contributions to the Company's ability to exceed its commercial revenue goals during 2016 and in light of the Board's expectations for his performance in 2017. Based on the factors detailed above, our Compensation Committee granted the stock option and restricted stock awards described under the "Tabular presentation of annual equity awards in 2017" below to our named executive officers, pursuant to our 2013 Long Term Incentive Plan, on January 3, 2017. Tabular presentation of annual equity awards in 2017. The table below sets forth the grant date fair value of the equity awards made to each of our named executive officers who were named executive officers in January 2017, calculated in accordance with the provisions of Financial Accounting Standards Board Accounting Standard Codification, Topic 718. _______________________________________________________________________________ (1) Each stock option has an exercise price of $11.23, the closing price of our common stock on January 3, 2017, the date of grant. The number of stock options and shares of restricted stock awarded to each named executive officer on January 3, 2017 were as follows: Severance Benefits. Each of our named executive officers has an employment agreement that entitles such executive to certain cash payments and other benefits in the event such officer's employment is terminated (other than for "cause") or the Company undergoes a change in control. See "Employment Agreements with Executive Officers" on page 40 for additional information with respect to the employment agreements in general and "Potential Payments Upon Termination or Change in Control (2017)" on page 44 for addition information concerning specific severance payments and other benefits that our named executive officers may be entitled to receive under their employment agreements. We believe the benefits under these employment agreements are consistent with market practice. The change in control provisions are intended to help to promote a continuity of management during a corporate transaction, while the severance arrangements are used primarily to attract, retain and motivate well-qualified executive management. Each employment agreement includes restrictive covenants (such as non-compete and non-solicitation provisions) that would apply in the event of the named executive officer's termination, which our Board believes helps us protect our value. Our change in control benefits are "double trigger" benefits. A "double trigger" benefit means that a change in control, by itself, would not trigger benefits. Instead, benefits would be paid only if the employment of the named executive officer is terminated during a specified period after the change in control. We believe this structure would help us secure the continued employment and focus of our named executive officers during change in control negotiations in which they believe they may lose their jobs, while preventing an unintended windfall in the event of a friendly change in control. Other Elements of Compensation. Our named executive officers are eligible to participate in all of our employee benefit plans, in each case on the same basis as other employees. We maintain broad-based benefits that are provided to eligible employees, including health, dental, life and disability insurance and a 401(k) saving and retirement plan, or 401(k) plan. During 2017, we provided a 84% matching contribution for up to the first 6% of each contributing employee's eligible compensation under our 401(k) plan. The matching contribution is subject to vesting at the rate of 25% at the end of each year of employment, for an employee's first four years of employment, following which the matching contribution vests at 100% upon receipt. Our named executive officers are also eligible to participate in our 2016 Employee Stock Purchase Plan, which is available on the same basis to other employees. Stock Ownership Guidelines In December 2016, as part of our Board's efforts to improve our governance and compensation practices, our Compensation Committee recommended, and our Board adopted, Executive and Director Stock Ownership Guidelines, or Guidelines. The purpose of the Guidelines is to encourage ownership of the Company's common stock by our executive officers and directors, promote the alignment of the long-term interests of our executive officers and directors with the long-term interests of the Company's stockholders, and to further promote our commitment to sound corporate governance. The Guidelines are applicable to our executive officers and our non-employee directors. Under the Guidelines, executive officers and directors must acquire ownership of target common stock ownership levels by the end of the five-year compliance period from adoption of the Guidelines. The target common stock ownership levels are specified as shares of our common stock with a value equal to a multiple of the three-year average cash compensation (sum of base salary plus annual cash incentive program award) in the case of executive officers, and a multiple of the three-year average cash retainer, in the case of non-employee directors, as follows: Three times (3x) average cash compensation for the Chief Executive Officer; * One time (1x) average cash compensation for each other executive officer; and * Three times (3x) average cash retainer for non-employee directors. Individuals covered by the Guidelines are expected to achieve their target ownership level by the fifth anniversary of their becoming subject to the Guidelines, or they will become subject to mandatory equity award retention requirements until compliance is achieved. Insider Trading, Prohibition Against Pledging, and Anti-Hedging Policies We have an Insider Trading Policy that has been adopted in light of restrictions under applicable securities laws. This policy prohibits trades in our common stock that would violate these laws, and it also imposes other restrictions such as blackout periods and prior notification and/or clearance requirements intended to protect against inadvertent violations of these laws. This policy also prohibits all employees, executive officers and directors from purchasing Company securities on margin, borrowing against Company securities held in a margin account, or pledging Company securities as collateral for a loans as well as prohibits engaging in any short sales of our common stock or any purchases or sales of puts or calls for speculative purposes. If and when the Securities and Exchange Commission adopts implementing regulations under Section 955, "Disclosure Regarding Employee and Director Hedging," under The Dodd-Frank Wall Street Reform and Consumer Protection Act, we anticipate that our Board will review and consider amending our Insider Trading Policy based on the disclosure requirements of such implementing regulations. Adjustment or Recovery of Awards—Clawback Provisions The Dodd-Frank Act requires the SEC to direct the national securities exchanges to prohibit the listing of any security of an issuer that does not develop and implement a clawback policy. At this time, the SEC has not finalized rules related to clawback policies. Once the final rules are in place, we intend to adopt a clawback policy that fully complies with SEC regulations. Further, under Section 304 of the Sarbanes-Oxley Act, if we are required to restate our financial results due to material noncompliance with any financial reporting requirements as a result of misconduct, our Chief Executive Officer and Principal Financial Officer could be required to reimburse the Company for (1) any bonus or other incentive-based or equity-based compensation received during the twelve months following the first public issuance of the non-complying document, and (2) any profits realized from the sale of our securities during those twelve months. Tax Considerations Section 162(m) of the Internal Revenue Code of 1986, as amended, or the Code, generally disallows a tax deduction to public companies for compensation in excess of $1 million paid to each of the company's principal executive officer and the three most highly compensated executive officers (other than the principal executive officer and principal financial officer). Pursuant to tax legislation signed into law on December 22, 2017 commonly known as the Tax Cuts and Jobs Act (the "Tax Act"), for taxable years beginning after December 31, 2017, the Section 162(m) deduction limitation is expanded so that it also applies to compensation in excess of $1 million paid to a public company's principal financial officer. Historically, compensation that qualified under Section 162(m) as performance-based compensation was exempt from the deduction limitation. However, subject to certain transition rules, the Tax Act eliminated the qualified performance-based compensation exception. As a result, for taxable years beginning after December 31, 2017, all compensation in excess of $1 million paid to each of the executives described above (other than certain grandfathered compensation or compensation paid pursuant to certain equity awards granted during the transition period following our IPO) will not be deductible by us. Compensation Committee Report The Compensation Committee furnishes the following report: The Compensation Committee has reviewed and discussed the Compensation Discussion and Analysis required by Item 402(b) of Regulation S-K with our management. Based on this review and discussion, the Compensation Committee recommended to our Board of Directors that the Compensation Discussion and Analysis be included in this proxy statement. By the Compensation Committee of the Board of Directors of PTC Therapeutics, Inc. Michael Schmertzler, Chair David P. Southwell Glenn D. Steele, Jr., M.D., Ph.D. Summary Compensation Table The following table sets forth information regarding compensation awarded to, earned by or paid to our named executive officers during the years indicated: _______________________________________________________________________________ (1) Dr. Peltz also serves a member of our Board but does not receive any additional compensation for his service as a director. (2) The amounts in the "Bonus" column in 2017 reflect the bonuses received by Ms. Utter and Mr. Souza in connection with their promotion to executive officer, and for Mr. Boulding represents an amount paid in connection with his 15-year employment anniversary, pursuant to a program available to all PTC employees. (3) These amounts do not represent the actual value realized by the named executive officers during the respective year. The amounts reported in the "Stock awards" and "Option awards" columns reflect the full grant date fair value of share-based compensation awarded during the applicable fiscal year computed in accordance with the provisions of Financial Accounting Standards Board Accounting Standard Codification, Topic 718, or FASB ASC Topic 718. The stock option values were calculated using the Black-Scholes option pricing model. See Notes 2 and 10 to our audited financial statements for the fiscal year ended December 31, 2017, included in our 2017 Annual Report on Form 10-K for information regarding assumptions underlying the valuation of equity awards. (4) For Ms. Utter and Mr. Souza, a portion of the amount reported in the "Option Awards" column reflects payments received through the vesting of Stock Appreciation Rights (SARs) in January 2017, in the amounts of $13,723 and $19,960, respectively. The SARs were awarded to all non-executive officer employees in 2016 and vest in equal annual installments over four years. Additionally, for Ms. Utter and Mr. Souza, a portion of the amounts reported in the "Option awards" column, and, for Mr. Souza, in the "Stock awards" column, reflect the full grant date fair value of share-based compensation awarded in connection with their promotion to executive officer. (5) Represents cash awards earned by our named executive officers under our annual incentive program. (6) The amounts reported in the "All other compensation" column in 2017 reflects, for each named executive officer, PTC's 401(k) plan matching contribution. In addition, for Ms. Utter and for Messrs. Boulding, Souza, Kovacs and Rothera, the figures include amounts paid under an employee-wide travel incentive program, and for Mr. Boulding includes a tax gross-up of his 15 year anniversary bonus payment. Additionally, for Mr. Kovacs and Mr. Rothera, the figures include payments made in conjunction with their resignations from the Company as an employee. For Mr. Kovacs, this included payment of $6,821 for vacation day payouts. For Mr. Rothera, this included payments of $169,236 for severance, $34,528 for COBRA premium payments and $11,386 for vacation day payouts. Additionally, for Mr. Rothera, the figure includes payments of $44,349 for his service as a consultant made pursuant to his Consulting Agreement as described on page 41. (7) Ms. Utter was appointed as our Principal Financial Officer effective as of June 2, 2017. In connection with her promotion, her annual base salary increased to $330,000 in 2017, which increased salary was paid pro-rata for 2017. (8) Mr. Souza was appointed as our Chief Operating Officer effective as of May 31, 2017. In connection with his promotion, his annual base salary increased to $435,000 in 2017, which increased salary was paid pro-rata for 2017. (9) Mr. Kovacs stepped down from his position as Chief Financial Officer effective May 31, 2017. The amount reported in the "Salary Column" is the amount earned by Mr. Kovacs prior to his resignation from the Company. Mr. Kovacs forfeited his entire annual stock option award and annual restricted stock award granted in 2017 upon his resignation from the Company, which are the amounts reported in "Stock awards" and "Option awards" columns for 2017. (10)Mr. Rothera stepped down from his position as Chief Commercial Officer effective August 9, 2017. The amount reported in the "Salary Column" is the amount earned by Mr. Rothera prior to his resignation from the Company. Mr. Rothera also received payments as a consultant for the remainder of 2017 as reported in the "All other compensation" column. Of the amounts reported in "Stock awards" and "Option awards" columns for 2017, Mr. Rothera forfeited $270,550 attributable to his annual stock option award and $80,856 attributable to his annual restricted stock award granted in 2017 upon his resignation as Chief Commercial Officer as provided in his Consulting Agreement. Grants of Plan-Based Awards in 2017 The following table sets forth information concerning each grant of an award made in 2017 to the named executive officers under any plan. Estimated Future Payouts _______________________________________________________________________________ (1) Amounts represent potential awards under the annual cash incentive program, which equal a specified percentage of the participant's 2017 base salary. Dr. Peltz can earn, at target, an amount equal to 50% of his base salary, and each other named executive officer can earn, at target, an amount equal to 40% of his respective base salary. No definitive threshold value was established by the Compensation Committee in 2017. The amount reflected under "maximum" is the largest potential award that was achievable by each named executive officer in 2017, which is two times the target. The maximum award may not be increased above this limitation to reflect the individual performance modifier. Since 2010, payouts under the annual cash incentive program have ranged from a low of 75% to a high of 150%, in each case subject to upward or downward adjustment based on the individual performance modifier. The amounts reflected for Ms. Utter and Mr. Souza are based on the awards they were eligible to receive following their promotion to executive officers, which, at target, were amounts equal to 40% of their respective base salary following their promotion. Additionally, Mr. Souza is eligible to receive a retention bonus equal to his target cash bonus if he remains employed with PTC for a period of one year from the effective date of the appointment. The actual amounts earned by each named executive officer are set forth in the "Non-Equity Incentive Plan Compensation" column of the Summary Compensation Table. For more information on the annual cash incentive program in 2017, please see "Compensation Discussion and Analysis— Annual cash incentive program" on page 30. (2) The restricted stock awards (and in the case of Ms. Utter, restricted stock units) granted on January 3, 2017, vest in four equal annual installments over four years, commencing on January 3, 2018. The restricted stock award granted to Mr. Souza on May 31, 2017, vests in two equal annual installments, commencing on May 31, 2018. (3) The options granted on January 3, 2017, vest over four years, with 25% of the shares underlying such options vested on January 3, 2018 and 6.25% of the shares vesting at the end of each successive three-month period thereafter beginning on April 3, 2018. The options granted to Mr. Souza on May 31, 2017, vest in two equal annual installments, commencing on May 31, 2018. The options granted to Ms. Utter on June 2, 2017, vest over two years, with 50% of the shares underlying the option vesting on June 2, 2018, and an additional 12.5% of the original number of shares underlying the option vesting at the end of each successive three-month period thereafter, beginning on September 2, 2018. (4) The exercise price is the closing price of PTC common stock, as traded on the Nasdaq Global Select Market on January 3, 2017. For more information on stock options granted to the named executive officers in 2017, please see "Compensation Discussion and Analysis—Annual equity award" on page 33. (5) This column represents the full grant date fair value of stock options, restricted stock and restricted stock units granted to each of the named executive officers in 2017, as calculated in accordance with FASB ASC Topic 718. These amounts do not represent the actual value realized by the named executive officers during 2017. (6) The equity grant Ms. Utter received on January 3, 2017, relates to her award under the Company's annual equity incentive program based on her employment at the Company in 2016, prior to her appointment as an executive officer. The equity grant Ms. Utter received on June 2, 2017, relates to her award granted in conjunction with her appointment as an executive officer. (7) The equity grant Mr. Souza received on January 3, 2017, relates to his award under the Company's annual equity incentive program based on his employment at the Company in 2016, prior to his appointment as an executive officer. The equity grant Mr. Souza received on May 31, 2017, relates to his award granted in conjunction with his appointment as an executive officer. Employment Agreements with Executive Officers Prior to our initial public offering in June 2013, we negotiated employment agreements with Dr. Peltz, Mr. Kovacs, Dr. Almstead, Mr. Boulding and Mr. Rothera. The employment agreements established initial base salaries to be effective following our initial public offering and a minimum annual cash incentive opportunity, calculated as a percentage of each executive's annual base salary. Actual amounts earned under the annual cash incentive program, and any increases to base salary or annual cash opportunity, are determined by our Compensation Committee. These agreements provide that employment will continue until either we or the applicable named executive officer provides written notice of termination in accordance with the terms of the agreement. Under the terms of their respective employment agreements, each executive is entitled to receive an annual base salary (subject to annual review and increase, but not decrease) and participate in our annual cash incentive program (subject to the discretion of the Board). Each named executive officer is also entitled to participate in any employee benefit plans that we make available to senior executives (including group life, medical, dental and other insurance, retirement, profit-sharing and similar plans). In addition, we have agreed to indemnify each of our named executive officers in any action or proceeding arising out of his or her service to us, unless he or she initiates such action or proceeding. These indemnification obligations require us, among other things, to indemnify such named executive officer for certain expenses, including attorneys' fees, that are incurred by him or her, and to advance him or her such expenses upon request. In addition, each of these agreements prohibits our named executive officers from disclosing confidential information and competing with us during the term of their employment and for a specified time thereafter. Upon execution and effectiveness of a release of claims, each of our named executive officers will be entitled to severance payments and other benefits if his employment is terminated under specified circumstances. The terms of the agreements were intended to attract and retain our named executive officers by providing them with a measure of financial security as the Company prepared for its initial public offering, which was balanced against our need to protect our value through the use of restrictive covenants (such as non-compete and non-solicitation provisions) in the event of the officer's termination. Christine Utter, our Principal Financial Officer and Treasurer, entered into an employment agreement with us on August 16, 2014, when she was promoted to Vice President, Finance. Ms. Utter's employment agreement was amended on January 1, 2017, when Ms. Utter was promoted to Senior Vice President, Finance. The terms of Ms. Utter's employment agreement are materially consistent with the terms of the employment agreements discussed above. Marcio Souza, our Chief Operating Officer, entered into an employment agreement with us on July 8, 2014, when he joined PTC as our Vice President, Global Marketing. Mr. Souza's employment agreement was amended on June 1, 2016, when Mr. Souza was promoted to Senior Vice President, Head of Product Strategy. The terms of Mr. Souza's employment agreement are materially consistent with the terms of the employment agreements discussed above. For information concerning severance payments and other benefits that our named executive officers may be entitled to receive under their employment agreements see "Potential Payments Upon Termination or Change in Control (2017)" on page 44. Consulting Agreements In conjunction with his separation from the Company, the Company and Mr. Rothera entered into a consulting agreement effective as of August 10, 2017, with a term continuing through September 30, 2018. Pursuant to the consulting agreement, Mr. Rothera receives a monthly consulting fee of $9,500. In accordance with the consulting agreement, certain of Mr. Rothera's restricted stock awards and stock options which had not fully vested were forfeited per the following schedule: * of the 9,600 shares of restricted stock Mr. Rothera was granted on January 3, 2017, all of which remained unvested, the 2,400 shares scheduled to vest from August 10, 2017 through September 30, 2018 will continue to vest per the regular schedule set forth in the applicable restricted stock agreement and the remaining 7,200 shares were forfeited effective August 10, 2017; * of the 56,000 stock options Mr. Rothera was granted on January 3, 2017, all of which remained unvested, the 21,000 options scheduled to vest from August 10, 2017 through September 30, 2018 will continue to vest per the regular schedule set forth in the applicable stock option agreement and the remaining 35,000 options were forfeited effective August 10, 2017; * of the 70,000 stock options Mr. Rothera was granted on January 4, 2016, all of the 43,750 options which remained unvested were forfeited effective August 10, 2017; and * of the 69,550 stock options Mr. Rothera was granted on January 2, 2015, all of the 26,082 options which remained unvested were forfeited effective August 10, 2017. Outstanding Equity Awards at December 31, 2017 The following table sets forth information regarding outstanding stock options, restricted stock awards, restricted stock units and stock appreciation rights (SARs) held by our named executive officers as of December 31, 2017: Option awards Stock awards 58,850 26,750 (2) 51.00 1/1/2025 _______________________________________________________________________________ (1) This option vests over four years, with 25% of the shares underlying the option vested on January 1, 2015, and 6.25% of the shares underlying the option vesting quarterly thereafter beginning on April 1, 2015. (2) This option vests over four years, with 25% of the shares underlying the option vested on January 1, 2016 and 6.25% of the shares underlying the option vesting quarterly thereafter beginning on April 1, 2016. (3) This option vests over four years, with 25% of the shares underlying the option vesting on January 4, 2017 and 6.25% of the shares underlying the option vesting quarterly thereafter beginning on April 4, 2017. (4) This option vests over four years, with 25% of the shares underlying the option vesting on January 3, 2018 and 6.25% of the shares underlying the option vesting quarterly thereafter beginning on April 3, 2018. (5) This restricted stock award vests in four equal annual installments, commencing on January 3, 2018. (6) This vests over two years, with 50% of the shares underlying the option vesting on June 2, 2018, and 12.5% of the shares underlying the option vesting quarterly thereafter beginning on September 2, 2018. (7) Represents SARs that vest in four equal installments, commencing on January 1, 2017 and are automatically payable in cash in connection with the vesting. (8) This restricted stock unit vests in four equal annual installments, commencing on January 3, 2018. (9) This option vests over four years, with 25% of the shares underlying the option vested on July 31, 2015, and 6.25% of the shares underlying the option vesting quarterly thereafter, beginning on October 31, 2015. (10)This option vests over four years, with 25% of the shares underlying the option vesting on November 17, 2017, and 6.25% of the shares underlying the option vesting quarterly thereafter, beginning on February 17, 2018. (11)This option vests in two equal annual installments, commencing on May 31, 2018. (12)This restricted stock award vests in two equal annual installments, commencing on May 31, 2018. (13)All of Mr. Kovacs' unvested outstanding stock option awards and restricted stock awards terminated immediately upon his resignation from the Company. All of Mr. Kovacs' vested outstanding stock option awards and restricted stock awards that remained unexercised terminated 90 days following his resignation from the Company. (14)A portion of this award was forfeited on August 10, 2017 in accordance with Mr. Rothera's consulting agreement, as described under "Consulting Agreements" on page 41. (15)A portion of this award was forfeited on August 10, 2017 in accordance with Mr. Rothera's consulting agreement, as described under "Consulting Agreements" on page 41. Of the remaining options, 14,000 options vested on January 3, 2018, 3,500 options vested on April 3, 2018 and 3,500 options will vest on July 3, 2018. (16)A portion of this award was forfeited on August 10, 2017 in accordance with Mr. Rothera's consulting agreement, as described under "Consulting Agreements" on page 41. All of the remaining shares vested on January 3, 2018. Option Exercises and Stock Vested in 2017 The following table sets forth information concerning stock options that were exercised and restricted stock, restricted stock units and stock appreciation rights that vested during 2017. All stock option awards exercised were held, and no sales were effected, by our named executive officers during 2017 with the exception of one option exercise by Shane Kovacs after his termination date, prior to the expiration of his vested but unexercised options. Option Awards Stock Awards _______________________________________________________________________________ (1) Values realized upon stock option exercises are calculated based on the difference between the market price of PTC common stock at the time of exercise and the exercise price of the option. For Ms. Utter and Mr. Souza, value realized represents exercise and settlement of cash settled stock appreciation rights. (2) The value realized for restricted stock was determined by multiplying the number of shares that vested by the market price of PTC common stock on the date of vesting. Potential Payments upon Termination or Change in Control (2017) As described below, each of our named executive officers has an employment agreement with us that entitles such executive to certain cash payments or other benefits in the event such officer's employment is terminated or the Company undergoes a change in control. Pre-Conditions to Severance and Restrictive Covenants The receipt of severance benefits by a named executive officer is conditioned upon the execution and non-revocation of a separation and release of claims agreement. These agreements include standard continued assistance and cooperation clauses and require reconfirmation of each executive's commitment to abide by the non-competition, non-solicitation and confidentiality provisions of their employment agreements. Pursuant to non-competition provisions in the employment agreements, each executive has agreed that for 18 months following his or her separation from PTC he or she will not engage in or assume any role involving directly or indirectly our field of interest, including, among other things, the research, development and commercialization of products and strategies relating to therapies for genetic disorders or diseases that include Duchenne muscular dystrophy, other diseases caused in whole or part by nonsense (or stop) codons, and other therapeutic targets, mechanisms of action and/or therapies in which the Company has a research, development or commercialization program. In addition, non-solicitation provisions in the employment agreements also prohibit each named executive officer for a period of 18 months following separation from PTC from soliciting, directly or indirectly, any customers, partners, vendors, employees or contractors. Each agreement includes confidentiality provisions and assignment of invention provisions that do not expire following a separation of employment. Definitions A named executive officer's termination by PTC would generally be considered "without cause" unless our Board determined in writing that: there was a willful and continued failure by the named executive officer to substantially perform his or her duties or responsibilities; he or she engaged in willful misconduct or gross negligence with detrimental effect to the 44 Company; he or she was convicted of a felony; he or she materially breached a fiduciary duty to the Company; or he or she materially breached the terms of his or her employment agreement. Unless the named executive officer has consented to any of the following, his or her decision to terminate his or her employment with PTC would generally be considered "for good reason" (following a failure of PTC to cure the condition) if: he or she was required to relocate more than 50 miles (or to New York City); there was a material adverse change in his or her responsibilities or a material reduction in his or her base compensation; the Company materially breached his or her employment agreement (and such breach was not promptly cured); or the Company failed to obtain the assumption of his or her employment agreement by any successor to the Company. In addition, the failure of the Board to appoint Dr. Peltz as our CEO or re-nominate him as a Board member would generally qualify as "good reason" for Dr. Peltz to terminate his employment with us. A "change in control" would generally be deemed to have occurred if: as a result of a merger or other reorganization, PTC was not the surviving entity; there was a sale of, or agreement to sell, substantially all of PTC's assets; any person or group acquires or gains control of more than 50% of PTC's common stock; or, as a result of or in connection with a contested election of directors, PTC's current Board members (or their approved nominees) ceased to comprise a majority of the Board. Overview of Payments—Dr. Peltz If we terminate Dr. Peltz's employment without cause or if he terminates his employment with us for good reason, we are obligated to: pay Dr. Peltz a lump sum amount equal to his base salary for 18 months; extend the exercise period of certain of his option awards, subject to specified limitations; and, to the extent allowed by applicable law and the applicable plan documents, continue to provide him and certain of his dependents with group health insurance for a period of up to 18 months. If we terminate Dr. Peltz's employment without cause or if he terminates his employment with us for good reason, in each case within six months prior to or 18 months following a change in control, we are obligated to: pay Dr. Peltz a lump sum amount equal to his base salary for 24 months; accelerate in full the vesting of all of his outstanding equity awards; extend the exercise period of certain of his option awards, subject to specified limitations; pay Dr. Peltz his annual cash incentive award at target for the year in which he is terminated; and, to the extent allowed by applicable law and the applicable plan documents, continue to provide him and certain of his dependents with group health insurance for a period of up to 24 months. All stock option awards granted since our initial public offering are "double-trigger" awards that require both a change in control and a termination of employment before vesting is accelerated. In order to transition Dr. Peltz's responsibilities as our Chief Executive Officer to any successor, his employment agreement provides that we will retain his services as a consultant for up to 24 months, at his per-diem base salary rate immediately before termination of his employment, if under any circumstances we terminate Dr. Peltz's employment without cause or if Dr. Peltz terminates his employment with us for good reason. In addition, subject to specified limitations, Dr. Peltz will be permitted to continue to purchase coverage under our group health insurance plan following the expiration of any benefits continuation provided by us as described above until such time as he is eligible for Medicare. Overview of Payments—Other Executive Officers For our named executive officers, other than Dr. Peltz, if we terminate the named executive officer's employment without cause or if such executive terminates his or her employment with us for good reason, we are obligated to: pay such named executive officer's base salary for a period of 12 months and, to the extent allowed by applicable law and the applicable plan documents, continue to provide to such executive and certain of his or her dependents with group health insurance for a period of up to 12 months. If we terminate any named executive officer's employment without cause or if such named executive officer terminates his or her employment with us for good reason, in each case within three months prior to or 12 months following a change in control, we are obligated to: pay the named executive officer a lump sum amount equal to his or her base salary for 12 months; to the extent allowed by applicable law and the applicable plan documents, continue to provide to such named executive officer and certain of his or her dependents with group health insurance for a period of up to 12 months; accelerate in full the vesting of all outstanding equity awards held by such named executive officer; and pay each such named executive officer his or her annual cash incentive award at target for the year in which he or she is terminated. Taxation To the extent that any severance or other compensation payment to any of our named executive officers pursuant to an employment agreement or any other agreement constitutes an "excess parachute payment" within the meaning of Sections 280G and 4999 of the Internal Revenue Code of 1986, as amended (the "Code"), then such named executive officer 45 will receive the full amount of such severance and other payments, or a reduced amount intended to avoid the application of Sections 280G and 4999 of the Code, whichever provides the executive with the highest amount on an after-tax basis. Potential Payments upon Termination or Change in Control Table (2017) The following table summarizes the potential payments to each named executive officer under various termination events, assuming a hypothetical termination on December 31, 2017. Mr. Kovacs is not included in the below table as no termination payments were made in connection with his mid-year departure in 2017. _______________________________________________________________________________ (1) Represents the COBRA premium for continued health care coverage for each executive and their dependents that would be paid by the Company based on rates in effect January 1, 2018. (2) Represents the aggregate value of the accelerated vesting of stock option awards, calculated by multiplying the difference between the closing price of PTC common stock on December 29, 2017 ($16.68) and the stock option exercise price by the number of stock options subject to accelerated vesting. All unvested stock option awards are "double-trigger" awards that require both a change in control and a termination of employment before vesting is accelerated. (3) Represents the aggregate value of the accelerated vesting of restricted stock awards, calculated by multiplying the closing price of PTC common stock on December 29, 2017 ($16.68) by the number of shares subject to accelerated vesting. (4) Represents the aggregate severance payment to be paid to Mr. Rothera, in accordance with his employment agreement, following his resignation as an executive officer in 2017. The severance payment will be paid in equal monthly payments over 12 months, commencing in August 2017. Pay Ratio Disclosure As required by the Dodd-Frank Act and SEC rules, we are providing the following information about the relationship of the annual total compensation of our employees and the annual total compensation of Dr. Peltz, our Chief Executive Officer: For our fiscal year ended December 31, 2017: * The median annual total compensation for all employees (other than our CEO) was $163,265; and * The annual total compensation of our CEO, as reported in the 2017 Summary Compensation Table included elsewhere in this proxy statement, was $2,172,683. Based on this information the ratio of the annual total compensation of Dr. Peltz to the median of the annual total compensation of our employees was approximately 13.3:1. The above ratio is appropriately viewed as an estimate. To identify the median of the annual compensation of our employees, we reviewed the base salary, on an annualized basis, in U.S. dollars, for all of our employees as of December 31, 2017, for the period from January 1, 2017 through December 31, 2017. As of December 31, 2017, we had 373 employees worldwide. No cost-of-living adjustment or other adjustments were made and exclusions for non-U.S. employees were not utilized in determining our median employee with the exception of converting base salaries into U.S. dollars with respect to our international employees. Once we identified our "median employee," using the methodology described above, we determined that employee's annual total compensation in accordance with the requirements of Item 402(c)(2)(x) of Regulation S-K for purposes of calculating the required pay ratio. EQUITY COMPENSATION PLAN INFORMATION Since the closing of our initial public offering in June 2013, we have granted awards to eligible participants under our 2013 Long-Term Incentive Plan. In addition, from time to time, the Compensation Committee grants inducement equity awards to individuals as an inducement material to the individual's entry into employment with us within the meaning of Nasdaq Listing Rules. Prior to the closing of our initial public offering in June 2013, we granted awards to eligible participants under the 1998 employee, director and consultant stock option plan, as amended and restated, or the 1998 plan, the 2009 equity and long-term incentive plan, as amended, or the 2009 plan, and the 2013 stock incentive plan. Awards granted under these plans prior to our initial public offering remain outstanding under the applicable plan. Any shares of common stock subject to awards under these plans that expire, terminate or are otherwise surrendered, canceled, forfeited or without having been fully exercised or resulting in any common stock being issued will be available for grant under the 2013 Long-Term Incentive Plan up to a specified number of shares. Following stockholder approval at our 2016 annual meeting, we adopted the 2016 Employee Stock Purchase Plan, or 2016 ESPP. The following table sets forth information as of December 31, 2017 with respect to compensation plans under which shares of our common stock are authorized for issuance: _______________________________________________________________________________ (1) Reflects, as of December 31, 2017, the total number of shares of our common stock available for issuance under the 2013 Long-Term Incentive Plan (927,478 shares) and 2016 ESPP (730,229 shares). Immediately prior to our initial public offering, all shares remaining available for future issuance under the 2009 plan and the 2013 stock incentive plan became available for future issuance under the 2013 Long-Term Incentive Plan. In August 2008, the 1998 plan expired and since then no further grants of stock options have been made under this plan. All shares available to grant under the 1998 plan automatically transferred to the 2009 plan at that time. Our 2013 Long-Term Incentive Plan contains an "evergreen" provision, which allows for an annual increase in the number of shares of our common stock available for issuance under the plan on the first day of each fiscal year. The annual increase in the number of shares is equal to the lowest of: (i) 2,500,000 shares of our common stock; (ii) 4% of the number of shares of our common stock outstanding on the first day of the fiscal year; and (iii) an amount determined by our Board. On January 1, 2018, 1,664,295 shares of our common stock were added to the 2013 Long-Term Incentive Plan pursuant to this provision. (2) Represents option awards granted to individuals as an inducement material to the individual's entry into employment with us. Each such grant was approved by our Compensation Committee and disclosed in a press release. Under applicable Nasdaq Listing Rules, inducement grants are not subject to security holder approval. The terms of each inducement grant are materially consistent with the terms of awards made under our 2013 Long-Term Incentive Plan. Inducement grants vest over four years, with 25% of the shares underlying the option vesting on the one-year anniversary of the new hire's employment date and an additional 6.25% of the original number of shares underlying the option vesting at the end of each successive three-month period thereafter. Inducement option awards have an exercise price equal to the closing price of PTC's common stock on the date of the grant. The date of grant is the later of the date our Compensation Committee approves the awards or the applicable employee's pre-scheduled new hire start date. 48 2017 DIRECTOR COMPENSATION The following table sets forth information regarding compensation awarded to, earned by or paid to our directors, other than Dr. Peltz, during 2017: _______________________________________________________________________________ * Dr. Koppel and Mr. Renaud ceased their service on the Board of Directors on June 9, 2017. ** Dr. McDonough ceased his service on the Board of Directors on September 18, 2017. (1) These amounts do not represent the actual value realized by the directors during the respective year. The amounts reported in the "Option awards" column reflect the full grant date fair value of stock options awarded during 2017 computed in accordance with the provisions of FASB ASC Topic 718. The stock option values were calculated using the Black-Scholes option pricing model. See Notes 2 and 10 to our audited financial statements for the fiscal year ended December 31, 2017, included in our 2017 Form 10-K for information regarding assumptions underlying the valuation of equity awards. At December 31, 2017, the aggregate number of shares of our common stock subject to each non-employee director's outstanding option awards were as follows: Mr. Schmertzler—93,283; Dr. Jacobson—109,499; Mr. Southwell—61,506; Dr. Steele—44,000; Ms. Svoronos—32,000 and Dr. Zeldis—56,000. (2) Represents consulting fees and fees received by Dr. Jacobson in connection with his service as chair of our scientific advisory board. Narrative to 2017 Director Compensation Table During 2017, our non-employee directors were compensated for their service as directors, including as members of the various committees of our Board, as follows: * an annual retainer for board service of $45,000; * an annual option grant to purchase 12,000 shares of our common stock, which vests over one year in twelve equal monthly installments, commencing on February 3, 2017; * for our Chair of the Board, an additional annual option grant to purchase 12,000 shares of our common stock, which vests over one year in twelve equal monthly installments, commencing on February 3, 2017; * for members of our Audit Committee, an additional annual retainer of $8,000 ($21,000 for the Chair); * for members of our Compensation Committee, an additional annual retainer of $5,000 ($15,000 for the Chair); and * for members of our Nominating and Corporate Governance Committee, an additional annual retainer of $3,000 ($11,000 for the Chair). The stock options granted to our non-employee directors have an exercise price equal to the closing price of PTC's common stock on the date of grant and expire ten years after the date of grant. Vesting of the awards is subject to the director's continued service to us. Each member of our Board is also entitled to reimbursement for reasonable travel and other expenses incurred in connection with attending meetings of the Board and any committee on which he or she serves. 50 PROPOSAL 3: ADVISORY VOTE TO APPROVE NAMED EXECUTIVE OFFICER COMPENSATION Our Compensation Discussion and Analysis, which appears earlier in this proxy statement on page 25, describes our executive compensation program and the compensation decisions that our Compensation Committee made with respect to the 2017 compensation of our named executive officers (listed in the Summary Compensation Table). As required pursuant to Section 14A of the Exchange Act, our Board of Directors is asking that stockholders cast a nonbinding, advisory vote FOR the following resolution: "RESOLVED, that the compensation paid to the Company's named executive officers, as disclosed pursuant to Item 402 of Regulation S-K, including the Compensation Discussion and Analysis, compensation tables and narrative discussion, is hereby APPROVED." This proposal, commonly known as a "say-on-pay" proposal, gives our stockholders the opportunity to express their views on the design and effectiveness of our executive compensation program. As an advisory vote, this proposal is not binding. The outcome of this advisory vote will neither overrule any decision nor create or imply any change to the fiduciary duties of the Company or the Board (or any committee thereof). However, our Board and our Compensation Committee will review and consider the voting results when making future decisions regarding our executive compensation program. Our Board has adopted a policy to hold a "say-on-pay" advisory vote on an annual basis. As a result, we expect that the next "say-on-pay" advisory vote will be held at our 2019 annual meeting of stockholders. As described in the Compensation Discussion and Analysis, our executive compensation programs are designed to reward executives based on the achievement of Company objectives and individual performance which, as a whole, are intended to drive value creation for stockholders. A significant portion of compensation paid to our named executive officers is allocated to annual cash and long-term equity incentives which are directly linked to Company and/or stock price performance. In 2017, 70.5% and 57.5%, respectively, of our Chief Executive Officer's and other named executive officers' primary compensation elements (base salary, annual cash incentive at target, and annual equity award) were variable based on our performance and/or our stock price. For these reasons, our Board is asking that stockholders support this proposal. Our Board Recommends that You Vote "FOR" the Advisory Vote to Approve Named Executive Officer Compensation. STOCKHOLDER PROPOSALS AND NOMINATIONS FOR DIRECTOR Director Nominations for Inclusion in Proxy Materials (Proxy Access) On April 21, 2017, our Board amended our bylaws to implement proxy access. As amended, our bylaws permit a stockholder, or a group of up to 20 stockholders, owning 3% or more of the Company's outstanding common stock continuously for at least three years to nominate and include in our proxy materials director candidates constituting up to 25% of the Board, provided that the stockholder(s) and the director nominee(s) satisfy the requirements specified in the bylaws. Eligible stockholders who wish to have a director nominee included in our proxy statement relating to the annual meeting of stockholders to be held in 2019 must deliver a written notice, containing the information specified in our bylaws regarding the stockholder(s) and the proposed nominee(s), to us by March 15, 2019, but not before February 13, 2019, which is not less than 90 days nor more than 120 days prior to the first anniversary of the date of this year's Annual Meeting. However, in the event that the date of next year's annual meeting is advanced by more than 20 days, or delayed by more than 60 days, from the first anniversary of this year's Annual Meeting, we must receive written notice of stockholder proposals no earlier than the 120th day prior to such annual meeting and not later than the close of business on the later of (A) the 90th day prior to such annual meeting and (B) the tenth day following the day on which notice of the date of such annual meeting was mailed or public disclosure of the date of such annual meeting was made, whichever first occurs. The requirements for a stockholder nomination are more fully set forth in Section 1.12 of our bylaws, and the following summary is qualified by reference to the applicable sections of our bylaws. Other Stockholder Proposals to be Included in the 2019 Proxy Statement To be considered for inclusion in the proxy statement relating to the annual meeting of stockholders to be held in 2019, we must receive stockholder proposals no later than December 31, 2018, which is a date no less than 120 calendar days before the anniversary of the date on which our proxy statement was released to stockholders in connection with this year's Annual Meeting. If the date of next year's annual meeting is changed by more than 30 days from the anniversary date of this year's Annual Meeting on June 13, 2018, then the deadline is a reasonable time before we begin to print and mail proxy materials. Upon receipt of any such proposal, we will determine whether or not to include such proposal in the proxy statement and proxy in accordance with the rules and regulations governing the solicitation of proxies. Stockholder Proposals to be Brought Before the 2019 Annual Meeting (Not Included in the Proxy Statement) Our bylaws establish an advance notice procedure for stockholder proposals to be brought before an annual meeting of stockholders, including proposed nominations of persons for election to our Board. Stockholders at an annual meeting may only consider proposals or nominations specified in the notice of meeting or brought before the meeting by or at the direction of our Board or by a stockholder of record on the record date for the meeting, who is entitled to vote at the meeting and who has delivered timely notice of the stockholder's intention to bring such business before the meeting in proper form. We must receive written notice of stockholder proposals (including director nominations) intended to be presented at the 2019 annual meeting of stockholders but that will not be included in the proxy statement by March 15, 2019, but not before February 13, 2019, which is not less than 90 days nor more than 120 days prior to the first anniversary of this year's annual meeting. However, in the event that the date of next year's annual meeting is advanced by more than 20 days, or delayed by more than 60 days, from the first anniversary of this year's Annual Meeting, we must receive written notice of stockholder proposals no earlier than the 120th day prior to such annual meeting and not later than the close of business on the later of (A) the 90th day prior to such annual meeting and (B) the tenth day following the day on which notice of the date of such annual meeting was mailed or public disclosure of the date of such annual meeting was made, whichever first occurs. Any proposals we do not receive in accordance with the above standards will not be voted on at the 2019 annual meeting. The foregoing time limits also apply to determining whether notice is timely for purposes of rules adopted by the SEC relating to the exercise of discretionary voting authority. These rules are separate from and in addition to the requirements a stockholder must meet to have a proposal included in our proxy statement. In addition, stockholders are required to comply with any applicable requirements of the Exchange Act and the rules and regulations thereunder. The requirements for a stockholder notice are more fully set forth in Sections 1.10 and 1.11 of our bylaws, and the following summary is qualified by reference to the applicable sections of our bylaws. HOUSEHOLDING OF PROXIES The SEC has adopted rules that permit companies and intermediaries such as brokers to satisfy delivery requirements for annual reports and proxy statements with respect to two or more stockholders sharing the same address by delivering a single annual report and/or proxy statement addressed to those stockholders. This process, which is commonly referred to as "householding," potentially provides extra convenience for stockholders and cost savings for companies. We and some brokers household proxy materials, delivering a single annual report and/or proxy statement to multiple stockholders sharing an address unless contrary instructions have been received from the affected stockholders. Once you have received notice from your broker or us that they or we will be householding materials to your address, householding will continue until you are notified otherwise or until you revoke your consent. If, at any time, (1) you no longer wish to participate in householding and would prefer to receive a separate set of proxy materials in the future or (2) you and another stockholder sharing the same address wish to participate in householding and prefer to receive a single copy of our proxy materials, please notify your broker if your shares are held in a brokerage account or us if you hold registered shares. You can notify us by sending a written request to Vice President, Corporate Communications, PTC Therapeutics, Inc., 100 Corporate Court, South Plainfield, New Jersey 07080 or via e-mail at firstname.lastname@example.org or phone at 908-9129167. OTHER MATTERS As of the date of this proxy statement, we know of no matter not specifically referred to above as to which any action is expected to be taken at the Annual Meeting. The persons named as proxies will vote the proxies, insofar as they are not otherwise instructed, regarding such other matters and the transaction of such other business as may be properly brought before the meeting, as seems to them to be in the best interest of our Company and our stockholders. Your vote is important. Please vote your proxy promptly so your shares are represented, even if you plan to attend the Annual Meeting. You may vote by Internet, by telephone, by requesting a printed copy of the proxy materials and using the enclosed proxy card or in person at the Annual Meeting. Your cooperation in giving this your immediate attention will be appreciated. You may obtain a copy of our Annual Report on Form 10-K for the fiscal year ended December 31, 2017, as filed with the SEC, except exhibits, without charge upon written request to Vice President, Corporate Communications, PTC Therapeutics, Inc., 100 Corporate Court, South Plainfield, New Jersey 07080. The Board of Directors of PTC Therapeutics, Inc. South Plainfield, New Jersey April 30, 2018 VOTE BY INTERNET - www.proxyvote.com Use the internet to transmit your voting instructions up until 11:59p.m. Eastern Time on June 12, 2018. Have your proxy card in hand when you access the website and follow the instructions to obtain your proxy materials and to create an electronic voting instruction form. ELECTRONIC DELIVERY OF FUTURE PROXY MATERIALS If you would like to reduce the costs incurred by our company in mailing proxy materials, you can consent to receiving all future proxy statements, proxy cards and annual reports electronically via email or the internet. To sign up for electronic delivery, please follow the instructions above to vote using the internet and, when prompted, indicate that you agree to receive or access proxy materials electronically in future years. VOTE BY PHONE - 1-800-690-6903 Use any touch-tone telephone to transmit your voting instructions up until 11:59p.m. Eastern Time on June 12, 2018. Have your proxy card in hand when you call and then follow the instructions. VOTE BY MAIL Mark, sign and date your proxy card and return it in the postage-paid envelope we have provided or return it to Vote Processing, c/o Broadridge, 51 Mercedes Way, Edgewood, NY 11717. TO VOTE, MARK BLOCKS BELOW IN BLUE OR BLACK INK AS FOLLOWS KEEP THIS PORTION FOR YOUR RECORDS THIS PROXY CARD IS VALID ONLY WHEN SIGNED AND DATED. DETACH AND RETURN THIS PORTION ONLY PTC THERAPEUTICS, INC. For All Withhold All For All Except To withhold authority to vote for any individual nominee(s), mark "For All Except" and write the number(s) of the nominee(s) on the line below. The Board of Directors recommends you vote FOR each of the following nominees ☐ ☐ ☐ 1. Election of Directors Nominees: 01) Michael Schmertzler 02) Glenn D. Steele, Jr., M.D., Ph.D. The Board of Directors recommends you vote FOR proposal 2: For Against Abstain 2. Ratification of the appointment of Ernst & Young LLP as the Company's independent registered public accounting firm for the fiscal year ending December 31, 2018 ☐ ☐ ☐ The Board of Directors recommends you vote FOR proposal 3: For Against Abstain 3. Advisory vote to approve named executive officer compensation. ☐ ☐ ☐ NOTE: To transact any other business that may be properly brought before the meeting or any adjournment or postponement of the meeting. For address changes and/or comments, please check this box and write them on the back where indicated ☐ Please indicate if you plan to attend this meeting ☐ ☐ Yes No Please sign exactly as name(s) appear(s) hereon. Joint owners should each sign. When signing as attorney, executor, administrator, corporate officer, trustee, guardian, or custodian, please give full title. Signature [PLEASE SIGN WITHIN BOX] Date Signature (Joint Owners) Date Important Notice Regarding the Availability of Proxy Materials for the Annual Meeting: The Notice and Proxy Statement and 2017 Annual Report are available at www.proxyvote.com. PTC THERAPEUTICS, INC. Annual Meeting of Stockholders June 13, 2018 9:00 a.m., Eastern Time Proxy Solicited by the Board of Directors The undersigned hereby appoints Stuart W. Peltz and Mark E. Boulding, and each of them, proxies for the undersigned, with full power of substitution, and hereby authorizes them to represent and vote all shares of common stock of PTC Therapeutics, Inc., that the undersigned may be entitled to vote at the Annual Meeting of Stockholders of the company to be held on June 13, 2018 at 9:00a.m., Eastern Time at the Embassy Suites, 121 Centennial Ave., Piscataway Township, NJ 08854 or at any adjournment or postponement thereof, upon the matters set forth on the reverse side and described in the accompanying proxy statement and any other matter that may properly come before the meeting. This proxy, when properly executed, will be voted as specified herein. If no specification is made, this proxy will be voted FOR the election of each of the director nominees listed under proposal 1 and FOR proposals 2 and 3. If any other matters are voted on at the meeting, this proxy will be voted by the proxies on such matters in their sole discretion. Address Changes/Comments: (If you noted any Address Changes/Comments above, please mark corresponding box on the reverse side.) PLEASE MARK, SIGN, DATE AND RETURN THIS PROXY CARD PROMPTLY USING THE ENCLOSED REPLY ENVELOPE. 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FOR IMMEDIATE RELEASE CONTACT: Jane Ballentine 29 September 2011 O: 443/552-5278 C: 301/332-1742 MARYLAND ZOO IN BALTIMORE ANNOUNCES BIRTH OF HAMERKOP CHICKS BALTIMORE, MD -- The Maryland Zoo in Baltimore is happy to announce that two female hamerkop chicks were hatched the week of August 18, 2011, and they are about to take flight from their nest in the African Aviary. Hamerkops are wading birds that forage for food in shallow water and are widely dispersed throughout sub-Saharan Africa. They live in diverse habitats, from forest to semi-desert, wherever water is accessible. The birds are brown, with a flat crest on their head that resembles a hammer and in fact, the word hamerkop is Afrikaans for "hammer-head." Hamerkops are distinguished by their huge, domed nests. They build the biggest nests of any bird in Africa as the pair build the nest together, collecting many thousand twigs and other items to build it. Although enormous itself, the nest is accessible only by a small, narrow entrance hole. The female hamerkop lays her eggs, and male and female take turns sitting on them during the incubation period, which lasts about 30 days. Both parents help feed the chicks once they hatch out. Chicks are ready to fly after about 50 days. They continue to return to the nest for two weeks after first flight, and may roost together in the nest for another month before dispersing. "It's hard to miss the hamerkops building a nest this size," said Mike McClure, general curator at the Zoo. "Staff had been checking inside periodically to see if there were chicks, and we were happy to find two healthy chicks on August 18. They are now fledging and are preparing to leave the nest, so the public should be able to see them in the Aviary very soon." The young birds will spend a lot of their top on top of the nest as they learn how to fly. Zoo visitors can see the hamerkops' massive nest in the African Aviary at the African Watering Hole exhibit, and should be able to see the chicks learning to fly. "They should begin flying about 50 days after they are born, which would be approximately the first week of October," continued McClure. The Maryland Zoo's has a breeding pair of hamerkops, Edith, 10, and Archie, 12, and this is their third successful clutch of chicks. The Maryland Zoo in Baltimore is located in Druid Hill Park. For more information, please visit the Zoo's Web site, www.marylandzoo.org, or call 410-366-LION (5466). Stay up to date on Zoo events and information by becoming a Maryland Zoo fan on Facebook www.facebook.com/marylandzoo or following us on Twitter @MarylandZoo About The Maryland Zoo in Baltimore Founded in 1876, The Maryland Zoo in Baltimore is the third oldest zoo in the United States and is internationally known for its contributions in conservation and research. More than 1,500 animals are represented in the Zoo's varied natural habitat exhibits in areas such as Polar Bear Watch, the Maryland Wilderness, African Journey and the award-winning Children's Zoo. Situated in Druid Hill Park near downtown Baltimore, the Zoo is accredited by the Association of Zoos & Aquariums. For more information, visit www.marylandzoo.org.	<urn:uuid:739eaf09-2152-4ea4-9c04-8ffc03066452>	CC-MAIN-2024-42	https://www.marylandzoo.org/wp-content/uploads/2017/12/Hamerkopchicks1.pdf	2024-10-07T01:45:24+00:00	crawl-data/CC-MAIN-2024-42/segments/1727944253447.49/warc/CC-MAIN-20241007004935-20241007034935-00137.warc.gz	783,137,745	744	eng_Latn	eng_Latn	0.99647	eng_Latn	0.997732	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 2816, 3393 ]	[ 2.375 ]	[ 2.734375 ]	[ 2.546875 ]	[ 2.4375 ]	1	1	HuggingFaceFW/finepdfs
Basin-Scale Topographic Waves in the Gulf of Riga* URMAS RAUDSEPP† Estonian Marine Institute, Tallinn, Estonia DMITRY BELETSKY Department of Naval Architecture and Marine Engineering, University of Michigan, Ann Arbor, Michigan DAVID J. SCHWAB NOAA/Great Lakes Environmental Research Laboratory, Ann Arbor, Michigan (Manuscript received 8 May 2001, in final form 18 November 2002) ABSTRACT A two-dimensional circulation model has been used to test the hypothesis of whether the observed low-frequency current variations in the central Gulf of Riga, Baltic Sea, can be explained by basin-scale topographic wave response. A comparison of two-dimensional model results with measurements from a single current meter in the gulf showed good correlation. More sophisticated three-dimensional barotropic and baroclinic models provided only marginal improvement over the two-dimensional model. The model results indicate that wind-driven flow over variable bottom topography is the dominant process during moderate and strong winds. The double-gyre circulation pattern resembles the gravest basin-scale topographic wave. The free topographic wave propagates cyclonically around the basin, but does not complete a full cycle because of the shallowness of the Gulf of Riga. The evolution of the topographic wave under realistic wind conditions is analyzed using vorticity dynamics in a basin-scale sense. The topographic wave is reinforced by cyclonically rotating wind and can be destroyed most effectively by anticyclonically rotating wind. The topographic wave signature is more apparent in deep water and almost absent in shallow areas of the basin. During calm periods or under the influence of weak winds, the double-gyre circulation will evolve into predominantly cyclonic circulation. 1. Introduction The barotropic circulation in large lakes and enclosed seas driven by spatially uniform wind, which is often a reasonable approximation, is characterized by downwind currents at the coast and return flow in the center (deep part) of the basin (Bennett 1974). The spatial structure of the flow (double-gyre circulation) corresponds to the first mode basin-scale topographic wave (Lamb 1932; Ball 1965) and has been predicted by analytical solutions for many different depth profiles (e.g., Stocker and Hutter 1987). Under the influence of rotation this pattern will propagate slowly (with a frequency considerably less than inertial frequency) counterclockwise in the Northern Hemisphere (Csanady 1974). If the wind stress is removed after the initiation of the flow and bottom stress is neglected, the double-gyre structure will propagate around the basin as a free topographic wave, with a period that depends on basin geometry and bathymetry (Saylor et al. 1980). In natural basins with irregular topography, the basin-scale topographic waves may have far more complex spatial structure than predicted by analytical models (Rao and Schwab 1976). Also, the basin-scale topographic wave, once generated by a strong wind impulse, is influenced by subsequent wind events, altered by depth variations, and modified by friction and nonlinear effects. There is some evidence from numerical model experiments that the basin-scale double-gyre topographic wave is excited in a natural basin, and that the wave persists after wind forcing ceases or changes direction. Simons (1975) showed that storm-generated topographic modes evolve in accordance with the theory of free topographic waves in Lake Ontario for several days. His simulation was made for the case of a stratified lake, but the same results should apply to a homogeneous lake. Schwab (1983) simulated the topographic mode in Lake Michigan driven by an idealized oscillatory wind. Simons (1983) addressed the problem of variable wind effect on topographic waves in a closed basin, but with the main emphasis on wave response in the coastal area. The dynamics of basin-scale topographic waves has mainly been studied with the linear vorticity equation for depth-averaged flow in the $f$ plane, but Simons (1986) showed that the double-gyre structure will evolve into a predominant cyclonic vortex under the influence of weak winds because of nonlinear topographic wave interactions. There are not very many cases in which current observations have sufficient spatial coverage to resolve the basin-scale topographic wave structure. Intensive measurements in southern Lake Michigan by Saylor et al. (1980) showed strong oscillatory currents over the central deep area of the lake, which were explained as basin-scale topographic waves. Recent observations have shown energetic low-frequency cyclonic rotation of the velocity vector in the near-bottom layer of the central Gulf of Riga, Baltic Sea. It was suggested that this was due to topographic wave response (Raudsepp and Kouts 2001). We will test this hypothesis in the present study by applying a series of numerical models of various complexity to the Gulf of Riga. The Gulf of Riga is a relatively closed, almost circular eastern subbasin of the Baltic Sea (Fig. 1). It has two openings—the Irbe Strait (with a sill depth of 25 m and a minimum cross-section area of 0.4 km$^2$) in the west and the Virtsu Strait (with a sill depth of 5 m and a minimum cross-section area of 0.04 km$^2$) in the north. The gulf has a surface area of 14 000 km$^2$, a volume of 408 km$^3$, a mean depth of 29 m, and a maximum depth of 55 m. In this study, the Gulf of Riga is modeled as a closed basin. The numerical models are described in section 2. The basin-scale circulation in the Gulf of Riga initiated by impulsive wind and its unforced evolution for linear and nonlinear models are discussed in section 3. Simulated currents for different levels of model sophistication are compared with measurements in section 4. The model results are analyzed for basin-scale vorticity dynamics, for rotating wind, and for weak wind in section 5. Conclusions are presented in section 6. 2. Numerical models The numerical model adapted for the Gulf of Riga is based on the three-dimensional (3D) Princeton Ocean Model (Blumberg and Mellor 1987) and is a nonlinear, hydrostatic, primitive equation, finite-difference model with the Mellor and Yamada (1982) level-2.5 turbulence closure parameterization. The boundary condition for an enclosed basin is that there is no flow normal to the shoreline. The model uses time-dependent wind stress at the surface, free-slip lateral boundary conditions and a quadratic bottom friction. The model was mostly used in the two-dimensional (2D) mode (a shallow-water model), while 3D calculations were conducted as sensitivity studies. The bottom drag coefficient in the 2D model was 0.0025, horizontal diffusion was 50 m$^2$ s$^{-1}$. Comparison with 3D model results and observations indicated that these values provide reasonable results. In the 3D model, the drag coefficient in the bottom friction formulation is spatially variable. It is calculated based on the assumption of logarithmic bottom boundary layer using constant bottom roughness of 0.01 m. Horizontal diffusion is calculated with a Smagorinsky eddy parameterization (Smagorinsky 1963). To examine the dynamics of basin-scale topographic waves in an idealized setting, a linearized version of 2D Princeton Ocean Model will also be used. In this model horizontal advection and diffusion is neglected and bottom friction is approximated by a linear drag law. The effect of tides is negligible in the Baltic Sea (Mälkki 1975) and was not included in model simulations. The hydrodynamic models of the Gulf of Riga have uniform horizontal grid size of 1 km. The 3D model has 20 vertical layers. Mean sea level of 1 m is added to avoid drying of the shallow area during storms, which otherwise may cause the model to blow up. 3. Basin-scale topographic wave structure: Linear versus nonlinear response The initiation of the circulation in the Gulf of Riga due to suddenly imposed wind stress and its subsequent evolution after the wind forcing is removed is investigated by both linear and nonlinear 2D numerical models. Both models are forced by an idealized impulse-type wind from the northwest, which approximately coincides with the orientation of the main topographic features of the basin. The wind stress increases linearly from zero to its maximum value (0.4 N m$^{-2}$) over 18 h, remains constant at this maximum value for another 6 h, and then decreases linearly to zero during the next 5 h. The wind forcing then remains at zero for the duration of model simulation (10 days). Normalized transport streamfunctions are shown in Figs. 2a and 2e after 25 h from the imposition of wind. This time instant still corresponds to a relatively strong wind forcing. The double-gyre structure that represents the gravest mode basin-scale topographic wave (Lamb 1932; Ball 1965; Saylor et al. 1980; Bennett and Schwab 1981) is well developed. The cyclonic gyre has formed over the southwest part of the basin and the anticyclonic gyre is apparent over the northeast part of the basin. Downwind flow has been established along the western and eastern shores and return flow over the central part of the basin. Small deflections of the gyres from a two-gyre pattern are due to the irregular shape and bottom topography of the Gulf of Riga. Because of the island in the center of the basin, the return flow is split into two branches on both sides of the island. An anticyclonic eddy to the west of the island develops due to wind-forced currents over local bottom topography. Both models produce similar circulation patterns (Fig. 2). Still there are several differences that are clearly brought up by nonlinearity and horizontal diffusion. The streamlines are packed closer to the coast in the linear model. This indicates stronger currents over the shallow area and enhanced differences of the longshore velocity between coastal and offshore areas. The eddy west of the central island is more pronounced in the nonlinear model response. The circulation pattern propagates cyclonically completing a half cycle in 4 days. At this rate, the period of the topographic wave would be 8 days. However, dissipation by bottom friction begins to slow the wave down and decrease the amplitude so that it is difficult to track after 4 days. The double-gyre structure has been retained in a basin-scale sense, with dominant cyclonic circulation over the northeast part of the basin and anticyclonic circulation over the southwest part of the basin. Locally, a number of small-scale circulation cells have been formed. Compared to the initial circulation structure, which was dominated by the first basin-scale topographic mode, the contribution from higher modes has been increased. The differences between the linear and nonlinear model are more pronounced. At the end of the simulation (day 11), the circulation has become predominantly cyclonic in the nonlinear model compared to the linear model (Figs. 2d,h) (e.g., Simons 1986). Relatively fast dissipation of the flow due to bottom friction is corroborated by calculating mean kinetic energy over different depth intervals. Mean kinetic energy over the shallow area (0–9 m) and deep area ($\geq 40$ m) were compared (Fig. 3). During the forcing period, the wind drives stronger currents over the shallow area than over the deep area. The difference between levels of mean kinetic energy is about an order of magnitude. After the forcing is removed, the kinetic energy decreases rapidly over the shallow area. The most significant decrease occurs within a day after the removal of the forcing. Then mean kinetic energy drops more than two orders of magnitude over the shallow area and about an order of magnitude over the deep area, so that mean kinetic energy over the deep area becomes higher than over the shallow area. The free topographic wave does not complete a full cycle due to the shallowness of the Gulf of Riga. Even so, the remnants of the gravest mode topographic wave can be identified at the end of the simulation. Variations of the bottom friction coefficient within reasonable limits does not change the results qualitatively. 4. Comparison of model results with observations The hydrodynamic model was applied with realistic wind for a 45-day period (1 June–17 July 1994). The model was forced by horizontally uniform but temporally variable wind (Fig. 4), which was measured at an island-based meteorological station. The station is a little bit outside of the basin’s area, but is less influenced by coastal irregularities, from which the wind around the basin’s perimeter should suffer. The use of wind data from a single station is justified by the fact that typical synoptic-scale atmospheric disturbances cover a larger area than the Gulf of Riga. Moreover, the wind data used were corroborated by the wind observations at two other meteorological stations in the northeastern and northern part of the gulf. The wind record consists of wind speed and direction measured at 6-h intervals, potentially aliasing the higher-frequency (<12 h period) part of the wind forcing. However, since the characteristic response period of the gulf to wind forcing is several days, this would not affect the results essentially. Wind speed was converted to wind stress assuming neutral stability of the atmospheric boundary layer. In order to test the validity of the numerical model, model results are compared to observations from a current meter mooring which was deployed in the central Gulf of Riga (57°35.5′N, 23°37.1′E) in 54 m of water during a 3-week period in June 1994 (Fig. 1). The mooring consisted of two current meters attached to a cable at 50 and 52 m. The differences of the currents between the current meters were marginal—that is, the mean current speeds are 0.071 and 0.067 m s$^{-1}$ at 50 and 52 m, respectively, and the correlation coefficients are 0.91 and 0.93 for the east and north velocity component, respectively (Raudsepp and Kouts 2001). The model currents were compared with both current meter data records with similar results. Only the 52-m current meter is presented in the model comparison. Time dependent model currents are compared with measured currents for three different model configurations: the 1) 2D model (nonlinear), 2) 3D barotropic model (zero stratification), and 3) 3D baroclinic model. Temperature and salinity fields for the baroclinic model were prepared based on the climatological June temperature and salinity profiles in the Gulf of Riga (Raudsepp 2001). The temperature field varied only in the vertical, while both vertical and horizontal salinity variations were included. The model was run for 10 days in the diagnostic mode (temperature and salinity fields kept fixed) to generate steady baroclinic currents in the absence of wind. The wind forcing was applied on 1 June (model day 0) while the salinity and temperature fields were kept fixed throughout the model run. The depth-averaged currents are compared with the measured currents for the first case (2D model). In the other cases (3D models), the modeled 3D currents were used (Fig. 5). The 2D model yields results in agreement with the measurements. The 3D models provide only marginal improvement. Comparative tests by the barotropic model with depth-dependent bottom roughness, \[ z_b = 0.002 \left(1 + \frac{20}{h}\right), \] where $h$ is depth, and by the prognostic model (prognostic equations for temperature and salinity were implemented) did not show any significant improvement. The model results indicate the dominance of wind-forced currents in the Gulf of Riga during this period. In the following sections, only the 2D model results are used. 5. Discussion a. Basin-scale vorticity dynamics Topographic waves belong to the so called vorticity wave class (Longuet-Higgins 1968; Rhines 1969). Therefore, we use the vorticity equation instead of momentum and continuity equations to analyze the dynamics of the topographic wave response. The vorticity equation for vertically averaged flow in response to spatially uniform wind is \[ \frac{\partial}{\partial t} \zeta + \mathbf{u} \cdot \nabla \zeta - \frac{\zeta}{h} (\mathbf{u} \cdot \nabla h) - \frac{f}{h} \mathbf{u} \cdot \nabla h \] \[ = \frac{1}{h^2} \mathbf{k} \cdot \left(\frac{\tau_w}{\rho}\right) \times \nabla h - \mathbf{k} \cdot \nabla \times \left(\frac{\tau_b}{\rho h}\right) + \mathbf{k} \cdot \nabla \times \mathbf{G}, \] (1) where $\zeta$ is relative vorticity; $u$ is depth-averaged velocity; $h$ is depth; $f$ is the Coriolis parameter; $\tau_w$ and $\tau_b$ are wind and bottom stress, respectively; $k$ is the vertical unit vector; $\rho$ is the reference density; and $G$ is implicitly written horizontal diffusion. The vorticity [term I in (1), “vorticity tendency”] is generated by the wind stress component perpendicular to the depth gradient [term IV in (1), “bottom slope vorticity”]; Weenink (1958) referred to the water circulation excited by spatially uniform wind stress perpendicular to the depth gradient as a “bottom slope current”]. The vorticity pattern will propagate cyclonically around the basin in the form of a vorticity wave due to Earth’s rotation [term III in (1), “wave vorticiThe terms I and III form the equation for the free topographic waves. The wave will be dissipated by bottom friction [term V in (1), “friction vorticity”] and horizontal diffusion [term VI in (1), “vorticity diffusion”], and will be modified by nonlinear topographic wave interactions [terms IIa and IIb in (1), “nonlinear vorticity”]. The basin-scale dynamics are investigated by estimating the relative importance of the terms in (1). To estimate relative values, the root-mean-square (rms) value for each term was calculated. The basin is separated into five regions according to the basin’s depth in the intervals: 0–9, 10–19, 20–29, 30–39, 40–max(h). The vorticity tendency and wave vorticity should represent topographic wave response. The time series of these terms are presented in Fig. 6 for the depth range of 10–19 m. The wave vorticity and vorticity tendency compare reasonably well for this depth range and others (not shown), except for short-term (>1 cpd) fluctuations. Time series of four terms in (1), wave vorticity, bottom slope vorticity, friction vorticity, and nonlinear vorticity, for each region and also for the whole basin are shown in Fig. 7. The values of the terms vary over several orders of magnitude. The average magnitudes of the terms was estimated by calculating the means of log_{10} of rms of different terms in (1). Vorticity diffusion was lower than the other terms in (1) for each region and is neglected in the analysis. The values calculated over the shallow area are about two orders of magnitude higher than the values calculated over the deeper area. Because of that, the variations of the vorticity terms for the whole basin resemble the variations in the shallow area. In the depth range of 0–9 m, bottom slope vorticity dominates other terms. It is not canceled entirely by the friction vorticity. The wave vorticity and nonlinear vorticity are at least one order of magnitude smaller than the other two terms. Also, vorticity dissipation is too low to balance the bottom slope vorticity. Therefore, relative vorticity changes locally according to the wind and the topographic wave is practically absent. The direct effect of wind and the role of friction vorticity decreases while the importance of wave vorticity and nonlinear vorticity increases with the basin’s depth. Still, over the shallow area (depth 10–19 m) the main balance is between bottom slope vorticity and friction vorticity. Especially during moderate and strong winds, the bottom slope vorticity is balanced by friction vorticity due to the flow along the depth contours in the direction of wind \[ 0 \cong \frac{1}{h^2} \mathbf{k} \cdot \left( \frac{\tau_w}{\rho} \right) \times \nabla h - \frac{1}{h^2} C_p \|\mathbf{u}\| \mathbf{k} \cdot \mathbf{u} \times \nabla h. \] The magnitude of the sum of bottom slope vorticity and friction vorticity, as these terms balance each other, compares with the magnitude of wave vorticity (Fig. 8) and vorticity tendency (Fig. 6). Dynamically, this is the region of strong influence of the topographic wave (the absolute magnitude of the wave vorticity is considerably higher in the shallow area than in the deeper area). This phenomenon, where wind forcing is balanced by bottom friction to the first order, while the residual of the sum of these terms and the topographic wave terms give the next order balance, may be called the “hidden topographic wave.” Thus, the topographic wave response is scarcely observed over the depth range of 10–19 m, which agrees with the result by Hickey (1981) on the continental shelf. All terms have comparable magnitude between 20- and 29-m depth (Fig. 7). The response consists of a combination of the forced and free wave. During moderate and strong winds the forced response dominates, while during calm periods, when it is preceded by strong wind, the response should resemble the free wave. For the regions deeper than 30 m, the friction vorticity is negligible, except during the storms. The balance is between vorticity tendency and wave vorticity, only moderate and strong wind events have a direct effect on the wave. There, the model results and the measurements show preferred cyclonic rotation of the velocity vector, which is consistent with the dominant basin-scale topographic wave. Changes in the sense of rotation of wind direction do not reverse the sense of rotation of the velocity. Wave vorticity and nonlinear vorticity follow each other rather closely (Fig. 7). All terms follow bottom slope vorticity in the shallow area, that is, in the region of direct wind effect. In the deep area (h ≥ 30 m), the wave vorticity and nonlinear vorticity differ from the bottom slope vorticity considerably. The disparity of the variations of nonlinear vorticity and bottom slope vorFig. 7. Rms value of wave vorticity (bold), friction vorticity (regular), bottom slope vorticity (thin), and nonlinear vorticity (dashed) for (a) whole basin, (b) region where water depth is 1–9 m, (c) 10–19 m, (d) 20–29 m, (e) 30–39 m, and (f) $\geq 40$ m. Day 0 corresponds to 1 Jun 1994. vorticity increases during low winds and emerges over more shallow areas. During strong winds nonlinear vorticity follows the changes of bottom slope vorticity much closer, even over the deep area. The wave vorticity has a higher value than nonlinear vorticity most of the time, both terms are in phase, while having phase shift with bottom slope vorticity. The above arguments indicate that nonlinear processes are associated with topographic waves, especially during low winds and over the deep area. b. Topographic wave dynamics in the presence of rotating wind The wind effect on generation and evolution of the basin-scale topographic wave is shown for the period of days 16–20 (Fig. 9). Wind speed was about 10 m s$^{-1}$ without significant changes. The topographic mode structure is established for day 16.5 after one day of NW wind. The wind destroyed the previous topographic wave structure and the new structure resembles the topographic mode structure generated by impulse-type wind. Between day 16.5 and 17.5, the wave has propagated cyclonically about one-eighth of a cycle. The wind was turning slowly from NW to SW being mostly in phase with the wave. Between day 17.5 and day 18.25, the wind turned from SW to SE and then, between day 18.25 and 18.5, rapidly back to SW. During the first period the wind changed direction faster than the topographic wave. Between day 17.5 and 18.5, the wave has propagated one-quarter cycle, which is twice the phase propagation between day 16.5 and 17.5. The basic double-gyre structure is maintained well. The anticyclonic eddies over the area to the west from the island are the result of wave scattering over local bottom topography. The circulation structure corresponds to the unforced response 4 days after the wind forcing was removed (Fig. 2g). The forced topographic wave has propagated faster than the free wave, that is, 1/4 cpd (Figs. 9a,c) and 1/8 cpd (Figs. 2e,g), respectively. Cyclonically rotating wind, that changes direction faster than the wave, increases the apparent phase speed of the wave. Since day 18.5, the wind, as it turns anticyclonically from SW to NW, acts to destroy the existing wave, and the wave structure has been destroyed by day 19.5. The remnants of the topographic mode can be identified in the central area of the gulf in the form of a dipole eddy—the cyclonic part on the north and anticyclonic part on the south (Fig. 9d). There, the wind-forcing term is relatively small due to large depth, while the wave term is locally large because of large bottom gradient. The new wave structure emerged on day 20, similar to the one on day 16.5. Subsequently, this topographic wave evolution was repeated under the influence of similar forcing. Overall, cyclonically rotating wind appears to support the topographic wave (from day 16.5 to 18.5), while anticyclonically rotating wind tends to destroy the existing wave structure (from day 18.5 to 19.5). c. Topographic wave dynamics in response to weak wind The nonlinear model simulation showed that the double-gyre circulation evolves slowly into a predominantly cyclonic vortex after the wind forcing is removed (section 3). Because the wind never ceases for a sufficiently long time during the realistic case simulation, there is no period when unforced propagation of the topographic wave could be examined. The closest approximation to this condition would be to examine the propagation and evolution of the topographic mode structure under the weak wind conditions (days 39–44). The wind speed was about 5 m s$^{-1}$ and the wind direction changed cyclonically during this period, which should support the double gyre pattern. In general, the current velocities were also low (<5 cm s$^{-1}$, except in the coastal area). The sequence of streamfunction patterns is presented in Fig. 10. The streamfunction patterns represent a double-gyre structure in a basin-scale sense. Locally, there are a number of eddies both cyclonic and anticyclonic that dominate in the velocity field. Still, the basin-scale streamfunction pattern propagates cyclonically and completes about half of a cycle in 3 days, from day 39 to day 42. Thus, the propagation speed is higher than in unforced case because even the weak wind occasionally affects the wave in the area where basin is shallower than 30 m (Fig. 7). Similar to the model experiment with impulse-type wind, the circulation becomes more cyclonic under the weak wind forcing. In the velocity field, there are many small-scale eddies, but in general they contribute to the cyclonic circulation pattern. 6. Conclusions A barotropic two-dimensional model was used to study the basin-scale circulation in the Gulf of Riga, forced by spatially uniform wind measured at 6-h time intervals. The model can accurately simulate low-frequency observed current variability in the central Gulf of Riga even with the straits being closed. More sophisticated models—3D barotropic and baroclinic models—produce only marginal improvement. The model simulation proves the hypothesis that observed low-frequency current variations can be explained by basin-scale topographic wave. The response to a spatially uniform wind consists of double-gyre circulation pattern that resembles the gravest mode basin scale topographic wave. Moderate and strong winds of about 1-day duration are sufficient to change the existing circulation pattern and to establish a new basin-scale topographic wave structure. The free topographic wave propagates cyclonically around the basin. Using basin-scale vorticity dynamics it was shown that in very shallow areas (depth less than 10 m) the topographic wave is absent. In areas shallower than 20 m, the free topographic wave is easily destroyed because of the dominance of direct wind forcing and bottom friction in the vorticity balance. The wave survives in the deep area where the direct wind effect is much smaller compared to other terms. The Gulf of Riga is relatively shallow so that a free basin-scale topographic wave is signifiFig. 10. Normalized streamfunction on day (a) 39, (b) 40, (c) 41, (d) 42, (e) 43, and (f) 44. Day 0 corresponds to 1 Jun 1994. Bold arrow shows the direction of the wind. cantly distorted and does not complete a full cycle. Also, higher modes of the basin-scale topographic wave will contribute to the overall circulation field. If the wind varies in time, then the temporal evolution of the flow field consists of the combined effects of the free wave and wind-forced response. Cyclonically rotating wind can reinforce the basin-scale topographic wave. If the wind changes direction faster than the topographic wave, then the apparent phase speed of the wave increases compared to the free wave. Anticyclonically rotating wind tends to destroy the wave. During calm periods or under the influence of weak winds, the doudouble-gyre circulation will evolve into predominantly cyclonic circulation. This phenomenon occurs only in the nonlinear model simulations and therefore is essentially nonlinear. Acknowledgments. This work was carried out while Urmas Raudsepp was visiting GLERL under the sponsorship of the Great Lakes–Baltic Sea Partnership program. REFERENCES Ball, F. K., 1965: Second-class motions of a shallow liquid. J. Fluid Mech., 23, 545–561. Bennett, J. R., 1974: On the dynamics of wind-driven lake currents. J. Phys. Oceanogr., 4, 400–414. ——, and D. J. Schwab, 1981: Calculation of the rotational normal modes of oceans and lakes with general orthogonal coordinates. J. Comput. Phys., 44, 359–376. Blumberg, A. F., and G. L. Mellor, 1987: A description of a three-dimensional coastal ocean circulation model. Three-Dimensional Coastal Ocean Models, Coastal and Estuarine Sciences, N. S. Heaps, Ed., Vol. 4, Amer. Geophys. Union, 1–16. Csanady, G. T., 1974: Reply. J. Phys. Oceanogr., 4, 271–273. Hickey, B. M., 1981: Alongshore coherence on the Pacific Northwest continental shelf, January to April, 1975. J. Phys. Oceanogr., 11, 822–835. Lamb, H., 1932: Hydrodynamics. Dover, 738 pp. Longuet-Higgins, M. S., 1968: Double Kelvin waves with continuous depth profiles. J. Fluid Mech., 34, 49–80. Mälkki, P., 1975: On the variability of currents in a coastal region of the Baltic Sea. Merentutkimuslaitoksen Julk., 240, 3–56. Mellor, G. L., and T. Yamada, 1982: Development of a turbulence closure model for geophysical fluid problems. Rev. Geophys. Space Phys., 20 (4), 851–875. Rao, D. B., and D. J. Schwab, 1976: Two-dimensional normal modes in arbitrary enclosed basins on a rotating earth: Application to Lakes Ontario and Superior. Philos. Trans. Roy. Soc. London, A281, 63–96. Raudsepp, U., 2001: Interannual and seasonal temperature and salinity variations in the Gulf of Riga and corresponding saline water inflow from the Baltic Proper. Nordic Hydrol., 32, 135–160. ——, and T. Kõuts, 2001: Observations of near-bottom currents in the Gulf of Riga, Baltic Sea. Aquat. Sci., 63, 385–405. Rhines, P. B., 1969: Slow oscillations in an ocean of varying depth. J. Fluid Mech., 37, 161–205. Saylor, J. H., J. C. K. Huang, and R. O. Reid, 1980: Vortex modes in southern Lake Michigan. J. Phys. Oceanogr., 10, 1814–1823. Schwab, D. J., 1983: Numerical simulation of low-frequency current fluctuations in Lake Michigan. J. Phys. Oceanogr., 13, 2213–2224. Simons, T. J., 1975: Verification of numerical models of Lake Ontario. Part II. Stratified circulation and temperature changes. J. Phys. Oceanogr., 5, 98–110. ——, 1983: Resonant topographic response of nearshore currents to wind forcing. J. Phys. Oceanogr., 13, 512–523. ——, 1986: The mean circulation of unstratified bodies driven by nonlinear topographic wave interaction. J. Phys. Oceanogr., 16, 1138–1142. Smagorinsky, J., 1963: General circulation experiments with the primitive equations. Mon. Wea. Rev., 91, 91–164. Stocker, T., and K. Hutter, 1987: Topographic waves in channels and lakes on the f-plane. Lecture Notes on Coastal and Estuarine Studies, Vol. 21, Springer, 176 pp. Weenink, M. P. H., 1958: A theory and method of calculation of wind effects on sea levels in a partly enclosed sea. Royal Netherlands Meteorological Institute, Mededeelingen en verhandelingen 73, 111 pp.	<urn:uuid:f56cfac0-f41d-4faa-a445-6fcb0ad63874>	CC-MAIN-2019-47	https://www.glerl.noaa.gov/pubs/fulltext/2003/20030035.pdf	2019-11-21T22:58:16	crawl-data/CC-MAIN-2019-47/segments/1573496670987.78/warc/CC-MAIN-20191121204227-20191121232227-00424.warc.gz	785,323,018	7,582	eng_Latn	eng_Latn	0.924043	eng_Latn	0.994502	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	rolmOCR	[ 3759, 7422, 9917, 13290, 16504, 17288, 22078, 22367, 26899, 28415, 29236, 32710 ]	[ 0.88671875, 0.984375 ]	[ 4.78125, 4.625 ]	[ 3.015625, 3.171875 ]	[ 2.703125, 0.7265625 ]	1	0	HuggingFaceFW/finepdfs
Pelham City Schools’ Goals for Student Achievement 2024–2025 In Math: All students demonstrate growth and score Proficient or higher in math on the Georgia Milestones EOG test. In Literacy: All students demonstrate growth in reading and writing and score Proficient or higher on the Georgia Milestones EOG test. Behavior: Increase Climate Star Rating scores by continuing Positive Behavioral Interventions and Supports (PBIS) CKH strategies, and reducing office discipline referrals. --- Teachers, Parents, and Students – Together for Success In Third Grade Teachers will work with students and their families to support students’ success in reading and math. Some of the ways we will accomplish this include: - Encourage parents to read with student daily for 20 minutes and have students retell what they read. - Provide parent resources in math and reading for at home accessing through Google classroom & Progress Learning. - Make parents aware of supplemental resources through Parent Events, in the PIRC, and the digital newsletter. - Stay in communication with parents through conferences and weekly folders. - Provide parents with Math fact flashcards to practice daily. At Home PES parents worked with staff to develop ideas about how families can support students’ success in reading and math at home. Some of the suggestions include: - Encourage students to read and practice reading for fluency. - Attend parent activities, and events and utilize resources available. - Help students daily with practice work: practice fast facts with flash cards, sight words and vocabulary words. - Stay informed with digital monthly newsletter sent through email, posted on Facebook and website, and in the school lobby rack. - Communicate with teachers through conferences and weekly folders. - Use online resources: [www.getepic.com](http://www.getepic.com) for Reading & [http://www.pelham-city.k12.ga.us/Content2/InstructionalResources](http://www.pelham-city.k12.ga.us/Content2/InstructionalResources) for Math. Also Zearn.org. --- 3rd Grade Students A sampling of Pelham Elementary School students were asked their ideas about how they can succeed in Math and Literacy. Students thought of the following ways to make connections between learning at home and school: - Practice fast facts and oral reading daily. - Visit the public library. - Read and retell about passages daily and use free apps and resources available. - Play games at home to build Math and Reading skills. - Talk to parents about school each day. What is a School–Parent–Student Compact? A School-Parent-Student Compact is an agreement that is developed together with parents, students, and teachers. Effective Compacts will: - Link goals of the school improvement plan. - Focus on specific learning skills to work on at home. - Share teacher strategies. Jointly Developed PES parents and staff have jointly developed the school-parent-student compact. The process consisted of: The PES staff and third grade teachers were given an opportunity to update the compact. Parents provided input and then the compact was revised according to all feedback provided. Discussion of the compact occurs throughout the school year via surveys, Parent Chat meetings, the PCS website input form, surveys, and parent involvement questionnaires at various events and community forums. Ongoing parental engagement and input is welcomed. Please contact Mrs. Cindy Smith, PCS Title I Parent Involvement Coordinator, at 294-8170 ext. 214 or 221-2336 for any suggestions or input. Activities to Build Partnerships and Communication for Student Learning Open House-Meet teachers and visit classrooms. Parent Engagement Events-Volunteer Orientation, Literacy Fair, STEM/Mathfest, Title 1 Game Night, Grandparents Night, Test Prep Night, Donuts with the Dude Goodies with Gals and more! Parent/Teacher Conferences- Three early release days are provided during the school year or conferences can be scheduled during planning times or after school. Call 294-8170 to schedule a conference. Parent chat - opportunities to “chat,” share concerns and give input. Parent Power Hour- parent sessions offered to build capacity for student academic success and parent advocacy. Parent Resource Center-parent, staff, and student resources and computer/online access. The PIRC is located near PES main entrance. Parental Engagement Parents are invited to join all parent engagement activities. These opportunities, as well as our school website, Facebook page and annual surveys, are vehicles for parent input and engagement. Stay in the know with: Parent Portal-Infinite Campus, PCS school website, Facebook, emails, monthly parent newsletters, progress reports/report cards, PCS phone message system, and Parent Inv Remind (sign up by texting 229-588-2949, message @058f27). Revised May 30, 2024 www.pelham-city.k12.ga.us contact teachers via email: (teacher’s first initial last name) @pelham-city.k12.ga.us	<urn:uuid:cf587df5-227b-42b4-bc87-4c5b1119d768>	CC-MAIN-2025-08	https://resources.finalsite.net/images/v1736361745/pelhamcityk12gaus/rh98bavyzvzlf0gurebo/3rdgradecompactfy25-final.pdf	2025-02-09T23:51:29+00:00	crawl-data/CC-MAIN-2025-08/segments/1738831951628.13/warc/CC-MAIN-20250209230119-20250210020119-00014.warc.gz	479,655,649	1,015	eng_Latn	eng_Latn	0.995728	eng_Latn	0.996127	[ "eng_Latn", "eng_Latn" ]	false	rolmOCR	[ 2565, 5006 ]	[ 2.203125 ]	[ 3.15625 ]	[ 2.8125 ]	[ 2.828125 ]	1	0	HuggingFaceFW/finepdfs
Environment and Natural Resources Trust Fund 2020 Request for Proposals (RFP) ENRTF ID: Project Title: Total Project Budget: $ Proposed Project Time Period for the Funding Requested: Name: Sponsoring Organization: Address: Telephone Number: Email Web Address: County Name: City / Township: Region: Summary: Location: Bee Minnesota - Protect our Native Bumblebees 693,000 June 30, 2023 (3 yrs) By screening and neutralizing bee pathogens we wish to promote best management practices to maintain honey bee health and prevent pathogen spill-over into native bee populations. Declan U of MN 1365 Gortner Avenue St. Paul MN 55108 (612) 626-1916 firstname.lastname@example.org https://www.vetmed.umn.edu/bio/veterinary-population-medicine/declan-schroeder Statewide Statewide Schroeder _____ Funding Priorities _____ Multiple Benefits _____ Outcomes _____ Knowledge Base _____ Extent of Impact _____ Innovation _____ Scientific/Tech Basis _____ Urgency _____ Capacity Readiness _____ Leverage _______ TOTAL ______% A. Foundational Natural Resource Data and Information Category: Alternate Text for Visual: Screening (I) and disease prevention (II) of bee pathogen infections for public bee health (III) to protect our native bumblebees Department: Veterinary Population Medicine Job Title: Dr Sub-Category: 018-A Environment and Natural Resources Trust Fund (ENRTF) 2020 Main Proposal Template PROJECT TITLE: Bee Minnesota ‐ Protect our Native Bumblebees I. PROJECT STATEMENT Our goal is to protect native pollinators from risk of disease transmission and population declines.By screening and neutralizing bee pathogens we wish to promote best management practices to maintain honey bee health and prevent pathogen spill‐over into native bee populations.Native bumblebees,Bombusspp., are important pollinators of wild flowering plants and crops such as tomatoes and berries, and are appreciated for their beauty. Unfortunately, five of our twenty‐three species of native bumblebees in Minnesota are considered vulnerable, endangered, or critically endangered by the International Union for Conservation of Nature. The rusty patched bumblebee,Bombus affinisCresson, was the first bumblebee to be listed as federally endangered in the U.S. Rusty patched bumble bee populations in Minnesota are crucial to recovery as over 35% of all observed individuals in 2018 were in Minnesota. The global decline in bee populations has been attributed to habitat loss, pesticides, parasites, and pathogens. For some bumblebee species, a leading problem may be infectious diseases. For example, the spread of the bumblebee pathogen,Nosema bombi, exacerbated through commercial rearing and distribution ofBombus impatiensacross the U.S., was associated with declining bumblebee species. Another emerging threat is viral pathogen transmission among pollinator species as they forage on common flowers. For example, there is evidence that Deformed wing virus (DWV), may be transmitted from honey bees to bumblebees if diseased honey bees deposit viruses on flower parts (spillover) and other bees subsequently pick them up when visiting the same flowers. Very little is known about pathogen prevalence in bumblebees in the U.S. and in Minnesota. To first understand and then mitigate further declines in these important pollinators, it is critical to collect baseline data on archetypal pathogens in our local populations of honey bees and bumblebees. We propose to use cutting edge technology to rapidly screen for DWV andNosemapresence in three common bumblebees:Bombus impatiens, B. bimaculatus,andB. griseocollis(accounting for ~80% of bumblebee individuals in this region of Minnesota) in three locations near honey bee colonies.Finding a solution or even a cure to bee pathogens is a high priority for our assembled team; therefore, we propose to run an innovative pilot study in an attempt to neutralize DWV. Finally, we will protect our native pollinators by educating beekeepers about the critical "public health" need to keep managed bees as healthy as possible. Beekeepers within 2 miles of the three sampling locations will be engaged in monitoring their colonies for DWV,Varroamite parasites that vector DWV, and other health concerns. II. PROJECT ACTIVITIES AND OUTCOMES Activity 1 Title: Screen for DWV andNosemain bumblebees and quantify potential for virus transmission between honey bees and bumblebees. Description: There is potential for pathogens to be transmitted from honey bees to bumblebees while foraging on flowers, but the extent of this transmission in nature has not been explored. In three locations where we manage honey bee colonies (8 colonies per location: Minneapolis, the MSP airport, and in Rochester), we will use a new sequencing assay, first developed in the Schroeder Lab, to quantify the prevalence and abundance of DWV andNosemain three species of bumblebees collected while foraging. We also will monitor pathogen load in honey bees foraging on the same species of flowers during early, mid, and late summer and throughout the year in our managed honey bee colonies. Furthermore, we will also set out pathogen‐freeB. impatienscolonies (reared from wild‐caught queens) in the same locations to monitor possible infection over the season, and how the infection affects their health and reproduction.ENRTF BUDGET: $505,000 Environment and Natural Resources Trust Fund (ENRTF) 2020 Main Proposal Template Activity 2 Title: Explore potential to neutralize DWV in bees. Description: Run laboratory‐based cage and cell culture assays to determine if DWV can be neutralized in honey bees and bumblebees. It was recently reported that an effective treatment for a related virus of DWV, namely Sacbrood virus, was discovered. This treatment is based on a specific antibody raised from egg yolk against the virus which was used to immunize honey bee pupae. This work will be repeated here to determine whether DWV can be neutralized in both honey bees and bumblebees. Antibody synthesis, formulation, and production will be carried out in collaboration with Dr Ben Hause (vaccine production specialist).ENRTF BUDGET: $101,500 Activity 3 Title: Beekeeper and community "public health" education about native and non‐native bees in Minnesota. Description: Minnesota's bee diversity boasts over 450 species and includes both native and non‐native, managed and wild species. While we recognize the important role of managed honey bees in Minnesota, it is critical to provide outreach regarding the importance of our native bee pollinators and how unmindful bee management might negatively impact native bee health. We propose an educational campaign (Bee Minnesota) that increases understanding of the roles of native and managed bees in Minnesota. Additionally, we will engage backyard beekeepers in the cities of Minneapolis and Rochester to participate as beekeeper citizen scientists via pathogen and pest sampling in their honey bee colonies. Everyone will be kept updated as to progress made throughout the project by means of a well‐managed and curated website.ENRTF BUDGET: $86,500 III. PROJECT PARTNERS AND COLLABORATORS: Dr Declan Schroeder (Pathogen detection & surveillance Associate Professor, U of M) is the project leader. Project partners are with Dr Marla Spivak (Distinguished McKnight Professor Apiculture / Social Insects, U of M), Dr Rebecca Masterman (Assistant Extension Professor and Bee Squad Program Director, U of M), and Dr Elaine Evans (Assistant Extension Professor, Bee Researcher, U of M). Project Collaborator is Dr Ben Hause (Tallgrass Biologics LLC). IV. LONG‐TERM IMPLEMENTATION AND FUNDING: The Bee Lab at the University of Minnesota has an active Extension and Outreach program run by Dr. Rebecca Masterman (honey bees) and Dr. Elaine Evans (native bees, especially bumblebees) who will continue to disseminate results after project completion. Drs. Schroeder and Spivak will publish research findings and present to scientific communities. Funds from this project will build on federal resources being used to pursue these goals, greatly expanding the scope of our efforts. V. SEE ADDITIONAL PROPOSAL COMPONENTS: A. Proposal Budget Spreadsheet; B. Visual Component or Map & F. Project Manager Qualifications and Organization Description Attachment A: Project Budget Spreadsheet Environment and Natural Resources Trust Fund M.L. 2020 Budget Spreadsheet Legal Citation: Project Manager: Dr Declan Schroeder Project Title: Protect our Native Bumblebees Organization: University of Minnesota Project Budget: Project Length and Completion Date: 3 years, 06/30/2023 Today's Date: 03/15/2019 Project Manager Qualifications and Organization Description Dr. Declan Schroeder, PhD in Cell & Molecular Biology He was appointed in February 2018, through the Agricultural Research, Education, Extension and Technology Transfer (AGREETT) program, as an Associate Professor of Virology in the Veterinary Population Medicine Department in the College of Veterinary Medicine at the University of Minnesota. He also holds an honorary Chair in Viral Metagenomics in the School of Biological Sciences at the University of Reading, United Kingdom. Previously, he held the positions of Director of the MBA Culture Collection (2014-2018) and Senior Research Fellow in Viral and Molecular Ecology (2001-2018) at the Marine Biological Association of the UK. He has over 20 years of research experience as a molecular biologist in the areas of virology, biodiversity, pathology and genomics – in particular the use of genomic tools to study key biological processes. Moreover, his track record in winning and administered research projects (over $8 million equivalent from 10 different funders), collaborated with other researchers (within departments, nationally and internationally), and produced several high impact peer-reviewed publications (4 Nature & Science papers). He has also enjoy mentoring and teaching the next generation of scientists. To date he has mentored 9 postdoctoral assistants/fellows, 15 PhD students, 18 Masters students and 7 graduate students. In summary, he has a demonstrated record of accomplished research and teaching in an area of relevance for environmental and animal health sciences. Duties of the UMN Bee Minnesota Team pertaining to the proposal "The University of Minnesota (UMN) is the state's land-grant university and one of the most prestigious public research universities in the nation. It was founded in the belief that all people are enriched by understanding; is dedicated to the advancement of learning and the search for truth; to the sharing of this knowledge through education for a diverse community; and to the application of this knowledge to benefit the people of the state, the nation, and the world." University of Minnesota mission statement. In keeping with the mission statement of our university, Dr. Schroeder's research program is focused on pathogen discovery; comparing and contrasting a diverse array of host-virus interactions. He is particularly interested in seeing his fundamental mechanistic based research translated into practical solutions. He continues to develop molecular tools to enhance detection and surveillance of pathogens to enhance insect, animal and human health (One Health paradigm). His role in this project is to oversee and implement the molecular screening protocol previously developed in his lab. In addition, he will be directly responsible for all communication between the team and the Minnesotan company Tallgrass Biologics to effectively deliver on Activity 2 of the proposal. Dr. Marla Spivak will be assisting with the project. She is a professor in the Department of Entomology in the College of Food, Agriculture and Natural Resource Sciences. Her office and lab are in the Bee Research lab on St Paul campus, along with Drs. Masterman and Evans. She will advise on the experimental design for surveying and collecting honey bees and bumblebees (Activities 1 and 3) and will assist with data analysis and publication, and with all dissemination of results and outreach. Dr. Elaine Evans is a UMN Extension Educator and Bee Researcher working on pollinator education and research relating to bee conservation. She will be responsible for bumble bee surveys and rearing to support Activity 1 due to her expertise in native bees, particularly bumble bees. In addition, she will be responsible for developing and delivering content to increase awareness and protection of native pollinators in Activity 3. Dr. Rebecca Masterman runs the Bee Squad for the University of Minnesota Bee Lab and is also a Minnesota Extension Educator. She will lead the Bee Squad in collecting the honey bee samples for analysis in Activity 1 as well as coordinating the beekeeper citizen science sampling effort in Activity 3. Additionally, Masterman will collaborate with Dr. Evans on the educational campaign and will lead the dissemination of information to beekeepers in Minnesota in Activity 3. As a team we will collectively apply our experience, leadership and motivational skills to educate decisionmakers about the roles of managed and native bees in Minnesota and as result, protect pollinators. Members of the public, municipalities and beekeepers often promote beekeeping, the management of a nonnative bee, as an effort that hobbyists can pursue to support the environment. This educational campaign combined with data collected in Activities 1 and 3 will influence how these user groups view bees in Minnesota. Using these data, we will be able to promote best management practices to maintain honey bee colony health and prevent spill-over of viruses (Activity 2) and other pathogens into native bee population. 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3966 information described in paragraph (b) of this section. (b) Required information—(1) In general. The information required under paragraph (a) of this section shall include the following information: (i) The passport applicant's full name and, if applicable, previous name; (ii) Address of the passport applicant's regular or principal place of residence within the country of residence and, if different, mailing address; (iii) The passport applicant's taxpayer identifying number (TIN), if such a number has been issued to the passport applicant. A TIN means the individual's social security number (SSN) issued by the Social Security Administration. A passport applicant who does not have an SSN must enter zeros in the appropriate space on the passport application; and (iv) The passport applicant's date of birth. (2) Time for furnishing information. A passport applicant must provide the information required by this section at the time of submitting his or her passport application, whether by personal appearance or mail, to the Department of State (including United States Embassies and Consular posts abroad). (c) Penalties—(1) In general. If the information required by paragraph (b)(1) of this section is incomplete or incorrect, or the information is not timely filed, then the passport applicant shall be subject to a penalty equal to $500 per application. Before assessing a penalty under this section, the IRS will ordinarily provide to the passport applicant written notice of the potential assessment of the $500 penalty, requesting the information being sought, and offering the applicant an opportunity to explain why such information was not provided at the time the passport application was submitted. A passport applicant has 60 days (90 days if the notice is addressed to an applicant outside the United States) to respond to the notice. If, after considering all the surrounding circumstances, the passport applicant demonstrates to the satisfaction of the Commissioner or his delegate that the failure is due to reasonable cause and not due to willful neglect, then the IRS will not assess the penalty. (2) Example. The following example illustrates the provisions of paragraph (c) this section. Example. C, a citizen of the United States, makes an error in supplying information on his passport application. Based on the nature of the error and C's timely response to correct the error after being contacted by the IRS, and considering all the surrounding circumstances, the Commissioner concludes that the mistake is due to reasonable cause and not due to willful neglect. Accordingly, no penalty is assessed. (d) Effective/applicability date. The rules of this section apply to passport applications submitted after the date of publication of the Treasury decision adopting these rules as final regulations in the Federal Register. Steven T. Miller, Deputy Commissioner for Services and Enforcement. [FR Doc. 2012–1567 Filed 1–25–12; 8:45 am] BILLING CODE 4830–01–P ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA–R05–OAR–2011–0598; FRL–9622–6] Approval and Promulgation of Air Quality Implementation Plans; Illinois; Regional Haze AGENCY : Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Illinois State Implementation Plan (SIP) addressing regional haze for the first implementation period. Illinois submitted its regional haze plan on June 24, 2011. The Illinois regional haze plan addresses Clean Air Act (CAA) section 169B and Regional Haze Rule requirements for states to remedy any existing and prevent future anthropogenic impairment of visibility at mandatory Class I areas. EPA is also proposing to approve two state rules and incorporating two permits into the SIP. DATES: Comments must be received on or before February 27, 2012. ADDRESSES: Submit your comments, identified by Docket ID No. EPA–R05– OAR–2011–0598, by one of the following methods: 1. www.regulations.gov: Follow the on-line instructions for submitting comments. 2. Email: firstname.lastname@example.org. 3. Fax: (312) 692–2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR–18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR–18J), U.S. Environmental Protection Agency, 77 VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 West Jackson Boulevard, Chicago, Illinois 60604. Such deliveries are only accepted during the Regional Office normal hours of operation, and special arrangements should be made for deliveries of boxed information. The Regional Office official hours of business are Monday through Friday, 8:30 a.m. to 4:30 p.m., excluding Federal holidays. Instructions: Direct your comments to Docket ID No. EPA–R05–OAR–2011– 0598. EPA's policy is that all comments received will be included in the public docket without change and may be made available online at www.regulations.gov, including any personal information provided, unless the comment includes information claimed to be Confidential Business Information (CBI) or other information whose disclosure is restricted by statute. Do not submit information that you consider to be CBI or otherwise protected through www.regulations.gov or email. The www.regulations.gov Web site is an ''anonymous access'' system, which means EPA will not know your identity or contact information unless you provide it in the body of your comment. If you send an email comment directly to EPA without going through www.regulations.gov your email address will be automatically captured and included as part of the comment that is placed in the public docket and made available on the Internet. If you submit an electronic comment, EPA recommends that you include your name and other contact information in the body of your comment and with any disk or CD–ROM you submit. If EPA cannot read your comment due to technical difficulties and cannot contact you for clarification, EPA may not be able to consider your comment. Electronic files should avoid the use of special characters, any form of encryption, and be free of any defects or viruses. For additional instructions on submitting comments, go to Section I of this document. Docket: All documents in the docket are listed in the www.regulations.gov index. Although listed in the index, some information is not publicly available, e.g., CBI or other information whose disclosure is restricted by statute. Certain other material, such as copyrighted material, will be publicly available only in hard copy. Publicly available docket materials are available either electronically in www.regulations.gov or in hard copy at the Environmental Protection Agency, Region 5, Air and Radiation Division, 77 West Jackson Boulevard, Chicago, Illinois 60604. This facility is open from 8:30 a.m. to 4:30 p.m., Monday through Friday, excluding Federal holidays. We recommend that you telephone Matt Rau, Environmental Engineer, at (312) 886–6524 before visiting the Region 5 office. FOR FURTHER INFORMATION CONTACT: Matt Rau, Environmental Engineer, Control Strategies Section, Air Programs Branch (AR–18J), Environmental Protection Agency, Region 5, 77 West Jackson Boulevard, Chicago, Illinois 60604, (312) 886–6524, email@example.com. SUPPLEMENTARY INFORMATION: Throughout this document whenever ''we,'' ''us,'' or ''our'' is used, we mean EPA. Table of Contents I. What should I consider as I prepare my comments for EPA? II. What is the background for EPA's proposed action? III. What are the requirements for regional haze SIPs? IV. What is EPA's analysis of Illinois' regional haze plan? V. What action is EPA taking? VI. Statutory and Executive Order Reviews I. What should I consider as I prepare my comments for EPA? When submitting comments, remember to: 1. Identify the rulemaking by docket number and other identifying information (subject heading, Federal Register date and page number). 2. Follow directions—EPA may ask you to respond to specific questions or organize comments by referencing a Code of Federal Regulations (CFR) part or section number. 3. Explain why you agree or disagree; suggest alternatives and substitute language for your requested changes. 4. Describe any assumptions and provide any technical information and/ or data that you used. 5. If you estimate potential costs or burdens, explain how you arrived at your estimate in sufficient detail to allow for it to be reproduced. 6. Provide specific examples to illustrate your concerns, and suggest alternatives. 7. Explain your views as clearly as possible, avoiding the use of profanity or personal threats. 8. Make sure to submit your comments by the comment period deadline identified. II. What is the background for EPA's proposed action? A. The Regional Haze Problem Regional haze is visibility impairment that is produced by a multitude of sources and activities located across a broad geographic area that emit fine particles (PM2.5) (e.g., sulfates, nitrates, organic carbon, elemental carbon, and soil dust) and its precursors—sulfur dioxide (SO2), nitrogen oxides (NOX), and in some cases ammonia (NH3) and volatile organic compound (VOCs). Fine particle precursors react in the atmosphere to form fine particulate matter. Aerosol PM2.5 impairs visibility by scattering and absorbing light. Visibility impairment reduces the clarity and distance one can see. PM2.5 can also cause serious health effects and mortality in humans and contributes to detrimental environmental effects such as acid deposition and eutrophication. Data from the existing visibility monitoring network, the ''Interagency Monitoring of Protected Visual Environments'' (IMPROVE) monitoring network, show that visibility impairment caused by air pollution occurs virtually all of the time at most national park and wilderness areas. The average visual range, the distance at which an object is barely discernable, in many Class I areas 1 in the western United States is 100–150 kilometers. That is about one-half to two-thirds of the visual range that would exist without anthropogenic air pollution. In the eastern and midwestern Class I areas of the United States, the average visual range is generally less than 30 kilometers, or about one-fifth of the visual range that would exist under estimated natural conditions. 64 FR 35715 (July 1, 1999). B. Requirements of the Clean Air Act and EPA's Regional Haze Rule In section 169A of the 1977 Amendments to the CAA, Congress created a program for protecting visibility in the nation's national parks and wilderness areas. This section of the CAA establishes as a national goal the ''prevention of any future, and the remedying of any existing, impairment of visibility in mandatory Class I 1 Areas designated as mandatory Class I Federal areas consist of national parks exceeding 6000 acres, wilderness areas, and national memorial parks exceeding 5000 acres and all international parks that were in existence on August 7, 1977. 42 U.S.C. 7472(a). In accordance with section 169A of the CAA, EPA, in consultation with the Department of Interior, promulgated a list of 156 areas where visibility is identified as an important value. 44 FR 69122 (November 30, 1979). The extent of a mandatory Class I area includes subsequent changes in boundaries, such as park expansions. 42 U.S.C. 7472(a). Although states and tribes may designate as Class I additional areas which they consider to have visibility as an important value, the requirements of the visibility program set forth in section 169A of the CAA apply only to ''mandatory Class I Federal areas.'' Each mandatory Class I Federal area is the responsibility of a ''Federal Land Manager.'' 42 U.S.C. 7602(i). When we use the term ''Class I area,'' we mean ''mandatory Class I Federal area.'' VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 Federal areas which impairment results from manmade air pollution.'' On December 2, 1980, EPA promulgated regulations to address visibility impairment in Class I areas that is ''reasonably attributable'' to a single source or small group of sources known as, ''reasonably attributable visibility impairment'' (RAVI). 45 FR 80084. These regulations represented the first phase in addressing visibility impairment. EPA deferred action on regional haze that emanates from a variety of sources until monitoring, modeling, and scientific knowledge about the relationships between pollutants and visibility impairment were improved. Congress added section 169B to the CAA in 1990 to address regional haze issues. EPA promulgated the Regional Haze Rule (RHR) on July 1, 1999 (64 FR 35713). The RHR revised the existing visibility regulations to integrate into the regulations provisions addressing regional haze impairment and established a comprehensive visibility protection program for Class I areas. The requirements for regional haze, found at 40 CFR 51.308 and 51.309, are included in EPA's visibility protection regulations at 40 CFR 51.300–309. Some of the main elements of the regional haze requirements are summarized in section III. The requirement to submit a regional haze SIP applies to all 50 states, the District of Columbia, and the Virgin Islands. 2 C. Roles of Agencies in Addressing Regional Haze Successful implementation of the regional haze program will require longterm regional coordination among states, tribal governments, and Federal agencies. Pollution affecting the air quality in Class I areas can be transported over long distances, even hundreds of kilometers. Therefore, effectively addressing the problem of visibility impairment in Class I areas means that states need to develop coordinated strategies that take into account the effect of emissions from one jurisdiction on the air quality of another state. EPA has encouraged the states and tribes to address visibility impairment from a regional perspective because the pollutants that lead to regional haze can originate from sources located across broad geographic areas. Five regional planning organizations (RPOs) were developed to address regional haze and 2 Albuquerque/Bernalillo County, New Mexico must also submit a regional haze SIP to satisfy the section 110(a)(2)(D) requirements of the CAA for the entire state under the New Mexico Air Quality Control Act (section 74–2–4). PO 00000 related issues. The RPOs first evaluated technical information to better understand how their states and tribes impact Class I areas across the country and then pursued the development of regional strategies to reduce PM2.5 emissions and other pollutants leading to regional haze. The Midwest RPO (MRPO) is a collaborative effort of state governments and various Federal agencies established to initiate and coordinate activities associated with the management of regional haze, visibility, and other air quality issues in the Midwest. The member states are Illinois, Indiana, Michigan, Ohio, and Wisconsin. III. What are the requirements for regional haze SIPs? Regional haze SIPs must assure reasonable progress toward the national goal of achieving natural visibility conditions in Class I areas. Section 169A of the CAA and EPA's implementing regulations require states to establish long-term strategies for making reasonable progress toward meeting this goal. Plans must also give specific attention to certain stationary sources that were in existence on August 7, 1977, but were not in operation before August 7, 1962, and must require those sources to install emission controls reducing visibility impairment if appropriate. The specific regional haze SIP requirements are discussed in further detail below. A. Determination of Baseline, Natural, and Current Visibility Conditions The RHR establishes the deciview 3 (dv) as the principal metric or unit for expressing visibility impairment. This visibility metric expresses uniform proportional changes in haziness in terms of common increments across the entire range of visibility conditions, from pristine to extremely hazy conditions. Visibility expressed in deciviews is determined by using air quality measurements to estimate light extinction and then transforming the value of light extinction using a logarithm function. The deciview is a more useful measure for tracking progress in improving visibility than light extinction itself because each deciview change is an equal incremental change in visibility perceived by the human eye. Most people can detect a change in visibility at one deciview. The deciview is used in expressing RPGs, defining baseline, current, and 3 The preamble to the RHR provides additional details about the deciview. 64 FR 35714, 35725 (July 1, 1999). natural conditions, and tracking changes in visibility. The regional haze SIPs must contain measures that ensure ''reasonable progress'' toward the national goal of preventing and remedying visibility impairment in Class I areas caused by anthropogenic air pollution. The national goal is a return to natural conditions such that anthropogenic sources of air pollution would no longer impair visibility in Class I areas. To track changes in visibility over time at each of the 156 Class I areas covered by the visibility program (40 CFR 81.401–437) and as part of the process for determining reasonable progress, states must calculate the degree of existing visibility impairment at each Class I area at the time of each regional haze SIP submission and at the progress review every five years, midway through each 10-year implementation period. The RHR requires states with Class I areas (Class I states) to determine the degree of impairment in deciviews for the average of the 20 percent least impaired (best) and 20 percent most impaired (worst) visibility days over a specified time period at each of its Class I areas. Each state must also develop an estimate of natural visibility conditions for the purpose of comparing progress toward the national goal. Natural visibility is determined by estimating the natural concentrations of pollutants that cause visibility impairment and then calculating total light extinction based on those estimates. EPA has provided guidance to states regarding how to calculate baseline, natural, and current visibility conditions in documents titled, EPA's Guidance for Estimating Natural Visibility Conditions Under the Regional Haze Rule, September 2003, (EPA–454/B–03–005 located at http:// www.epa.gov/ttncaaa1/t1/memoranda/ rh_envcurhr_gd.pdf) (hereinafter referred to as ''EPA's 2003 Natural Visibility Guidance'') and Guidance for Tracking Progress Under the Regional Haze Rule (EPA–454/B–03–004 September 2003 located at http://www. epa.gov/ttncaaa1/t1/memoranda/rh_ tpurhr_gd.pdf) (EPA's 2003 Tracking Progress Guidance). For the first regional haze SIP, the ''baseline visibility conditions'' are the starting points for assessing ''current'' visibility impairment. Baseline visibility conditions represent the degree of visibility impairment for the 20 percent best days and 20 percent worst days for each calendar year from 2000 to 2004. Using monitoring data for 2000 through 2004, states calculate the average degree of visibility impairment for each Class I area, based on the average of annual VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 values over the five-year period. The comparison of initial baseline visibility conditions to natural visibility conditions indicates the amount of improvement necessary to attain natural visibility, while the future comparison of baseline conditions to the then current conditions will indicate the amount of progress made. In general, the 2000 to 2004 baseline period is considered the time from which improvement in visibility is measured. B. Determination of Reasonable Progress Goals (RPGs) The vehicle for ensuring continuing progress towards achieving the natural visibility goal is the submission of a series of regional haze SIPs from the states that establish two distinct RPGs, one for the best days and one for the worst days for every Class I area for each approximately 10-year implementation period. The RHR does not mandate specific milestones or rates of progress, but instead calls for states to establish goals that provide for ''reasonable progress'' toward achieving natural visibility conditions. In setting RPGs, Class I states must provide for an improvement in visibility for the worst days over the approximately 10-year period of the SIP and ensure no degradation in visibility for the best days. Class I states have significant discretion in establishing RPGs, but are required to consider the following factors established in section 169A of the CAA and in EPA's RHR at 40 CFR 51.308(d)(1)(i)(A): (1) The costs of compliance; (2) the time necessary for compliance; (3) the energy and non-air quality environmental impacts of compliance; and, (4) the remaining useful life of any potentially affected sources. The state must demonstrate in its SIP how these factors are considered when selecting the RPGs for the best and worst days for each applicable Class I area. States have considerable flexibility in how they take these factors into consideration, as noted in EPA's Guidance for Setting Reasonable Progress Goals Under the Regional Haze Program, (''EPA's Reasonable Progress Guidance''), July 1, 2007, memorandum from William L. Wehrum, Acting Assistant Administrator for Air and Radiation, to EPA Regional Administrators, EPA Regions 1–10 (pp. 4–2, 5–1). In setting the RPGs, states must also consider the rate of progress needed to reach natural visibility conditions by 2064 (''uniform rate of progress'' or ''glide path'') and the emissions reduction needed to achieve that rate of progress over the approximately 10-year period of the SIP. In setting RPGs, each Class I state must also consult with potentially contributing states, i.e. those states that may affect visibility impairment at the Class I state's areas. 40 CFR 51.308(d)(1)(iv). C. Best Available Retrofit Technology (BART) Section 169A of the CAA directs states to evaluate the use of retrofit controls at certain older large stationary sources to address visibility impacts from these sources. Specifically, CAA section 169A(b)(2)(A) requires states to revise their SIPs to contain such measures as may be necessary to make reasonable progress towards the natural visibility goal including a requirement that certain categories of existing major stationary sources built between 1962 and 1977 procure, install, and operate BART as determined by the state. The set of ''major stationary sources'' potentially subject to BART is listed in CAA section 169A(g)(7). The state can require source-specific BART controls, but it also has the flexibility to adopt an alternative such as a trading program as long as the alternative provides greater progress towards improving visibility than BART. On July 6, 2005, EPA published the Guidelines for BART Determinations Under the Regional Haze Rule at Appendix Y to 40 CFR Part 51 (BART Guidelines) to assist states in determining which of their sources should be subject to the BART requirements and in determining appropriate emission limits for each applicable source. A state must use the approach in the BART Guidelines in making a BART determination for fossil fuel-fired electric generating units (EGUs) with total generating capacity in excess of 750 megawatts. States are encouraged, but not required, to follow the BART Guidelines in making BART determinations for other sources. States must address all visibilityimpairing pollutants emitted by a source in the BART determination process. The most significant visibility impairing pollutants are SO2, NOX, and PM. EPA has stated that states should use their best judgment in determining whether VOC or NH3 compounds impair visibility in Class I areas. States may select an exemption threshold value for their BART modeling under the BART Guidelines, below which a BART-eligible source would not be expected to cause or contribute to visibility impairment in any Class I area. The state must document this exemption threshold value in the SIP and must state the basis for its selection of that value. The exemption threshold set by the state should not be higher than 0.5 dv. Any source with emissions that model above the threshold value would be subject to a BART determination review. The BART Guidelines acknowledge varying circumstances affecting different Class I areas. States should consider the number of emission sources affecting the Class I areas at issue and the magnitude of the individual source's impact. The state must identify potential BART sources in its SIP, described as ''BART-eligible sources'' in the RHR, and document its BART control determination analyses. In making BART determinations, section 169A(g)(2) of the CAA requires the state to consider the following factors: (1) The costs of compliance; (2) the energy and non-air quality environmental impacts of compliance; (3) any existing pollution control technology in use at the source; (4) the remaining useful life of the source; and, (5) the degree of improvement in visibility which may reasonably be anticipated to result from the use of such technology. A regional haze SIP must include source-specific BART emission limits and compliance schedules for each source subject to BART. The BART controls must be installed and in operation as expeditiously as practicable, but no later than five years after the date of EPA's approval of the state's regional haze SIP. CAA section 169(g)(4); 40 CFR 51.308(e)(1)(iv). In addition to what is required by the RHR, general SIP requirements mandate that the SIP must also include all regulatory requirements related to monitoring, recordkeeping, and reporting for the BART controls on the source. D. Long-Term Strategy Consistent with the requirement in section 169A(b) of the CAA that states include in their regional haze SIP a 10 to 15 year strategy for making reasonable progress, section 51.308(d)(3) of the RHR requires that states include a long-term strategy (LTS) in their regional haze SIPs. The LTS is the compilation of all control measures a state will use during the implementation period of the specific SIP submittal to meet applicable RPGs. The LTS must include enforceable emissions limitations, compliance schedules, and other measures as necessary to achieve the RPGs for all Class I areas within or affected by emissions from the state. 40 CFR 51.308(d)(3). When a state's emissions are reasonably anticipated to cause or contribute to visibility impairment in a VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 Class I area located in another state, the RHR requires the impacted state to coordinate with the contributing states in order to develop coordinated emissions management strategies. 40 CFR 51.308(d)(3)(i). In such cases, the contributing state must demonstrate that it has included in its SIP all measures necessary to obtain its share of the emission reductions needed to meet the RPGs for the Class I area. The RPOs have provided forums for significant interstate consultation, but additional consultations between states may be required to address interstate visibility issues sufficiently. States should consider all types of anthropogenic sources of visibility impairment in developing their LTS, including stationary, minor, mobile, and area sources. At a minimum, states must describe how each of the following seven factors are taken into account in developing their LTS: (1) Emission reductions due to ongoing air pollution control programs, including measures to address RAVI; (2) measures to mitigate the impacts of construction activities; (3) emissions limitations and schedules for compliance to achieve the RPG; (4) source retirement and replacement schedules; (5) smoke management techniques for agricultural and forestry management purposes including plans as currently exist within the state for these purposes; (6) enforceability of emissions limitations and control measures; and, (7) the anticipated net effect on visibility due to projected changes in point, area, and mobile source emissions over the period addressed by the LTS. 40 CFR 51.308(d)(3)(v). E. Coordinating Regional Haze and Reasonably Attributable Visibility Impairment Long-Term Strategy EPA revised 40 CFR 51.306(c) as part of the RHR regarding the LTS for RAVI to require that the RAVI plan must provide for a periodic review and SIP revision not less frequently than every three years until the date of submission of the state's first plan addressing regional haze visibility impairment in accordance with 40 CFR 51.308(b) and (c). The state must revise its plan to provide for review and revision of a coordinated LTS for addressing RAVI and regional haze on or before this date. It must also submit the first such coordinated LTS with its first regional haze SIP. Future coordinated LTSs, and periodic progress reports evaluating progress towards RPGs, must be submitted consistent with the schedule for SIP submission and periodic progress reports set forth in 40 CFR 51.308(f) and 51.308(g), respectively. The periodic review of a state's LTS must report on both regional haze and RAVI impairment and be submitted to EPA as a SIP revision. F. Monitoring Strategy and Other Implementation Plan Requirements Section 51.308(d)(4) of the RHR includes the requirement for a monitoring strategy for measuring, characterizing, and reporting of regional haze visibility impairment that is representative of all mandatory Class I Federal areas within the state. The strategy must be coordinated with the monitoring strategy required in section 51.305 for RAVI. Compliance with this requirement may be met through participation in the IMPROVE network, meaning that the state reviews and uses monitoring data from the network. The monitoring strategy must also provide for additional monitoring sites if the IMPROVE network is not sufficient to determine whether RPGs will be met. The monitoring strategy is due with the first regional haze SIP and must be reviewed every five years. The SIP must also provide for the following: * Procedures for using monitoring data and other information in a state with no mandatory Class I areas to determine the contribution of emissions from within the state to regional haze visibility impairment at Class I areas in other states. * Procedures for using monitoring data and other information in a state with mandatory Class I areas to determine the contribution of emissions from within the state to regional haze visibility impairment at Class I areas both within and outside of the state; * Reporting of all visibility monitoring data to the Administrator at least annually for each Class I area in the state, and where possible in electronic format; * Other elements including reporting, recordkeeping, and other measures necessary to assess and report on visibility; * A statewide inventory of emissions of pollutants that are reasonably anticipated to cause or contribute to visibility impairment in any Class I area. The inventory must include emissions for a baseline year, emissions for the most recent year with available data, and future projected emissions. A state must also make a commitment to update the inventory periodically; and The RHR requires control strategies to cover an initial implementation period extending to the year 2018 with a comprehensive reassessment and revision of those strategies, as appropriate, every 10 years thereafter. Periodic SIP revisions must meet the core requirements of section 51.308(d) with the exception of BART. The requirement to evaluate sources for BART applies only to the first regional haze SIP. Facilities subject to BART must continue to comply with the BART provisions of section 51.308(e), as noted above. Periodic SIP revisions will assure that the statutory requirement of reasonable progress will continue to be met. G. Consultation With States and Federal Land Managers The RHR requires that states consult with Federal Land Managers (FLMs) before adopting and submitting their SIPs. 40 CFR 51.308(i). States must provide FLMs an opportunity for consultation, in person and at least 60 days prior to holding any public hearing on the SIP. This consultation must include the opportunity for the FLMs to discuss their assessment of impairment of visibility in any Class I area and to offer recommendations on the development of the RPGs and on the development and implementation of strategies to address visibility impairment. Further, a state must include in its SIP a description of how it addressed any comments provided by the FLMs. Finally, a SIP must provide procedures for continuing consultation between the state and FLMs regarding the state's visibility protection program, including development and review of SIP revisions, five-year progress reports, and the implementation of other programs having the potential to contribute to impairment of visibility in Class I areas. IV. What is EPA's analysis of Illinois' regional haze plan? Illinois submitted its regional haze plan on June 24, 2011, which included revisions to the Illinois SIP to address regional haze. A. Class I Areas States are required to address regional haze affecting Class I areas within a state and in Class I areas outside the state that may be affected by the state's emissions. 40 CFR 51.308(d). Illinois does not have any Class I areas within the state. Illinois reviewed technical analyses conducted by MRPO to determine what Class I areas outside the state are affected by Illinois emission sources. MRPO conducted both a back trajectory analysis and modeling to determine the affects of its states' emissions. The conclusion from the technical analysis is that emissions from Illinois sources affect 19 Class I areas. The affected Class I areas are: Sipsey VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 Wilderness Area in Alabama; Caney Creek and Upper Buffalo Wilderness Areas in Arkansas; Mammoth Cave in Kentucky; Acadia National Park and Moosehorn Wilderness Area in Maine; Isle Royale National Park and Seney Wilderness Area in Michigan; Boundary Waters Canoe Wilderness Area in Minnesota; Hercules-Glades and Mingo Wilderness Areas in Missouri; Great Gulf Wilderness Area in New Hampshire; Brigantine Wilderness Area in New Jersey; Great Smoky Mountains National Park in North Carolina and Tennessee; Lye Brook Wilderness Area in Vermont; James River Face Wilderness Area and Shenandoah National Park in Virginia; and, Dolly Sods/Otter Creek Wilderness Area in West Virginia. B. Baseline, Current, and Natural Conditions The RHR requires states with Class I areas to calculate the baseline and natural conditions for their Class I areas. Because Illinois does not have any Class I areas, it was not required to address the requirements for calculating baseline and natural conditions. C. Reasonable Progress Goals Class I states must set RPGs that achieve reasonable progress toward achieving natural visibility conditions. Because Illinois does not have any Class I areas, it is not required to establish RPGs. Illinois consulted with affected Class I states to ensure that it achieves its share of the overall emission reductions necessary to achieve the RPGs of Class I areas that it impacts. Illinois's coordination with affected Class I states is discussed under Illinois Long Term Strategy, in Section IV. E. Illinois included the MRPO technical support document (TSD) in its submission. In Section 5 of the TSD, MRPO assessed the reasonable progress for regional haze. It first assessed potential control measures using the four factors required to be considered by Class I states when selecting the RPGs: the cost of compliance, time needed, energy and non-air impacts, and remaining useful life of any potentially affected sources. The cost of compliance factor includes calculating the average cost effectiveness and can include costs to health and industry vitality as well as considering the different visibility effects of different pollutants. The time necessary for compliance factor considers whether control measures can be implemented by 2018. The third factor, energy and non-air quality impacts, considers additional energy consumed by or because of the control measure as well as effects due to waste generated or water consumption. The final factor, remaining useful life, allows states to consider planned source retirements in calculating costs. MRPO also assessed the visibility benefits of existing programs. MRPO considered existing on-highway mobile source, off-highway mobile source, area source, power plant, and other point source programs. MRPO also included reductions from the Clean Air Interstate Rule (CAIR) in its analysis, as well from rules adopted by Illinois and included in its regional haze SIP requiring the control of emissions from EGUs. Illinois has a distinctive situation regarding CAIR, insofar as it has adopted state rules that require EGUs to control NOX and SO2 emissions beyond the control expected from CAIR, even in the absence of CAIR, particularly by 2018 and beyond. Further discussion of these Illinois rules is provided below. The RPGs that pertinent Class I states have adopted are predicated on other contributing states achieving the EGU emission reductions anticipated under CAIR. Since Illinois is mandating a greater degree of control than is expected from other states, EPA concludes that Illinois's regional haze plan is expected to provide emission reductions representing an appropriate contribution toward meeting the RPGs for the affected Class I areas, irrespective of the status of CAIR and irrespective of the associated issues regarding the adequacy of other state's plans. For similar reasons, EPA believes that the approvability of the Illinois plan is also not affected by the status of the Transport Rule, which was promulgated on August 8, 2011 at 76 FR 48208 and stayed on December 30, 2011. D. Best Available Retrofit Technology States are required to submit an implementation plan containing emission limitations representing BART and schedules for compliance with BART for each BART-eligible source that may reasonably be anticipated to cause or contribute to any impairment in a Class I area, unless the State demonstrates that an emissions trading program or other alternative will achieve greater reasonable progress toward natural visibility conditions. 40 CFR 51.308(e). Using the criteria in the BART Guidance at 40 CFR 51.308(e) and Appendix Y, Illinois first identified all of the BART-eligible sources and assessed whether the BART-eligible sources were subject to BART. Illinois initially identified 26 potential BART facilities—11 EGUs, four petroleum refineries, three chemical process plants, two Portland cement plants, two glass fiber processing plants, one lime plant, and one iron and steel plant. The state further analyzed these facilities to identify those sources subject to BART. Illinois relied on modeling conducted by MRPO using a modeling protocol MRPO developed. MRPO conferred with its states, EPA, and the FLMs in developing its BART modeling protocol. EPA guidance says that, ''any threshold that you use for determining whether a source 'contributes' to visibility impairment should not be higher than 0.5 dv.'' The Guidelines affirm that states are free to use a lower threshold if the location of a large number of BART-eligible sources in proximity of a Class I area justifies this approach. Illinois used a contribution threshold of 0.5 dv for determining which sources warrant being subject to BART. Illinois concluded that the threshold of 0.5 dv was appropriate since its BART-eligible sources are located state-wide and no Class I areas are nearby causing Illinois to correctly conclude that a stricter contribution threshold is not justified. The modeled impact of these facilities indicated that 11 sources have at least 0.5 dv impact (98th percentile) and thus are subject to BART. The 11 sources determined to be subject to BART are nine EGUs and two petroleum refineries. The other 15 potential BART sources were determined not to be subject to BART because the analysis showed impacts well below the 0.5 dv contribution threshold. The EGUs subject to BART are: • Dynegy Midwest Generating— Baldwin Boilers 1, 2, and 3. * Ameren Energy Generating— Coffeen Boilers CB–1 and CB–2. * Dominion Kincaid Generation— Boilers 1 and 2. * Ameren Energy Generating—E.D. Edwards Boilers 2 and 3. * Midwest Generation—Powerton Boilers 51, 52, 61, and 62. * Ameren Energy Generating—Duck Creek Boiler 1. * Midwest Generation—Joliet Boilers 71, 72, 81, and 82. * City Water, Light, and Power— Dallman Boiler 1 and 2. * Midwest Generation—Will County Boiler 4. * City Water, Light, and Power— Lakeside Boiler 8. To address mercury emissions from EGUs, Illinois adopted Part 225 of Illinois's air pollution regulations, entitled ''Control of Emissions from Large Combustion Sources.'' In this rule, Illinois offered affected utilities two options, one of which imposes stringent limits on mercury emissions alone and the other of which mandates VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 implementation of specific mercury control technology in conjunction with satisfaction of stringent emission limits for SO2 and NOX. Part 225 includes section 225.233, entitled ''MultiPollutant Standards,'' addressing emissions from facilities owned by Ameren and Dynegy, and sections 225.293 to 225.299, collectively referred to as the Combined Pollutant Standards (CPS), addressing emissions from facilities owned by Midwest Generation. In all cases, the utilities have selected the option including mercury control technology and applicability of the SO2 and NOX limits. The emission limits are in the earlier noted sections of the state rules, so these SO2 and NOX limits are now fully enforceable by the state. The SO2 and NOX emission limits in Part 225 rules reflect substantial averaging across units and across facilities. For example, the collective set of facilities in Illinois owned by Midwest Generation (as listed in the Part 225 rules) are subject to NOX and SO2 limits based on annual average emissions across all facilities. The limit for NOX emissions is 0.11 pounds per million British Thermal Units (lb/ MMBTU) starting in 2012 and the limits for SO2 are 0.15 lb/MMBTU in 2017 and 0.11 lb/MMBTU starting in 2019. The collective set of Ameren facilities in Illinois, under the Multi-Pollutant Standards (MPS), must meet an annual average emission limit for NOX of 0.11 lb/MMBTU starting in 2012 and for SO2 of 0.23 lb/MMBTU starting in 2017. Similar limits under the MPS apply to the Dynegy facilities in Illinois. EPA believes this degree of averaging is acceptable in this context. The limits that Illinois has imposed are sufficiently stringent that the companies have only limited latitude to over control at some facilities in trade for having elevated emissions at other facilities. The facilities owned by each company are sufficiently close to each other, relative to their distances from the nearest Class I areas, that modest shifts in emissions from one facility to another should have minimal impact on the combined impact on regional haze at the Class I areas. Furthermore, regional haze is evaluated across a considerable number of days, e.g., the 20 percent of days with the worst visibility. Therefore, a limit that allows elevated emissions on individual days, so long as other days have lower emissions, should suffice to address the pertinent measures of regional haze. Illinois's limits should also be adequately enforceable since the sources at issue are required to conduct continuous emission monitoring of both SO2 and NOX. Dynegy has five facilities with 10 units covered by MPS, including the three Dynegy Baldwin units that are subject to BART. Emission reductions required for seven other Dynegy units not subject to BART will allow it meet the MPS reduction requirements. MPS will reduce emissions from all Dynegy facilities by 23,831 tons per year (TPY) of NOX and 47,347 TPY of SO2, as compared to emissions in the 2002 base year. Ameren has seven facilities with 21 units covered by MPS. This includes the subject to BART units: Coffeen units 1 and 2, Duck Creek unit 1, and Edwards units 2 and 3. Ameren has installed selective catalytic reduction (SCR) for NOX control and wet scrubbers to limit SO2 emissions from both Coffeen units. Duck Creek unit 1 is controlled by low NOX burners, SCR, and wet scrubbers. Edwards unit 2 will receive an upgraded low NOX burner and overfire air (OFA) to reduce NOX emissions. Edwards unit 3 is already controlled for NOX with low NOX burners, OFA, and SCR. Ameren plans to install a new scrubber and fabric filter at Edwards unit 3. Company-wide reductions from Ameren EGUs are projected to be 27,896 TPY NOX and 131,367 TPY SO2 by 2015 and 134,464 TPY of SO2 by 2017. Midwest Generating operates six facilities with 19 total units that must comply with CPS, including the Midwest Generation units subject to BART: Powerton units 51, 52, 61, and 62; Joliet units 71, 72, 81, and 82; and Will County unit 4. The four Powerton units currently have low NOX burners and OFA. Midwest Generation plans to add selective non-catalytic reduction (SNCR) in 2012 to reduce NOX emissions and flue gas desulfurization (FGD) in 2013 to cut SO2 emissions. Both control improvements will be added to all four units. Midwest Generating's Joliet facility currently has low NOX burners and OFA on its four BART units. SNCR is expected to be added in 2012 to all four BART units. Midwest Generating is also planning to add FGD on units 71, 72, 81, and 82 by 2019. Will County unit 4 is currently controlled with low NOX burners and OFA. Midwest Generating plans to upgrade the NOX control to SNCR in 2012 and to add FGD control by 2019. CPS will reduce NOX emissions from all Midwest Generating facilities by 38,155 TPY, while SO2 emissions will decrease by 35,465 TPY in 2015, increasing to a 61,194 TPY reduction in 2019. A state may opt to implement an alternate measure rather than requiring each subject to BART unit to install, operate, and maintain BART if it demonstrates that the alternate measure will achieve greater reasonable progress. The criteria for the assessment if an alternative measure demonstrates greater reasonable progress are provided in 40 CFR 51.308(e)(2). MPS will reduce emissions from both subject to BART and non-BART units at the Ameren and Dynegy facilities. Similarly, CPS will require emission reductions from Midwest Generation's subject to BART and non-BART units. Illinois elected to use MPS and CPS participation as alternative to requiring BART control on each of the Ameren, Dynegy, and Midwest Generation units subject to BART. Illinois stated that implementation of the MPS and CPS emission limits will provide much deeper NOX and SO2 reductions than implementing BART on the subject to BART units and thus the alternate will provide greater reasonable progress. However, Illinois did not provide an analysis comparing BART for each subject unit to the alternative. Illinois compared the emission reductions from MPS and CPS to the presumptive BART emission levels suggested in EPA's guidance. EPA generally requires states to compare the alternative strategy to a fully analyzed set of BART limits for the BART-subject units. However, in this case, the results of such a comparison are clear even without Illinois conducting a full BART analysis for these units. The total NOX emission reductions due to MPS on Dynegy EGUs are greater than the base year NOX emissions from Dynegy's subject to BART units. Therefore, the emission reductions from MPS are greater than the maximum possible reductions from the BART units. The same is true for SO2 emissions for the Dynegy EGUs, the NOX emissions from the Ameren EGUs, and the SO2 emissions from the Ameren EGUs. Similarly, the total NOX emission reductions from all Midwest Generating are greater than the NOX emissions from the BART units and the same for its SO2 emissions. Therefore, even without a full analysis of the precise emission levels that would constitute BART for the BART-subject units, EPA finds that the Illinois rules, MPS and CPS, are an acceptable BART alternative because the emission reductions are greater than the reductions that could possibly be obtained by only requiring BART at the BART-subject units. Three other EGUs, owned by two other utilities Dominion Energy and the City of Springfield's City Water, Light, and Power (CWLP), are not covered by MPS and CPS but have units subject to BART. CWLP is a smaller utility with a total generating capacity of less than 750 MW and Dominion Energy has only one VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 electric generating facility in Illinois such that these utilities do not have the opportunities for multi-plant averaging of emission limits that the larger utilities have. Rather than adopting an alternative program to address the BART requirements for these two utilities, Illinois is requiring these utilities to meet the BART requirements for the units subject to BART and establish enforceable emission limits for SO2 and NOX. CWLP's Dallman and Lakeside plants, along with Dominion's Kincaid plant, have units subject to BART. Both utilities must reduce emissions to meet the BART limits. The emission limits for Dallman units 31 and 32, Lakeside unit 8, and Kincaid units 1 and 2 are contained in Joint Construction and Operating permits. Illinois evaluated potential controls and what control level the current emission controls can achieve in setting the BART emission limits for the CWLP Dallman and Dominion Kincaid units. CWLP currently has SCRs and FGD on Dallman units 31 and 32. As of 2010, CWLP has been operating the SCRs to achieve an annual average NOX emission rate of 0.14 lb/MMBTU on both Dallman units, combined. The annual average NOX emission rate will be limited to 0.12 lb/MMBTU by 2015 and then further decreased to 0.11 lb/ MMBTU by 2017 for both units, combined. CWLP will operate the controls to achieve an annual average SO2 emissions rate on both Dallman units, combined, of 0.29 lb/MMBTU by 2012, then reduced to 0.25 lb/MMBTU by 2015, and finally to 0.23 lb/MMBTU by 2017. Illinois has determined these emission limits satisfy BART for both units. CWLP permanently shut down Lakeside unit 8 in 2009, which is reflected in the permit. Dominion's Kincaid facility operates SCRs on its units 1 and 2. The permit for the Kincaid facility limits NOX emissions to an annual average of 0.07 lb/MMBTU by March 1, 2013, on both units, combined. Illinois determined the appropriate SO2 control system for Kincaid is a dry sorbent injection system along with using low sulfur coal. Illinois initially gave the Kincaid facility a SO2 emission limit of 0.20 lb/MMBTU on both units, but found that a stricter limit of 0.15 lb/MMBTU can be achieved with the control system. Illinois thus set the SO2 emission limits for both Kincaid units, combined, at an annual average emission rate of 0.20 lb/ MMBTU by January 1, 2014, and reduced the limit further to an annual average emission rate of 0.15 lb/ MMBTU beginning on January 1, 2017. Illinois issued the Joint Construction and Operating permits pursuant to its authority in the SIP and submitted the two permits as part of its Regional Haze plan to be incorporated into the SIP. The permits set Federally enforceable NOX and SO2 limits as necessary to meet the Regional Haze requirements of the CAA and effectively mandate that the utilities to run the SCRs year round and for CWLP to shut down its Lakeside unit 8. Two petroleum refineries, the CITGO and Exxon Mobil refineries, also have units subject to BART: the CITGO refinery in Lemont, Illinois and the Exxon Mobil refinery south of Joliet, Illinois. Both refineries will be required to reduce emissions by a Federal consent decree resolving an enforcement action brought by EPA against a number of refineries. The consent decrees require the CITGO, Exxon Mobil, and the other refineries to operate controls at the Best Available Control Technology level. Illinois evaluated the subject-to-BART units at the CITGO and Exxon Mobil refineries. It found that the NOX and SO2 emission limits on the subject-to-BART units in the consent decrees satisfy BART. A consent decree between the United States and CITGO Petroleum Corporation was entered in the U.S. District Court for the Southern District of Texas on October 6, 2004 (No. H–04– 3883). The consent decree requires the company to operate SCR and a wet scrubbing system at its Fluid Catalytic Cracking Unit (FCCU) that will reduce NOX emissions by more than 90 percent and SO2 emissions by 85 percent. The controls on the FCCU will result in a reduction of NOX emissions from 1,065.7 to 106.6 TPY and SO2 emissions from 10,982.5 to 107.9 TPY by 2013. CITGO has also added a tail gas recovery unit that reduces SO2 emissions from its sulfur train units from 4340.0 to 91.2 TPY, a 98 percent reduction. The emission controls on all units at CITGO's Lemont refinery will reduce NOX emissions by 1,268 TPY and SO2 emissions by 15,123 TPY. A consent decree between the United States and Exxon Mobil Corporation was entered in the U.S. District Court for the Northern District of Illinois on October 11, 2005 (No. O5–C–5809). The consent decree for Exxon Mobil requires SCR operation on its FCCU in addition to maintenance of the existing wet scrubbing system. The controls on the FCCU result in a 1,636.2 TPY decrease in NOX emissions from 1,818.0 to 181.8 TPY and a 9,667.7 TPY decrease in SO2 emissions from 9,865.0 to 197.3 TPY. Exxon Mobil also has added a tail gas recovery unit on its south sulfur recovery unit. That reduces SO2 emissions by 9,153.8 TPY to 186.8 TPY. The emission controls at Exxon Mobil's Joliet refinery will reduce 1,695 TPY NOX and 18,821 TPY SO2. These two consent decrees are Federally enforceable and also require that the refineries submit permit applications to Illinois to incorporate the required emission limits into Federally enforceable air permits (other than Title V). Therefore, emission limits established by the consent decrees may be relied upon by Illinois for addressing the BART requirement for these facilities. Based on modeling, MRPO determined that the visibility impact of directly emitted particulate matter from the facilities with subject to BART units is minimal. In particular, MRPO assessed the impact of the directly emitted particulate matter from all facilities potentially subject to BART in the five MRPO states, and found the impact to be less than 0.5 dv at any Class I area as compared to natural background conditions. Illinois therefore concludes that PM emissions from its subset of these BART sources have a negligible visibility impact. Furthermore, these facilities are already subject to federally enforceable PM emission control requirements mandated by SIP-approved state particulate matter regulations, so that there is minimal potential for further PM emission reductions. Therefore, based particularly on the substantial existing controls on these facilitiesfabric filters, electrostatic precipitators, and cyclones; and the minimal benefits of further control, Illinois concluded that BART did not include further control of PM emissions from these facilities. EPA is satisfied with the state's BART determinations. The emission limits that Illinois adopted generally will require state-of-the-art emission controls, not just at the units subject to BART requirements but also at numerous units that are not subject to BART. The Illinois facilities subject to BART are a long distance from any Class I area such that, so the geographical redistributions of emissions within Illinois do not significantly affect visibility and the benefits of alternate control strategies may be judged simply by comparing the net emission reductions. The MPS and CPS provide emission reduction well in excess of simply implementing BART on subject units. The reduction in NOX emissions from the Ameren, Dynegy, and Midwest Generation units by 2015 from MPS and CPS is expected to be 89,882 TPY. Illinois estimated that simply implementing BART on the subject units from these entities would yield 32,992 TPY of NOX emission VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 reductions, which is 56,890 TPY less that from MPS and CPS. Illinois estimated that implementing BART on the subject units at Ameren, Dynegy, and Midwest Generation facilities would require an 117,252 TPY reduction in SO2 emission, but MPS and CPS will require a 214,179 TPY SO2 reduction by 2015. Thus, Illinois estimated that its plan will require 96,927 TPY lower SO2 emissions than simply requiring BART. EPA believes that Illinois has thereby demonstrated the emission limits on the subject to BART units covered by MPS and CPS satisfy the BART requirements. Illinois did not rely on the Clean Air Interstate Rule (CAIR) for its BART determinations. Illinois is in the CAIR region. However, it used its state rules, permits, and consent decrees to achieve emission reductions that satisfy BART. This means that Illinois is not reliant on CAIR and, thus, it has avoided the issues of other CAIR region states that relied on CAIR. For similar reasons, Illinois' satisfaction of regional haze rule requirements is not contingent on the Transport Rule and thus is not affected by the stay of that rule. E. Long-Term Strategy Under section 169A(b)(2) of the CAA and 40 CFR 51.308(d), states' regional haze programs must include an LTS for making reasonable progress toward meeting the national visibility goal. Illinois's LTS must address visibility improvement for the Class I areas impacted by Illinois sources. Section 51.308(d)(3) requires that Illinois consult with the affected states in order to develop a coordinated emission management strategy. A contributing state, such as Illinois, must demonstrate that it has included, in its SIP, all measures necessary to obtain its share of the emissions reductions needed to meet the RPGs for the Class I areas affected by Illinois sources. As described in section III.D. of this proposed rule, the LTS is the compilation of all control measures Illinois will use to meet applicable RPGs. The LTS must include enforceable emissions limitations, compliance schedules, and other measures as necessary to achieve the RPGs for all Class I areas affected by Illinois emissions. Illinois complied with the consulting requirements by participating in meetings and conference calls with affected Class I states and RPOs to discuss the states' assessments of visibility conditions, analyses of culpability, and possible measures that could be taken to meet visibility goals. Illinois engaged in extensive consultations with other MRPO states, including Indiana, Michigan, Ohio, and Wisconsin. Illinois also consulted with Arkansas, Kentucky, Minnesota, Missouri, New Hampshire, New Jersey, and Vermont. As part of the MRPO, Illinois participated in inter-RPO consultation on regional haze. This consultation is detailed in Chapter 9 of the state's plan. EPA finds that the state's consultation with Class I states satisfies applicable consultation requirements. Illinois's LTS includes the modeling and monitoring results on which it relied to determine its share of emission reductions necessary to meet the reasonable progress goals of impacted Class I areas. This information is provided in Chapter 9 of the Illinois regional haze plan. Portions of this technical work were provided by MRPO as it worked with other RPOs to provide this information on Class I areas outside the Midwest. At 40 CFR 51.308(d)(3)(v), the RHR identifies seven factors that a state must consider in developing its LTS: (A) Emission reductions due to ongoing programs; (B) measures to mitigate impact from construction; (C) emission limits to achieve the RPG; (D) replacement and retirement of sources; (E) smoke management techniques; (F) Federally enforceable emission limits and control measures; and (G) the net effect on visibility due to projected emission changes over the LTS period. Illinois considered the seven factors in developing its LTS. Chapter 8 of the Illinois regional haze plan provides a full analysis of each factor. Illinois relied on MRPO's modeling and analysis along with its emission information in developing a LTS. Illinois considered the factors set out in 51.308(d)(3)(v) in developing its LTS. Based on these factors and the MRPO's technical analysis, in conjunction with RPGs that were set by the pertinent Class I states in consultation with Illinois and other contributing states, Illinois concludes that existing control programs, together with the BART controls described above, address Illinois's impact on Class I areas. This is because the combination of the existing controls and the BART controls suffice to meet the impacted Class I areas' RPGs by 2018. These existing control programs include Federal motor vehicle emission control program, reformulated gasoline, emission limits for area sources of VOCs, Title IV, the NOX SIP Call, NOX Reasonable Achievable Control Technology, Maximum Achievable Control Technology standards, and Federal nonroad standards for construction equipment and vehicles. As discussed in prior sections, implementation of the existing control programs, supplemented by the control measures in the submission that require power plant and petroleum refinery emission reductions, will satisfy the LTS requirements because, for reasons discussed above, the expected emission reductions will meet requirements both to provide for BART and to provide emission reductions in Illinois that, in combination with emission reductions elsewhere, should improve visibility sufficiently for the pertinent Class I areas to meet their RPGs. Illinois assessed all point sources in the state that emit at least 1,000 TPY of NOX and SO2 combined and are more than 100 km from a Class I area to determine if the sources could potentially affect visibility in a Class I area. The assessment followed EPA guidance in calculating the ratio of emission rate in TPY (Q) to the distance to the nearest Class I area (d). The exclusions also followed guidance. Illinois found 15 facilities with a Q/d ratio equal to and greater than 10, EPA's recommended threshold. The results of the Q/d assessment are found in Table 8.1 in the Illinois TSD. Illinois found that it expects the implementation of existing control measures will result in emission reductions from the 15 facilities. As such, Illinois believes that the expected emission reductions will ensure reasonable progress. F. Monitoring Strategy Illinois maintains a monitoring network that provides data to analyze air quality problems including regional haze. Illinois's monitoring network includes State and Local Air Monitoring Sites (SLAMS), Special Purpose Monitors (SPM), Photochemical Assessment Monitoring Sites (PAMS), and PM2.5 speciation sites. Illinois does not operate any sites under the IMPROVE program, but does have a site in Bondville, Illinois that monitors using the IMPROVE procedure method. Illinois is required under 40 CFR 51.308(d)(4) to have procedures for using the monitoring data to determine the contribution of emissions from within the state to affected Class I areas. Illinois developed procedures in conjunction with the MRPO. The procedures are detailed in the MRPO TSD. EPA finds that Illinois's regional haze plan meets the monitoring requirements for the RHR and that Illinois's network of monitoring sites is satisfactory to measure air quality and assess its contribution to regional haze. VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 G. Federal Land Manager Consultation Illinois was required to consult with the FLMs under 40 CFR 51.308(i). Illinois consulted with the FLMs electronically and by telephone. The FLMs were also included in discussions with Illinois during MRPO conference calls and meetings. A draft regional haze plan was submitted for FLMs comments on August 6, 2009. Illinois then provided the FLMs a revised regional haze plan on October 7, 2010 for review. That provided the FLMs enough time to comment prior to the December 6, 2010, public hearing on the regional haze plan. Illinois has included comments from the FLMs in Attachment 9 to its regional haze plan, a document providing the comments Illinois received and its responses. The state has committed to consulting the FLMs on future SIP revisions and progress reports. H. Comments Illinois took comments on its proposed regional haze plan. It held a public hearing on December 6, 2010. The public comment period ended on January 5, 2011. Evidence of the public notice and evidence of the public hearing were submitted to EPA. Illinois's submission includes a document, Attachment 9, which summarized the comments it received from both the FLMs and from the public and provides its responses to the comments. The state revised portions of its plan based on the comments to correct errors and clarify portions that caused confusion. Illinois responded to other comments without revising its plan. EPA concludes that Illinois has satisfied the requirements from 40 CFR Part 51, Appendix V to provide evidence that it gave public notice, took comments, and that it compiled and responded to comments. V. What action is EPA taking? EPA is proposing to approve revisions to the Illinois SIP, submitted on June 24, 2011, addressing regional haze for the first implementation period. The revisions address CAA and regional haze rule requirements for states to remedy any existing anthropogenic and prevent future impairment of visibility at Class I areas. EPA finds that Illinois has satisfied all the requirements and, thus, is proposing approval of the regional haze plan. EPA is also proposing to approve two state rules, MPS and CPS, and incorporating two permits, issued to City Water, Light, & Power and to Dominion Energy, into the SIP. VI. Statutory and Executive Order Reviews Under the CAA, the Administrator is required to approve a SIP submission that complies with the provisions of the CAA and applicable Federal regulations. 42 U.S.C. 7410(k); 40 CFR 52.02(a). Thus, in reviewing SIP submissions, EPA's role is to approve state choices, provided that they meet the criteria of the CAA. Accordingly, this action merely approves state law as meeting Federal requirements and does not impose additional requirements beyond those imposed by state law. For that reason, this action: * Is not a ''significant regulatory action'' subject to review by the Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); * Does not impose an information collection burden under the provisions of the Paperwork Reduction Act (44 U.S.C. 3501 et seq.); * Is certified as not having a significant economic impact on a substantial number of small entities under the Regulatory Flexibility Act (5 U.S.C. 601 et seq.); * Does not contain any unfunded mandate or significantly or uniquely affect small governments, as described in the Unfunded Mandates Reform Act of 1995 (Pub. L. 104–4); * Does not have Federalism implications as specified in Executive Order 13132 (64 FR 43255, August 10, 1999); * Is not an economically significant regulatory action based on health or safety risks subject to Executive Order 13045 (62 FR 19885, April 23, 1997); * Is not a significant regulatory action subject to Executive Order 13211 (66 FR 28355, May 22, 2001); * Is not subject to requirements of Section 12(d) of the National Technology Transfer and Advancement Act of 1995 (15 U.S.C. 272 note) because application of those requirements would be inconsistent with the CAA; and * Does not provide EPA with the discretionary authority to address, as appropriate, disproportionate human health or environmental effects, using practicable and legally permissible methods, under Executive Order 12898 (59 FR 7629, February 16, 1994). In addition, this rule does not have tribal implications as specified by Executive Order 13175 (65 FR 67249, November 9, 2000), because the SIP is not approved to apply in Indian country located in the state, and EPA notes that it will not impose substantial direct costs on tribal governments or preempt tribal law. List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control, Intergovernmental relations, Nitrogen dioxide, Particulate matter, Reporting and recordkeeping requirements, Sulfur oxides, Volatile organic compounds. Dated: January 17, 2012. Susan Hedman, Regional Administrator, Region 5. [FR Doc. 2012–1606 Filed 1–25–12; 8:45 am] BILLING CODE 6560–50–P ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA–R05–OAR–2011–0080; FRL–9622–7] Approval and Promulgation of Air Quality Implementation Plans; Indiana; Regional Haze AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing a limited approval of revisions to the Indiana State Implementation Plan (SIP) addressing regional haze for the first implementation period. Indiana submitted its regional haze plan on January 14, 2011, and supplemented it on March 10, 2011. The Indiana regional haze plan addresses the requirements of the Clean Air Act (CAA or Act) and Regional Haze Rule (RHR) requirements for states to remedy any existing and prevent future anthropogenic impairment of visibility in mandatory Class I areas caused by emissions of air pollutants from numerous sources located over a wide geographic area (also referred to as the ''regional haze program''). States are required to assure reasonable progress toward the national goal of achieving natural visibility conditions in Class I areas. EPA is proposing a limited approval of these SIP revisions to implement the regional haze requirements for Indiana on the basis that the revisions, as a whole, strengthen the Indiana SIP. In a separate action, EPA has previously proposed a limited disapproval of the Indiana regional haze SIP because of the deficiencies in Indiana's regional haze SIP submittal arising from the remand by the U.S. Court of Appeals for the District of Columbia (D.C. Circuit) to EPA of the Clean Air Interstate Rule (CAIR). Consequently, we are not proposing to take action in this notice to address the state's reliance on CAIR to meet certain regional haze requirements. VerDate Mar<15>2010 16:43 Jan 25, 2012 Jkt 226001 PO 00000 DATES: Comments must be received on or before February 27, 2012. ADDRESSES: Submit your comments, identified by Docket ID No. EPA–R05– OAR–2011–0080, by one of the following methods: 1. www.regulations.gov: Follow the on-line instructions for submitting comments. 2. Email: firstname.lastname@example.org. 3. Fax: (312) 692–2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR–18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR–18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. Such deliveries are only accepted during the Regional Office normal hours of operation, and special arrangements should be made for deliveries of boxed information. The Regional Office official hours of business are Monday through Friday, 8:30 a.m. to 4:30 p.m., excluding Federal holidays. Instructions: Direct your comments to Docket ID No. EPA–R05–OAR–2011– 0080. EPA's policy is that all comments received will be included in the public docket without change and may be made available online at www.regulations.gov, including any personal information provided, unless the comment includes information claimed to be Confidential Business Information (CBI) or other information whose disclosure is restricted by statute. Do not submit information that you consider to be CBI or otherwise protected through www.regulations.gov or email. The www.regulations.gov Web site is an ''anonymous access'' system, which means EPA will not know your identity or contact information unless you provide it in the body of your comment. If you send an email comment directly to EPA without going through www.regulations.gov your email address will be automatically captured and included as part of the comment that is placed in the public docket and made available on the Internet. If you submit an electronic comment, EPA recommends that you include your name and other contact information in the body of your comment and with any disk or CD–ROM you submit. If EPA cannot read your comment due to technical difficulties and cannot contact you for clarification, EPA may not be able to consider your comment. 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HP iLO 4 Release Notes 1.50 HP Part Number: 684917-401 Published: May 2014 © Copyright 2014 Hewlett-Packard Development Company, L.P Confidential computer software. Valid license from HP required for possession, use or copying. Consistent with FAR 12.211 and 12.212, Commercial Computer Software, Computer Software Documentation, and Technical Data for Commercial Items are licensed to the U.S. Government under vendor's standard commercial license. The information contained herein is subject to change without notice. The only warranties for HP products and services are set forth in the express warranty statements accompanying such products and services. Nothing herein should be construed as constituting an additional warranty. HP shall not be liable for technical or editorial errors or omissions contained herein. Acknowledgements Microsoft® and Windows® are U.S. registered trademarks of Microsoft Corporation. Java is a registered trademark of Oracle and/or its affiliates. Revision History Description The HP iLO subsystem is a standard component of HP ProLiant servers that simplifies initial server setup, server health monitoring, power and thermal optimization, and remote server administration. The HP iLO subsystem includes an intelligent microprocessor, secure memory, and a dedicated network interface. This design makes HP iLO independent of the host server and its operating system. HP iLO 4 includes the following key features: * HP Active Health System—Monitors and records changes in the server hardware and system configuration. * Agentless Management—Provides true Agentless Management with SNMP alerts from HP iLO, regardless of the state of the host server. * Remote Support—Allows Gen8 server Insight Remote Support registration from iLO, regardless of the operating system software and without the need for additional host software, drivers, or agents. Update recommendation Recommended. Update to this firmware version if your system is affected by one of the documented fixes or to take advantage of the enhanced functionality provided by this version. Replaces version HP iLO 4 1.40 Product models HP iLO 4 Operating systems * Microsoft Windows Server 2008, R2 * Microsoft Windows 2012, R2 * Red Hat Enterprise Linux 5 (x86, AMD64/EM64T) * Red Hat Enterprise Linux 6 (x86, AMD64/EM64T) * SUSE Linux Enterprise Server 11 (x86, AMD64/EM64T) * VMware ESX/ESXi Server 4.0, 4.1 * VMware ESXi Server 5.0 * VMware vSphere 5.1, 5.5 Browser requirements The following browsers are supported for running the iLO web interface: * Internet Explorer 8, 10 * Firefox ESR 24 * Chrome (latest version) The following settings must be enabled when using the iLO 4 web interface: * JavaScript—Client-side JavaScript is used extensively by this application. * Cookies—Cookies must be enabled for certain features to function correctly. * Pop-up Windows—Pop-up windows must be enabled for certain features to function correctly. Verify that pop-up blockers are disabled. Description 3 Devices supported * HP ProLiant BL660c Gen8 Server * HP ProLiant BL465c Gen8 Server * HP ProLiant BL460c Gen8 Server * HP ProLiant BL420c Gen8 Server * HP Proliant DL3000 Server * HP ProLiant DL580 Gen8 Server * HP ProLiant DL560 Gen8 Server * HP ProLiant DL385p Gen8 Server * HP ProLiant DL380p Gen8 Server * HP ProLiant DL380e Gen8 Server * HP ProLiant DL360p Gen8 Server * HP ProLiant DL360p Gen8 SE Server * HP ProLiant DL360e Gen8 Server * HP ProLiant DL320e Gen8 v2 Server * HP ProLiant DL320e Gen8 Server * HP ProLiant DL160 Gen8 Server * HP ProLiant ML350e Gen8 Server * HP ProLiant ML350p Gen8 Server * HP ProLiant ML310e Gen8 v2 Server * HP ProLiant ML310e Gen8 Server * HP ProLiant SL4540 Gen8 Server * HP ProLiant SL210t Gen8 Server * HP ProLiant SL270s Gen8 Server * HP ProLiant SL270s Gen8 SE Server * HP ProLiant SL250s Gen8 Server * HP ProLiant SL230s Gen8 Server * HP ProLiant MicroServer Gen8 * HP ProLiant WS460c Gen8 Graphics Server Blade Enhancements This version adds support for the following features and enhancements: * Added an SNMP trap for Uncorrectable Machine Check Error. * Added the ability for iLO to get Domain name to Get or Display from DHCPv6 server. * Implemented significant performance improvements when making iLO Federation Management queries. Devices supported 4 Fixes The following issues are resolved in this firmware version: * Auto Power On does not work on server blades after upgrading to iLO 4 v1.40. * SSH keys cannot be imported by using XML after upgrading to iLO 4 v1.40. * Random Embedded Flash/SD-CARD: Failed restart errors appear in the iLO 4 Event Log after server shutdown. * The Windows Server 2008 or 2012 installer might fail with the following error message when used with Virtual Media on iLO 4 1.32 and 1.40: A required CD/DVD drive device driver is missing. * If you create a disk image when Virtual Media is mounted in the Java IRC, an invalid message is displayed. * The keyboard doesn't work when using the Java IRC to mount an image file through a URL. * When using the Java IRC in Linux, some characters cannot be entered from a Japanese keyboard when the Japanese layout is selected. * iLO might stop responding if the DNS server fails to respond when iLO is trying to log multiple entries that require DNS reverse lookup. * Time zones that are south of the Equator and use DST are handled incorrectly. * An incomplete Japanese message is displayed in the Set to factory defaults interface when the Japanese Language Pack is loaded. * AlertMail implementation is inconsistent between the iLO web interface and the CLI. * iLO does not always respond to multicast M-SEARCH requests. * Multicast replies display the incorrect iLO version number. * iLO requires a reset when the IPv6 Multicast Scope is changed for iLO Federation discovery. * The SERVER_POST_STATE element is missing from RIBCL output. * iLO Virtual Media CD-ROM connect says "ok" when http://name is unreachable. * Multiple iLO Federation Management groups cannot be deleted in a certain order. * Menu and Title area return to English characters when the Japanese Language Pack is loaded. * EBIPA IPv6 settings not always updated on iLO when iLO DHCP IPv4 is disabled. * The iLO web page could stop responding after a firmware update via the group firmware update in iLO Federation Management. Prerequisites * For Direct Connect Remote Support only: When you enter your HP Passport credentials, enter your HP Passport User ID in the HP Passport Username box. In most cases, your HP Passport User ID is the email address you used during the HP Passport registration process. If you changed your User ID in HPSC, enter your User ID and not your e-mail address. * If you use any of the following utilities, update them to the versions shown below. The minimum versions are required for IPv6 support. Fixes 5 6 * Some iLO 4 features are part of an iLO licensing package. For more information about iLO Licensing, see the following website: http://www.hp.com/go/ilo/licensing. * You must install Java Runtime Environment Standard Edition 1.4.2_13 or later to use the Java Integrated Remote Console. * The .NET IRC requires one of the following versions of the Microsoft .NET Framework. You can use Windows Update to install the .NET Framework. * .NET Framework 3.5 Full (SP1 Recommended) * .NET Framework 4.0 Full * .NET Framework 4.5 NOTE: The .NET Framework versions 3.5 and 4.0 have two deployment options: Full and Client Profile. The Client Profile is a subset of the Full framework. The .NET IRC is supported with the Full framework only. The Client Profile is not supported. Version 4.5 of the .NET Framework does not have the Client Profile option. * The .NET Integrated Remote Console is launched using Microsoft ClickOnce, which is part of the .NET Framework. * Mozilla Firefox requires an add-on to launch a ClickOnce application. You can launch the .NET IRC from a supported version of Firefox using a ClickOnce plug-in such as the Microsoft .NET Framework Assistant. You can download the .NET Framework Assistant from the following website: https://addons.mozilla.org/en-US/firefox/addon/ microsoft-net-framework-assist/ . * Google Chrome requires an add-on to launch a ClickOnce application. You can launch the .NET IRC from a supported version of Chrome using the ClickOnce plugin for the Chrome browser. You can download this plugin from the following website: http://code.google.com/ p/clickonceforchrome/. Installation instructions See the following document for installation instructions: HP iLO 4 User Guide Part number: 684918-006 Edition: 1 Installation instructions Support * HP iLO 4 firmware updates and utilities can be found here: http://www.hp.com/support/iLO4 * HP iLO 4 1.50 supports the following IPv6 dedicated network communications: IPv6 Static Address Assignment ◦ * IPv6 SLAAC Address Assignment * IPv6 Static Route Assignment * Integrated Remote Console * OA Single Sign-On * Web Server * SSH Server * SNTP Client * DDNS Client * DHCPv6 Address Assignment * DHCPv6 DNS, and NTP Configuration * RIBCL over IPv6 * SNMP * HP-SIM Single Sign-On * WinDBG Support * HPQLOCFG/HPLOMIG over an IPv6 connection * Scriptable Virtual Media * CLI/RIBCL Key Import over IPv6 * iLO Federation * HP iLO 4 1.50 does not support the following IPv6 networking features: Shared Network Port Connections ◦ * Authentication using LDAP and Kerberos over IPv6 * IPMI * NETBIOS-WINS * ESKM Support for Storage * ERS Support Support 7 * There may be times when you run iLO Federation Management that you will receive a "data inconsistency error". Those errors occur when an iLO on your network is not responding correctly refer to the multisystem map page to help troubleshoot that condition. * HP iLO 4 1.50 does not accept IPv6 multicast global scope configuration. Documentation feedback HP is committed to providing documentation that meets your needs. To help us improve the documentation, send any errors, suggestions, or comments to Documentation Feedback (email@example.com). 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Survivors Nepal Procurement Policy 2017 (2074 BS) \| Policy number: \| SN-004 \| Version: \| \|---\|---\|---\| \| Drafted by: \| Sushil Koirala \| Approved by Board on: \| \| Responsible person: \| Arya Shakya \| Scheduled review date \| Table of contents: PROCUREMENT POLICIES AND PROCEDURES This procurement policy is developed as a guideline for procurement of goods and services for all programs/projects in Survivors Nepal. This procurement policy is based on the principle of assuring the most cost efficient and rational use of resources for goods or services that will best serve the organization both at the present and in the long term. Survivors follow a multi-quote system procurement policy for the supply of both products and services. In instances where long-term business relations have developed with suppliers to the extent of sole-sourcing, the relationship will be subject to market-related standards and competitive review. All assets are to be reflected in the organization's fixed asset register. Asset disposal shall occur in compliance with asset management guideline and or in consultation with the relevant donor if it contradicts Survivors Nepal's policy. Procurement will be conducted following these principles: 1. Contracts shall be awarded only to responsible contractors/suppliers that possess the ability to successfully perform the contracts. 2. No more than a reasonable price (as determined, for example, by a comparison of price quotations and market prices) shall be paid to goods and services. All procurement is planned in advance and recorded. The plan shall list: 1. Purpose of procurement 2. Description of goods, services or works 3. Estimated cost 4. Date required 5. Method of procurement (e.g. direct assignment, quotations or competitive bidding) Different approaches apply to the purchase of non-expendable items, or fixed assets (such as computers, cars, printers and copying machines), on the one hand, and general purchases (such as office stationery) on the other. Non-expendable items are those with a useful life span of more than one year; they are permanent in nature and include (but are not limited to) office furniture, computer equipment, photocopiers and electronic equipment. In the case of non-expendable items, or fixed assets, such as computers, printers and photocopying machines: 1. The purchase must be provided for by the agreement and approved by the Executive Director 2. At least two quotations must be obtained if the purchase value of a single item exceeds NRs 5,000.00, or as specified by the agreement 3. The Executive Director must confirm the choice (made from the quotations) of the item to be purchased by signing the quotation before the item is actually ordered. A fixed asset register, listing the following details relating to non-expendable equipment, must be maintained: 1. Type of equipment 2. Serial number 3. Date purchased 4. Cost of purchase 5. Current cost (depreciated value) 6. Location (office assigned to). All items removed from the asset register should be accounted for by the Executive Director. The asset register should be updated as soon as new items are purchased or acquired, but at least once a year. PROCESS: In the case of general purchases (fuel, stationery, refreshments, cleaning material): 1. A purchase order is completed before the item is purchased; 2. The delivery note, confirming receipt of goods, is signed by the person of the organization receiving the goods; 3. The invoice is approved by the Executive Director for payment and signed, along with the payment request form and he or she indicates the relevant budget line item; 4. The payment is made by cheque or electronic transfer; 5. Low cost items such as refreshments and cleaning materials are mainly purchased via petty cash. Competitive bidding at the Survivors secretariat level Competitive bidding will be employed for procurement of goods and services forecasted to have a value over NRs 50,000 and for consultants with estimated cost/value of NRs 100,000 and above. Competitive bidding will be through a Single-Stage: One-Envelope Bidding Procedure. The process for competitive bidding will be: 1. Development of a scope of work/terms of reference, plus proposal evaluation criteria 2. Advertisement through list servers, print media, limited to known suppliers for very specialised services or through consultancy agencies as relevant with at least 2 weeks between advertisement and proposal deadline 3. Proposals received will include technical details (where relevant) as well as financial quote and both will be reviewed at the same time 4. Evaluation of proposals is by the grant management unit (and as needed, external technical experts) who will rate the proposals, based on criteria related to both cost and technical proposal or details of scope of work, with one preferred vendor and one back-up 6. A contract with the vendor is finalised by the Survivors Nepal designated grant program officer and approved by executive director 5. Recommendation for award must be in written form and must address how each vendor has met or failed to meet the evaluation criteria 7. After award, the relevant grant program officers will monitor the vendor's performance as per the contractual agreement. 8. Standard bidding DOCUMENTS – Will include instructions to bidders, evaluation criteria, the scope of work/terms of reference, bidding forms, conditions of the contract and contract forms. Monitoring vendors Only vendors providing goods and services valued over NRs 100,000 will be monitored. Monitoring of vendors will be done by the Survivors Nepal and on a 6-monthly basis. The vendors will be monitored using a vendor performance checklist, which will cover the following: 1. Timeliness 2. Quality of parts/materials/deliverables 3. Technical quality of consultant product 4. Client satisfaction (where relevant) 5. Price Payment for work will be disbursed against milestones where appropriate. Procurement code of conduct The individuals and organizations involved in the procurement of goods and services are obliged to: 1. Undertake the task of procuring the goods/services properly, with a strong sense of responsibility for achieving the goals efficiently and appropriately 2. Work professionally, independently and honestly, and appreciate the confidentiality of good/services procurement documents to prevent any deviations in goods/services procurement. 3. Avoid influencing one another, either directly or indirectly, in order to prevent and avoid unhealthy competition. 4. Accept and be responsible for all decisions made in agreement with all parties. 6. Avoid and prevent the wasting or leakage of the grant money. 5. Avoid and prevent direct or indirect conflict of interest between any related parties in the process of goods and services procurement. 7. Avoid and prevent misuse of authority and/or collusion for personal interest and benefit, or for the benefit of another group/party that directly or indirectly disadvantages the funding agency. 8. Avoid accepting, offering, or promising to give or receive any kind of gift or reward to anyone who is known to be or is suspected of being related to goods/service procurement. Emergency protocol: Since much of its activities and work revolves around disaster response, an emergency protocol can be activated by the president for the expenditure of funds for up to Nrs. 10,00,000 by putting all the board member though email notice. The following procedure applies during emergencies: 1. The executive director assumes responsibility for checks and balances and all the procurement checks and balances mentioned above are suspended for up to two weeks from the start date of emergency protocol. 3. These expenses can only be the supplies and support for a disaster and not be used for any other expenses. 2. While the protocol is enacted, the president can inform the board members of the expenses and priority investment depending on the need of the affected community. 4. The same procurement principles (Value, transparency and integrity) apply to disaster protocol and the board president should audit the expenses and present it to management board for a retrospective approval. FIXED ASSETS AND MANAGEMENT All fixed assets procured under Survivors Nepal programs/projects should follow the asset management policies. Tagging of Assets: All fixed assets shall be tagged with identification numbers which shall correspond to the inventory list or the fixed assets register. Holders of the assets shall be responsible for the safekeeping, custodial care, proper use, maintenance and repair of the item issued to them. The holders shall be held liable for the loss or theft, replacement of, or damage to any and all items purchased with grant funds. Safeguard of Assets All acquisitions under the program shall be the responsibility of Survivors Nepal. Admin and Finance Officer shall maintain a fixed asset register for all purchases above the equivalent of NRs 5,000.00, which shall include the type of item, date of purchase, cost, funding source, serial number, inventory item tag number, condition, and location. The management of consumable supply sets (i.e., office supplies, fuel, car parts, etc.) shall be done using an Inventory Sheet documenting the purchase date and use of these items. Asset management shall be reviewed during the capacity assessment and ensure their proper maintenance and use. All the assets shall have insurance coverage by a reputable insurance firm. Disposition and Transfer of Assets The assets remain to be the property of the Survivors Nepal until a decision as to its proper disposition after the project ends, is decided between the Survivors Nepal and the Funding Agency. Any transfer of an asset valued at more than NRs 5,000.00 shall be documented in a Property Transfer Document. Fixed Asset Register A Fixed Asset register shall be maintained and updated regularly to include without limitation 1. The legal form/ownership 2. The source of Funding 3. Reference numbers/codes/serial numbers/unique identifier codes 4. Date of Acquisition 5. Location/possession 6. Condition of the asset (usable/poor condition), where applicable The Survivors Nepal undertakes to verify Fixed Asset register through an independent Audit Unit (External Audit) at the end of the financial year. Insurance: The insurance of building and the properties are mandatory by Law in Nepal. The products procured under projects are insured using common sense approach. Computers procured under the projects are protected under the insurance provided by the product companies. Survivors Nepal office is insured under Laxmi Intercontinental Pvt. Ltd and staff's insurance is covered by Survivors Nepal. Special conditions: Non-expendable items should not be removed from the office building unless for purposes relating to a programme. In such a case, prior authorization must be given by the Executive Director. A prescribed consent form must be completed prior to the removal of the item from the office building. If a staff member removes a non-expendable item from the office without prior consent and it is damaged or stolen, the staff member will take responsibility for the damage or loss of property. A policy does not normally allow for the lending of any nonexpendable items to a person or organization. However, the Executive Director may use his or her discretion if the need arises for lending out a specific item. FORMS AND FORMAT OF SURVIVORS NEPAL Forms and format used for procurement of goods and services are as follows; 1. Comparative Chart Comparison is one of the most critical activities users perform on the web. It's a necessary step before your Supervisor will perform the desired action, like buying your product, signing up for membership, contacting you, or requesting a quote. The first step to enabling comparison is providing consistent information for all comparable products or services. However, when that information is distributed across detail pages, the interaction cost and the cognitive load both increase: users are forced to remember information, take notes, flip between tabs, or open multiple browser windows. 2. Purchase requisition slip The Purchase Requisition is the procedural method by which departments may request the purchase of goods and/or services which require processing by Procurement Services, the nature of the purchase, or the type of goods and services. 3. Purchase Order A purchase order (PO) is a commercial document and first official offer issued by a supervisor to seller buyer indicating approval to buy the goods and services as mentioned its types, quantities, and agreed prices. It is used to control the purchasing of products and services from external suppliers. 4. Vendor Agreement A vendor agreement is a legal agreement that clearly states the provisions and conditions of the work to be performed by a contractor. The key points to be included in a vendor agreement include date, time and location where the services must be provided. 5. Inter- Office Memo A memorandum is a document that addresses specific people within the organization for the purpose of recording an agreement, delivering information or enabling some type of action. The memorandum or interoffice memo's purpose is to inform the reader -- not to persuade. 6. Payment Voucher Survivors Nepal issues payment voucher as a proof that a monetary transaction has occurred between two parties. In business, a payment voucher can be used for a variety of purposes, sometimes taking the place of cash in a transaction, acting as a receipt, or indicating that an invoice has been approved for payment. Annex 1: Comparative Chart Comparative Chart \| S.No \| Particulars \| Cost includes \| Package \| Cost \| Service Tax \| \|---\|---\|---\|---\|---\|---\| _________________ __________________________ ________________ Prepare by Checked & forwarded by Approved by Office Supplies Order Form Requisitioned For: Department _____________________________ Order date: _____________________ Deliver to: ______________________________ Account No: ____________________ Items Requisitioned: S. No Date Particulars Amount Total Remarks Approvals: (Any office supply items over Nrs 10,000.00 must be approved and signed by your Authority Personnel) _________________ __________________________ ________________ Prepare by Checked & forwarded by Approved by Annex 3: Purchase Order To, The Manager Concern party Kathmandu, Dear Sir, Subject: Confirmation of Order We confirm our order for concern product; Product Name: Address: Contact Person: Contact Number: Cost: Facilities/ Features: Amount: Warranty: (in case of furniture/ fixtures, computer etc) Delivery: Thapathali, Kathmandu Regards, Sushil Koirala President Annex 4: Vendor Agreement between Survivors Nepal and the Suppliers cfk"lt{stf{, ;\|f]tstf{ / las\|]tfsf] nfuL ;fdfGo ;]jf ;D´f}tf ;/efOe;{ g]kfnn] k\|f]h]S6 cGtu{t sf]if k\|fKt u/] cg';f/ ;/efOe;{ g]kfn, yfkfynL, sf7df08f+} र ________________________________________________aLr (JolSt jf sDklgsf] gfd jf b'a}) ___________________________________________________ sf] nfuL (sfo{) of] @)&_____ ;fn ______ ut], 7f]skf{ ;fd'bflos ;\|f]t k':tsfno / _________________________________________________( JolSt jf sDklgsf] gfd jf b'a}) aLrsf ;fdfGo ;]jf ;D´f}tf xf] . o; cGtu{t tn lgDg lnlvt sfo{x? ;DkGg ul/g]5; ! sfo{sf] ljj/0f @ sfd jf ;]jfsf] cjlw ______________________ (;fn ut] ;do) देखि ______________________ (;fn ut] ;do) ;Dd /x]sf] lyof] . ;]jfsf] cjlw ______________________ (lbg/3G6f) /x]sf] lyof] . # hDdf vr{ __________sf] b/n]____________hgfnfO{ / hDdf vr{ ? _______________ $ c? s'g} l6Kk0fL ;/efOe;{ g]kfnsf] nfuL cfk"lt{stf{, ;\|f]tstf{ / las\|]tfsf] nfuL _________________________ _________________________ gfd: gfd: kb: kb: ;/efOe;{ g]kfn: ;+:yf: Inter-Office Memo Survivors Nepal Inter Office Memo Date : No: - From : To : CC : Subject/Ref: Dear Sir, _________________________ Prepare by Checked & forwarded by Approved by Noting by Internal Audit & Compliance:- Payment Voucher Survivors Nepal Thapathali, Kathmandu, Nepal Tel.:977-1-4101620 Payment Voucher No: Date: Please Pay NRs: …………….……In Words:…………………………………………………………….. Pay to Mr. /Mr.: …………………………………………..on account of …………………...…………... Dr. S. No Particulars L/F Amount Cr. Cash/Cheque ……………...... ………………… …………………………….. ………………. Prepared by Checked by Approved/Accepted by Received by	<urn:uuid:a464876f-0365-40c7-9f93-9d03108516bb>	CC-MAIN-2021-04	http://the-survivors.org/uploads/finance/Survivors_4Procurement%20Policy.pdf	2021-01-20T20:39:50+00:00	crawl-data/CC-MAIN-2021-04/segments/1610703521987.71/warc/CC-MAIN-20210120182259-20210120212259-00000.warc.gz	110,850,754	3,598	eng_Latn	eng_Latn	0.735301	eng_Latn	0.993942	[ "unknown", "unknown", "unknown", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "hau_Latn", "eng_Latn", "dag_Latn" ]	false	docling	[ 51, 224, 244, 3209, 7252, 9915, 12538, 13771, 14099, 14716, 15099, 15750, 16177, 16442, 16936 ]	[ 0.6328125 ]	[ 2.78125 ]	[ 3.46875 ]	[ 2.171875 ]	2	0	HuggingFaceFW/finepdfs
NEW YORK THEATRE The Magnificent Seven Swing/Dance Captain Kylie Lavrenchik AEA Hair : Brown Eyes : Blue Height : 5'7" Weight : 130lbs (631) 338-3309 email@example.com Soprano w/ mix/belt Range E3-G6 Manager : Charlene Rawson firstname.lastname@example.org Kreativ Artists Nikki DiLoreto, Theatre Row WORKSHOPS/NEW WORKS Riverbend Diana (lead) Olivia Songer, Spark Theatre Festival Pregnancy Pact Jeannelle (lead) Catie Davis, NYU Graduate Musical Theatre Writing Saint Sebastian Nun/Ensemble Mia Sommesse, NYU Graduate Musical Theatre Writing EDUCATIONAL THEATRE Legally Blonde Vivienne Christopher Betts NYU Tisch New Studio on Broadway Pippin Berthe Tommy Ranieri Playwrights Horizons Theatre School You're A...Charlie Brown Sally Paul Whitthorne NYU Tisch New Studio on Broadway Here We Go Company of 5 Tommy Ranieri Playwrights Horizons Theatre School SELECTED REGIONAL THEATRE Children of Eden Aysha/Choreographer Tommy Ranieri Spring Awakening Wendla Angie Meller The Last Five Years Cathy Dan Kiernan Avenue Q Bad Idea Bear Karen Braun = paused due to COVID TRAINING NYU Tisch New Studio on Broadway (2022 Graduate) Vocal: Lindsay Mendez, Michael McElroy, Andrea Burns, Andrew Kober, Howard Mcgillin, Anthony Turner, Michele Ivey, Kurt Robinson, Karen Parks Dance: Byron Easley, Dell Howlett, Barry McNabb, Amy Hall Garner Acting: Kent Gash, Kenneth Noel Mitchell, Barbara Tirrell, Axel Avin Jr. Voice and Speech: Dawn-Elin Fraser, Steven Eng, Raife Baker SPECIAL SKILLS Ask me about my humps… , can spell the second longest word in the dictionary, a little too good at guitar hero thanks to the pandemic, Intermediate American Sign Language, choreography, partnering/ballroom, tap, puppetry, modeling experience, film experience, Long Island mom impression, basic stage combat, music theory skills, soccer skills, basic cheerleading, jump rope, piano skills (can self accompany), valid passport	<urn:uuid:7ff86abc-ea98-49a2-a453-6b2554ca6daf>	CC-MAIN-2024-30	https://www.kylielavrenchik.com/_files/ugd/22e264_25f15f60dfc84ce2b7bce4d29ba6fe15.pdf	2024-07-17T11:01:08+00:00	crawl-data/CC-MAIN-2024-30/segments/1720763514759.39/warc/CC-MAIN-20240717090242-20240717120242-00684.warc.gz	733,346,490	536	eng_Latn	eng_Latn	0.754757	eng_Latn	0.754757	[ "eng_Latn" ]	false	docling	[ 1971 ]	[ 0.66015625 ]	[ 1.2734375 ]	[ 1.09375 ]	[ 2.203125 ]	1	0	HuggingFaceFW/finepdfs
Biborough Speech and Language Therapy Parent Workshops Are you a resident of RBKC or Westminster? Do you have a primary/secondary school-aged child? We are running a workshop on: Talking About Feelings 06/07/22 13.30 Via Microsoft Teams This workshop will cover: [x] Why feelings are important [x] How we can begin to support our children to label and talk about their feelings To book a free place: email email@example.com by 30/06/22. In your email, include: name of the workshop, and your child's school. The link will be sent to you by 01/07/22. PLEASE CHECK YOUR JUNK FOLDER AS WELL AS YOUR INBOX FOR OUR EMAIL RESPONSE AND LINK	<urn:uuid:a911b87a-bdd0-4fc1-b586-5a4d7d4ade6c>	CC-MAIN-2022-33	http://www.stedwardsprimary.org/assets/Documents/Attachments/Talking-About-Feelings-Flyer.pdf	2022-08-10T17:48:11+00:00	crawl-data/CC-MAIN-2022-33/segments/1659882571198.57/warc/CC-MAIN-20220810161541-20220810191541-00321.warc.gz	100,344,359	164	eng_Latn	eng_Latn	0.995797	eng_Latn	0.995797	[ "eng_Latn" ]	false	docling	[ 649 ]	[ 1.0625 ]	[ 1.578125 ]	[ 1.2890625 ]	[ 2.375 ]	1	0	HuggingFaceFW/finepdfs
SIYADA NETWORK ﺷﺑﻛﺔ ﺳﯾﺎدة Agricultural Trade between North Africa and the EU in Times of Crisis A focus on Egypt and Tunisia 1 Saker El Nour, Mustapha Jouili, Mohamed Ramadan, and Sylvia Kay 2 Despite the noticeable growth in agricultural trade volumes between North Africa and the EU, stubborn issues such as food insecurity, escalating poverty and hunger rates, widening social and gender inequality, and the degradation and exhaustion of vital natural resources persist. These challenges undermine the region's stride towards the Sustainable Development Goals (SDGs). The policy brief evaluates the relationship between agricultural trade policies and prog ress towards a number of the SDGs. A special focus is given to analysing the impact of agricultural trade policies between the European Union (EU) and Egypt and Tunisia. Agricultural Trade Policies and Unequal Exchange The EU is the most important trading partner for both Egypt and Tunisia. The signing of the European External Action Service (EEAS) agreement between the EU and Egypt in Brussels on June 25, 2001 intensified trade relations between the two regions, with trade more than tripling since the trade agreement came into effect. 3 Approximately a quarter (25%) of Egypt's total trade is now transacted with the EU. 4 As for Tunisia, it was one of the first countries in North Africa to sign an Association Agreement with the EU in 1995. Since then, trade with the EU has steadily increased with European markets accounting for 70.9% of Tunisia's exports in 2022. 5 The benefits of this trade are not distributed evenly between both regions. This unequal exchange becomes clear when we look at the nature of the products exported from Tunisia and Egypt to Europe. Both countries export citrus fruits and fresh vegetables to the European market, while Tunisia alone exports olive oil and dates. These are mostly extractivist exports - intensively using or exhausting land, water and other natural resources or intensively using energy and labor - with low added value. 6 ideas into movement \| 2 For example, most Tunisian olive oil is exported in crude form (90%) and at a low price ($2.845 per liter in 2019) to Italy and Spain, where it is bottled and resold at higher prices. 7 This means a loss for Tunisia in terms of income while Italian and Spanish manufacturers capture most of the added value, benefitting from a stable and low-cost supply. Furthermore, a reliance on vast olive grove monocultural production for export has led to the depletion of water resources and land degradation in Tunisia, at the expense of natural pastures and land suitable for the cultivation of locally consumed grains. Another example of this unequal exchange is that of the trade in potatoes between Egypt and the EU. Egypt is highly reliant on the import of seed potatoes from Europe, which make up almost 40% of the production cost. The top four importers are private companies which together control nearly 60% of annual seed potato imports, with a small er number of exporters having access to foreign markets. After Egypt joined the Union for the Protection of New Varieties of Plants (UPOV) on the prompting of European partners, breeder's rights became protected with lawsuits filed in European courts to assert those rights against Egyptian agricultural export companies. 8 Meanwhile, the pro duction costs of small-scale Egyptian potato farmers have only increased in recent years with the rising costs of inputs and the removal of key subsidies, including energy. Challenges facing agricultural trade between North Africa and Europe Egypt and Tunisia demonstrate some of the broader challenges facing North Africa in its agricultural trading relationship with the EU. These include: * Food security and nutrition challenges: Egypt and Tunisia are facing a severe agricultural crisis, particularly due to fluctuations in global wheat prices which is a primary source of calories for both countries (30-40%). 9 Additionally, rural poverty and hunger are increasing due to the current economic crises and following on from the disruptions caused by the Covid-19 pandemic and the Russia-Ukraine war. In rural Tunisia, the poverty rate reached 24.8% in 2021, compared to 12.7% in urban areas. 10 In Egypt, a recent study on the impact of the pandemic on families revealed that 92% of the studied households reduced consumption and relied on cheaper food types, especially in rural areas. 11 * Environmental and climate challenges: Climate change projections predict increasing temperatures and decreasing rainfall, with more severe droughts and extreme weather events in North Africa. The region is expected to experience an average temperature increase of between 1.7 to 2.6°C, and drought is projected to increase by 150% between 2020 and 2070. 12 The region will also face rising sea levels, threatening coastal and low-lying agricultural areas such as Egypt's Nile Delta. 13 These changes will deepen climatic disparities between North Africa, which has significantly less rainfall than Europe, and European regions with relatively abundant rainfall, resulting in unequal values of exported and imported water units. * Gender and social challenges: In North Africa, agriculture is a major sector for female employment, employing around 55% of female labor compared to 23% of male labor. 14 With the growth of export-oriented agriculture, the feminization of agricultural labor has increased, including a reliance on young girls (sometimes as young as eight years old) under harsh working conditions due to the low cost of female and child labor. 15 transnational institute * Unequal Economic Support Challenges: There is a vast discrepancy in the levels of economic support between the two regions. For example, European subsidy levels are estimated at around 700 euros/hectare, while it does not exceed 40 euros in Tunisia. 16 The situation becomes more complicated with the increase in European ecological based protectionism and the funds of the EU's Green Deal policies related to the importance of the ecological transition in the agricultural sector. 17 * Legal Frameworks and Unequal Power Relations Challenges: Free trade agreements have been signed between the European Union as a bloc comprising dozens of countries and North African countries individually. This approach weakens the negotiating capacity of North African countries and creates competition among them regarding the entry prices of their products into EU markets, resulting in low price levels. A key example of this is in the EU-Tunisia Association Agreement under which the EU grants Tunisia market access and duty-free privileges but only for agricultural exports that do not threaten European products, such as dates and prickly pear. Policy recommendations The above challenges underscore the imperative for a thorough reevaluation of agricultural trade regulations and policies if progress towards the SDGs is to be made. The following recommendations are offered to move towards a more fair, equitable and sustainable agricultural trading relation within and between the two regions: At transnational level (EU-North Africa relations): 1 Review Free Trade Agreements (Main actors: EU policymakers, North African trade ministers): Revise free trade agreements to ensure a more balanced and fair relationship between North African countries and the European Union. Address power imbalances by involving civil society in the negotiation process and establishing mechanisms for monitoring sustainability outcomes. The still to be completed Deep and Comprehensive Free Trade Agreement (DCFTA) between the EU and Tunisia must be (re)negotiated along these lines if it is to benefit small and medium enterprises. 18 (SDG 17: Partnerships for the Goals) 2 Forge a North African Trade Coalition (Main actors: North African diplomatic corps, EU trade officials): Strengthen the negotiating capacity of North African countries by forming a unified platform for agricultural trade negotiations with the European Union. Promote cooperation and coordination among North African countries to develop a common strategy for addressing agricultural trade challenges. (SDG 17: Partnerships for the Goals) 3 Invest in Agroecology to Support a Just Agricultural Transition (Main actors: International financial institutions, EU development agencies, agricultural research institutes): Provide targeted financial and public policy support to small-scale food producers to enable the spread of agroecological practices, such as crop rotation, no till farming, use of organic fertilisers, oasis agroforestry, and mixed agro-pastoralism, that enhance ecological resilience and local livelihoods. Partner with civil society and research institutions, drawing on local and indigenous knowledge, to support an agroecological transformation at different scales. 19 End support for the expansion of unsustainable monocultures. (SDG 13: Climate Action, SDG 2: Zero Hunger) ideas into movement \|3 \| 4 4 Balance Agricultural Subsidies (Main actors: European Commission, national agricultural agencies, finance ministries): Address unequal support challenges by advocating for a fairer distribution of agricultural subsidies and assistance between European and North African countries. Encourage a re-evaluation of support mechanisms to empower North African nations to assist their small farmers using diverse methods. Assert the same right to a just transition for agriculture in North Africa as in Europe. Urge Europe to cease its support for austerity policies in North Africa. (SDG 2: Zero Hunger, SDG 10: Reduced Inequalities) 5 Foster Agricultural Research Partnerships (Main actors: Research and scientific institutes, higher education institutions, UN and development agencies): Bolster the capacity of North African nations in agricultural research, innovation, and technology transfer. Enhance collaboration between North African regional institutions and between North Africa and the EU through joint research programs, knowledge exchange, and technical assistance to address shared challenges and promote sustainable agricultural development. (SDG 9: Industry, Innovation and Infrastructure) 6 Empower Small Farmers', Agricultural Workers' and Trade Justice Organizations (Main actors: Farmers' cooperatives, workers' unions, civil society organizations): Defend the rights of farmers and agricultural workers to organize and ensure their voices are influential in regional policy discussions. Protect small-scale food producers' rights to land, water, seeds and plant genetic resources (SDG 16: Peace, Justice, and Strong Institutions) At national level: 7 Develop a Food Sovereignty Strategy (Main actors: National governments, regional coalitions): Partner with regional organizations, such as Siyada, 20 to develop a food sovereignty strategy that centers on the needs of North African countries, promoting local production and self-sufficiency. (SDG 2: Zero Hunger, SDG 12: Responsible Consumption and Production) 8 Support Territorial Markets (Main actors: National governments): Adopt the 2016 Policy Recommendations of the UN Committee on World Food Security to enact public policies to support local, national, and regional food systems– what are also referred to as territorial markets. These markets are often more conducive to smallholders than global value chains and export markets. 21 (SDG 2: Zero Hunger) 9 Adopt Sustainable Water Management (Main actors: National governments, local and regional water governance agencies): Promote the adoption of water preservation techniques, and sustainable irrigation systems as well as the use of less water intensive, locally-adapted varieties in order to enhance climate change mitigation and adaptation. Increase transparency around water use rights and allocation and strengthen participatory water governance systems so that small farmers are not unfairly marginalised. Use tools such as the 'water footprint' to measure the trade in embedded water resources in order to draw attention to the (unsustainable) trade in water-intensive agricultural products, particular from arid, semi-arid and desert regions towards more water abundant regions. (SDG 13: Climate Action, SDG 12: Responsible Consumption and Production) transnational institute 10 Enact Appropriate Food Standards (Main actors: National food safety authorities, agricultural departments): Rather than imitating or adjusting agricultural preferences based on European demands, countries should develop their own standards and norms, drawing on indigenous knowledge, local plant varieties and animal breeds, and local consumer preferences. This can help to maintain food cultures in the face of external pressures. (SDG 12: Responsible Consumption and Production) 11 Expand Public Agricultural Extension Services (Main actors: Agricultural extension departments, rural development agencies): Agricultural extension services provide farmers with the training and resources needed for sustainable agricultural practices. (SDG 4: Quality Education, SDG 2: Zero Hunger) 12 Enact and Enforce Gender-Inclusive Policies (Main actors: Women's advocacy groups, national policymakers): Recognize and address the role of women in the agricultural sector by instituting gender-sensitive policies and promoting women's empowerment. Ensure labor laws safeguard female farmworkers and guarantee their access to education, healthcare, and social services. Promote female participation in agricultural decisionmaking processes and facilitate their access to resources. (SDG 5: Gender Equality) 13 Improve Farmworker Rights and Remunerations (Main actors: Labor unions, national labor departments): Ensure adequate working conditions and remuneration for farmworkers, including their rights to a living wage, a healthy and safe working environment, and organizational representation. Special attention should be placed on the rights of female agricultural and farm workers. (SDG 8: Decent Work and Economic Growth; SDG 5: Gender Equality) 14 Fortify the Cooperative Sector (Main actors: Cooperative networks, agricultural ministries): Strengthen the cooperative sector and enhance the representativeness within cooperative membership in order to promote knowledge sharing, mutual assistance, and improve the negotiating position of small farmers. (SDG 8: Decent Work and Economic Growth, SDG 17: Partnerships for the Goals) ideas into movement \|5 \| 6 Endnotes 1 This policy brief builds on two in-depth reports, 'Olive Oil and Water: Moving Towards Sustainable Agricultural Trade between the EU and Tunisia' authored by Mustapha Jouili and 'Markets, Power, and Potatoes: An Analysis of Agricultural Trade between Egypt and Europe' authored by Mohamed Ram adan. These were published by TNI together with the Siyada network in September and December 2023 respectively as part of the MATS project. The brief has been significantly enhanced by valuable insights from participants of a workshop organised by the Tunisian Platform for Alternatives and TNI in Tunis in July 2023 which included farmers, NGOs, activists, producers' cooperatives, exporters, policy actors, academics and research experts. We thank them for their contributions. We also wish to acknowledge the assistance of the MATS team, in particular Mari Carlson and Bodo Steiner, and TNI colleagues, in particular Pietje Vervest and Hamza Hamouchene.. 3 See: https://www.eeas.europa.eu/node/410011_ro?s=95&page_lang=ar 2 Saker El Nour holds the position of Program Director at the Action Network for a Just Transition in North Africa and the Middle East (RESEAU TANMO). Mustapha Jouili, PhD in Economics and Assistant Professor at the University of Carthage, Tunisia. Mohamed Ramadan is an independent economic re searcher and financial analyst from Egypt. Sylvia Kay is a Project Officer at the Transnational Institute. 4 Ahmed El-Mowafi, Trade Openness And Economic Dependence: An Analytical Study With Focus On The Egyptian Agricultural Sector, Egyptian Journal of Agricultural Economics, Volume 26, Issue 1, March 2016. 6 Dorninger, C., Hornborg, A., Abson, D. J., Von Wehrden, H., Schaffartzik, A., Giljum, S., ... & Wieland, H. (2021). Global patterns of ecologically unequal exchange: Implications for sustainability in the 21st century. Ecological economics, 179, 106824. 5 European Union, Tunisia- Southern Neighbourhood, https://neighbourhood-enlargement.ec.euro pa.eu/system/files/2023-10/factograph_tunisia_en_oct2023.pdf 7 Ridha Bergaoui(2020) Et si on arrêtait d'exporter l'huile d'olive? https://www.leaders.com.tn/arti cle/28802-ridha-bergaoui-et-si-on-arrete-d-exporter-l-huile-d-olive 9 Bouët, A., Odjo, S. P., & Zaki, C. (2022).Africa agriculture trade monitor 2022(Vol. 2022). Intl Food Policy Res Inst. 8 Mada Masr, https://is.gd/rzCzjK, (Accessed on 25/03/2023). 10 Institut Nationale de la Statistique (2023) « Enquête nationale sur le budget, la consommation et le niveau de vie des ménages de 2021 » Principaux résultats, Tunis, Février 2023. 12 FAO. (2022), The State of Land and Water Resources for Food and Agriculture in the Near East and North Africa region, https://www.fao.org/3/cc0265en/cc0265en.pdf 11 Central Agency for Public Mobilization and Statistics, The Impact of the Coronavirus on the Egyptian Family until May 2020, Report, available at: https://www.arabdevelopmentportal.com/sites/default/ files/publication/effect_covid_egy.pdf (Accessed on 25/03/2023). 13 FAO. (2022). The State of Land and Water Resources for Food and Agriculture in the Near East and North Africa region – Synthesis report. Cairo. https://doi.org/10.4060/cc0265en 15 Bouzidi, Z., El Nour, S. and Moumen, W. (2011) 'Le travail des femmes dans le secteur agricole: Entre précarité et empowerment – cas de trois régions en Egypte, au Maroc et en Tunisie'. Gender and Work in the MENA Region Working Paper no. 22 Population Council, Cairo. 14 Kühn, S. (2019) 'Global employment and social trends',World Employment and Social Outlook 2019 (1): 5–24. 16 Sami Al-Awadi, Tunisian-European Trade Relations – Evaluation of the 1996 Partnership Agreement and Assessment of the Effects of the Comprehensive and Deep Free Trade Agreement Project, Frie drich Ebert Foundation, Tunisia. July 2020 18 Riahi, L. & Hamouchene, H. (2020). Deep and Comprehensive Dependency: How a trade agreement with the EU could devastate the Tunisian economy. Amsterdam: Transnational Institute. https://www.tni.org/ en/publication/deep-and-comprehensive-dependency 17 Goswami A., A New Order of Trade, Down to Earth, 16-28 february 2023, https://www.cseindia.org/anew-order-of-trade-11637 19 For an overview of agroecological practices and networks in the North Africa region (Algeria, Egypt, Morocco, Tunisia), refer to El Nour, S. (2021). Towards a just agricultural transition in North Africa. Am sterdam: Transnational Institute. Available at: https://www.tni.org/en/article/towards-a-just-agricul tural-transition-in-north-africa 21 CFS. (2016). Connecting Smallholders to Markets. Policy Recommendations. https://www.fao.org/3/ bq853e/bq853e.pdf 20 The Siyada network mobilises for food sovereignty in North Africa and the Middle East. It brings together popular organisations, trade unions and social movements opposed to capitalism, environ mentally destructive policies and all forms of racism, patriarchy and discrimination. www.siyada.org transnational institute SIYADA NETWORK ﺷﺑﻛﺔ ﺳﯾﺎدة The Siyada network mobilises for food sovereignty in North Africa and the Middle East. It brings together popular organisations, trade unions and social movements opposed to capitalism, environmentally destructive policies and all forms of racism, patriarchy and discrimination. www.siyada.org MATS aims to identify key leverage points for changes in agricultural trade policy that foster the positive and reduce the negative impacts of trade on sustainable development and human rights. Focus is on improving the governance, design and implementation of trade practices, regimes and policies at national, EU, African and global levels. The project partners aim to inform relevant debates and policy developments based on this diverse portfolio of perspectives. MATS wants to contribute to the development of a fair-trade system that supports local development and promotes labour and human rights on a global level. The Transnational Institute (TNI) is an international research and advocacy institute committed to building a just, democratic and sustainable planet. For 50 years, TNI has served as a unique nexus between social movements, engaged scholars and policy makers. www.TNI.org ideas into movement \|7	<urn:uuid:3f7b7d91-0f96-4a51-9e4e-d161135227ca>	CC-MAIN-2024-30	https://www.tni.org/files/2024-03/MATS_Policy_Brief_Final.pdf	2024-07-15T06:09:09+00:00	crawl-data/CC-MAIN-2024-30/segments/1720763514659.22/warc/CC-MAIN-20240715040934-20240715070934-00000.warc.gz	912,724,642	4,300	eng_Latn	eng_Latn	0.941127	eng_Latn	0.978381	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 2070, 5664, 9053, 12387, 14550, 19535, 20783 ]	[ 1.453125, 1.125 ]	[ 4.625, 3.1875 ]	[ 3.078125, 2.203125 ]	[ 1.25, 0.76953125 ]	1	0	HuggingFaceFW/finepdfs
Mount Washington Resort Community Fire Protection Service Establishment Bylaw The following is a consolidated copy of the Mount Washington Resort Community Fire Protection Service Establishment Bylaw No. 433, 2016 and includes the following bylaws: This bylaw may not be complete due to pending updates or revisions and therefore is provided for reference purposes only. Titles and whereas clauses may be different than in original bylaws to make this consolidated version more clear and identify historical changes and conditions. THIS BYLAW SHOULD NOT BE USED FOR ANY LEGAL PURPOSES. Please contact the corporate legislative officer at the Comox Valley Regional District to view the complete bylaw when required. COMOX VALLEY REGIONAL DISTRICT BYLAW NO. 433 A bylaw to establish a service to provide fire protection to the Mount Washington resort community WHEREAS under section 332 of the Local Government Act (RSBC, 2015, C. 1) a regional district may operate any service the board considers necessary or desirable for all or part of the regional district; AND WHEREAS the board of the Comox Valley Regional District wishes to establish a service to provide fire protection to the Mount Washington resort community; AND WHEREAS the approval of the inspector of municipalities has been obtained under section 342 of the Local Government Act (RSBC, 2015, C. 1); and AND WHEREAS the approval for the participating areas was obtained by assent of the electors under section 344 of the Local Government Ac (RSBC, 2015, C. 1); NOW THEREFORE the board of the Comox Valley Regional District in open meeting assembled enacts as follows: Service 1. (1) The service established by this bylaw is to provide fire protection to the Mount Washington resort community. (2) The service shall be known as the Mount Washington resort community fire protection service (the 'service'). Boundaries 2. The boundaries of the service shall be that portion of Electoral Area 'C' (Puntledge – Black Creek) as identified in schedule 'A' attached to and forming part of this bylaw. Participating areas 3. Electoral Area 'C' (Puntledge – Black Creek) includes the participating area in the service. Cost recovery (a) property value taxes; 4. As provided in section 378 of the Local Government Act (RSBC, 2015, C. 1), the annual cost for this service shall be recovered by one or more of the following: (b) parcel taxes; (d) revenues raised by other means authorized by the Local Government Act (RSBC, 2015, C. 1) or another Act; and (c) fees and charges imposed under section 363 of the Local Government Act (RSBC, 2015, C. 1); (e) revenues received by way of agreement, enterprises, gift, grant or otherwise, Maximum requisition 5. In accordance with section 339(1)(e) of the Local Government Act (RSBC, 2015, C. 1), the maximum amount that may be requisitioned annually for the cost of the service is the greater of $150,000.00 or $1.15 per $1,000 applied to the net taxable value of land and improvements for regional hospital district purposes. Citation This Bylaw No. 433 may be cited as "Mount Washington Resort Community Fire Protection Service Establishment Bylaw No. 433, 2016".	<urn:uuid:679f17b8-12ce-48eb-96cf-f427dd3be7cd>	CC-MAIN-2019-04	https://www.comoxvalleyrd.ca/sites/default/files/uploads/bylaws/bylaw_433_mtwashington_fire_services_est_consolidated.pdf	2019-01-22T01:16:09Z	crawl-data/CC-MAIN-2019-04/segments/1547583822341.72/warc/CC-MAIN-20190121233709-20190122015709-00143.warc.gz	750,801,564	714	eng_Latn	eng_Latn	0.986804	eng_Latn	0.987139	[ "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 716, 2704, 3186 ]	[ 0.474609375 ]	[ 1.4765625 ]	[ 1.96875 ]	[ 2.65625 ]	1	0	HuggingFaceFW/finepdfs
Contact(s): Kimberly Marsh Phone: 951.491.6300 Tina Graham 951.491.6300 Email: email@example.com firstname.lastname@example.org WestMar Commercial Real Estate Announces Recent Transactions TEMECULA, Calif. (Nov. 5, 2014) – WestMar Commercial Real Estate, a leading local real estate services firm, today announced the following transactions: Sales The Pechanga Band of Luiseno Indians purchased 19.8 acres of land from SPM Wolf Canyon, LLC. The property is located at the corner of Pechanga Parkway and Wolf Valley Road. Scott Forest and Fred Grimes of WestMar Commercial Real Estate represented the seller in the transaction. Malcolm Carter Enterprises purchased a 12,000 square foot multi-tenant industrial building from the Robert G. Andrei & Dawn M. Andrei Trust. The property is located at 831 N. Ramona Boulevard, in San Jacinto. Jerry Palmer of WestMar Commercial Real Estate represented the seller in the transaction. Leases Lori Torok, dba Eloia Healing Arts, leased 736 square feet of office space for two years within the Packard Professional Building from Zensei, LLC. The space is located at 41690 Enterprise Circle North, Suite 110. Lessee will be operating a meditative healing business at this location. Luanne Palmer and Jerry Palmer of WestMar Commercial Real Estate represented both parties in the transaction. Yamei Education and Counseling Center, Inc., dba Yamei Tutoring Center, leased 1,300 square feet of retail space for five years within Margarita Center from Mon Mon, LLC. The space is located at 39540 Murrieta Hot Springs Road, Suite 228, in Murrieta. Lessee will be operating a tutoring center at this location. Scott Forest of WestMar Commercial Real Estate represented both parties in the transaction. news release for immediate release Page 2 11/5/13 WestMar Commercial Real Estate Announces Recent Transactions Tercingmegkat, Inc., dba Massage Green, leased 2,400 square feet of retail space for five years within The Shops at Clinton Keith from CKSH Partners, LLC. The space is located at 32100 Clinton Keith Road, Suite D/E, in Wildomar. Lessee will be operating a massage studio at this location. Scott Forest of WestMar Commercial Real Estate represented the lessee in the transaction. Ronnie Renner Racing, Inc., dba Ride Out Productions, leased 3,738 square feet of industrial space for one year to expand its space within Westside Tech Center. The space is located at 42045 Remington Avenue, Suites 106 and 107. Lessee operates a competitive dirt bike racing business at this location. Luanne Palmer of WestMar Commercial Real Estate and Christopher Masino of Masino Industrial Consulting represented both parties in the transaction. Perceptyx, Inc. leased 11,284 square feet of office space for five years within Turner Commerce Center from Turner Temecula, LLC. The space is located at 28765 Single Oak Drive, Suite 250. Lessee will be operating a software development business at this location. Luanne Palmer and Jerry Palmer of WestMar Commercial Real Estate represented the lessee in the transaction. Medhat Agaibi, dba J & D Pizza, leased 1,200 square feet of retail space for ten years within Murrieta Springs Plaza from Murrieta Springs Retail Group, LLC. The space is located at 25320 Madison Avenue, Suite E, in Murrieta. Lessee will be operating a pizza restaurant at this location. Scott Forest of WestMar Commercial Real Estate represented both parties in the transaction. About WestMar Commercial Real Estate Based in Temecula, California and founded in 1988, WestMar Commercial Real Estate is one of the leading commercial real estate brokerage firms in Southwest Riverside County, with professionals specializing in office, industrial, retail, investment and land property types. Our collaborative platform enables us to help landlords, tenants, buyers, sellers and investors maximize the value of their real estate and align it with overall business strategy. ### WestMar Commercial Real Estate 41623 Margarita Rd, Suite 100, Temecula, CA 92591 \| 951.491.6300 main \| 951.491.6330 fax \| www.WestMarCRE.com	<urn:uuid:30923f3e-3e08-41ed-bfd4-601451cb4eef>	CC-MAIN-2018-51	http://www.westmarcre.com/pdf/press/WestMarCRE.MediaRelease.November2014.pdf	2018-12-18T23:34:11Z	crawl-data/CC-MAIN-2018-51/segments/1544376829997.74/warc/CC-MAIN-20181218225003-20181219011003-00209.warc.gz	488,570,348	948	eng_Latn	eng_Latn	0.957581	eng_Latn	0.958985	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 1798, 4120 ]	[ 0.16796875 ]	[ 0.9609375 ]	[ 1.6953125 ]	[ 2.296875 ]	1	2	HuggingFaceFW/finepdfs
Answer all questions from Part-A and Part-B. Part – A (8 X 5 = 40 Marks) (Short Answer Type) 1. Methylotrophs 2. Enzyme unit 3. Substrate-level phosphorylation 4. Glyoxylate cycle 5. Alleles 6. Frame shift mutations 7. Wobbel hypothesis 8. Vectors Part – B (4 X 15 = 60 Marks) (Essay Answer Type) 9. a) Discuss the nutritional requirements of micro-organisms in detail. OR b) Give an account on enzyme properties and their classification. 10. a) Describe the TCA cycle in detail with its metabolic significance. OR b) Describe the lactic acid fermentation in detail. 11. a) Describe briefly the semiconservative replication of DNA. OR b) Give an account on types of DNA damage and repair mechanisms. 12. a) Give an account on types of RNA and their functions. OR b) What are genomic and cDNA libraries? Give their importance in gene cloning.	<urn:uuid:356ea268-a35d-42f9-bc93-08d6bf082e7f>	CC-MAIN-2018-43	http://stpiouscollege.org/pdf/exams/oqp/bsc2016-micro-2yr.pdf	2018-10-22T22:44:00Z	crawl-data/CC-MAIN-2018-43/segments/1539583515555.58/warc/CC-MAIN-20181022222133-20181023003633-00401.warc.gz	335,382,711	231	eng_Latn	eng_Latn	0.944985	eng_Latn	0.944985	[ "eng_Latn" ]	false	rolmOCR	[ 878 ]	[ 1.234375 ]	[ 3.59375 ]	[ 2.625 ]	[ 2.5625 ]	1	1	HuggingFaceFW/finepdfs
Thermite additive manufacturing feedstocks S. M. La Vars 1 , M. G. Morgan 1 , J. S. Brusnahan 1 * 1 Defence Science and Technology Group P.O. Box 1500, Edinburgh, SA 5111, Australia *email: firstname.lastname@example.org Abstract: Thermites are mixtures of metals and metal oxides that are traditionally valued for their high reaction temperature, low gas production, molten solid reaction products and low explosive sensitiveness. This makes these formulations ideal for cutting, welding, and incendiary devices that require controllable burn rates and optimum heat production. Traditional thermites are used in powdered or block form. This requirement limits the geometry of thermite charges and can restrict their application. The pressing of thermite blocks is a process that has inherent hazards, and the final products can have mechanical or ignition failures, especially when multiple blocks are required to produce the desired effect (e.g. variable burn rates). A potential means of overcoming the geometric limitations and hazards associated with the production and handling of traditional thermite formulations is to employ additive manufacturing (AM). AM represents a means of producing energetic materials with bespoke, multi-material charge geometries that offer tailored energy release, improved safety and handling as well as on-demand production. Complex three-dimensional architectures can be obtained by the sequential layering of energetic material via extrusion-based additive manufacturing technologies, but the successful use of such AM techniques requires the development of thermite feedstocks that are compatible with the printer technology in question. This paper provides outcomes of initial AM-compatible thermite feedstock development research centred on satisfying ingredient compatibility and safe handling and processing whilst meeting nominal performance requirements. Results will be presented for traditional copper(II) oxide (CuO)/aluminium and bismuth(III) oxide (Bi2O3)/aluminium powder-based thermites and these will be compared with solvent-based, bindercontaining feedstocks that employ the same fuel-oxidiser constituents, with identical stoichiometry and that are suitable for extrusion-based AM. Keywords: thermite, additive manufacturing, extrusion, sensitiveness, simultaneous differential thermal analysis 1. Introduction Thermite compositions are reactive mixtures that consist of a metal oxide and a metal. Traditional thermites are mixtures of iron oxide and aluminium; however thermites can be prepared using other metals (e.g. magnesium, titanium) and a range of metal oxides (e.g. copper(II), bismuth(III), molybdenum(VI), manganese(II), chromium(III), lead(II, IV) oxides) depending on the desired pyrotechnic effect [1-3]. Thermites are typically used in applications that require a high concentration of heat, little to no gas production, the formation of solid reaction products, controlled burn rate that is independent of ambient pressure (e.g. underwater or in space), and insensitiveness to most ignition stimuli [1-3]. Common applications for thermite compositions are pyrotechnic devices for cutting, welding, and perforating, as well as incendiary devices [2]. Traditionally, due to the limitations of current production methods, thermites are used in powdered or block form. This limits the geometry of thermite charges and can restrict their application. For instance aluminium thermites do not press well and can be prone to both mechanical and ignition failures, especially when multiple blocks are required to produce the desired effect (e.g. variable burn rates) [1-3]. Recently, there has been a strong interest in the additive manufacturing (AM) of energetic materials to realise bespoke three-dimensional architectures that can improve their performance (e.g. propellants) and broaden their operational flexibility [4]. Similarly, the use of AM technologies in the production of thermites offers a potential means to overcome some of the current limitations of traditional thermites. These thermite AM feedstocks can allow compositions to be produced in novel architectures at low cost, and the tailoring of energy outputs through these architectures, whereas traditionally one had to rely on changing the formulation to meet new energy requirements. Other advantages of the AM of thermites are in the improved safety and handling characteristics of energetic AM feedstocks in comparison to traditional production methods. This technology enables remote production and in situ mixing of ingredients, reducing operator contact with the thermite, and removes the need to press loose powders. Inert feedstocks can also be prepared and combined at the point of printing, eliminating the need to store and transport energetic material. However, to achieve this will require the identification of suitable AM technologies and the development of AM-suitable feedstocks. Current AM technology is divisible into seven main categories; material extrusion, vat photopolymerisation, material jetting, binder jetting, sheet lamination, powder bed fusion and direct energy deposition [5-8]. Not all of these techniques are suitable for use with energetic materials, with the directed energy deposition and powder bed fusion categories being particularly ill-suited due to higher energy requirements and greater potential for accidental ignition. Material extrusion, which encompasses techniques such as fused deposition modelling (FDM) and direct ink writing (DIW), is of particular interest as an AM technology as it allows for great flexibility in feedstock materials; solid filaments, powders, pastes and inks [6, 7] and achievable multi-material architectures. Material extrusion AM consists of moving material through a nozzle onto a build platform, building three-dimensional structures layer-by-layer. The advantages of material extrusion over other technologies include low cost, geometric consistency, a wide variety of available binders, and lower quantities of energetic material feedstocks required for a given object compared to other AM technologies [5, 9]. This work describes the development of suitable thermite feedstocks for use with extrusion based AM technologies. The ignition sensitiveness of these thermite AM feedstocks were compared to traditional thermite compositions, the chemical compatibility of the ingredients was determined, and the impact of feedstock formulation on the pyrotechnic output was also examined. 2. Materials and Methods 2.1. Materials It should be noted that pyrotechnic compositions are highly energetic and that suitable safety precautions must be employed when working with them to minimise the likelihood of inadvertent ignition. The reagent grade ingredients used to produce thermite mixtures were copper(II) oxide (CuO) (Sigma-Aldrich), bismuth(III) oxide (Bi 2 O 3 ) (Sigma-Aldrich), and Standart Pyro 5413 H Super aluminium (Al) powder (ResChem Technologies). The thermoplastics polymethyl methacrylate (PMMA) and polylactic acid (PLA) (Sigma-Aldrich, Australia) were employed as the AM binder. Dichloromethane (Bio-Strategy) was selected as an appropriate solvent for this investigation. 2.2. Thermite Preparation After drying the thermite ingredients overnight at 100 °C, a maximum of 10 g of each composition was prepared by weighing out the ingredients required for each formulation and fully combining the thermite ingredients using a WAB Turbula mixer (50 rpm for 20 minutes). Both inert and thermite AM formulations were produced by predissolving the selected binder in a minimal amount of dichloromethane. The thermite or inert solids were then hand mixed with the predissolved binder solution. The feedstocks were allowed to cure by evaporation of the solvent under ambient conditions. Initially, formulations consisting of binders and individual thermite ingredients were qualitatively assessed for structural integrity and homogeneity before proceeding to the production of thermite compositions. The properties of the cured inert formulations were visually inspected for testing as potential energetic AM feedstock. 2.3. Modelling Thermodynamic equilibrium calculations were performed on the binary thermite formulations with FactSage 7.0 (Thermfact/CRCT and GTTTechnologies) [10]. The particular databases used were FactPS, FToxid, and a custom database containing thermodynamic data for CuO, Bi2O3, and Al. The custom database was professionally built by The Spencer Group, Inc. using available literature data [10]. All simulations assumed a constant pressure of 1 atm with the reactants initially at 298.15 K. The analyses were performed in adiabatic mode ( H = 0). The results consist of predicted adiabatic reaction temperatures (Tad) and the thermodynamic products at those temperatures. Possible thermodynamic equilibrium products included neutral species in the gas, liquid, and solid phases. 2.4. Characterisation Scanning electron microscope (SEM) images of the thermite ingredients were captured using an FEI Inspect F50 SEM. Particle sizing was performed using a Mastersizer 2000, with water as the dispersant. Initial flame ignition testing was achieved through the application of a burning safety match to 0.5-1.0 g of the thermite AM formulations deposited on a square of aluminium foil. This initial attempt was followed by application of a MAPP gas blowtorch if match ignition failed. All still and video images were captured using a Sony Alpha (SLTA58) DSLR camera. Post processing of the videos was undertaken utilising Windows Live Movie Maker (Version 2011, Build 15.4.3555.0308) by Microsoft Corporation (2010). Sensitiveness data was measured in accordance with established protocols [11]. Friction sensitiveness was measured using a Julius Peters BAM friction apparatus and the values reported represent the lowest setting at which a 10 mg sample initiated; 6 repetitions of the experiment at the next lower setting produced nil initiations. Sensitiveness to impact was determined utilising a Rotter Impact apparatus (DST Group). The experiment was repeated 25 times utilising 30 mg samples with a standard drop weight of 5 kg and the reported values for Figure of Insensitiveness (F of I) were standardised to RDX (F of I = 80). A 'go' event was determined via visual inspection of the rotter caps indicating a colour change, presence of charring and/or smoke. Temperature of Ignition (T of I) was determined utilising 200 mg samples heated (in duplicate) at 5 °C/min to a maximum temperature of 400 °C within a shielded heating block. Sensitiveness to electrostatic discharge (ESD) was measured by passing electrical discharges of 4.5 J, 0.45 J and 0.045 J through ≈ 10 mg samples utilising purpose-built equipment (DST Group). Chemical compatibility of the various ingredients was examined using both Pressure Vacuum Stability Test (PVST) analysis (TNO and Tamson Instruments TC 16) and Simultaneous Differential Thermal (SDT) analysis (TA Instruments, Q600). Duplicate samples consisting of neat binder and thermite ingredients and 1:1 mixture by weight of each ingredient combination were prepared. For PVST, each sample was placed into an evacuated test tube in a water bath at 100 °C for 48 hours. The stabilised pressure inside the test tubes was measured before and after the heating process, and the amount of gas per gram of material was calculated. The amount of gas per 5 g of mixture was then compared to the amount of gas per 2.5 g of neat ingredient. Less than 5 mL of gas produced by any reaction between the ingredients indicates the ingredients are compatible. For SDT analysis, a total mass of 3-7 mg of each sample was heated in an alumina pan at 10 °C/min to a final temperature of 600 °C, under a nitrogen atmosphere with a flow rate of 50 mL/min. A comparison was then made of the SDT curve features of the compositions and the neat ingredient control samples. Chemical compatibility was determined by the degree to which the thermal features of the composition trace differed from the control. The tolerances for chemical compatibility are as follows: A difference of <4 °C indicates chemical compatibility, a difference of between 4-20 °C indicates a degree of chemical incompatibility, and a difference of >20 °C indicates chemical incompatibility [12]. 3. Results and Discussion 3.1. Modelling To determine the weight ratios of each oxidiser and aluminium required for optimum thermite performance, thermodynamic modelling was conducted using the FactSage 7.0 software. The plots for potential CuO/Al and Bi2O3/Al thermite reactions are shown in Figure 1. The desired pyrotechnic effect may be obtained by maximising temperature output, or amount of gaseous or liquid products. For instance, cutting applications may require a high reaction temperature, while thermite welding or rockbreaking may require the production of molten or gaseous products, respectively. The FactSage modelling predicted the maximum adiabatic flame temperature and reaction products, including their physical state (solid, liquid, gas) for a range of possible oxidiser wt% values. The thermodynamic modelling suggests the maximum possible temperatures produced by the CuO/Al and Bi2O3/Al thermite reactions are 2566 °C and 2917 °C, respectively. A summary of potential mix ratios suggested by the modelling to maximise temperature output, gaseous reaction products and liquid reaction products is presented in Table 1. Table 1: Oxidiser wt% and predicted output of thermites with optimal temperature, gas and liquid production As a result of the thermodynamic modelling, the ingredients were used to produce close to stoichiometric thermite compositions, as these ratios were determined to provide optimal performance through heat output, within a reasonable margin of error; CuO/Al (80:20 wt%) and Bi2O3/Al (90:10 wt%). 3.2. Thermite Ingredient Characterisation As particle morphology and size can have a significant impact on pyrotechnic reaction rates [13], SEM images of the thermite ingredients were collected to characterise the particle shapes of the ingredients. Typical images of the Al, CuO and Bi2O3 particles are shown in Figure 2. The super fine aluminium particles (Figure 2a) were found to be angular and flake-like in appearance. The CuO particles (Figure 2b) were also angular and irregular in shape; however the particles appear less flaky and more porous. The Bi2O3 particles were found to be significantly smoother, mostly spheroidal particles (Figure 2c), with some wire-like structures scattered throughout. These particles were also more likely to appear as aggregates, and as such, extra care had to be taken during mixing to ensure the final formulations were homogeneous. Both the CuO and Bi2O3 oxidisers were determined to have similar mean particles sizes of 6.7 µm and 6.3 µm, respectively. The Al mean particle size was found to be slightly larger at 10.9 µm. Given their extensive use in AM, and desirable physical and mechanical properties the thermoplastics PMMA and PLA were selected as the AM binders to employ in this study [7, 14-16]. Dichloromethane has previously been used to successfully create highly solids loaded inks that have been utilised in the FDM of metal and metal oxides, and as such was chosen as an appropriate solvent for this work [17, 18]. Ideally, the amount of any solvent should be kept to a minimum in order to keep formulations as simple as possible and minimise other potential risks introduced by large quantities of toxic and/or flammable liquid or other chemical hazards. 3.3. Physical properties Previous studies have demonstrated high solidsloading is required in pyrotechnic AM feedstocks to avoid the dilution of energetic output, which must be balanced against the rheological properties of the feedstock and mechanical requirements of the final cured material [19]. The preparation of inert feedstocks for point-ofprinting energetic material production requires each component to be readily incorporated into binder matrices while maintaining mechanical strength at high solids loadings. As such, inert mixtures of each thermite ingredient (Al, CuO, and Bi2O3) with each binder (PLA and PMMA) at 90 wt% solids loading were prepared. These formulations were initially assessed for homogeneity and their mechanical properties qualitatively assessed by visual inspection and handling of the cured product. More rigorous testing of the mechanical properties of the final formulations will be required to precisely quantify the response of printed products to mechanical stresses. Images of the cured inert mixtures are shown in Figure 3. All of the inert mixtures cured quickly due to the fast evaporation of dichloromethane under ambient conditions. Although homogeneous, the resulting PMMA/Al mixture (Figure 3a) was found to be brittle, and readily crumbled. The PLA/Al mixture (Figure 3c) was noticeably less brittle. The SEM images show the PMMA/Al mixture (Figure 3b) consists of large particulate agglomerates held together by the binder, while the SEM images of the PLA/Al mixture (Figure 3d) present smaller particles distributed evenly throughout the binder matrix to form a more homogeneous material. It is expected that the brittleness of the PMMA formulation may be mitigated in the final thermite AM formulation, as the Al content will ultimately be <30 wt%, allowing for higher proportions of binder in any inert feedstock prepared for point-of-printing applications. Future compositions requiring greater powdered aluminium content will need to take this effect into consideration. The PMMA/CuO mixture (Figure 3e) appeared less homogeneous, with some sections of the cured material inclined to crumble, however the bulk of the material cured solid and hard. The SEM images of this formulation (Figure 3f) displayed similar particle distribution to the PMMA/Al mixture; particle agglomerates held together by the binder in a porous matrix. The PLA/CuO mixture (Figure 3g) cured rigid and tough, suggesting this binder will readily incorporate high proportions of this ingredient while maintaining good mechanical strength. As can be seen in the SEM image (Figure 3h) the CuO appeared more fully incorporated in the PLA matrix, with the particles appearing to be homogeneously distributed through the material; however the structure was obviously more porous than the PLA/Al mixture. The PMMA/Bi2O3 mixture (Figure 3i) cured rigid and tough, with the SEM images showing the solid homogeneously distributed through the binder matrix in much the same manner as the other PMMA-based mixtures (Figure 3j). This mixture also resulted in the formation of a binder "skin" over some sections of the bulk material. This is consistent with the observations made during the curing process, with skin formation typically coinciding with fast evaporation of the solvent. The PLA/Bi2O3 mixture exhibited agglomeration of Bi2O3 particles which appear to settle during cure, with loose powder and voids evident underneath the cured binder matrix (Figure 3k). The SEM images of this formulation (Figure 3l) reveal the PLA matrix, which in every other mixture appeared to evenly coat particles, in this instance appeared highly aerated and porous. This suggests potential chemical incompatibility between the Bi2O3 and PLA, resulting in the porous binder structure that is conspicuously absent in the other inert formulations. 3.4. Rheology An initial qualitative assessment of the rheological properties of potential AM feedstocks was performed. The feedstocks consisted of a 7-9 vol% solids loading in dichloromethane, with solid ingredient ratios maintained at 10 wt% binder (PLA or PMMA) and 90 wt% oxidiser (CuO or Bi2O3). For the feedstocks it was noted how readily the material extruded by hand through a 10 mL plastic syringe (internal tip diameter of 1.7 mm), in a serpentine pattern onto a glass slide. No significant clogging of the syringe tip was observed for the PLA/CuO, PLA/Bi 2 O 3 and PMMA/Bi 2 O 3 mixtures, and the resulting line spread was recorded by measuring the deposition at its thickest and thinnest points. Due to significant nozzle clogging, the PMMA/CuO mixture was unable to be assessed. The PLA/CuO and PLA/Bi 2 O 3 mixtures both showed minimal spreading, with the thinnest and thickest line widths of 2 mm and 4 mm, respectively. The PMMA/Bi 2 O 3 mixture showed much greater spreading, with the thinnest and thickest sections of the line measured at 3 mm and 5 mm, respectively. Adhesion of the dry extruded product to the glass substrate was also assessed, with both PLA mixtures adhering well to the glass substrate, and the PMMA/Bi2O3 mixture displaying a tendency to crack and peel. Multi-layer structures were also produced by adding layers with a glass pipette to both 'lines' and 'dots' of material to observe if the material adhered to itself, and whether it developed a three-dimensional structure or simply spread further upon the slide. Each layer was allowed to dry prior to subsequent depositions. All mixtures were able to be layered to develop threedimensional structure; however the PLA/Bi2O3 mixture showed signs of ingredient separation as the solvent evaporated. Overall, the PLA/CuO feedstock exhibited positive rheological properties; however the Bi2O3 feedstocks exhibited some behaviour that will require further investigation such as greater spreading of material, separation of the oxidiser from the binder and curling and cracking as the solvent evaporated. 3.5. Chemical compatibility The data provided by the various methods of chemical compatibility testing techniques is relative, and while they may each provide an indication of ingredient compatibility, the results are not absolute values. As such, a multi-faceted approach to chemical compatibility is taken, and reasonable caution should be exercised when determining the acceptability of the data. 3.5.1. Pressure vacuum stability test (PVST) The volume of gas generated by any reaction between ingredients (VR) in a mixture is calculated using the following equation: Where M is the measured volume of gas evolved from 5 g of the 1:1 mixture, E is the measured volume of gas evolved from 2.5 g of thermite ingredient, and S is the measured volume of gas evolved from 2.5 g of the polymeric binder. The V R value must be less than 5 mL for two materials to be compatible, which is equivalent to 1 mL/g of gas produced by chemical reaction in addition to the gas evolved by each ingredient alone. The average gas evolved per gram of sample and calculated V R values with associated standard deviations are shown in Table 2. Table 2: Average gas production per gram as measured by PVST, and calculated volume of gas produced by ingredient reactions per 5 g of 1:1 mixture (VR) The PVST of the control samples showed the average gas production by each neat thermite ingredient and binder was less than 1 mL. Most of the mixtures of thermite ingredients with the two binders resulted in significant VR values of <5 mL. This suggests the majority of the thermite ingredients are chemically compatible with both the PLA and PMMA binders. The Al/PLA mixture is the exception, with this combination resulting in a VR value of 5.19 mL. However, the error associated with this value encompasses the 5 mL threshold for compatibility set for PVST, suggesting further compatibility testing is required. 3.5.2. Simultaneous differential thermal (SDT) analysis The SDT heat loss and weight loss curves of the neat thermite ingredients (CuO, Bi2O3 and Al) show no significant thermal or weight change events over the 600 °C temperature range, well past the temperature of decomposition of both PLA and PMMA. Examples of the heat flow and weight loss SDT curves of PMMA and 1:1 mixtures of PMMA with each thermite ingredient are shown in Figure 4. Thermal PMMA decomposition is complicated, and the features observed during thermal analysis depend on the method of manufacture [21, 22]. The large variability in the type of polymerisation reactions and additives used during the manufacture of PMMA leads to large variability in the features of the thermal traces [21-24]. The PMMA heat flow curves consists of two distinct endothermic decomposition events at 250300 °C and 350-400 °C, which agree with previously reported initiation of unsaturated polymer chain ends (Td) and polymer backbone (T'd), respectively [25]. The heat flow curves show no obvious thermal event to indicate head-to-head interactions decomposing, nor is there an obvious melting temperature in the expected 85-170 °C range [23]. The exothermic event seen at >400 °C (To) has been observed in the literature under inert atmosphere, with exothermic decomposition also shown to occur under oxygen atmosphere over 400 °C [26, 27]. This event is occurring in the gaseous phase, with the mass loss curves indicating the solid polymer has decomposed by this point, and is likely due to monomer or other gas-phase reaction product reactions or residual random chain scissions [21, 22, 27]. It is also possible that shifts in these events observed when the polymer is combined with the thermite ingredients may be due to interactions between these decomposition products and the solid thermite components [26]. Table 3: Average chemical compatibility of PMMA and PLA with thermite ingredients determined by SDT analysis (°C) The average temperatures of the thermal events observed in the heat flow curves of PMMA and PMMA mixtures are shown in Table 3. The negative values indicate a decrease in the temperature, while positive values indicate an increase in temperature of a thermal event. The Bi2O3 shows a degree of chemical incompatibility with the PMMA, causing a shift in the temperatures at which the decomposition events in the polymer are occurring, and significantly decreasing the temperature of the exothermic event observed in the gaseous phase post-decomposition by an average of 27.4 °C. The Al also shows a degree of chemical incompatibility, by a significant shift of an average of 13.1 °C in the second decomposition event compared to neat PMMA, and a similar decrease in the exothermic event temperature to the PMMA/Bi2O3 mixture. The CuO displays a large degree of chemical incompatibility with the PMMA, with >20 °C shifts in all thermal events. This may impact the suitability of PMMA as a binder for CuO/Al thermite mixes, indicating a potential decrease in chemical stability of the mixture that may reduce shelf-life. Although it does not eliminate PMMA as a binder, it does suggest further investigation into ageing and heating effects are required. The heat flow curve of PLA shows the melting point (Tm) and the decomposition temperature (Td) of the polymer, with the decomposition occurring over the same temperature range at which the weight loss curve indicate a single mass reduction event. Similar to the PMMA traces, an exothermic event is observed occurring at >400 °C (To), past the point at which the weight loss traces indicate that the polymer has been consumed. This is also likely due to interactions between gaseous polymer decomposition products with each other and potentially with the thermite ingredients [22, 26]. Examples of the heat flow and weight loss SDT curves of PLA and 1:1 mixtures of PLA with the thermite ingredients are shown in Figure 5. The average temperatures of the thermal events observed in the heat flow curves of PLA and PLA mixtures are shown in Table 3. The negative values indicate a decrease in the temperature, while positive values indicate an increase in temperature of a thermal event. The PLA/CuO trace displayed a degree of chemical incompatibility between these ingredients, as indicated by a small shift of up to 4.9 °C in the melting point and the decomposition temperature. The PLA/Bi2O3, however, displays pronounced chemical incompatibility, as evident by the significant shift of 81.0 °C in the decomposition event compared to neat PLA. Overall, the CuO displays a much higher degree of chemical compatibility with the PLA binder compared to the PMMA, while the reverse is true for Bi2O3. The Al appears the most compatible with PLA, displaying a moderate degree of incompatibility with PMMA. These findings may translate to better performance and stability of formulations consisting of PLA/CuO/Al or PMMA/Bi2O3/Al. 3.6. Sensitiveness The sensitiveness properties of the neat stoichiometric thermite compositions and the AM thermite formulations are given in Table 4. As expected, the traditional CuO/Al thermite exhibited high thermal stability with Temperature of Ignition (T of I) values greater than 400 °C and low sensitiveness to friction. This thermite composition exhibited moderate sensitiveness to impact. However, the CuO/Al thermite displays significant ignition sensitiveness to ESD, which is of concern from a safe handling perspective. Bi2O3/Al also exhibited a similarly high thermal stability, with T of I in excess of 400 °C. However, as was the case with the CuO/Al composition, the Bi2O3 displayed very high sensitiveness to ESD. This is coupled with a greater sensitiveness to friction, and almost double the F of I value compared to the CuO/Al composition. The FactSage modelling of the Bi2O3/Al thermite indicated that for a stoichiometric mix, 80% of the predicted reaction products would be in gaseous state; which is much greater than that predicted for the CuO/Al stoichiometric composition, at only 33%. This was in agreement with observations during impact sensitiveness testing, with the average gas output of the Bi2O3/Al composition approximately 17% greater than the CuO/Al composition. As was the case with the traditional thermite compositions, the thermite AM feedstocks all exhibited high thermal stability with Temperature of Ignition (T of I) values greater than 400 °C. Table 4: Sensitiveness data for the thermite compositions The PMMA/CuO/Al and PLA/CuO/Al formulations also showed no measurable change to the friction sensitiveness, indicating no adverse increases by the inclusion of either binder. A marginal decrease in impact sensitiveness was observed in both PMMA/CuO/Al and PLA/CuO/Al formulations, although the average volume of gas produced during testing at least doubled compared to the traditional CuO/Al thermite. Of greatest significance is the reduction of the ESD sensitiveness by two orders of magnitude (0.045 to 4.5 J) by both AM thermite feedstocks compared to the traditional thermite. This result demonstrates the potentially significant improvement in the safe handling of these formulations through the reduction in ESD sensitiveness. The Bi2O3/Al AM feedstock formulations showed significant improvements in overall sensitiveness compared to the traditional thermite formulation. Both AM formulations significantly decreased the friction sensitiveness of the traditional Bi2O3/Al thermite from 168 N of force to >360 N with no observable ignition event. The inclusion of PMMA in the formulation doubles the F of I of the traditional Bi2O3/Al thermite from 40 to 80. This poses a significant reduction in impact sensitiveness. The PLA/Bi2O3/Al displayed higher impact sensitiveness compared to the PMMA/Bi2O3/Al, with an F of I of 70. This remains, however, a significant improvement compared to the neat Bi2O3/Al thermite F of I. The inclusion of both binders had no apparent impact on the volume of gas produced during an ignition event. As was the case for the CuO/Al thermite AM feedstock formulations, the combination of both binders with Bi2O3/Al resulted in a reduction of the ESD sensitiveness from 0.045 J to 0.45 J. Although this not as pronounced as the decrease in ESD sensitiveness for the CuO/Al formulations, these results still suggest potentially significant improvements in the safe handling of these formulations. 3.7. Ignition Initial formulations containing PMMA or PLA with either CuO/Al (80:20) or Bi2O3/Al (90:10) thermite, were prepared at a solid loading of 90 wt% for ignition testing. Still images of the resulting outputs are shown in Figure 6. All formulations were able to be readily ignited by the application of a flame, either from a safety match or a blow torch. Propagation of the combustion wave for the PMMA/CuO/Al formulation was inconsistent, with the composition producing sparks, popping and flashing bright white light. Quenching of the reaction was also observed before the composition was completely consumed, requiring extended application of a flame to re- ignite the remaining composition. This indicates quenching of the reaction via insufficient heat transfer along the combustion front, potentially due to too much heat being lost to the surrounding environment or poor contact between the fuel and oxidiser particles in the PMMA matrix. In contrast, the PLA/CuO/Al formulation burned evenly to completion, producing white light and minimal smoke. A reason for this increase in the reactivity of the PLA-based formulation could be attributed to the more positive oxygen balance of PLA (-133.2%) compared to that of PMMA (-191.8%), calculated based on the monomer unit of each polymer with complete oxidation to CO2. Due to the higher (i.e. more positive) oxygen balance of PLA, less oxygen is required to complete the combustion of the binder, thus ensuring that more oxygen is available to react with the aluminium fuel, when compared to that of the PMMA system. Similar trends have been previously reported in other pyrotechnic systems using non-energetic binders [20]. This suggests that the PLA/CuO/Al formulation has significant potential for future development of thermite AM feedstock from a performance perspective. Both the PMMA/Bi2O3/Al and PLA/Bi2O3/Al formulations were found to undergo sustained combustion. The PMMA/Bi2O3/Al formulation propagated with an orange flame, producing small sparks for the duration of the burn and a significant amount of smoke. Despite the heterogeneous nature of the PLA/Bi2O3/Al formulation, as evident by the bright yellow Bi2O3 agglomerates in an otherwise light grey binder matrix; the formulation was able to be ignited. After some initial sparks, this formulation propagated with an orange flame, giving off a considerable amount of smoke. 4. Conclusions This work compared the ignition sensitiveness of potential thermite AM feedstocks to traditional thermite compositions, with the aim of identifying potential improvements to the safe handling of thermites. The formulations were based on either CuO/Al or Bi2O3/Al thermites combined at 90 wt% with either PLA or PMMA binder. Ignition of each thermite AM feedstock was readily achievable through the application of thermal stimuli. It was found that these formulations are significantly less sensitive to processing and handling stimuli than the traditional thermite compositions, especially to ESD. The potential for the preparation of inert feedstocks for point-of-printing energetic material production is also possible with high solids loaded (90 wt%) binder matrices. This indicates that the utilisation of such pyrotechnic feedstocks for AM technologies may provide significant safety advantages over traditional production methods. 5. Future Work Work investigating the rheological properties of additive manufacturing feedstocks, potential utilisation of additives and further optimisation of formulations is ongoing as this emerging technology continues to change the landscape of energetic material production. 6. Acknowledgements The authors wish to thank Craig Wall, Joel Huf and Mark Mitchell for their assistance with sensitiveness testing. Phil Davies, Chad Prior and Andrew Hart are thanked for helpful discussions and for reviewing this manuscript. 7. Symbols and Abbreviations Simultaneous Differential Thermal 8. References 1. Shidlovskiy, A. A. (1997) Principles of Pyrotechnics, American Fireworks News 2. Fischer, S. and Grubelich, M. (1996) A survey of combustible metals, thermites, and intermetallics for pyrotechnic applications. In: 32nd AIAA/ASME/SAE/ASEE Joint Propulsion Conference and Exhibit, Lake Buena Vista, Florida, USA 3. Conkling, J. A. and Mocella, C. J. 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Adsorption Science & Technology 35 (5-6) 560-571 27. Holló, B. B., et al. (2014) Determination of natural rubber/poly(methyl methacrylate) blend composition by TG/DSC technique. Journal of Thermal Analysis and Calorimetry 119 (2) 1131-1137	<urn:uuid:000372bd-543e-4c09-8e69-413017b2dcd4>	CC-MAIN-2020-40	https://www.unsw.adfa.edu.au/conferences/sites/conferences/files/uploads/Session%201A%20Thermite%20Additive%20Feedstocks%20La%20Vars%20Research%20Paper.pdf	2020-09-25T17:30:13+00:00	crawl-data/CC-MAIN-2020-40/segments/1600400227524.63/warc/CC-MAIN-20200925150904-20200925180904-00534.warc.gz	1,088,093,597	8,908	eng_Latn	eng_Latn	0.964808	eng_Latn	0.9915	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 4327, 9692, 13175, 15174, 18030, 22726, 24880, 28469, 30763, 34376, 40436 ]	[ 0.82421875, 0.8125 ]	[ 4.25, 4.125 ]	[ 3.109375, 3.375 ]	[ 2.4375, 2.6875 ]	1	0	HuggingFaceFW/finepdfs
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Basketball Trivia Quiz \| How well you know Basketball MCQ ... Browse from thousands of Basketball questions and answers (Q&A). Become a part of our community of millions and ask any question that you do not find in our Basketball Q&A library. 47 Best Basketball Questions and Answers (Q&A) - ProProfs ... So for this, we have created a list of "baseball trivia questions and answers." Trivia quiz game is the best way to learn more about baseball and its incredible moments, so read the complete article to know more about the "baseball trivia questions." ... 57+ Basketball Trivia Questions with Answers(NBA) 100+ all time best cricket trivia ... 55+ Baseball Trivia Questions with Answers(quiz) Page 2/3 Copyright : laredosbargainbook.com Where To Download Basketball Quiz Questions And Answers For Kids Sports trivia questions for kids give them a clear concept about many facts of sports. S ports trivia questions for kids is not only interesting for the children, but also for any other. Older people also should check these sports trivia questions for kids if anything interesting found.. Let's solve these sports trivia questions for kids alone or with your friends. Copyright code : 379fca924ec79506c4d7b6adfb716c75 Page 3/3	<urn:uuid:44b8dac2-ca4b-42b0-9a71-12f7e1c1a9d6>	CC-MAIN-2021-31	http://laredosbargainbook.com/cgi-bin/content/view.php?data=basketball_quiz_questions_and_answers_for_kids_pdf&filetype=pdf&id=379fca924ec79506c4d7b6adfb716c75	2021-07-29T09:52:10+00:00	crawl-data/CC-MAIN-2021-31/segments/1627046153854.42/warc/CC-MAIN-20210729074313-20210729104313-00261.warc.gz	26,766,686	1,949	eng_Latn	eng_Latn	0.993591	eng_Latn	0.993411	[ "eng_Latn", "eng_Latn", "eng_Latn" ]	false	docling	[ 4548, 8176, 8708 ]	[ 1.1875 ]	[ 0.88671875 ]	[ 1.2265625 ]	[ 1.25 ]	2	1	HuggingFaceFW/finepdfs
Issue 6: What to do with Phase 8 Archiving in GSBPM? Durning yesterday's meeting, there was considerable discussion on the usefulness of Phase 8 Archiving, particularly in metadata-driven systems. At Statistics Canada, we have the concept of a data service centre layer in the business process model. A data service centre uses a common set of technologies and standards to store, organize and access statistical information as well as applying common information management practices. One option to explore is to have an additional overarching "management" layer called Information Management of Statistical Information instead of Phase 8. Please indicate your support for this change using the stars and legend below 5* (We should do this) 3* (I am not sure, we need to discuss) 4* (Good idea, but need to discuss) 2* (Should not make the change, but need to discuss) 1* (Should not make this change) Your Rating: Results: 12 rates	<urn:uuid:16d4aaca-7f0c-4975-8f6a-486d12da50fb>	CC-MAIN-2016-30	http://www1.unece.org/stat/platform/download/temp/pdfexport-20160727-270716-2112-6551/GSBPM-89261599-270716-2112-6552.pdf?contentType=application/pdf	2016-07-27T19:12:30Z	crawl-data/CC-MAIN-2016-30/segments/1469257827077.13/warc/CC-MAIN-20160723071027-00015-ip-10-185-27-174.ec2.internal.warc.gz	829,508,110	196	eng_Latn	eng_Latn	0.992462	eng_Latn	0.992462	[ "eng_Latn" ]	false	docling	[ 941 ]	[ 0.53125 ]	[ 2.515625 ]	[ 2.578125 ]	[ 2.171875 ]	4	2	HuggingFaceFW/finepdfs
A BETTER WAY TO BUILD ANALYTICAL APPLICATIONS BUILD ENTERPRISE APPLICATIONS AT THE SPEED OF EXCEL Open APIs Throughout \| Build-It-Once Modularity \| Enterprise-Ready Scalability \| Fast Dev Cycles DASHBOARDS THAT THINK AND DO. FAST. Maven dashboards help you discover, share and act. Our agile framework allows for near-time updates, dynamic drill-downs, hover-overs, data editing and actions. DON’T BUILD YET ANOTHER DATABASE. AGILE, DYNAMIC QUERIES. Mavenomics Query Language (MQL) allows developers to use SQL-like queries to pull data from many sources, aggregate, calculate and present in a few lines of a reusable query. SOPHISTICATED COMPONENTS. YOURS OR OURS. Our platform comes with rich tools, but also allows you to bring in your own or a 3rd party’s. Write your own components in common languages including JavaScript and C#. THE MAVENOMICS FRAMEWORK. OPEN AND FLEXIBLE. Easily access data across multiple sources and types. Use our powerful included calculation parts or leverage your own. Bring the results to our dashboards, into your own applications or export to build automated, rich reports. MORE AGILITY. LESS RISK. Key Features - Built-in calculation engine - Open .NET APIs - Near-time performance - Large library of pre-built functions and visualizations - Sophisticated, SQL-like query language Selected Use Cases In Finance - PnL Monitoring - Allocations across strategies - Limit Monitoring - Back-testing - Position Monitoring - Risk Management In Business - Customer Behavior Analysis - Business Analytics and Insights - Business Insights - PnL Monitoring across business lines BE NIMBLE - Modular: reuse almost anything - Scalable: installs in minutes, scales to the enterprise - Extensible, yet rich toolbox out-of-the-box - Data Agnostic: any data from almost anywhere MAINTAIN CONTROL - One source of truth firm-wide - Enterprise access controls - Central management, deployment, auditing - Robust version control Benefits For Business Users - Get new applications quickly - even for complex workflows and calculations - Access data from nearly any source and easily combine new data sources For Developers/IT - Do-it-once with modular architecture - Build applications faster - Collaborate better with faster rev cycles - Centrally control and deploy For the Organization - No more production Excel spreadsheets - One source of truth - Centralized access to critical information - More productivity, less risk Copyright ©2014. All Rights Reserved. \| Mavenomics, Inc. \| http://www.mavenomics.com	<urn:uuid:fb57bdc0-9c0e-4796-8a8d-43b5ba06a2e2>	CC-MAIN-2019-39	http://www.mavenomics.com/old-site/datasheet/MavenomicsDataSheet.pdf	2019-09-19T23:12:30Z	crawl-data/CC-MAIN-2019-39/segments/1568514573759.32/warc/CC-MAIN-20190919224954-20190920010954-00049.warc.gz	280,469,199	571	eng_Latn	eng_Latn	0.978923	eng_Latn	0.981894	[ "eng_Latn", "eng_Latn" ]	true	rolmOCR	[ 1119, 2551 ]	[ 0.486328125 ]	[ 1.515625 ]	[ 1.390625 ]	[ 2.921875 ]	1	0	HuggingFaceFW/finepdfs
Ian Gould PRESENTS England, Wales and Dublin Invasion November 19 - 27, 2023 $3,295 Per Person Double Occupancy from Chicago VisitBritain Ireland Welcome to Wrexham AN ORIGINAL DOCUMENTARY SERIES FROM WRYAN REYNOLDS & WROB McELHENNEY THIS ISN'T THEIR FIELD OF EXPERTISE. Visit Wales Croeso Cymru This is an exclusive travel program presented by InterTrav Corporation Sun., Nov. 19 - CHICAGO / EN ROUTE Depart Chicago’s O’Hare International Airport on our nonstop trans-Atlantic flight to London, England. (I) Mon., Nov. 20 - LONDON / BIRMINGHAM This morning we arrive in London and are met by our motor coach for the drive north to Birmingham. Along the way we visit Warwick Castle, a medieval castle developed from an original built by William the Conqueror in 1068. Here we will experience one thousand years of jaw-dropping history at Warwick Castle; great battles, ancient myths, spellbinding tales, pampered princesses, and heroic knights bring the history to life. A short drive remains to Birmingham and our hotel for the next two nights. (I) Tues., Nov. 21 - BIRMINGHAM This morning we are off on a Peaky Binders sightseeing tour - The Peaky Blinders are looking for new recruits so join Edward Shelby a distant cousin of the real-life Birmingham Gang as he shows you around the city and teaches you the ropes of being a Peaky Blinder. Mr Shelby has just returned from America after working with the Irish Mob in Boston selling prohibition alcohol and is looking for new recruits to help expand the Peaky Blinder empire around the world. Do you have what it takes to be a Peaky Blinder? On this tour, you will learn about the history of gangs in Birmingham as well as the cultural change the city has experienced in its rich history. You will also discover the impact Birmingham has had on the rest of the world be it the tea plantations of India or the slave ships of Africa. This afternoon is free in Birmingham, depending on schedules we will possibly attend a horse racing or football match. (B) Wed., Nov. 22 - BIRMINGHAM / LIVERPOOL We depart Birmingham this morning and drive into Wales to visit the town of Wrexham. If available we will visit the Wrexham Racecourse Ground, a football stadium in Wrexham, Wales. It is the home of Wrexham A.F.C. It is the world's oldest international football stadium. Next we will have lunch in a local pub and if we are lucky will learn a bit of Welsh. This afternoon we travel through Chester on our way to Liverpool and our hotel. (B,L) Thurs., Nov. 23 - LIVERPOOL This morning we’ll embark on our own Magical Mystery Tour with our expert guide Jay Johnson - you may remember his brother, Holly Johnson, from the band “Frankie Goes to Hollywood.” We’ll see the former schools of John, Paul, George and Ringo including Liverpool Art College and LIPA, and their childhood homes, as well as the former home and school of The Beatles manager, Brian Epstein. We’ll visit Penny Lane, and the many places mentioned in the song, including the bank, the barber shop and the shelter in the middle of the roundabout. We’ll see St. Peter’s Church Hall, where John and Paul met for the first time, Eleanor Rigby’s grave, and of course, Strawberry Fields. We’ll explore Mathew Street to see the many places associated with the Beatles, including the pubs where they went for a drink when the Cavern was a coffee bar, and finish the tour at the legendary Cavern Club where The Beatles performed in the early 1960s. The afternoon is at leisure before we meet up again this evening for the Ian Gould’s gig at the Cavern! (B) Fri., Nov. 24 - LIVERPOOL (Manchester) This morning we travel to nearby Manchester where we visit Old Trafford Stadium, the world-famous home of Manchester United. We will visit the Museum & tour the Stadium at Old Trafford. We will walk in the footsteps of greatness. We will have time to explore all the Museum has to offer. The Stadium Tour is next and follows a great route, so you'll see the players' tunnel, walk next to the world famous pitch, and visit the dugouts, before getting the view from the Ability Platform. There will be plenty of time for pictures, too. Afterwards there will be time to pop into the Red Café for a bite to eat. This afternoon we visit the National Football Museum. England's national museum of football. The National Football Museum offers a fun-packed visit for those wanting to learn more and about the country's favorite game. With four galleries to explore, six interactive games, plus an exciting program of exhibitions and workshops, there's something for everybody to enjoy. Late this afternoon, we return to Liverpool to enjoy dinner at our hotel. (B,D) Sat., Nov. 25 - LIVERPOOL / DUBLIN This morning an early departure from Liverpool will take us across Northern Coast Wales to Isle of Anglesey. Here we bid farewell to our British Driver and board the ferry that will take us across the Irish Sea to Dublin. We arrive in Dublin just in time to enjoy lunch at the Guinness Store House followed by a tour of Guinness. We will see exhibits on how this world famous stout was first created and why it is so popular today. We finish our visit in the roof-top bar, Gravity, overlooking the city center where you can sample a draft Guinness and enjoy the view of the city. Next, we make our way to the Jameson Distillery, nestled in the heart of Smithfield you can’t miss the distillery. It’s unmissable. And the Jameson Distillery Bow St. Experience is a must for visitors to the capital. Our Ambassador will show you around, take you back in time, and serve up an award-winning tour that includes stories, laughs, and a Jameson comparative whiskey tasting. You’ll also get to hear all about our ‘Grain to Glass’ process. At the end of your visit, you can enjoy a Jameson drink in the spot where it all began. We finish the day off with a pint at Connor McGregor’s Pub. (L) Sun., Nov. 26 - DUBLIN Today is free in Dublin to explore the city on our own. Perhaps a visit to wonderful Grafton Street to see Molly Malone or a stroll around Temple Bar with its delightful pubs with music coming out of every door way. This evening we end our holiday with a bang at the Irish House Party live traditional Irish music and Irish dancing at its very best. Lap up the pure talent of these All Ireland champion musicians, dancers and entertaining presenters, voted as one of the top ten things to do in Dublin year after year. (B,D) Mon., Nov. 27 - DUBLIN / CHICAGO All too soon, our vacation has come to the end. After breakfast we transfer to Dublin Airport in plenty of time to check in for our flight. You may do some last minute shopping at the duty free stores before boarding your flight returning us to the USA. We change planes on the East coast for the short flight to Chicago. (B,I) * * * Welcome Home * * * I = In-flight Meal, B = Breakfast, L = Lunch, D = Dinner --- The Vacation Price Includes: - Economy-class air transportation by scheduled flights: Chicago/London – Dublin/Newark /Chicago - Meals and light beverages served in-flight according to airline schedules - Transportation by deluxe air conditioned private motor coach - Accommodations in three and four star hotels in twin-bedded rooms with private bath or shower - Sightseeing as detailed in the itinerary and entrance fees to included excursions - Meals as indicated in the tour itinerary. - Luggage handling and porterage charges for one suitcase per person at hotels - Airport departure taxes, security fees, and fuel surcharges (subject to change) of $239, and taxes for included ground services The Vacation Price Does Not Include: Items of a personal nature such as passport fees and destination entry requirements, laundry and cleaning, telephone calls, optional tours and excursions, tips to the Driver, Driver/Guide and local guide(s), luggage handling at airports, personal and baggage insurance, meals other than those stated above, drinks with meals other than breakfast. TOUR CONDITIONS TOUR DEPOSIT AND PAYMENT: Reservations may be made by check or major credit card. Credit cards can be accepted for payment(s); however, the vacation price reflects a 4% cash discount. Please call InterTrav at 630-377-5840 to arrange payment by credit card; 4% of the payment amount will be assessed on credit card payments. You will be invoiced for the balance of payment due on or before FRIDAY, August 18, 2023. Reservation requests received after FRIDAY, August 18, 2023, are subject to tour availability. TOUR PRICING: The tour price is based on a minimum participation of 25 persons and includes planning, handling and operational charges and is quoted on the current rate of exchange, tariff rates and airfares in effect as of January 15, 2023. CANCELLATION: If after making your initial deposit you find it necessary to cancel from the tour for any reason, there is a cancellation charge equal to the per person deposit up to 90 days prior to departure. For cancellation between 89 and 60 days prior to departure, there is a cancellation charge equal to 50% of the tour cost. For cancellation within 59 days of departure, the cancellation charge is 100% of the tour cost. IMPORTANT: Cancellations will not be accepted by telephone and must be sent in writing to: InterTrav Corporation, 203 State Avenue, St. Charles, Illinois 60174, or emailed to email@example.com. TRAVEL PROTECTION: For your convenience, we offer a Travelex Insurance Services protection plan to help protect you and your travel investment against the unexpected. For more information and rates, please review the product flyer enclosed. If you would like to enroll, fill out the enrollment form on the back of the tour reservation form. The full coverage terms and details, including limitations and exclusions, are contained in the insurance Policy. To view/download the policy, go to policy.travelexinsurance.com/GCB-0521. Travelex Insurance Services, Inc. CA Agency License #0D10209. Travel Insurance is underwritten by Berkshire Hathaway Specialty Insurance Company; NAIC #22276, S6N. PASSPORTS AND VISAS: Your tour requires a passport valid for the duration of your travel. If you do not already have your passport, or it will expire before your return date, we suggest you apply for it immediately. No visas are required for your tour. However, if you are a citizen of a country other than the United States, you must advise us in writing with your Reservation Application, as other travel documents may be required. RESPONSIBILITY IAN GOULD and/or INTERTRAV CORPORATION, 203 State Avenue, St. Charles, Illinois 60174, and its employees, shareholders, agents, and representatives (InterTrav) uses third party suppliers to arrange tours, transportation, sightseeing, lodging, and all other services related to this tour. InterTrav is an independent contractor and is not an employee, agent, or representative of any of these suppliers. InterTrav does not own, manage, operate, supervise, or control any transportation, vehicle, airplane, hotel or restaurants, or any other entity that supplies services related to your tour. InterTrav is not affiliated with any other tour operator. All suppliers are independent contractors and are not agents or employees or representatives of InterTrav. All tickets, receipts, coupons, and vouchers are issued subject to the terms and conditions specified by each supplier, and by accepting the coupons, vouchers, and tickets, or utilizing the services, all customers agree that neither InterTrav, nor its employees, agents, or representatives are or shall not be responsible or become liable for any delay incurred or change in schedule by any person in connection with any means of transportation; nor for any loss, damage or injury to person or property or otherwise, in connection with any service supplied or not supplied resulting directly or indirectly from any occurrence beyond the control of InterTrav. by reason of any event beyond the control of any agency or supplier, or occurring without the fault or negligence of such agency or supplier. InterTrav assumes no responsibility or liability for any loss, injury or damage or loss of any traveler that may result from any act or omission on the part of others; InterTrav assumes no responsibility or liability for personal property; and InterTrav shall be relieved of any obligations under these terms and conditions in the event of any strike, labor dispute, act of God, or of government, fire, war, whether declared or not, terrorism, insurrection, riot, theft, pilferage, epidemic, pandemic, illness, physical injury, quarantine, medical or customs or immigration regulation, delay, or cancellation. InterTrav accepts no responsibility for lost or stolen items. InterTrav reserves the right to refuse any participant or potential participant at its sole discretion. No refund will be made for voluntary absence from the tour unless arrangements are made at the time of booking. The above tour conditions are provided in addition to the full terms and conditions of travel which can be found here www.grouptripsandtravel.com. By booking this trip you are agreeing to be bound by the full terms and conditions of travel in addition to the tour conditions above. It is therefore vital that you read the full terms and conditions before making any booking. Making a booking is indicative of your agreement to be bound by all of the terms and conditions. Please reserve _______ places for me/us on England, Wales and Dublin Invasion Tour. Enclosed is my/our check in the amount of $_______ ($500 deposit per person). Pay by credit card: \| Card Number: \| Expiration Date: \| \|--------------\|------------------\| \| Security Code: \| Amount To Be Charged: \| \| Signature: \| □ Mr. □ Mrs. □ Ms \| Please Print Name Identical to Passport Address City State Zip Code Email Address I will room with (if other than spouse) Name(s) of other people you are traveling with - I do not have a roommate but will share. If a roommate cannot be found, I will pay the single supplement of $495 - I desire single room accommodations (subject to availability) at the supplementary charge of $495 - I/We have read, understand, and are in agreement with the Terms & Conditions and Cancellation Policy of this trip package Pay by check: Please make checks payable to: INTERTRAV CORPORATION Payments made by credit card will incur a 4% service fee. □ Mr. □ Mrs. □ Ms Please Print Name Identical to Passport Home Phone Cell Phone PLEASE MAIL TO: InterTrav Corporation 203 State Avenue St. Charles, IL 60174 firstname.lastname@example.org Tel: 630-377-5840 www.grouptripsandtravel.com PLEASE ENCLOSE A COPY OF THE INFORMATION PHOTO PAGE OF YOUR PASSPORT IS TRAVEL PROTECTION FOR ME? Travel insurance is recommended to help protect you and your trip investment for events such as cancellations, delays and emergencies. Please read the following travel insurance purchase options and return the completed form to your travel provider. Contact us if you have any questions. ☐ I (We) have been advised that a Travelex Group protection plan is available at an additional cost. I (We) have read and understand the policy, including Exclusions and Limitations, as well as the fraud warning and travel retailer contained in the attached flyer. I (We) do wish to purchase trip protection. Sign and date below and return this form to your travel provider. ☐ I (We) have been advised that a Travelex protection plan is available at an additional cost. I (We) DO NOT wish to purchase trip protection. Sign and date below and return this form to your travel provider. SIGNATURE DATE SIGNATURE DATE NEXT STEPS: If you elected to purchase travel insurance please complete the enrollment form and return to your travel provider. TRAVEL INSURANCE PLAN CALCULATION Travel Protection Plan Rate (calculate rate below using full trip cost and current age for each traveler) $_________________________ + $_________________________ + $_________________________ + $_________________________ = $_________________________ Total Amount Due (and authorized as payment) $_________________________ Please submit payment to your travel provider. The product descriptions provided here are only brief summaries and may be changed without notice. The full coverage terms and details, including limitations and exclusions, are contained in the insurance policy. Travel Insurance is underwritten by Berkshire Hathaway Specialty Insurance Company, NAIC #22276. A person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Please visit travelexinsurance.com/company/fraud-warning to view the state specific fraud warnings or call 888.574.7026. BIS 05.21 The 360° Group Premier plan provides maximum travel protection for all ages at competitive group rates. Enjoy benefits like trip cancellation & interruption, emergency medical and 24/7 travel assistance & concierge services. PLAN HIGHLIGHTS - Primary coverage, no deductibles - Pre-existing medical condition exclusion waiver - Trip cancellation/interruption benefit includes: - Sickness, injury or death - Inclement weather - Financial default & labor strikes - Business reasons - Terrorist incident - 3 hour missed connection benefit - 5 hour trip delay benefit - 12 hour baggage delay benefit - Fast online claims ### PLAN BENEFITS & BONUS COVERAGES \| Benefits \| Coverage¹ \| \|-----------------------------------------------\|-----------\| \| Trip Cancellation \| 100% of trip cost ($20,000 limit) \| \| Trip Interruption \| 150% of trip cost ($30,000 limit) \| \| Trip Delay \| $1,000 ($250/day)² \| \| Sporting Equipment Delay \| $200 \| \| Missed Connection \| $1,000 \| \| Baggage & Personal Effects \| $1,500 \| \| Baggage Delay \| $250 \| \| Emergency Medical & Dental Expenses \| $50,000 ($500 dental sublimit) \| \| Emergency Evacuation & Repatriation \| $250,000 \| \| Accidental Death & Dismemberment⁵ \| $10,000 \| \| Travel Assistance & Concierge Services⁷ \| Included \| ### BONUS COVERAGES If plan is purchased at or before final trip payment. - Pre-existing Medical Condition Exclusion Waiver Included - Financial Default Coverage Included ### PLAN RATES \| Trip Cost \| Age 0-24 \| Age 25+ \| \|--------------------\|----------\|---------\| \| $0² \| $28 \| $43 \| \| $1 - $500 \| $28 \| $80 \| \| $501 - $1,000 \| $36 \| $116 \| \| $1,001 - $1,500 \| $52 \| $160 \| \| $1,501 - $2,000 \| $68 \| $207 \| \| $2,001 - $3,000 \| $97 \| $280 \| \| $3,001 - $4,000 \| $130 \| $370 \| \| $4,001 - $5,000 \| $164 \| $464 \| \| $5,001 - $6,000 \| $198 \| $552 \| \| $6,001 - $7,000 \| $232 \| $644 \| \| $7,001 - $8,000 \| $266 \| $736 \| \| $8,001 - $9,000 \| $299 \| $826 \| \| $9,001 - $10,000 \| $333 \| $916 \| \| $10,001 - $11,000 \| $368 \| $1,038 \| \| $11,001 - $12,000 \| $403 \| $1,135 \| \| $12,001 - $13,000 \| $438 \| $1,232 \| \| $13,001 - $14,000 \| $473 \| $1,329 \| \| $14,001 - $15,000 \| $508 \| $1,426 \| \| $15,001 - $16,000 \| $543 \| $1,524 \| \| $16,001 - $17,000 \| $578 \| $1,623 \| \| $17,001 - $18,000 \| $613 \| $1,721 \| \| $18,001 - $19,000 \| $648 \| $1,819 \| \| $19,001 - $20,000 \| $684 \| $1,918 \| Rates are per traveler and subject to change. --- 1. All coverages per insured up to limits listed. Coverage, rates and maximum trip length may vary by state. Please see your policy for details or call 888.574.7026. 2 Includes $1,000 in Trip Interruption - Return Air only. Coverage for Trip Interruption and Trip Interruption - Return Air Only cannot be combined. 3 Coverage when plan is purchased at or before final trip payment. 4 Of you, a Traveling Companion, Family Member or Business Partner. 5 Not available for NH residents. 6 Based on industry average. Fastest payment on approved claims is based on 'electronic payment' of claim. 7 Provided by the designated provider as listed in the Policy. 8 $200/day for IL residents 08.21! TRAVEL ASSISTANCE SERVICES Includes a wide range of services before and during trips through a 24/7 toll free number. MEDICAL SERVICES INCLUDE: - Medical Assistance - Medical Consultation & Monitoring - Medical Evacuation - Emergency Medical Payments - Prescription Assistance - Dependent Transportation & Family Visits - Repatriation of Remains ASSISTANCE SERVICES INCLUDE: - 24 Hour Legal Assistance - Message Services - Language Interpretation Services - Emergency Cash Transfer - Pre-Trip Travel Services - Travel Document & Ticket Replacement - Concierge Services - Business Services PRE-EXISTING CONDITION EXCLUSION WAIVER Pre-existing medical conditions are eligible for coverage when: - Plan is purchased at or before final trip payment - Full trip cost is insured - The traveler is medically able to travel at the time of plan purchase A pre-existing condition is an Injury, Sickness or other condition (excluding any condition from which death ensues) of an Insured, Travelling Companion, Business Partner or Family Member within the 60 day period immediately preceding and including the Insured’s coverage effective date. This exclusion also applies to those not traveling. This plan does not cover any loss caused by or resulting from: intentionally self-inflicted injury, suicide, or attempted suicide of the Insured, Family Member, Traveling Companion or Business Partner while sane or insane; Normal Pregnancy or Childbirth, other than Unforeseen Complications of Pregnancy, of the Insured, a Traveling Companion or a Family Member; participation in any extreme athletic event; motor sports; parachuting; including training or practice for the same; mountain climbing that requires the use of equipment such as; pick-axes, anchors, bolts, crampons, carabiners, and line or top- rope anchoring or other specialized equipment; operating or learning to operate any aircraft, student, pilot, or crew air travel on any air supported device, other than a regularly scheduled airline or air charter; war (whether declared or not) or act of war, participation in a civil disorder, riot, insurrection or unrest; any unlawful acts committed by the Insured; Mental, Nervous or Psychological Disorder; if the Insured's tickets do not contain specific travel dates (open tickets); being under the influence of drugs or narcotics, unless administered upon the advice of a Physician or intoxication above the legal limit; any Loss that occurs at a time when this coverage is not in effect; traveling solely or substantially for the purpose of securing medical treatment; any Trip taken outside the advice of a Physician; Pre-Existing Medical Conditions of an Insured, Traveling Companion, Business Partner or Family Member (within a 60 day period immediately preceding coverage effective date). The following exclusions also apply to the Medical Expense Benefit and the physical examination benefit: Eye glasses; contact lenses; dentures; routine dental care; any service provided by the Insured, a Family Member, or Traveling Companion; alcohol or substance abuse or treatment for the same; Experimental or Investigative treatment; any procedure, care or treatment which is not Medically Necessary, except for related reconstructive surgery resulting from trauma, infection or disease; coverage for Trips less than 100 miles from the Insured's Primary Residence (also applies to the Emergency Evacuation Benefit). The following exclusions also apply to Accidental Death and Dismemberment: Benefits will not be provided for the following: loss caused by or resulting directly or indirectly from Sickness or disease of any kind; stroke or cerebrovascular accident or event; cardiovascular accident or event; myocardial infarction or heart attack; coronary thrombosis; aneurysm. Please refer to your policy for a complete list of plan exclusions and limitations. The purchase of this product is not required in order to participate in any other travel product or service. Your travel retailer might not be licensed to sell travel insurance and will only be able to provide general information about the product. An unlicensed travel retailer may not be able to answer all questions about terms and conditions of the insurance offered and may not evaluate the adequacy of your existing insurance coverage. The products being offered provide insurance coverage that only applies during the covered trip. You may have insurance coverage from other sources that provide similar benefits but may be subject to different restrictions depending upon the coverage. You may wish to compare the terms of the travel policy offered through Travelex with the existing health, home and automobile insurance policies you may have. If you have questions about your coverage under your existing insurance policies, contact your insurer or insurance agent or broker. The product descriptions provided here are only brief summaries and may be changed without notice. The full coverage terms and details, including limitations and exclusions, are contained in the insurance policy. If you have questions about coverage available under our plans, please review the policy or contact Travelex Insurance Services Inc. Toll Free 888.574.7026 Email: email@example.com. Any inquiry regarding claims may be directed to firstname.lastname@example.org; 855.205.6054. To view the specific fraud warnings, visit travalexinsurance.com/about-us/fraud-warning. Consumers in California may also contact: California Department of Insurance Hotline 800.927.4357 or 213.897.8721. Travelex Insurance Services, Inc. CA Agent License #OD10209. Consumers in Maryland may contact: Maryland Insurance Administration 800.492.6116 or 410.468.2340. Travel Insurance is underwritten by Berkshire Hathaway Specialty Insurance Company; NAIC #22276 under Policy Form series (all states except as otherwise noted) PG-TA-IPL-USE, In KS, MA, MN, MO, MT, OR, VA, and VT Policy Form series PG-TA-IPL-NV, In CA Policy Form # PG-TA-IPL-USEIM and PG-TA-IPL-CAEAH, CO Policy Form # PG-TA-IPL-COEAH and PG-TA-IPL-COEIM, IL Policy Form # PG-TA-IPL-ILE, IN Policy Form # PG-TA-IPL-INEAH and PG-TA-IPL-NVIM, MD Policy Form # PG-TA-IPL-MDE, NH Policy Form # PG-TA-IPL-NHE, NY Policy Form # PG-TA-IPL-NVIM and PG-TA-IPL-NVAH-NY, PA Policy Form # PG-TA-IPL-USEIM and PG-TA-IPL-NVAH-PA, TX Policy Form # PG-TA-IPL-TXEAH and PG-TA-IPL-TXEM, UT Policy Form # PG-TA-IPL-UTE, WA Policy Form # PG-TA-IPLNVIM and PG-TA-IPL-WAEBH, 2GV 08.21	21fb5e96-b7a5-4c48-93dd-686371a22f28	CC-MAIN-2025-08	https://img1.wsimg.com/blobby/go/d46762e1-9204-4aee-920a-a2b7a1084eb5/Ian%20Gould%20Soccer%20Tour%20Brochure.pdf	2025-02-14T04:25:12+00:00	crawl-data/CC-MAIN-2025-08/segments/1738831951840.44/warc/CC-MAIN-20250214034103-20250214064103-00809.warc.gz	296,620,774	6,098	eng_Latn	eng_Latn	0.983186	eng_Latn	0.996193	[ "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn", "eng_Latn" ]	true	rolmOCR	[ 376, 5027, 7994, 13459, 14747, 16908, 20474, 26974 ]	[ 0.64453125, 0.359375 ]	[ 1.484375, 0.90625 ]	[ 1.421875, 1.2890625 ]	[ 2.734375, 2.546875 ]	1	0	HuggingFaceFW/finepdfs
"Ask Dr. J" The "Ask Dr. J" columns are authored monthly by Jennifer Christian, MD, MPH, President of Webility Corporation. See previous columns at www.webility.md. Dr. J's columns also appear in the monthly Bulletin of the Disability Management Employer Coalition (DMEC). To purchase a book of Dr. J's collected columns, go to www.dmec.org. The columns often summarize issues discussed by the Work Fitness and Disability Roundtable, a free, multi-disciplinary e-mail discussion group moderated by Dr. Christian. Apply to join the Roundtable at www.webility.md. March 2007 – Interventions for Inadequate or Inappropriate Care Dear Dr. J: As a claim manager, it makes me very sad to watch people develop chronic pain syndromes because their physicians are providing inadequate or inappropriate medical care. What can I do? Samantha in San Francisco Dear Samantha: It is very hard to see people going from bad to worse due to poor medical care, isn't it? The quality of medical care is very uneven in the US today, and in many communities there simply aren't any doctors who understand how to prevent or treat chronic pain conditions effectively. Here are a few ideas for simple things you can offer to people that will "beef up" or supplement the care they are getting from their own provider. 1. Since information is power, make sure your claimants get a good education about their own medical conditions, how to treat them, and what they can do for themselves. Why not establish a standard operating practice to offer good health education resources to them? Ask a healthcare professional to find you some high quality websites that deal with the kind of medical problems your claimants are dealing with – and then refer your claimants to those websites. And then, make a date to talk with them about what they read (so they'll actually do it). If you're not sure you know enough to talk with them about the material yourself, ask one of your nurse consultants or nurse case managers to do this for you. 2. Encourage the claimant to explore the other benefits or resources they may have available. If the claimant has healthcare coverage, does the health plan offer a disease management program? Does the claimant's employer have an EAP? Encourage the claimant to take advantage of these things – and then follow-up to show you really are interested and really do think they should take action. 3. Get a medical case manager involved, or better yet a physician with expertise in functional restoration / disability management. Ask them to work with the treating physician around a "big picture" patient management strategy, instead of arguing about a particular treatment or decision. Oftentimes, the treating physician simply doesn't know what to do with this problematic patient and feels very uncomfortable. A credible expert who calls, expresses empathy for the treating physician's position, and then offers help and concrete suggestions instead of criticism may find a warm welcome. 4. Are you aware of the American Chronic Pain Association (ACPA)? You should be encouraging all of your claimants who have chronic pain to take advantage of what ACPA offers. It is a non-profit self-help group whose goal is to provide education to help people better manage their pain and live more satisfying, productive lives. ACPA has an informative website (http://www.theacpa.org) and excellent printed materials. They also have hundreds of support groups that are meeting throughout the USA. Founded by Penny Cowan, herself a person living with pain and a graduate of the Cleveland Clinic's multi-disciplinary pain program, ACPA's purpose is to offer support and information for people with chronic pain by: * Facilitating peer support and education for individuals with chronic pain and their families so that these individuals may live more fully in spite of their pain. * Raising awareness among the health care community, policy makers, and the public at large about issues of living with chronic pain. I joined the board of ACPA because I think the way they approach the issue of living with chronic pain is very good, and because I want to help connect them with employers and insurers like you -- who every day see people who could benefit from ACPA's resources and support. 5. Provide the claimant with another medical professional's perspective. Find a reasonable excuse to send the claimant for a second opinion or independent medical examination – for example a request for treatment authorization or for continuing work disability. DON'T communicate about this in an adversarial way. Instead, tell the claimant that they don't seem to be doing as well as other people you've seen with the same problem. Say that you want a second pair of expert eyes to look at their situation and decide whether (a) this treatment or (b) this continuing disability is really the best for them. Select the examining physician carefully – find someone with a "good bedside manner" and expertise in functional recovery / chronic pain management / work disability prevention. Ask the examining physician to do more than consider that single issue. Ask them to comment on the entire treatment plan to date and to educate (or even persuade) the claimant about potential alternate and more effective strategies and approaches for future treatment. One employer I know sends people who are thinking about spine fusion surgery to an expert orthopedist for an "informed consent" session. He charges $500 for spending the time with the patient to fully educate them on the medical literature about the risks and benefits of the surgery and alternative treatments, and to explore with them what their life will be like with a fused spine. Very few patients still want the surgery after that appointment. Samantha, I hope these ideas prove useful. In particular, I think that your willingness to offer specific suggestions of where to go for help – and your follow-up to discuss what they find – will really make a difference. 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\| Date \| Location \| Prayer Requests \| \|------------\|----------\|---------------------------------------------------------------------------------\| \| May 29, 2022 \| NL \| Prayer Update – Jim and Tina Snook GCI members NL \| \| \| \| "I am writing to you with an update about my wife's hernia for those reading the prayer requests. ... I wanted to let people know Tina saw the surgeon on Friday and although the surgery needs to happen soon there is a backlog of cancer related ones that have to take priority. Meanwhile the doctor is confident that the hernia will not get worse or much bigger and the surgery will go ahead some time this summer. She is uncomfortable but she still able to work and function. Thank you all for your prayers". Jim and Tina Snook \| \| May 29, 2022 \| NB \| Prayer request for Marcia Macaulay long-time GCI church member who lives in the greater Saint John area of NB \| \| \| \| She is 89 years old. She suffers from a severe case of tinnitus. She also has great difficulty hearing. Her hearing loss is quite severe. She is requesting your prayers for her hearing and for help with additional problems that are related to her hearing loss. This hearing problem is severely impacting the quality of her life. Your intercessory prayers for God’s intervention is much appreciated. \| \| May 28, 2022 \| NB \| Prayer Update for Joanne Summers – Mrs. Edna Vautour’s sister \| \| \| \| Joanne wants to thank everyone who has prayed for her. She was supposed to receive 20 cancer treatments of radiation. After the oncologist reviewed her file, she will only need 5 radiation treatments which will be done over a period of 5 days. She is indeed very relieved that the recent surgical intervention was a success. She is very thankful for God’s intervention and mercy. \| \| May 22, 2022 \| NL \| Urgent Prayer request from Jim and Tina Snook (St John’s area) \| \| \| \| The following is what he wrote: “Jim Snook is requesting prayers for his wife Tina Rowe-Snook who has a very large hernia that requires surgery. She is scheduled to see the doctor again the 27th of May. There is currently a backlog of surgeries and there have been many delays. This hernia is increasing in size and there is a risk of rupture and bowel strangulation. We are praying for God’s intervention and healing. Your prayers are greatly appreciated at this time. Thank you, Jim & Tina” \| \| Date \| Location \| Message \| \|------------\|----------\|-------------------------------------------------------------------------\| \| May 22, 2022 \| NB \| Shirley Fanjoy, a long-time GCI member (Moncton area), and her grandson Jordan Steeves are soliciting your prayers. \| \| \| \| Jordan has lumps growing in the breast. He is awaiting the results of medical testing. The doctors have not been able to diagnose his physical problems yet. They are waiting for the results of the testing. Your prayers are much appreciated as this is all very concerning for Jordan, a young adult. Please note that Jordan had begun to attend our worship services on Zoom. \| \| May 15, 2022 \| NL \| Prayer update regarding Andrew Lee, Robert Collins brother-in-law. Here is what he wrote: \| \| \| \| “I was talking to my sister this morning( Andrew’s wife) she was happy that he is improving. Doctors told her that his brain is coming back to life, and he is doing a lot of laughing and crying. He also is starting to talk, but still paralyze on left side. Thanks for your prayers. I will keep you updated if things change”. Robert. \| \| May 14, 2022 \| ON \| Answered prayer Fraser Henderson, Pastor, GCI Ottawa/Gatineau & Smiths Falls \| \| \| \| I wanted to thank all the pastors for their prayers about a location in Ottawa. We received word last night that the board of Maison de la Francophonie d’Ottawa had approved a plan to rent out their space to us. While we still have to draw up a contract with them, it seems very much like it’s a formality given they had to change a standing policy to allow us to rent from them on a regular basis. \| \| \| \| The location is ideal, only about three blocks from where we were meeting before with easy access both from the main highway and through transit. Many of our francophone new immigrants are familiar with the location due to services they offer so that is an added bonus. \| \| \| \| Assuming we can do the necessary paperwork and finalize details we should hopefully be meeting in person in mid-June at the latest. \| \| \| \| Thanks again for all the prayer and encouragement. God Bless, \| \| \| \| Please continue to pray for the Edmonton church. They are still looking for a venue to be able to worship on Sundays. \| \| May 2, 2022 \| NL \| From Robert Collins for his brother-in-law Andrew Lee \| \| \| \| Robert wrote he has had “2 strokes that left his left arm paralyzed, he can not see or eat and his kidneys are failing. That is all I know at this present time. Thank You so much for your prayers and prayers of the Church”. \| \| \| \| Mr. Lee is presently hospitalized in NL. Robert will keep us informed. \| \| \| \| Thank you so much for your intercessory prayers on his behalf. \| \| April 22, 2022 \| NS \| Churches in Edmonton and Ottawa from Mr. Bill Hall \| \| \| \| I had a conversation with Bob Millman (GCI Edmonton) and Fraser Henderson (GCI Ottawa), and they told me of their problems trying to find a location for services where they could meet on Sunday. \| \| \| \| As you know we have all dealt with this issue and will continue to deal with it as we seek to find the neighbourhood where God wants us to meet in our individual cities and towns. It has become even more difficult given the fact that some places are not allowing outside renters because of COVID. Currently Edmonton is meeting in another church on Saturday, and they are seeking to find a new location to meet on Sunday where they could reach out to their community. \| In Ottawa, the situation is more critical as they have lost their Saturday meeting place because of COVID and are trying to find a Sunday location that would be available for their large new-Canadian membership that is close to transit and central for those coming in from Quebec. They are still meeting online, but it is important that they are able to meet again in person. I just wanted to bring their requests forward to you so that we could all pray that God would open doors (literally) for them to find new locations. Thanks so much. 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City of San Antonio AGENDA Transportation and Mobility Committee City Hall Complex San Antonio, Texas 78205 Videoconference 10:30 AM Tuesday, December 1, 2020 To protect the health of the public and limit the potential spread of COVID-19, the Transportation and Mobility Committee will hold this meeting via videoconference. These meeting standards are based upon the various suspended provisions of the Open Meetings Act issued by the Texas Governor in response to the COVID-19 crisis. These modified standards shall remain in place until further notice or until the state disaster declaration expires or is otherwise terminated by the Texas Governor. The meeting will be available to the public at AT&T channel 99, Grande channel 20, Spectrum channel 21, digital antenna 16, and www.sanantonio.gov/TVSA. The meeting will also be available by calling (210) 207-5555 (English and Spanish available). Members of the public can comment or speak on items on the agenda. To submit comments or sign up to speak, please go to www.sanantonio.gov/agenda and click on the eComment link associated with the agenda for instructions. Questions relating to the rules on addressing the Committee may be directed to the Office of the City Clerk at (210) 207-7253. Once a quorum is established, the Transportation and Mobility Committee shall consider the following Public Comment Approval of the Minutes for the February 17, 2020 Transportation and Mobility Committee Meeting. 20-6998 1. Briefing and Possible Action on A briefing on docked bike share services, including a proposed assignment of the agreement between the City and San Antonio Bike Share to BCycle. [Lori Houston, Assistant City Manager; John Jacks, Director, Center City Development and Operations] 20-6996 2. Briefing by Alamo Area Metropolitan Planning Organization (AAMPO) on the AAMPO Transportation Policy Board, including an overview of 20-6972 3. 20-6973 4. its current structure and appointment process. [Roderick Sanchez, Assistant City Manager; Razi Hosseini, Director, Public Works] Briefing on the Alamo Area Metropolitan Planning Organization (AAMPO) call for projects process for the FY 2023-2026 Transportation Improvement Program (TIP). [Roderick Sanchez, Assistant City Manager; Razi Hosseini, Director, Public Works] Adjourn At any time during the committee meeting, the Transportation and Mobility Committee may convene in executive session regarding any of the matters posted above for attorney-client consultation in compliance with the Texas Open Meetings Act (Texas Government Code Section 551.071). DISABILITY ACCESS STATEMENT Auxiliary Aids and Services, including Deaf interpreters, must be requested forty-eight [48] hours prior to the meeting. For assistance, call (210) 207-7268 or 711 Texas Relay Service for the Deaf. Transportation and Mobility Committee Members Shirley Gonzales, Dist. 5, Chair Roberto Treviño, Dist. 1 \| Melissa Cabello Havrda, Dist. 6 Ana Sandoval, Dist. 7 \| Clayton Perry, Dist. 10 * Other members of City Council may attend to observe, but not vote, on matters before the Committee.	<urn:uuid:b107ca1c-4aeb-49ef-ba26-b29c7e0e0d5a>	CC-MAIN-2021-04	https://sanantonio.legistar.com/View.ashx?M=A&ID=817202&GUID=B2EE50F7-5579-4AD4-A9FE-20CC47B38D17	2021-01-22T13:44:35+00:00	crawl-data/CC-MAIN-2021-04/segments/1610703529331.99/warc/CC-MAIN-20210122113332-20210122143332-00132.warc.gz	540,450,446	700	eng_Latn	eng_Latn	0.959484	eng_Latn	0.973299	[ "eng_Latn", "eng_Latn" ]	false	docling	[ 1925, 3122 ]	[ 0.5390625 ]	[ 1.4453125 ]	[ 1.984375 ]	[ 1.609375 ]	1	0	HuggingFaceFW/finepdfs