Nutrient supply from marine small-scale fisheries

Over 2 billion people are unable to access safe, nutritious and sufficient food year-round. While global fisheries are considered key in providing essential nutrients to hundreds of millions of people around the globe, the specific contribution of small-scale fisheries to the nutrient supply given other available food supplies is unknown. Here, we combined multiple global databases to quantify the importance of marine small-scale fisheries to national-level nutrient supply of coastal populations. We found that, on average across assessed nutrients (iron, zinc, calcium, DHA + EPA and vitamins A and B12), small-scale fisheries contributed about 32% of overall global seafood nutrient supply, 17% of the nutrient supply from animal-sourced foods and 10% of nutrient supply from all foods. These global averages, however, underrepresent some key roles of ocean-based foods. Combining nutrient supply estimates with global estimates of inadequate nutrient intake, we found that about half of coastal countries that have a mean inadequate intake of at least 50% across assessed nutrients (iron, zinc, calcium, DHA + EPA and vitamins A and B12) rely on small scale fisheries for at least 15% of mean nutrient supply, and many rely on small scale fisheries for more than 30% of mean nutrient supply. Catch from small-scale fisheries is particularly important for the supply of vitamin B12, calcium and DHA + EPA, representing up to 100% of supply in selected countries. Our study demonstrates the significance of small-scale fisheries for nutritionally vulnerable coastal populations, emphasizing how effective fisheries management can contribute to public health.

Applying a participatory approach to the promotion of a culture of respect during childbirth

Disrespect and abuse (D&A) during facility-based childbirth is a topic of growing concern and attention globally. Several recent studies have sought to quantify the prevalence of D&A, however little evidence exists about effective interventions to mitigate disrespect and abuse, and promote respectful maternity care. In an accompanying article, we describe the process of selecting, implementing, and evaluating a package of interventions designed to prevent and reduce disrespect and abuse in a large urban hospital in Tanzania. Though that study was not powered to detect a definitive impact on reducing D&A, the results showed important changes in intermediate outcomes associated with this goal. In this commentary, we describe the factors that enabled this effect, especially the participatory approach we adopted to engage key stakeholders throughout the planning and implementation of the program. Based on our experience and findings, we conclude that a visible, sustained, and participatory intervention process; committed facility leadership; management support; and staff engagement throughout the project contributed to a marked change in the culture of the hospital to one that values and promotes respectful maternity care. For these changes to translate into dignified care during childbirth for all women in a sustainable fashion, institutional commitment to providing the necessary resources and staff will be needed.