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Obstetric Facility Quality and Newborn Mortality in Malawi: A Cross-Sectional Study
Authors: Hannah H. Leslie, Günther Fink, Humphreys Nsona, and Margaret E. Kruk
Source: PLOS Medicine, 13(10):e1002151; DOI:10.1371/journal.pmed.1002151
Topic(s): Health care utilization
Infant mortality
Neonatal mortality
Country: Africa
  Malawi
Published: OCT 2016
Abstract: Background Ending preventable newborn deaths is a global health priority, but efforts to improve coverage of maternal and newborn care have not yielded expected gains in infant survival in many settings. One possible explanation is poor quality of clinical care. We assess facility quality and estimate the association of facility quality with neonatal mortality in Malawi. Methods and Findings Data on facility infrastructure as well as processes of routine and basic emergency obstetric care for all facilities in the country were obtained from 2013 Malawi Service Provision Assessment. Birth location and mortality for children born in the preceding two years were obtained from the 2013–2014 Millennium Development Goals Endline Survey. Facilities were classified as higher quality if they ranked in the top 25% of delivery facilities based on an index of 25 predefined quality indicators. To address risk selection (sicker mothers choosing or being referred to higher-quality facilities), we employed instrumental variable (IV) analysis to estimate the association of facility quality of care with neonatal mortality. We used the difference between distance to the nearest facility and distance to a higher-quality delivery facility as the instrument. Four hundred sixty-seven of the 540 delivery facilities in Malawi, including 134 rated as higher quality, were linked to births in the population survey. The difference between higher- and lower-quality facilities was most pronounced in indicators of basic emergency obstetric care procedures. Higher-quality facilities were located a median distance of 3.3 km further from women than the nearest delivery facility and were more likely to be in urban areas. Among the 6,686 neonates analyzed, the overall neonatal mortality rate was 17 per 1,000 live births. Delivery in a higher-quality facility (top 25%) was associated with a 2.3 percentage point lower newborn mortality (95% confidence interval [CI] -0.046, 0.000, p-value 0.047). These results imply a newborn mortality rate of 28 per 1,000 births at low-quality facilities and of 5 per 1,000 births at the top 25% of facilities, accounting for maternal and newborn characteristics. This estimate applies to newborns whose mothers would switch from a lower-quality to a higher-quality facility if one were more accessible. Although we did not find an indication of unmeasured associations between the instrument and outcome, this remains a potential limitation of IV analysis. Conclusions Poor quality of delivery facilities is associated with higher risk of newborn mortality in Malawi. A shift in focus from increasing utilization of delivery facilities to improving their quality is needed if global targets for further reductions in newborn mortality are to be achieved
Web: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002151


Debugging Information
ColdFusion Server Developer 2018,0,19,330149
Template /Publications/journal-details.cfm
Time Stamp 01-Jul-24 01:18 AM
Locale English (US)
User Agent Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
Remote IP 10.0.2.129
Host Name 10.0.2.129


Execution Time

Total Time Avg Time Count Template
656 ms 27 ms 24 C:/inetpub/wwwroot/commonspot/utilities/ct-render-element.cfm
641 ms 27 ms 24 C:/inetpub/wwwroot/commonspot/utilities/ct-render-element-core.cfm
453 ms 453 ms 1 C:/inetpub/wwwroot/commonspot/master.cfm
453 ms 453 ms 1 C:/inetpub/wwwroot/dhs/Publications/journal-details.cfm
375 ms 375 ms 1 C:/inetpub/wwwroot/commonspot/master-render.cfm
375 ms 375 ms 1 C:/inetpub/wwwroot/commonspot/render-page-meat.cfm
375 ms 375 ms 1 C:/inetpub/wwwroot/commonspot/render-page.cfm
375 ms 375 ms 1 C:/inetpub/wwwroot/commonspot/uncached-master.cfm
375 ms 375 ms 1 C:/inetpub/wwwroot/commonspot/utilities/cached-page-render.cfm
344 ms 344 ms 1 C:/inetpub/wwwroot/dhs/templates/template-basepage.cfm
328 ms 33 ms 10 C:/inetpub/wwwroot/commonspot/utilities/ct-render-named-element.cfm
265 ms 265 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c1378-l70-t51-dAny.read
265 ms 265 ms 1 C:/inetpub/wwwroot/commonspot/utilities/run-element.cfm
63 ms 63 ms 1 C:/inetpub/wwwroot/commonspot/set-page-vars.cfm
62 ms 62 ms 1 C:/inetpub/wwwroot/commonspot/controls/customcf/cpe-customcf.cfm
32 ms 16 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/public_api/cache.cfc | getElementCacheSettings(9706, 4304) ] from C:/inetpub/wwwroot/commonspot/public_api/cache.cfc
31 ms 31 ms 1 C:/inetpub/wwwroot/commonspot/site-application.cfm
31 ms 31 ms 1 C:/inetpub/wwwroot/dhs/Publications/Application.cfm
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19152-l70-t51-dAny.read
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19155-l70-t51-dAny.read
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19169-l70-t51-dAny.read
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19177-l70-t51-dAny.read
15 ms 15 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19153-l70-t51-dAny.read
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/controls/upfront-generic.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/render-head.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/startup/site-application-meat.cfm
15 ms 15 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/livebookmarks.cfc | getTags(9706) ] from C:/inetpub/wwwroot/commonspot/public_api/livebookmarks.cfc
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c1432-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19154-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19172-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19174-l70-t51-dAny.read
0 ms 0 ms 1 C:/inetpub/wwwroot/ADF/core/load_site_adf.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/control-setup.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/controls/ct-include-once.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/dhtmlmenu/menu-output-display.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/handle-styles.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/lview-contribute-mode-redirect-check.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/non-dashboard-include.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/pagemode/pagemodeui.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-body-tag.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-foot.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-metatags.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-tracking-code.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/security/security-page.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/browser-detect-methods.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/build-request-params.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/core-application-meat.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/handle-head-request.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/handle-request-timeout.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/init-customer-scope.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/init-server-scope.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/session-first-global.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/session-first-site.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/add-resource-request.cfm
0 ms 0 ms 6 C:/inetpub/wwwroot/commonspot/utilities/add-unregistered-resource-request.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/append-to-resource-group.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/build-user-struct.cfm
0 ms 0 ms 3 C:/inetpub/wwwroot/commonspot/utilities/cp-cfheader.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/cp-cfmail-request-queue.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/utilities/define-upfront-vars.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/flush-cache-db-queue.cfm
0 ms 0 ms 4 C:/inetpub/wwwroot/commonspot/utilities/handle-in-list.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/load-template-properties.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/newwindow-js-meat.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/utilities/newwindow-js.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/nocache-headers.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/update-page-cache-status.cfm
0 ms 0 ms 3 C:/inetpub/wwwroot/commonspot/utilities/validate-date-string.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/verify-stub-data.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/custom-application.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/custom-search/inc-custom-application-search-vars.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/customcf/legacy/journal/detail_article_summary.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/templates/template-basepage.head
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(1) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(1652) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(9706) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | DBQueue_Count() ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | GetPageCacheStatus(1652, 2, 2, 0) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | GetPageCacheStatus(9706, 2, 1652, 0) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | UpdateStatus(argumentCollection = [complex value]) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc | getCustomAppPath(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc | getCustomModulePath(post-page-render, 2) ] from C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/item-security-cache.cfc | GetEntry(9706) ] from C:/inetpub/wwwroot/commonspot/components/cache/item-security-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/rewrite-rules-cache.cfc | getRewriteSettings(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/rewrite-rules-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc | getLatest() ] from C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc | getSecurityPageIDMap([complex value]) ] from C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/template-cache.cfc | LoadTemplateProperties(publication-template.cfm, 1652, 2) ] from C:/inetpub/wwwroot/commonspot/components/cache/template-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/custom-application-framework/handle-applications.cfc | executeFunction(handleRequestStart) ] from C:/inetpub/wwwroot/commonspot/components/custom-application-framework/handle-applications.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc | checkFileExists(C:/inetpub/wwwroot/dhs/templates/template-basepage.cfm, 0, false) ] from C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc | queryRowToStruct(ArgumentCollection = [complex value]) ] from C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/commonspot-context.cfc | getDSN(site) ] from C:/inetpub/wwwroot/commonspot/components/util/commonspot-context.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent('head' request check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(CGI variable processing) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(New (global) session initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Request object updates) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Request.Params initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(RequestTimeout check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Server-level remote requests checked) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Subsite context updated (ID=2)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(authoring suspended check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(basic setup) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(check for server property changes) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core cleanup) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core initialization) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core variables) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(custom-application.cfm) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(customerScope object initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(handleRequestStart) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(init-server-scope loaded) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(lock checks/updates) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(site environment initialization) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(site session check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(subsite context refreshed) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(user object created) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(user session initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(wait for lock: CommonSpot_Server_Scope (read)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(wait for lock: CommonSpot_Site1_Core (exclusive)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | init() ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Cache) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Element) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Keywords) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(LiveBookmarks) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/visitor-context-rule-actions.cfc | onPageVisit(9706, 2) ] from C:/inetpub/wwwroot/commonspot/components/util/visitor-context-rule-actions.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/element.cfc | getInfo(elementTypeID = 26) ] from C:/inetpub/wwwroot/commonspot/public_api/element.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/keywords.cfc | appendEnforced(subsiteIDOrURL = , keywordList = Journal Details) ] from C:/inetpub/wwwroot/commonspot/public_api/keywords.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/udf/database.cfc | getUDF(commonspot-site-dhs) ] from C:/inetpub/wwwroot/commonspot/udf/database.cfc
0 ms  STARTUP, PARSING, COMPILING, LOADING, & SHUTDOWN
484 ms  TOTAL EXECUTION TIME
red = over 250 ms average execution time


SQL Queries

get (Datasource=dhs_legacy_live, Time=0ms, Records=217) in C:\inetpub\wwwroot\dhs\custom-application.cfm @ 01:18:11.011
    	SELECT lang_text_var, lang_text_en
        FROM dataset_lang_dictionary
    
SelectedCustomRenderElements (Datasource=commonspot-site-dhs, Time=31ms, Records=2117) in C:\inetpub\wwwroot\commonspot\set-page-vars.cfm @ 01:18:11.011
		SELECT dcr.*
		  FROM Data_Custom_Render dcr, CustomElementModules cem
		 WHERE (dcr.PageID IN (?,?,?,?)) 
			AND dcr.VersionState=?
			AND (dcr.ModuleID = cem.ID OR dcr.ModuleID <= 0)
	 ORDER BY dcr.ControlID, dcr.PageID DESC, dcr.VersionID DESC
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1
Parameter #2(CF_SQL_INTEGER) = 2
Parameter #3(CF_SQL_INTEGER) = 1652
Parameter #4(CF_SQL_INTEGER) = 9706
Parameter #5(CF_SQL_INTEGER) = 2

Request.PageData.PageParams (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\render-page-meat.cfm @ 01:18:11.011
			SELECT *
			  FROM Param_Page
			 WHERE (PageID=9706 OR (PageID IN (1652,2,1) AND (VersionState = 2)))
			   AND VersionState=2
			 ORDER BY PageID DESC
		
qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\core.cfm @ 01:18:11.011
					SELECT SubsiteID
					  FROM SitePages
					 WHERE ID = ? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=15ms, Records=0) in C:\inetpub\wwwroot\commonspot\commands\livebookmarks.cfc @ 01:18:11.011
		SELECT Data_SeeAlso.ID, SubSites.SubSiteURL, SitePages.filename as pagename,
				 XMLPublications.name as feedname, XMLPublicationFormat.name as feedformat,
				 XMLPublications.description,
				 CASE
					 	WHEN XMLPublicationFormat.IsSyndication = 0 THEN 0
						ELSE 1
				 END AS IsSyndicationFeed
		  FROM Data_SeeAlso, XMLPublications, XMLPublicationFormat, SitePages, SubSites
		 WHERE Data_SeeAlso.PageID = ?
		 	AND Data_SeeAlso.Action = ?
		 	AND Data_SeeAlso.ItemID = XMLPublicationFormat.XMLPublicationFormatID
		 	AND Data_SeeAlso.TargetPageID = XMLPublications.XMLPublicationID
		 	AND XMLPublications.XMLPublicationFormatID = XMLPublicationFormat.XMLPublicationFormatID
		 	AND XMLPublications.PageID = SitePages.ID
		 	AND SitePages.SubSiteID = SubSites.ID
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706
Parameter #2(CF_SQL_INTEGER) = 11

ControlInstanceData (Datasource=commonspot-site-dhs, Time=0ms, Records=76) in C:\inetpub\wwwroot\commonspot\controls\control-setup.cfm @ 01:18:11.011
		SELECT ControlID, ControlName, ControlType, ParentControlID, ParentControlType, pageID
		  FROM ControlInstance
		 WHERE (PageID IN (?,?,?,?)) 
	 ORDER BY ControlID, PageID DESC
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1
Parameter #2(CF_SQL_INTEGER) = 2
Parameter #3(CF_SQL_INTEGER) = 1652
Parameter #4(CF_SQL_INTEGER) = 9706

qInfo (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\element.cfc @ 01:18:11.011
		SELECT ac.ShortDesc AS Name, CustomRenderSupport AS SupportsCustomLayouts,
				 CASE
					WHEN ac.ID <?
					 THEN 'Standard'
					WHEN (ac.Name is NULL or ac.Name = '')
					 THEN 'Saved'
					WHEN fcm.ClassID = 1
					 THEN 'Global'
					ELSE 'Local'
				 END AS ElementType,
				 CASE WHEN ac.Name = 'custom' THEN 'custom/ce' ELSE ac.ControlPrefix END AS ElementURLPrefix,
				 CASE WHEN (ac.ID IN (?,?,?,?,?,?,?,?,?,?,?,?))  THEN 0 ELSE 1 END AS HasFontColorProperties,
				 CASE WHEN (ac.ID IN (?,?,?,?,?,?,?))  THEN 0 ELSE 1 END AS HasLayoutProperties,
				 1 AS HasStyleProperties
		  FROM AvailableControls ac
		  LEFT OUTER JOIN FormControlMap fcm ON fcm.FormID = ac.ID
		 WHERE ac.ID = ? 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 400
Parameter #2(CF_SQL_INTEGER) = 22
Parameter #3(CF_SQL_INTEGER) = 44
Parameter #4(CF_SQL_INTEGER) = 55
Parameter #5(CF_SQL_INTEGER) = 1
Parameter #6(CF_SQL_INTEGER) = 56
Parameter #7(CF_SQL_INTEGER) = 47
Parameter #8(CF_SQL_INTEGER) = 26
Parameter #9(CF_SQL_INTEGER) = 48
Parameter #10(CF_SQL_INTEGER) = 27
Parameter #11(CF_SQL_INTEGER) = 28
Parameter #12(CF_SQL_INTEGER) = 51
Parameter #13(CF_SQL_INTEGER) = 31
Parameter #14(CF_SQL_INTEGER) = 33
Parameter #15(CF_SQL_INTEGER) = 26
Parameter #16(CF_SQL_INTEGER) = 48
Parameter #17(CF_SQL_INTEGER) = 37
Parameter #18(CF_SQL_INTEGER) = 27
Parameter #19(CF_SQL_INTEGER) = 38
Parameter #20(CF_SQL_INTEGER) = 28
Parameter #21(cf_sql_integer) = 26

Request.customCFUpfront (Datasource=commonspot-site-dhs, Time=15ms, Records=1) in C:\inetpub\wwwroot\commonspot\controls\upfront-generic.cfm @ 01:18:11.011
	SELECT *
	  FROM Data_CustomCF
	 WHERE (PageID=9706 OR (PageID IN (1652,2,1) AND (VersionState = 2)))
		AND (VersionState = 2) 
 ORDER BY ControlID, PageID DESC, VersionID DESC 
testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\cache.cfc @ 01:18:11.011
		SELECT SubsiteID, InheritedTemplateList
		  FROM SitePages
		 WHERE ID=? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1652

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 2

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1

getArticlesDetails (Datasource=dhs_legacy_live, Time=0ms, Records=1) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 01:18:11.011
SELECT distinct(a.article_id),p.pub_id,tp.article_type_id,title,authors,article_date,article_year,
vol,link,active,source,pub_name,article_type_name,
abstract as abstractText
FROM dhs_articles a
INNER JOIN  Dhs_article_pub p ON a.pub_id = p.pub_id
INNER JOIN   Dhs_article_type Tp ON a.article_type_id = Tp.Article_type_Id

WHERE active=1	and tp.article_type_id=1

AND a.article_id =? 
Order By title
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 2447

getart_topic (Datasource=dhs_legacy_live, Time=0ms, Records=3) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 01:18:11.011
				select * from dhs_article_topics_lnk l, dhs_article_topics t 
				where article_id=?
				and l.topic_id=t.topic_id
				order by topic_name
			 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 2447

getart_Ctry (Datasource=dhs_legacy_live, Time=0ms, Records=1) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 01:18:11.011
				select * from dhs_article_ctry_lnk l, dhs_article_ctry c ,dhs_article_rgn r
				where article_id=? and l.country_id=c.country_id
				and R.Rgn_id = c.country_rgn_id	
			 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 2447

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\cache.cfc @ 01:18:11.011
		SELECT SubsiteID, InheritedTemplateList
		  FROM SitePages
		 WHERE ID=? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1652

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 2

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 01:18:11.011
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1


Scope Variables

Application Variables:
activesubsites=1,2,5,6,8,17,18,19,20,21,22,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58
adf=Struct (89)
adfscheduler=Struct (0)
applicationname=site1
assocpubdocs=Struct (4)
blogcache=Struct (4)
cachedimages=Struct (32)
cacheinfocache=Struct (53)
confidentiality=Array (5)
controlinstance_toplevel_cache=Struct (126)
covid_articlecount=10
covid_newsarticlecount=49
covid_pressreleasecount=4
covid_pubcount=3
cs_elementcache=Struct (10)
cs_resourcesmissing=Struct (0)
cs_rewriterulescache=Struct (21)
cs_subsitecachemanager=Struct (28)
customerinfo=Complex type
customerscope=Struct (21)
custommodulecache=Struct (21)
defaultconfidentiality=2
dhspagesyncdata=Struct (1)
itemsecuritycache=Struct (31)
languagenames=Struct (51)
languages=Struct (51)
lastknownchange=Struct (18)
lastupdate=Struct (14)
metadatacache=Struct (4)
pendingstubrequests=Struct (0)
rsscache=Struct (2)
search_archive_next_clean=2024-07-01 11:48:40
serverstatus=Struct (1)
site=Struct (74)
sitescope=Struct (9)
styleids=Struct (248)
stylenames=Struct (248)
subsitecache=Struct (46)
subsitecachebysecuritypageid=Struct (46)
templatecache=Struct (28)
templatedefaultsecuritycache=Struct (60)
templateenforcedsecuritycache=Struct (60)
treecache=Struct (25)
twittercache=Struct (2)
typefactory=Complex type
youtubecache=Struct (3)
CGI Variables:
AUTH_PASSWORD=
AUTH_TYPE=
AUTH_USER=
CERT_COOKIE=
CERT_FLAGS=
CERT_ISSUER=
CERT_KEYSIZE=
CERT_SECRETKEYSIZE=
CERT_SERIALNUMBER=
CERT_SERVER_ISSUER=
CERT_SERVER_SUBJECT=
CERT_SUBJECT=
CF_TEMPLATE_PATH=C:\inetpub\wwwroot\dhs\Publications\journal-details.cfm
CONTENT_LENGTH=0
CONTENT_TYPE=
CONTEXT_PATH=
GATEWAY_INTERFACE=CGI/1.1
HTTPS=off
HTTPS_KEYSIZE=
HTTPS_SECRETKEYSIZE=
HTTPS_SERVER_ISSUER=
HTTPS_SERVER_SUBJECT=
HTTP_ACCEPT=*/*
HTTP_ACCEPT_ENCODING=gzip, br, zstd, deflate
HTTP_ACCEPT_LANGUAGE=
HTTP_CONNECTION=
HTTP_COOKIE=
HTTP_HOST=preview.dhsprogram.com
HTTP_REFERER=
HTTP_URL=/Publications/journal-details.cfm?C_id=0&P_ID=0&T_ID=0&article_id=2447&r_id=0
HTTP_USER_AGENT=Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
LOCAL_ADDR=10.0.0.111
PATH_INFO=
PATH_TRANSLATED=C:\inetpub\wwwroot\dhs\Publications\journal-details.cfm
QUERY_STRING=C_id=0&P_ID=0&T_ID=0&article_id=2447&r_id=0
REMOTE_ADDR=10.0.2.129
REMOTE_HOST=10.0.2.129
REMOTE_USER=
REQUEST_METHOD=GET
SCRIPT_NAME=/Publications/journal-details.cfm
SERVER_NAME=preview.dhsprogram.com
SERVER_PORT=80
SERVER_PORT_SECURE=0
SERVER_PROTOCOL=HTTP/1.1
SERVER_SOFTWARE=Microsoft-IIS/10.0
WEB_SERVER_API=
Cookie Variables:
CSRFTOKEN=1031871EC5B74F1BA8D856CB5C732A3FF4FE7404
Request Parameters:
anonnoreadelements=
applockname=CS_App_Site1_1
archiveemail=archive@dhsprogram.com
assetsdir=/assets/
author_approve_whereclause=(VersionState = 2)
authormode=0
authorok=1
blupfront=
browser=Struct (13)
browserallincluded=1
cachefilesused=22
cachestatus=Complex type
cfflushcount=0
cgivars=Struct (49)
cloudfrontkeypairid=K3LSHNFSZFMIUC
cloudfronturl=d1vyaiefsqy4pf
constants=Complex type
cors.isCorsRequest=NO
cp=Struct (123)
cs_includedobjects=nwjs
cs_init_timings=Struct (23)
cs_isdashboardcmd=0
cs_request_start_memory=2914220032
cs_runningdashboardcmdcode=0
csrftoken=1031871EC5B74F1BA8D856CB5C732A3FF4FE7404
ctrl_data=Struct (64)
customcf_data=Struct (2)
customcfupfront=Query (1)
customerinfo=Complex type
customhead=1
customrenderhandlerpairs=
customsearch=Struct (11)
dbdsn=measure_db
debugstate=Struct (1)
dhspagesyncdata=Struct (1)
dhtmlmenuitemsprefetch=
disablehideformenus=0
dsource=dhs_legacy_live
editmode=0
element=Struct (42)
elementrundetail=Struct (1)
elementsrun=1
environment=Struct (5)
finalreportids=5,26,21,10,18,30,39
finalreportna=139,315,445,488,107,138,459,518
formattedtimestamp=2024-07-01 01:18:11
getghost=
hivbold=1,3,8,9
imageupfront=
imgdir=/images/
includerootdir=/
initialsiteid=1
initticks=1719796691102
jswarnmessage=
linkdataupfront_itempos=
linkdataupfront_itemtitle=
lockid=0
mainpage=Struct (84)
master_cfm_used=1
maxperms=Complex type
modeorderbyclause=VersionID Desc
modewhereclause=(VersionState = 2)
modewhereclause_page=(VersionState = 2)
multisectionupfront=
noauthorreason=
nocacheelementtypes=
nocacheheaderincluded=1
nondashboardincludedone=1
obcountires=EG,ZM
package=Struct (0)
page=Struct (84)
pagedata=Struct (1)
pagedhtmlitems=
pagedhtmlmenus=
pageperms=Complex type
pagesync=Struct (4)
params=Struct (9)
params_formfields=
params_urlfields=r_id,C_id,P_ID,T_ID,article_id
previewmode=0
readmodewhereclause=(VersionState = 2)
renderedelements=Struct (0)
renderelementdata=Struct (0)
renderfordiff=0
renderforprint=0
renderstate=Struct (73)
req_cam_callcount=1
req_inittimestamp=2024-07-01 01:18:11.086
req_sequenceid=32278
req_startticks=1719796691086
rootdir=/
rootpath=
rooturldatasetadmin=https://preview.dhsprogram.com/data/dataset_admin
samesite_value=
scheduleupfront=
serverdatasource=commonspot-sites
sessionlockname=Session_1_D9228A3E18258EB00B614D21D3A42ADC.cfusion
sessionstring=1_D9228A3E18258EB00B614D21D3A42ADC.cfusion
sicupfront=
sicupfrontparam=
site=Struct (74)
siteid=1
standardrenderhandlers=
styleids=Struct (248)
stylenames=Struct (248)
subsite=Struct (0)
subsitecache=Struct (46)
subsitecachebysecuritypageid=Struct (46)
subsiteid=2
taiupfrontparam=
tbupfront=
tbupfrontparam=
templatecachestatus=Struct (0)
templaterootdir=/
timestamp={ts '2024-07-01 01:18:11'}
trustcachestatus=1
typefactory=Complex type
udslockname=CS_Customer_commonspot-users
updatingschemas=0
user=Struct (30)
usersdatasource=commonspot-users
wanterrorsrethrown=0
warnmessage=
xmlbrowser=Struct (13)
Server Variables:
ADF=Struct (15)
COMMONSPOT=Struct (44)
EMAILALERTKEY=BSu0cRa8xSWdSrClnnGvpA==
coldfusion=Struct (10)
os=Struct (5)
system=Struct (2)
Session Variables:
_csrf_token=1031871EC5B74F1BA8D856CB5C732A3FF4FE7404
adf=Struct (0)
authormode=0
contributemode=read
currentpageid=9706
debugmode=0
debugstate=Struct (1)
editmode=0
environment=Struct (5)
hasusertempfiles=0
language=Struct (216)
lastupdate=Struct (2)
lastuserupdate=1719796691102
lockid=0
lockobjectid=0
lockobjecttype=
locktype=
logintime=
ownedobjecttypes=
pendingapprovalpages=
pendingapprovals=
previewmode=0
requestedversioncounter=
requestedversiontimestamp=
sessionid=D9228A3E18258EB00B614D21D3A42ADC.cfusion
sessionstring=1_D9228A3E18258EB00B614D21D3A42ADC.cfusion
urltoken=CFID=2165873&CFTOKEN=7e52e6f637effb61-36B52A64-A8C1-72CD-FB5AE55509E27316&jsessionid=D9228A3E18258EB00B614D21D3A42ADC.cfusion
usagelist=
user=Struct (30)
xmlbrowser=Struct (13)
xmlenvironment=Struct (5)
URL Parameters:
C_id=0
P_ID=0
T_ID=0
article_id=2447
r_id=0
Debug Rendering Time: 32 ms