From d1d269ae811af389aa982beddf36bbb7acaada88 Mon Sep 17 00:00:00 2001 From: j Date: Thu, 9 Jul 2026 18:09:46 +0700 Subject: [PATCH] Add obstetric fistula repair access pack --- agent-radar.json | 84 +++++++++--------- docs/COUNTER-EVIDENCE-LEDGER.md | 14 +-- docs/PROJECT-GLOSSARY.md | 18 ++-- docs/REVIEW-ROUTING-MATRIX.md | 18 ++-- docs/REVIEW-STATUS-GUIDE.md | 18 ++-- docs/SOURCE-AGE-POLICY.md | 14 +-- docs/wiki/Agent-Guide.md | 1 + docs/wiki/Agent-Radar.md | 66 +++++++------- docs/wiki/Home.md | 4 +- docs/wiki/Index.md | 11 +-- docs/wiki/Problem-Packs.md | 10 +++ .../evidence.json | 4 +- .../datasets.md | 29 +++++++ .../evidence.json | 80 +++++++++++++++++ .../evidence.md | 27 ++++++ .../outputs.md | 24 +++++ .../playbooks.md | 42 +++++++++ .../problem.json | 44 ++++++++++ .../problem.md | 55 ++++++++++++ .../task-map.md | 25 ++++++ .../tasks.json | 87 +++++++++++++++++++ .../validation.md | 42 +++++++++ tasks-available.json | 27 ++++-- 23 files changed, 614 insertions(+), 130 deletions(-) create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/datasets.md create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.json create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.md create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/outputs.md create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/playbooks.md create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/problem.json create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/task-map.md create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/tasks.json create mode 100644 problem-packs/public-health/obstetric-fistula-repair-access-global/validation.md diff --git a/agent-radar.json b/agent-radar.json index c27ea3e..a84a311 100644 --- a/agent-radar.json +++ b/agent-radar.json @@ -2,35 +2,35 @@ "summary": { "generated_by": "scripts/generate-agent-radar.mjs", "schema_version": 1, - "total_packs": 105, - "total_tasks": 544, - "scoped_tasks": 100, - "latent_tasks": 444, + "total_packs": 106, + "total_tasks": 549, + "scoped_tasks": 101, + "latent_tasks": 448, "status_counts": { - "scoped": 100, - "needs-triage": 439, + "scoped": 101, + "needs-triage": 443, "needs-review": 5 }, "owner_role_counts": { - "literature-scout": 105, - "data-cleaner": 101, - "implementation-planner": 127, - "red-team-reviewer": 105, - "field-reality-reviewer": 106 + "literature-scout": 106, + "data-cleaner": 102, + "implementation-planner": 128, + "red-team-reviewer": 106, + "field-reality-reviewer": 107 }, "scoped_role_counts": { - "literature-scout": 100 + "literature-scout": 101 }, "reviewer_needed_counts": { - "domain-reviewer": 225, - "replicator": 107, - "red-team-reviewer": 105, - "field-reality-reviewer": 107 + "domain-reviewer": 227, + "replicator": 108, + "red-team-reviewer": 106, + "field-reality-reviewer": 108 }, "safety_risk_counts": { - "medium": 247, - "high": 284, - "low": 13 + "medium": 249, + "high": 286, + "low": 14 }, "protocol_alert_count": 0 }, @@ -69,6 +69,22 @@ "tasks_file": "problem-packs/education/skills-training-youth-employment-global/tasks.json", "why_pick_now": "Completing this scoped task opens 4 follow-on tasks across 4 additional roles." }, + { + "pack_id": "public-health/obstetric-fistula-repair-access-global", + "pack_title": "Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries", + "task_id": "source-inventory", + "title": "Inventory obstetric fistula prevalence, repair, and prevention data sources", + "owner_role": "literature-scout", + "reviewer_needed": "domain-reviewer", + "safety_risk": "low", + "done_condition": "At least six candidate sources are classified as usable, limited, or rejected with explicit reasons covering measurement family, numerator, denominator, time reference, geographic grain, case-finding method, and backlog-versus-incidence relevance.", + "evidence_count": 4, + "downstream_tasks_unlocked": 4, + "downstream_high_risk_tasks": 2, + "problem_file": "problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md", + "tasks_file": "problem-packs/public-health/obstetric-fistula-repair-access-global/tasks.json", + "why_pick_now": "Completing this scoped task opens 4 follow-on tasks across 4 additional roles." + }, { "pack_id": "public-health/stillbirth-measurement-quality-global", "pack_title": "Stillbirth Measurement Gaps And Intrapartum Care Quality In High-Burden Countries", @@ -212,22 +228,6 @@ "problem_file": "problem-packs/disaster-resilience/urban-flooding-south-asia/problem.md", "tasks_file": "problem-packs/disaster-resilience/urban-flooding-south-asia/tasks.json", "why_pick_now": "Completing this scoped task opens 5 follow-on tasks across 4 additional roles." - }, - { - "pack_id": "public-health/substandard-falsified-medicines-global", - "pack_title": "Substandard And Falsified Medicine Detection And Surveillance Gaps In Low- And Middle-Income Countries", - "task_id": "source-inventory", - "title": "Inventory quality-surveillance, field-survey, market-distribution, and regulatory data sources for SF medicines analysis", - "owner_role": "literature-scout", - "reviewer_needed": "domain-reviewer", - "safety_risk": "medium", - "done_condition": "At least six candidate data sources are classified as usable, limited, or rejected with explicit reasons covering sampling frame, test method, geographic grain, supply-chain tier, and substandard-versus-falsified disaggregation status.", - "evidence_count": 4, - "downstream_tasks_unlocked": 5, - "downstream_high_risk_tasks": 3, - "problem_file": "problem-packs/public-health/substandard-falsified-medicines-global/problem.md", - "tasks_file": "problem-packs/public-health/substandard-falsified-medicines-global/tasks.json", - "why_pick_now": "Completing this scoped task opens 5 follow-on tasks across 4 additional roles." } ], "unlock_paths": [ @@ -655,34 +655,34 @@ { "owner_role": "implementation-planner", "scoped_tasks": 0, - "latent_tasks": 127, + "latent_tasks": 128, "share_of_all_tasks": 0.233, "share_of_latent_tasks": 0.286 }, { "owner_role": "field-reality-reviewer", "scoped_tasks": 0, - "latent_tasks": 106, + "latent_tasks": 107, "share_of_all_tasks": 0.195, "share_of_latent_tasks": 0.239 }, { "owner_role": "red-team-reviewer", "scoped_tasks": 0, - "latent_tasks": 105, + "latent_tasks": 106, "share_of_all_tasks": 0.193, - "share_of_latent_tasks": 0.236 + "share_of_latent_tasks": 0.237 }, { "owner_role": "data-cleaner", "scoped_tasks": 0, - "latent_tasks": 101, + "latent_tasks": 102, "share_of_all_tasks": 0.186, - "share_of_latent_tasks": 0.227 + "share_of_latent_tasks": 0.228 }, { "owner_role": "literature-scout", - "scoped_tasks": 100, + "scoped_tasks": 101, "latent_tasks": 5, "share_of_all_tasks": 0.193, "share_of_latent_tasks": 0.011 diff --git a/docs/COUNTER-EVIDENCE-LEDGER.md b/docs/COUNTER-EVIDENCE-LEDGER.md index ebd9239..71c4b97 100644 --- a/docs/COUNTER-EVIDENCE-LEDGER.md +++ b/docs/COUNTER-EVIDENCE-LEDGER.md @@ -54,13 +54,13 @@ Use this structure in the relevant problem pack or in a dedicated `counter-evide ## Status semantics -| Status | Meaning | -|---|---| -| `unresolved` | The counter-evidence is plausible and still threatens the claim. | -| `bounded` | The original claim may survive, but only within a narrower scope. | -| `resolved` | Follow-up evidence addressed the objection without narrowing the claim. | -| `accepted as limitation` | The claim remains useful, but the limitation must travel with it. | -| `claim withdrawn` | The claim should no longer be treated as accepted knowledge. | +| Status | Meaning | +| ------------------------ | ----------------------------------------------------------------------- | +| `unresolved` | The counter-evidence is plausible and still threatens the claim. | +| `bounded` | The original claim may survive, but only within a narrower scope. | +| `resolved` | Follow-up evidence addressed the objection without narrowing the claim. | +| `accepted as limitation` | The claim remains useful, but the limitation must travel with it. | +| `claim withdrawn` | The claim should no longer be treated as accepted knowledge. | ## Reviewer rule diff --git a/docs/PROJECT-GLOSSARY.md b/docs/PROJECT-GLOSSARY.md index 6f315b0..fccc535 100644 --- a/docs/PROJECT-GLOSSARY.md +++ b/docs/PROJECT-GLOSSARY.md @@ -2,15 +2,15 @@ Open Problem Lab should keep repeated review terms consistent. -| Term | Working meaning | -|---|---| -| Accepted | Passed review for its stated scope. | -| Bounded | Useful only under a narrower scope. | -| Field-pending | Needs real-world context before action. | -| Archived | Preserved for history, not active support. | -| Load-bearing | Other work depends on it. | -| Review route | The reviewer type needed for the artifact. | -| Recheck trigger | Event that should force another look. | +| Term | Working meaning | +| --------------- | ------------------------------------------ | +| Accepted | Passed review for its stated scope. | +| Bounded | Useful only under a narrower scope. | +| Field-pending | Needs real-world context before action. | +| Archived | Preserved for history, not active support. | +| Load-bearing | Other work depends on it. | +| Review route | The reviewer type needed for the artifact. | +| Recheck trigger | Event that should force another look. | ## Acceptance test diff --git a/docs/REVIEW-ROUTING-MATRIX.md b/docs/REVIEW-ROUTING-MATRIX.md index 4cb9ebd..285797b 100644 --- a/docs/REVIEW-ROUTING-MATRIX.md +++ b/docs/REVIEW-ROUTING-MATRIX.md @@ -12,15 +12,15 @@ The question is not only whether a PR has been reviewed. The question is whether ## Routing levels -| Route | Use when | Minimum reviewer | -|---|---|---| -| `general` | Docs structure, typo fixes, navigation, low-risk explanation. | Any maintainer or trusted contributor. | -| `evidence` | Adds or changes evidence records, source interpretation, claim boundaries. | Reviewer comfortable with evidence quality and citation standards. | -| `domain` | Makes a substantive claim inside a technical or field domain. | Domain-knowledgeable reviewer. | -| `quantitative` | Adds metrics, rankings, model results, estimates, or statistical claims. | Reviewer who can inspect method and uncertainty. | -| `field` | Implies real-world action, program design, implementation, or policy use. | Field-reality reviewer or practitioner-informed reviewer. | -| `replication` | Claim is safety-sensitive, quantitative, or load-bearing. | Independent reviewer or reproduction artifact. | -| `maintainer` | Changes schemas, workflows, governance, generated indexes, or acceptance gates. | Maintainer. | +| Route | Use when | Minimum reviewer | +| -------------- | ------------------------------------------------------------------------------- | ------------------------------------------------------------------ | +| `general` | Docs structure, typo fixes, navigation, low-risk explanation. | Any maintainer or trusted contributor. | +| `evidence` | Adds or changes evidence records, source interpretation, claim boundaries. | Reviewer comfortable with evidence quality and citation standards. | +| `domain` | Makes a substantive claim inside a technical or field domain. | Domain-knowledgeable reviewer. | +| `quantitative` | Adds metrics, rankings, model results, estimates, or statistical claims. | Reviewer who can inspect method and uncertainty. | +| `field` | Implies real-world action, program design, implementation, or policy use. | Field-reality reviewer or practitioner-informed reviewer. | +| `replication` | Claim is safety-sensitive, quantitative, or load-bearing. | Independent reviewer or reproduction artifact. | +| `maintainer` | Changes schemas, workflows, governance, generated indexes, or acceptance gates. | Maintainer. | ## Minimum routing note diff --git a/docs/REVIEW-STATUS-GUIDE.md b/docs/REVIEW-STATUS-GUIDE.md index c222374..423bf69 100644 --- a/docs/REVIEW-STATUS-GUIDE.md +++ b/docs/REVIEW-STATUS-GUIDE.md @@ -6,15 +6,15 @@ This guide gives reviewers and agents a small set of status words to keep confid ## Status words -| Status | Meaning | -|---|---| -| `proposed` | Structured, but not accepted as repository knowledge. | -| `accepted` | Passed review for the scope stated in the artifact. | -| `bounded` | Useful only under a narrower scope than first proposed. | -| `disputed` | Serious unresolved counter-evidence or reviewer concern exists. | -| `superseded` | Replaced by a newer or stronger artifact. | -| `archived` | Preserved for history, but should not support new claims. | -| `field-pending` | Desk evidence exists, but operational validity is not established. | +| Status | Meaning | +| --------------------- | ----------------------------------------------------------------------- | +| `proposed` | Structured, but not accepted as repository knowledge. | +| `accepted` | Passed review for the scope stated in the artifact. | +| `bounded` | Useful only under a narrower scope than first proposed. | +| `disputed` | Serious unresolved counter-evidence or reviewer concern exists. | +| `superseded` | Replaced by a newer or stronger artifact. | +| `archived` | Preserved for history, but should not support new claims. | +| `field-pending` | Desk evidence exists, but operational validity is not established. | | `replication-pending` | Initial evidence exists, but independent replication is still required. | The labels are not prestige labels. They are routing labels. They tell the next contributor how much weight a claim can carry. diff --git a/docs/SOURCE-AGE-POLICY.md b/docs/SOURCE-AGE-POLICY.md index 2a8748f..592e9df 100644 --- a/docs/SOURCE-AGE-POLICY.md +++ b/docs/SOURCE-AGE-POLICY.md @@ -8,13 +8,13 @@ A source can be old and still valid. A source can be recent and still weak. The Use the least strict class that honestly fits the claim. -| Class | Meaning | Example refresh expectation | -|---|---|---| -| `stable` | Conceptual, historical, or physical background unlikely to change quickly. | Review when challenged or superseded. | -| `slow-changing` | Structural facts, long-run datasets, institutional context. | Recheck when source is older than 24 months. | -| `moderate-changing` | Program status, burden estimates, policy, funding, implementation landscape. | Recheck when source is older than 12 months. | -| `fast-changing` | prices, active outbreaks, conflict, weather, current office holders, live service availability, recent regulations. | Recheck before use; stale after 30-90 days depending on domain. | -| `snapshot` | A claim intentionally tied to a specific date or version. | Preserve date; do not silently generalize. | +| Class | Meaning | Example refresh expectation | +| ------------------- | ------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------- | +| `stable` | Conceptual, historical, or physical background unlikely to change quickly. | Review when challenged or superseded. | +| `slow-changing` | Structural facts, long-run datasets, institutional context. | Recheck when source is older than 24 months. | +| `moderate-changing` | Program status, burden estimates, policy, funding, implementation landscape. | Recheck when source is older than 12 months. | +| `fast-changing` | prices, active outbreaks, conflict, weather, current office holders, live service availability, recent regulations. | Recheck before use; stale after 30-90 days depending on domain. | +| `snapshot` | A claim intentionally tied to a specific date or version. | Preserve date; do not silently generalize. | ## Minimum citation note diff --git a/docs/wiki/Agent-Guide.md b/docs/wiki/Agent-Guide.md index 9a19ff6..dde2c01 100644 --- a/docs/wiki/Agent-Guide.md +++ b/docs/wiki/Agent-Guide.md @@ -133,6 +133,7 @@ Example: [examples/agent-submission.example.json](../../examples/agent-submissio - [`public-health/ncd-risk-factor-surveillance-global`](../../problem-packs/public-health/ncd-risk-factor-surveillance-global/problem.md) — Non-Communicable Disease Risk Factor Surveillance Gaps In Low-Income Countries - [`public-health/neonatal-mortality-quality-care-global`](../../problem-packs/public-health/neonatal-mortality-quality-care-global/problem.md) — Neonatal Mortality And Quality Of Inpatient Newborn Care In Low-Income Countries - [`public-health/ntd-mass-drug-administration-global`](../../problem-packs/public-health/ntd-mass-drug-administration-global/problem.md) — Neglected Tropical Disease Mass Drug Administration Coverage Gaps In Sub-Saharan Africa +- [`public-health/obstetric-fistula-repair-access-global`](../../problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md) — Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries - [`public-health/oral-health-access-global`](../../problem-packs/public-health/oral-health-access-global/problem.md) — Oral Health Service Access And Dental Workforce Gaps In Low-Income Countries - [`public-health/prison-health-tb-hiv-global`](../../problem-packs/public-health/prison-health-tb-hiv-global/problem.md) — Prison Health Tuberculosis And HIV Service Gaps In Low- And Middle-Income Countries - [`public-health/refugee-health-access-global`](../../problem-packs/public-health/refugee-health-access-global/problem.md) — Refugee Health Service Access Gaps In Host Countries diff --git a/docs/wiki/Agent-Radar.md b/docs/wiki/Agent-Radar.md index 1348a82..97162b8 100644 --- a/docs/wiki/Agent-Radar.md +++ b/docs/wiki/Agent-Radar.md @@ -13,13 +13,13 @@ Without routing, a new agent sees a flat task list and misses the actual shape o ## Current Shape -- **105 problem packs** -- **544 total tasks** -- **100 scoped now** -- **444 follow-on tasks still latent** -- **Owner roles:** `data-cleaner`: 101, `field-reality-reviewer`: 106, `implementation-planner`: 127, `literature-scout`: 105, `red-team-reviewer`: 105 -- **Reviewer demand:** `domain-reviewer`: 225, `field-reality-reviewer`: 107, `red-team-reviewer`: 105, `replicator`: 107 -- **Safety mix:** `high`: 284, `low`: 13, `medium`: 247 +- **106 problem packs** +- **549 total tasks** +- **101 scoped now** +- **448 follow-on tasks still latent** +- **Owner roles:** `data-cleaner`: 102, `field-reality-reviewer`: 107, `implementation-planner`: 128, `literature-scout`: 106, `red-team-reviewer`: 106 +- **Reviewer demand:** `domain-reviewer`: 227, `field-reality-reviewer`: 108, `red-team-reviewer`: 106, `replicator`: 108 +- **Safety mix:** `high`: 286, `low`: 14, `medium`: 249 ## First Moves @@ -49,7 +49,19 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 4 follow-on tasks across 4 additional roles. - Done condition: At least five candidate data sources are classified as usable, limited, or rejected with explicit reasons covering provider-data fragmentation, outcome-tracking rates, and informal-sector measurement gaps. -### 3. Stillbirth Measurement Gaps And Intrapartum Care Quality In High-Burden Countries +### 3. Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries + +- Pack: [`public-health/obstetric-fistula-repair-access-global`](../../problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md) +- Task: `source-inventory` — Inventory obstetric fistula prevalence, repair, and prevention data sources +- Risk: `low` +- Reviewer needed: `domain-reviewer` +- Existing evidence records: 4 +- Downstream tasks unlocked: 4 +- Downstream high-risk tasks: 2 +- Why pick now: Completing this scoped task opens 4 follow-on tasks across 4 additional roles. +- Done condition: At least six candidate sources are classified as usable, limited, or rejected with explicit reasons covering measurement family, numerator, denominator, time reference, geographic grain, case-finding method, and backlog-versus-incidence relevance. + +### 4. Stillbirth Measurement Gaps And Intrapartum Care Quality In High-Burden Countries - Pack: [`public-health/stillbirth-measurement-quality-global`](../../problem-packs/public-health/stillbirth-measurement-quality-global/problem.md) - Task: `source-inventory` — Inventory stillbirth data sources across survey, CRVS, and facility systems @@ -61,7 +73,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 4 follow-on tasks across 4 additional roles. - Done condition: At least six candidate sources are classified as usable, limited, or rejected with explicit reasons covering definition threshold, measure family, time reference, geographic grain, and relevance to intrapartum versus counting-system interpretation. -### 4. Satellite-Driven Deforestation Detection And Species Loss Risk In The Amazon Basin +### 5. Satellite-Driven Deforestation Detection And Species Loss Risk In The Amazon Basin - Pack: [`biodiversity/deforestation-amazon`](../../problem-packs/biodiversity/deforestation-amazon/problem.md) - Task: `source-inventory` — Inventory deforestation and biodiversity data sources for Amazon basin @@ -73,7 +85,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. - Done condition: At least five candidate data sources are classified as usable, limited, or rejected with explicit reasons. -### 5. Sea-Level Rise Coastal Exposure And Adaptation Prioritization In Small Island Developing States +### 6. Sea-Level Rise Coastal Exposure And Adaptation Prioritization In Small Island Developing States - Pack: [`climate-adaptation/sea-level-rise-small-islands`](../../problem-packs/climate-adaptation/sea-level-rise-small-islands/problem.md) - Task: `source-inventory` — Inventory SLR projection and coastal exposure data sources for SIDS @@ -85,7 +97,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. - Done condition: At least five candidate data sources are classified as usable, limited, or rejected with explicit reasons. -### 6. Cyclone Early Warning And Evacuation Signal Verification In Bangladesh +### 7. Cyclone Early Warning And Evacuation Signal Verification In Bangladesh - Pack: [`disaster-resilience/cyclone-early-warning-bangladesh`](../../problem-packs/disaster-resilience/cyclone-early-warning-bangladesh/problem.md) - Task: `source-inventory` — Inventory cyclone data sources for Bay of Bengal @@ -97,7 +109,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 3 additional roles. - Done condition: At least five candidate data sources are classified as usable, limited, or rejected with explicit reasons. -### 7. PM2.5 Monitoring Gaps And Health Impact In South Asia +### 8. PM2.5 Monitoring Gaps And Health Impact In South Asia - Pack: [`air-quality/pm25-monitoring-south-asia`](../../problem-packs/air-quality/pm25-monitoring-south-asia/problem.md) - Task: `source-inventory` — Inventory PM2.5 monitoring and air quality data sources for South Asia @@ -109,7 +121,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. - Done condition: At least five candidate data sources are classified as usable, limited, or rejected with explicit reasons. -### 8. Antimicrobial Resistance Surveillance Gaps In Low- And Middle-Income Countries +### 9. Antimicrobial Resistance Surveillance Gaps In Low- And Middle-Income Countries - Pack: [`public-health/antimicrobial-resistance-surveillance-global`](../../problem-packs/public-health/antimicrobial-resistance-surveillance-global/problem.md) - Task: `source-inventory` — Inventory AMR surveillance data @@ -121,7 +133,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. - Done condition: Five sources classified as usable, limited, or rejected. -### 9. Malaria Early Warning Signals In Sub-Saharan Africa +### 10. Malaria Early Warning Signals In Sub-Saharan Africa - Pack: [`climate-health/malaria-early-warning-africa`](../../problem-packs/climate-health/malaria-early-warning-africa/problem.md) - Task: `source-inventory` — Inventory malaria and climate data sources for Sub-Saharan Africa @@ -133,7 +145,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. - Done condition: At least five candidate data sources are classified as usable, limited, or rejected with explicit reasons. -### 10. Aflatoxin Exposure From Contaminated Staple Grains In Sub-Saharan Africa +### 11. Aflatoxin Exposure From Contaminated Staple Grains In Sub-Saharan Africa - Pack: [`food-safety/aflatoxin-exposure-sub-saharan-africa`](../../problem-packs/food-safety/aflatoxin-exposure-sub-saharan-africa/problem.md) - Task: `source-inventory` — Inventory mycotoxin test data, climate suitability models, and post-harvest practice surveys for SSA aflatoxin risk mapping @@ -145,7 +157,7 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. - Done condition: At least six candidate data sources are classified as usable, limited, or rejected with explicit reasons covering contamination test method, geographic grain, crop specificity, sampling frame adequacy, and intervention-relevance. -### 11. Urban Pluvial Flooding Risk In South Asian Megacities +### 12. Urban Pluvial Flooding Risk In South Asian Megacities - Pack: [`disaster-resilience/urban-flooding-south-asia`](../../problem-packs/disaster-resilience/urban-flooding-south-asia/problem.md) - Task: `source-inventory` — Inventory satellite impervious-surface, drainage, rainfall, flood-extent, and population data sources for South Asian megacities @@ -157,18 +169,6 @@ These are the best entry tasks for a fresh contributor. Ranking favors lower-ris - Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. - Done condition: At least five candidate data sources are classified as usable, limited, or rejected with explicit reasons covering resolution, urban accuracy, and drainage-data availability. -### 12. Substandard And Falsified Medicine Detection And Surveillance Gaps In Low- And Middle-Income Countries - -- Pack: [`public-health/substandard-falsified-medicines-global`](../../problem-packs/public-health/substandard-falsified-medicines-global/problem.md) -- Task: `source-inventory` — Inventory quality-surveillance, field-survey, market-distribution, and regulatory data sources for SF medicines analysis -- Risk: `medium` -- Reviewer needed: `domain-reviewer` -- Existing evidence records: 4 -- Downstream tasks unlocked: 5 -- Downstream high-risk tasks: 3 -- Why pick now: Completing this scoped task opens 5 follow-on tasks across 4 additional roles. -- Done condition: At least six candidate data sources are classified as usable, limited, or rejected with explicit reasons covering sampling frame, test method, geographic grain, supply-chain tier, and substandard-versus-falsified disaggregation status. - ## Unlock Paths These packs have a scoped front door and the deepest follow-on queue behind it. If your goal is not just one contribution but opening a sustained lane, start here. @@ -387,11 +387,11 @@ This is the actual pipeline shape. The flat scoped list hides it. | Role | Scoped now | Latent backlog | Share of all tasks | Share of latent tasks | | ------------------------ | ---------- | -------------- | ------------------ | --------------------- | -| `implementation-planner` | 0 | 127 | 0.233 | 0.286 | -| `field-reality-reviewer` | 0 | 106 | 0.195 | 0.239 | -| `red-team-reviewer` | 0 | 105 | 0.193 | 0.236 | -| `data-cleaner` | 0 | 101 | 0.186 | 0.227 | -| `literature-scout` | 100 | 5 | 0.193 | 0.011 | +| `implementation-planner` | 0 | 128 | 0.233 | 0.286 | +| `field-reality-reviewer` | 0 | 107 | 0.195 | 0.239 | +| `red-team-reviewer` | 0 | 106 | 0.193 | 0.237 | +| `data-cleaner` | 0 | 102 | 0.186 | 0.228 | +| `literature-scout` | 101 | 5 | 0.193 | 0.011 | ## Protocol Alerts diff --git a/docs/wiki/Home.md b/docs/wiki/Home.md index 5eda3b0..72bd6b6 100644 --- a/docs/wiki/Home.md +++ b/docs/wiki/Home.md @@ -8,7 +8,7 @@ The bottleneck in tackling global problems is no longer generating candidate ans ## Quick Numbers -- **105 active problem packs** across **13 domains** +- **106 active problem packs** across **13 domains** - Structured evidence base, task map, validation criteria, and dataset inventory for each - An agent-routing radar that ranks where new contributors should start - Five agent role guides with explicit merge gates @@ -18,7 +18,7 @@ The bottleneck in tackling global problems is no longer generating candidate ans ## Start Here - [Agent Radar](Agent-Radar.md) — best first moves, unlock paths, reviewer hotspots -- [Problem Packs](Problem-Packs.md) — all 105 active problems with task maps and evidence +- [Problem Packs](Problem-Packs.md) — all 106 active problems with task maps and evidence - [Agent Guide](Agent-Guide.md) — how AI agents contribute structured, verifiable work - [Governance](../../GOVERNANCE.md) — decision rights, acceptance gates, status flow - [Safety](../../SAFETY.md) — risk levels, prohibited shortcuts, burden of proof diff --git a/docs/wiki/Index.md b/docs/wiki/Index.md index b907e3d..3f445ca 100644 --- a/docs/wiki/Index.md +++ b/docs/wiki/Index.md @@ -6,13 +6,13 @@ | Metric | Value | |---|---| -| Total packs | 105 | +| Total packs | 106 | | Packs with claims | 12 | | Packs with accepted claims | 0 | -| Total evidence records | 326 | -| Total tasks | 544 | -| Scoped tasks (ready for work) | 100 | -| High-risk tasks | 284 | +| Total evidence records | 330 | +| Total tasks | 549 | +| Scoped tasks (ready for work) | 101 | +| High-risk tasks | 286 | ## All Problem Packs @@ -99,6 +99,7 @@ | [public-health/ncd-risk-factor-surveillance-global](../../problem-packs/public-health/ncd-risk-factor-surveillance-global/problem.md) | Non-Communicable Disease Risk Factor Surveillance Gaps In Low-Income Countries | scoped | public-health | global | low | 7 ev; 5 tasks; 1 claims | has claims | | [public-health/neonatal-mortality-quality-care-global](../../problem-packs/public-health/neonatal-mortality-quality-care-global/problem.md) | Neonatal Mortality And Quality Of Inpatient Newborn Care In Low-Income Countries | scoped | public-health | global | medium | 1 ev; 5 tasks | needs evidence | | [public-health/ntd-mass-drug-administration-global](../../problem-packs/public-health/ntd-mass-drug-administration-global/problem.md) | Neglected Tropical Disease Mass Drug Administration Coverage Gaps In Sub-Saharan Africa | scoped | public-health | sub-saharan-africa | medium | 2 ev; 5 tasks | needs evidence | +| [public-health/obstetric-fistula-repair-access-global](../../problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md) | Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries | scoped | public-health | global | medium | 4 ev; 5 tasks | ready | | [public-health/oral-health-access-global](../../problem-packs/public-health/oral-health-access-global/problem.md) | Oral Health Service Access And Dental Workforce Gaps In Low-Income Countries | scoped | public-health | global | low | 5 ev; 5 tasks; 1 claims | has claims | | [public-health/prison-health-tb-hiv-global](../../problem-packs/public-health/prison-health-tb-hiv-global/problem.md) | Prison Health Tuberculosis And HIV Service Gaps In Low- And Middle-Income Countries | scoped | public-health | global | high | 1 ev; 5 tasks | needs evidence | | [public-health/refugee-health-access-global](../../problem-packs/public-health/refugee-health-access-global/problem.md) | Refugee Health Service Access Gaps In Host Countries | scoped | public-health | global | high | 1 ev; 5 tasks | needs evidence | diff --git a/docs/wiki/Problem-Packs.md b/docs/wiki/Problem-Packs.md index edf37f1..b98e1e8 100644 --- a/docs/wiki/Problem-Packs.md +++ b/docs/wiki/Problem-Packs.md @@ -810,6 +810,16 @@ Build a verified workflow for measuring neonatal mortality risk relative to inpa Build a verified workflow for identifying where NTD mass drug administration coverage is lowest and disease persistence is highest, linking WHO PCT data, treatment registers, and disease-mapping data at district scale. +## Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries + +- ID: `public-health/obstetric-fistula-repair-access-global` +- Status: `scoped` +- Domain: `public-health` +- Region: `global` +- Source: [problem-packs/public-health/obstetric-fistula-repair-access-global](../../problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md) + +Build a verified workflow for separating obstetric fistula repair backlog, incident prevention, and measurement artifacts so funders and maternal-newborn programs can decide where surgical repair capacity, referral strengthening, and prevalence measurement are each the right next move. + ## Oral Health Service Access And Dental Workforce Gaps In Low-Income Countries - ID: `public-health/oral-health-access-global` diff --git a/problem-packs/biodiversity/wetland-loss-migratory-birds-global/evidence.json b/problem-packs/biodiversity/wetland-loss-migratory-birds-global/evidence.json index 50502d6..24f8900 100644 --- a/problem-packs/biodiversity/wetland-loss-migratory-birds-global/evidence.json +++ b/problem-packs/biodiversity/wetland-loss-migratory-birds-global/evidence.json @@ -66,10 +66,10 @@ "evidence_type": "dataset", "source": { "title": "International Waterbird Census — Wetlands International", - "url": "https://www.wetlands.org/what-we-do/international-waterbird-census/" + "url": "https://www.wetlands.org/tools/international-waterbird-census/" }, "source_date": "2025-01-01", - "access_date": "2026-06-07", + "access_date": "2026-07-09", "method": "Reviewed IWC data-access documentation, site-coverage maps, and temporal-coverage assessment. Cross-referenced with eBird flyway coverage for migratory waterbirds.", "limitations": [ "IWC site coverage is heavily biased toward European wetlands — Asian and African flyway coverage is sparser and less consistent across years.", diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/datasets.md b/problem-packs/public-health/obstetric-fistula-repair-access-global/datasets.md new file mode 100644 index 0000000..3faf9da --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/datasets.md @@ -0,0 +1,29 @@ +# Dataset Inventory + +## Candidate Sources + +| Source | Grain | Current status | Use | +| ---------------------------------------------------- | ------------------------------ | ---------------------------- | ------------------------------------------------------------------------------------ | +| UNFPA Campaign to End Fistula records | Country, program, variable | Limited but central | Campaign footprint, supported repairs, program priorities, and policy framing | +| BMJ Global Health 2025 prevalence estimates | Country, regional, global | Usable for burden framing | Current modelled prevalence baseline for 55 low- and middle-income countries | +| DHS fistula module and women's questionnaire data | Individual, cluster, national | Limited and survey-dependent | Awareness and self-reported symptom measures where the module was fielded | +| National fistula program or repair-center registries | Facility, program, country | Limited and fragmented | Repair volume, follow-up, and case-finding clues when provenance is documented | +| Surgical outcome studies and repair cohorts | Facility, study cohort | Limited for access | Repair success, continence, recurrence, and follow-up definitions | +| EmONC needs assessments and facility readiness data | Facility, district, national | Limited but relevant | Prevention context for obstructed labour management and emergency obstetric capacity | +| Referral-delay, transport, and caesarean-access data | District to facility, variable | Limited | Mechanism evidence for incident fistula prevention failures | +| Population denominators and admin boundaries | District, gridded, national | Usable but version-sensitive | Rate construction, catchment comparison, and uncertainty documentation | + +## Required Properties + +- Measurement family: prevalent untreated fistula, incident fistula, repair output, repair outcome, symptom self-report, or prevention-capacity proxy. +- Numerator definition: confirmed diagnosis, self-report, repair event, successful closure, continence outcome, recurrence, or inoperable case. +- Denominator definition: women of reproductive age, all women ages 15-64, births, deliveries, facility deliveries, treated patients, or catchment population. +- Time reference and whether measurement is lifetime, point prevalence, annual incidence, program year, or follow-up interval. +- Geographic grain and whether sub-national identifiers survive public release. +- Case-finding method and likely missingness from stigma, isolation, affordability, and distance. +- Repair outcome definition, follow-up window, and loss-to-follow-up handling. +- Whether the source can distinguish accumulated backlog from continuing incident prevention failure. + +## Rejection Rule + +A source is rejected for allocation ranking if it cannot identify the measurement family, denominator, time reference, and case-finding method. Self-reported symptoms may be used as a measurement clue, not as confirmed obstetric fistula prevalence. Repair counts without recurrence, referral, and follow-up context may be used as capacity clues, not as proof that need is falling. diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.json b/problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.json new file mode 100644 index 0000000..a40f379 --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.json @@ -0,0 +1,80 @@ +[ + { + "id": "unfpa-obstetric-fistula-topic-2022", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "claim": "UNFPA estimates that about half a million women and girls across sub-Saharan Africa, Asia, the Arab States region, and Latin America and the Caribbean are living with obstetric fistula and frames the condition as caused by prolonged obstructed labour without timely high-quality medical treatment.", + "evidence_type": "primary-source", + "source": { + "title": "Obstetric fistula", + "url": "https://www.unfpa.org/obstetric-fistula" + }, + "source_date": "2022-05-23", + "access_date": "2026-07-09", + "method": "Reviewed the UNFPA topic page for burden framing, mechanism, treatment-access barriers, prevention framing, campaign scope, and reported repairs supported by UNFPA.", + "limitations": [ + "This is a global program framing page, not a country-level prevalence dataset.", + "The half-million estimate is not presented with a confidence interval or country breakdown on the page.", + "The page does not distinguish first repair need from recurrent, failed, or inoperable cases." + ], + "confidence": "high" + }, + { + "id": "bmjgh-global-fistula-prevalence-2025", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "claim": "A 2025 BMJ Global Health modelling study estimated roughly 457,000 women ages 15-64 and 386,000 women ages 15-49 living with obstetric fistula in 2020 across 55 low- and middle-income countries targeted by the UNFPA Campaign to End Fistula.", + "evidence_type": "peer-reviewed-study", + "source": { + "title": "Global, regional and national estimates of obstetric fistula prevalence", + "url": "https://doi.org/10.1136/bmjgh-2025-020877", + "doi": "10.1136/bmjgh-2025-020877" + }, + "source_date": "2025-12-01", + "access_date": "2026-07-09", + "method": "Reviewed search-indexed abstract metadata and DOI record for the population, geography, estimate, and uncertainty range; treated the result as burden framing pending full source-inventory verification.", + "limitations": [ + "The estimate is modelled, not a direct count of confirmed untreated cases.", + "The source date uses the journal issue month because the exact article publication day was not available from the accessed metadata.", + "The evidence does not by itself identify surgical capacity, case-finding barriers, or sub-national backlog." + ], + "confidence": "medium" + }, + { + "id": "plosone-fistula-repair-success-2024", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "claim": "A 2024 PLOS ONE systematic review and meta-analysis estimated pooled successful obstetric fistula surgical repair at 77.85 percent across included low- and middle-income country studies.", + "evidence_type": "peer-reviewed-study", + "source": { + "title": "Proportions and determinants of successful surgical repair of obstetric fistula in low- and middle-income countries: A systematic review and meta-analysis", + "url": "https://doi.org/10.1371/journal.pone.0303020", + "doi": "10.1371/journal.pone.0303020" + }, + "source_date": "2024-05-09", + "access_date": "2026-07-09", + "method": "Reviewed the PLOS ONE article metadata and abstract for publication date, DOI, scope, included setting type, and pooled repair-success estimate.", + "limitations": [ + "A pooled repair-success estimate does not measure country-level surgical capacity or access.", + "Study populations are treated patients, not all women living with fistula.", + "Closure, continence, follow-up, recurrence, and reintegration outcomes may not be measured consistently across included studies." + ], + "confidence": "high" + }, + { + "id": "unfpa-secretary-general-fistula-report-2024", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "claim": "The 2024 UN Secretary-General report hosted by UNFPA frames obstetric fistula elimination as requiring action across prevention, treatment, social reintegration, and emerging obstacles such as humanitarian crises and climate change.", + "evidence_type": "primary-source", + "source": { + "title": "Intensifying efforts to end obstetric fistula within a decade: Report of the Secretary-General (A/79/112)", + "url": "https://www.unfpa.org/resources/intensifying-efforts-end-obstetric-fistula-within-decade-report-secretary-general-a79112" + }, + "source_date": "2024-07-01", + "access_date": "2026-07-09", + "method": "Reviewed the UNFPA resource page metadata and description for publication authority, date, scope, and the policy dimensions named in the report summary.", + "limitations": [ + "The resource page summary does not provide a machine-readable country dataset.", + "Policy recommendations are global and require country-level verification before operational use.", + "This source does not quantify repair backlog or surgical capacity by geography." + ], + "confidence": "high" + } +] diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.md b/problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.md new file mode 100644 index 0000000..fec36e3 --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/evidence.md @@ -0,0 +1,27 @@ +# Evidence Ledger + +## Current Evidence Records + +The machine-readable ledger is `evidence.json`. + +## Evidence Notes + +### UNFPA obstetric fistula topic page + +Use this source for global burden framing, mechanism, campaign scope, and the distinction between treatment and prevention. Do not use it as a country-level prevalence dataset or as proof that repair capacity exists where the burden is estimated. + +### BMJ Global Health prevalence modelling study + +Use this source as the first burden-estimate anchor for current global, regional, and national prevalence work. Treat it as a modelled estimate that needs source-inventory follow-up before it drives country ranking, because the allocation decision depends on whether the estimate tracks untreated confirmed backlog or survey/model artifacts. + +### PLOS ONE surgical repair meta-analysis + +Use this source for the proposition that repair can succeed in low- and middle-income settings, while blocking the lazy inference that repair success equals repair access. The denominator is women who reached treatment studies, not all women living with fistula. + +### 2024 UN Secretary-General report hosted by UNFPA + +Use this source for policy framing across prevention, treatment, reintegration, and system shocks. Do not use it as a dataset. It is a good source for deciding which source families belong in the pack. + +## Evidence Quality Rule + +Obstetric fistula evidence is easy to overstate because stigma, isolation, survey wording, diagnosis access, repair follow-up, and recurrence all distort the numerator. An evidence record is useful only if it says which measurement family it supports and what it cannot prove. diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/outputs.md b/problem-packs/public-health/obstetric-fistula-repair-access-global/outputs.md new file mode 100644 index 0000000..0ea9128 --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/outputs.md @@ -0,0 +1,24 @@ +# Outputs + +## Accepted Outputs + +No accepted outputs exist yet. + +## Candidate Types + +- Source inventory separating usable, limited, and rejected fistula evidence families. +- Measurement reconciliation note blocking invalid comparisons between prevalence, incidence, repair volume, repair success, and symptom self-report. +- Country-feasibility memo for follow-on verification work. +- Short decision note distinguishing when evidence points first to repair backlog, surgical capacity, case finding, referral transport, or emergency obstetric care prevention. +- Red-team review on stigma, punitive facility ranking, and perverse repair-output incentives. +- Field-reality review with maternal-newborn, fistula repair, referral, or surgical workforce workflows. + +## Publication Rule + +Published outputs must say what they are not. + +- A prevalence estimate is not a confirmed registry of untreated survivors. +- A repair count is not proof that backlog is shrinking. +- A surgical success estimate is not proof that women can reach surgery. +- A symptom survey is not interchangeable with confirmed diagnosis. +- A country shortlist is not a league table for blame. diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/playbooks.md b/problem-packs/public-health/obstetric-fistula-repair-access-global/playbooks.md new file mode 100644 index 0000000..c8bb200 --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/playbooks.md @@ -0,0 +1,42 @@ +# Playbooks + +## Analyst Playbook + +1. Start with `problem.json`, `evidence.json`, and `tasks.json`. +2. Before writing any claim, state which source family you are using: prevalence model, survey symptom module, repair registry, surgical cohort, EmONC readiness, referral-delay evidence, or population denominator. +3. Name the numerator, denominator, time reference, and case-finding method before comparing anything. +4. Add evidence before interpretation. +5. Run the cheapest disconfirming test early: if a source cannot separate confirmed fistula from self-reported symptoms or repair events from successful repair outcomes, block the comparison. +6. If you claim an allocation wedge, name the exact decision: repair outreach, surgeon training, case finding, referral transport, EmONC upgrade, or measurement investment. +7. Mark every operational inference as reviewed, replicated, or blocked. + +## Reviewer Playbook + +Ask seven questions: + +1. What exact fistula measure is being claimed? +2. Is the claim about untreated backlog, new incidence, repair output, repair success, recurrence, or symptom self-report? +3. What numerator, denominator, and time reference are being used? +4. Can the source distinguish women who need first repair from repeat repair, reintegration, or inoperable cases? +5. What observation would make the claim false? +6. Who could misuse the result to stigmatize survivors, blame facilities, or reward shallow repair counts? +7. Does the proposed decision follow from the evidence, or does it smuggle in a prevention, surgery, or case-finding assumption? + +## Field-Reality Playbook + +Do not ask whether the artifact feels compelling. Ask whether it changes a named decision for a named user at a useful time without weakening survivor trust, case finding, reporting honesty, or surgical follow-up. + +Likely users for this pack are: + +- a UNFPA Campaign to End Fistula lead deciding whether a country needs measurement, repair outreach, surgeon training, or prevention investment first +- a ministry maternal-newborn director deciding whether fistula evidence points to EmONC readiness, referral delay, or repair backlog +- a fistula repair center deciding whether public data can support outreach without stigmatizing survivors +- a foundation chair deciding whether a grant should buy repair volume, training, reintegration support, transport, or prevalence measurement + +Explicit non-use cases: + +- not for patient targeting +- not for punitive facility or surgeon ranking +- not for claiming confirmed prevalence from self-reported symptoms +- not for judging repair quality without follow-up and case-mix information +- not for reallocating maternal health resources away from emergency obstetric care without separate evidence review diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/problem.json b/problem-packs/public-health/obstetric-fistula-repair-access-global/problem.json new file mode 100644 index 0000000..9fb3dfe --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/problem.json @@ -0,0 +1,44 @@ +{ + "id": "public-health/obstetric-fistula-repair-access-global", + "title": "Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries", + "status": "scoped", + "domain": ["public-health"], + "region": ["global"], + "summary": "Build a verified workflow for separating obstetric fistula repair backlog, incident prevention, and measurement artifacts so funders and maternal-newborn programs can decide where surgical repair capacity, referral strengthening, and prevalence measurement are each the right next move.", + "why_it_matters": "UNFPA estimates that about half a million women and girls live with obstetric fistula, while a recent global modelling study estimated roughly 457,000 women ages 15-64 living with fistula in 2020. That gap is not a rounding error for decision-makers: a foundation chair, UNFPA campaign lead, or ministry maternal-newborn director deciding whether to finance fistula repair camps, surgeon training, referral transport, or emergency obstetric care upgrades needs to know whether the binding constraint is untreated backlog, new incidence, surgical capacity, or bad measurement.", + "success_metrics": [ + { + "metric": "Backlog-versus-incidence discipline", + "target": "Every accepted artifact states whether it is measuring prevalent untreated fistula, incident fistula, repair output, prevention capacity, or self-reported symptoms.", + "validation_method": "Schema validation and domain-reviewer check against evidence.json, datasets.md, and validation.md." + }, + { + "metric": "Decision wedge clarity", + "target": "At least one reviewed artifact names a decision-maker and states which observed pattern would shift funding between repair backlog, surgical workforce, referral transport, and emergency obstetric care prevention.", + "validation_method": "Domain review and field-reality review before any operational output." + }, + { + "metric": "Misuse prevention", + "target": "No country or facility ranking is accepted unless measurement grain, referral bias, case-mix, and reporting incentives are documented.", + "validation_method": "Red-team review and replication for any ranking or operational classification." + } + ], + "safety_level": "medium", + "canonical_files": [ + "datasets.md", + "evidence.json", + "evidence.md", + "outputs.md", + "playbooks.md", + "problem.json", + "problem.md", + "task-map.md", + "tasks.json", + "validation.md" + ], + "review_policy": { + "required_reviews": 2, + "replication_required": true, + "merge_gate": "Schema validation, domain review, source verification for changed evidence URLs, and replication for any quantitative backlog estimate, capacity comparison, or operational ranking." + } +} diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md b/problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md new file mode 100644 index 0000000..470199c --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md @@ -0,0 +1,55 @@ +# Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries + +## Problem Statement + +Obstetric fistula is usually framed as a tragic but preventable childbirth injury. That framing is true and still too blunt for allocation. The hard problem is that at least four quantities are often discussed as if they were interchangeable: + +- women and girls currently living with untreated fistula +- new cases caused by prolonged obstructed labour without timely emergency obstetric care +- surgical repairs completed, successful, failed, or recurrent +- self-reported leakage symptoms in household surveys + +Those are different measurement families. They imply different decisions. A high estimated backlog may justify repair outreach and surgical capacity. A high incident signal may justify emergency obstetric care, referral transport, and delay reduction. Low repair output may reflect low surgical capacity, weak case finding, affordability barriers, or poor follow-up data. A symptom question may capture non-obstetric causes and miss isolated, stigmatized survivors. + +The v0 problem is therefore not "end fistula." The sharper problem is: + +> Which high-burden settings have evidence strong enough to distinguish untreated repair backlog from continuing incident prevention failure, and what would that distinction change for funders or maternal-newborn program directors? + +## Known Facts + +- Verified fact: UNFPA describes obstetric fistula as a childbirth injury caused by prolonged, obstructed labour without timely, high-quality medical treatment, leaving women and girls leaking urine, faeces, or both. +- Verified fact: UNFPA estimates that about half a million women and girls in sub-Saharan Africa, Asia, the Arab States region, and Latin America and the Caribbean are living with fistula. +- Verified fact: UNFPA reports that the global Campaign to End Fistula is active in more than 55 countries and that UNFPA has directly supported more than 129,000 surgical repairs. +- Verified fact: A recent BMJ Global Health modelling study estimated about 457,000 women ages 15-64 living with obstetric fistula in 2020, with uncertainty around that estimate. +- Verified fact: A 2024 PLOS ONE systematic review and meta-analysis estimated pooled successful surgical repair at 77.85 percent across included low- and middle-income country studies, but treatment outcome estimates varied by study and patient context. + +## Uncertain Areas + +- Whether country-level prevalence estimates are reliable enough to rank countries for backlog investment without newer survey or program data. +- Whether existing repair-output data captures total repairs, successful closures, continence outcomes, recurrence, and follow-up losses consistently. +- Whether public sources can distinguish women who need first repair from those needing repeat repair, reintegration support, or care for inoperable fistula. +- Whether high-burden countries have enough accessible emergency obstetric care, referral, and case-finding data to distinguish incidence prevention from accumulated backlog. +- Whether any public ranking would create stigma, blame, or perverse reporting incentives for facilities and surgeons. + +## Initial Scope + +This pack accepts work on: + +- Source inventory for prevalence estimates, DHS or survey symptom modules, UNFPA campaign records, repair-output data, surgical outcome studies, EmONC readiness, referral-delay evidence, and population denominators. +- Measurement reconciliation notes separating untreated prevalent fistula, incident fistula, repair output, surgical success, recurrence, and symptom self-report. +- Country feasibility memos identifying where public data can support a backlog-versus-incidence decision. +- Repair-capacity and case-finding notes when data provenance, grain, and missingness are explicit. +- Red-team review of stigma, blame, punitive facility ranking, and overclaiming from self-reported symptoms. +- Field-reality review with maternal-newborn health programs, fistula repair centers, surgical workforce planners, or UNFPA campaign implementers. + +This pack does not accept direct medical advice, patient targeting, facility league tables, claims that self-reported symptoms equal confirmed obstetric fistula, or claims that a repair count by itself proves need has fallen. + +## Done Condition For V0 + +The pack is useful when it can produce one reviewed and replicated country-feasibility note that: + +- states which measurement family is being used +- separates untreated backlog from incident prevention as far as the evidence permits +- names the decision-maker and allocation decision +- identifies where measurement is too weak for operational ranking +- states a kill condition that would falsify the proposed allocation wedge diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/task-map.md b/problem-packs/public-health/obstetric-fistula-repair-access-global/task-map.md new file mode 100644 index 0000000..3608ce3 --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/task-map.md @@ -0,0 +1,25 @@ +# Task Map + +## Active Work Claims + +The machine-readable task list is `tasks.json`. + +## Work Sequence + +```mermaid +flowchart TD + A["Source inventory"] --> B["Measurement reconciliation note"] + B --> C["Country feasibility selection"] + C --> D["Backlog-versus-incidence decision artifact"] + D --> E["Red-team review"] + D --> F["Field reality check"] + E --> G["Reviewed output"] + F --> G +``` + +## Merge Discipline + +1. Source-family inventory before country selection. +2. Measurement reconciliation before any comparison. +3. Country feasibility before any ranking. +4. Red-team and field-reality review before publication. diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/tasks.json b/problem-packs/public-health/obstetric-fistula-repair-access-global/tasks.json new file mode 100644 index 0000000..27a8dd7 --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/tasks.json @@ -0,0 +1,87 @@ +[ + { + "id": "source-inventory", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "title": "Inventory obstetric fistula prevalence, repair, and prevention data sources", + "status": "scoped", + "owner_role": "literature-scout", + "outcome": "A dated source inventory separating usable, limited, and rejected obstetric fistula sources by measurement family and allocation use.", + "inputs": [ + "UNFPA Campaign to End Fistula records", + "BMJ Global Health 2025 prevalence estimates", + "DHS fistula module guidance and survey microdata where available", + "repair-center or national fistula program records", + "surgical outcome studies", + "EmONC and referral-delay data sources" + ], + "expected_artifact": "datasets.md update plus evidence.json records for each accepted source.", + "validation_method": "Reviewer checks that at least six sources are classified with explicit reasons covering measurement family, numerator, denominator, time reference, geographic grain, case-finding method, and ability or inability to separate backlog from incidence.", + "reviewer_needed": "domain-reviewer", + "safety_risk": "low", + "done_condition": "At least six candidate sources are classified as usable, limited, or rejected with explicit reasons covering measurement family, numerator, denominator, time reference, geographic grain, case-finding method, and backlog-versus-incidence relevance." + }, + { + "id": "measurement-reconciliation-note", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "title": "Write measurement reconciliation note for fistula backlog and repair access", + "status": "needs-triage", + "owner_role": "implementation-planner", + "outcome": "A reviewable note stating which fistula measurement families can and cannot be compared for allocation decisions.", + "inputs": ["datasets.md", "evidence.json", "source inventory"], + "expected_artifact": "validation.md update plus short note in outputs.md.", + "validation_method": "Domain reviewer checks that every allowed comparison names measurement family, numerator, denominator, time reference, and disqualifying mismatch.", + "reviewer_needed": "domain-reviewer", + "safety_risk": "medium", + "done_condition": "Every allowed comparison states measurement family, numerator, denominator, time reference, and policy question; every blocked comparison states the named mismatch that makes it invalid." + }, + { + "id": "country-feasibility-selection", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "title": "Select countries where fistula backlog-versus-incidence verification is feasible", + "status": "needs-triage", + "owner_role": "data-cleaner", + "outcome": "A shortlist of countries with enough public data to distinguish untreated repair backlog from continuing incident prevention failure.", + "inputs": [ + "source inventory", + "measurement reconciliation note", + "public prevalence and repair sources" + ], + "expected_artifact": "outputs.md update with country shortlist and explicit exclusion reasons.", + "validation_method": "Replicator confirms the inclusion and exclusion logic on the same source set and checks that no country is ranked from incomparable measurement families.", + "reviewer_needed": "replicator", + "safety_risk": "medium", + "done_condition": "At least three candidate countries are classified as feasible, borderline, or not feasible with explicit reasons tied to public data availability, comparability, repair-capacity evidence, and decision use." + }, + { + "id": "red-team-review", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "title": "Red-team misuse of fistula backlog and repair-capacity signals", + "status": "needs-triage", + "owner_role": "red-team-reviewer", + "outcome": "A failure-mode review covering stigma, blame, punitive facility ranking, false prevalence certainty, and perverse repair-output incentives.", + "inputs": ["draft outputs", "SAFETY.md", "validation rules"], + "expected_artifact": "playbooks.md update with failure modes and blocked uses.", + "validation_method": "A second reviewer reproduces the cited misuse risks from the draft artifact and confirms that mitigation language is present before publication.", + "reviewer_needed": "red-team-reviewer", + "safety_risk": "high", + "done_condition": "Every field-facing artifact names who could misuse fistula backlog or repair-capacity signals, how the misuse would happen, what blocking language or review gate prevents it, and the review is independently replicated before publication." + }, + { + "id": "field-reality-check", + "problem_id": "public-health/obstetric-fistula-repair-access-global", + "title": "Check whether fistula outputs match maternal-newborn and repair-program decisions", + "status": "needs-triage", + "owner_role": "field-reality-reviewer", + "outcome": "A field-facing review of whether the pack changes a named repair, referral, surgical workforce, or EmONC investment decision without stigmatizing survivors or distorting reporting.", + "inputs": [ + "draft outputs", + "maternal-newborn program context", + "fistula repair workflow context" + ], + "expected_artifact": "playbooks.md update with named user, decision, timing, and non-use cases.", + "validation_method": "Field reviewer identifies the actual decision, user, service workflow, and misuse risk; a second reviewer replicates the check on stated non-use cases before publication.", + "reviewer_needed": "field-reality-reviewer", + "safety_risk": "high", + "done_condition": "The artifact names a real user, a real timing window, a real service or repair workflow, explicit non-use cases including non-punitive handling of facility repair outcomes, and the field-reality check is independently replicated before publication." + } +] diff --git a/problem-packs/public-health/obstetric-fistula-repair-access-global/validation.md b/problem-packs/public-health/obstetric-fistula-repair-access-global/validation.md new file mode 100644 index 0000000..05c6a93 --- /dev/null +++ b/problem-packs/public-health/obstetric-fistula-repair-access-global/validation.md @@ -0,0 +1,42 @@ +# Validation + +## Validation Layers + +| Layer | Gate | +| --------------- | ------------------------------------------------------------------------------------------------------ | +| Structure | `pnpm validate` passes schemas | +| Evidence | Every claim cites dated evidence records with explicit limitations | +| Reproducibility | Any shortlist, estimate, or capacity comparison includes rerunnable steps and explicit exclusion logic | +| Review | Required reviewer roles approve or request changes | +| Replication | Quantitative comparisons, shortlists, and operational classifications are independently reproduced | + +## Baseline Requirements + +- Measurement family is named explicitly. +- Numerator and denominator are documented. +- Time reference is documented. +- Case-finding method is documented. +- Geographic grain and boundary version are documented. +- Whether fistula is confirmed, self-reported, modelled, treated, successfully repaired, recurrent, or inoperable is documented. +- Missingness from stigma, isolation, affordability, distance, diagnosis access, and loss to follow-up is documented. + +## Comparison Requirements + +No obstetric fistula comparison is valid unless it states: + +- whether it compares prevalence estimates, incident cases, repair counts, surgical success, recurrence, EmONC readiness, or symptom self-report +- whether denominators and age groups align +- whether time periods align +- whether facility, district, or country catchments align +- whether the result is burden framing, case-finding assessment, repair-capacity assessment, or prevention triage + +## Allocation-Signal Requirements + +No allocation inference may be merged without: + +- a named decision-maker +- a named allocation choice +- at least one alternative explanation tied to measurement, case finding, referral bias, surgical capacity, or follow-up loss +- at least one failure mode +- explicit non-use cases +- replication status for any ranking or classification artifact diff --git a/tasks-available.json b/tasks-available.json index 740f8af..532ff0d 100644 --- a/tasks-available.json +++ b/tasks-available.json @@ -2,18 +2,18 @@ "summary": { "generated_by": "scripts/generate-task-index.mjs", "schema_version": 1, - "total_packs": 105, - "total_scoped_tasks": 100, + "total_packs": 106, + "total_scoped_tasks": 101, "by_role": { - "literature-scout": 100 + "literature-scout": 101 }, "by_risk": { "medium": 97, - "low": 3 + "low": 4 }, "by_domain": { "air-quality": 6, - "public-health": 63, + "public-health": 64, "climate-health": 13, "biodiversity": 7, "food-security": 19, @@ -1336,6 +1336,23 @@ "tasks_file": "problem-packs/public-health/ntd-mass-drug-administration-global/tasks.json", "problem_file": "problem-packs/public-health/ntd-mass-drug-administration-global/problem.md" }, + { + "pack_id": "public-health/obstetric-fistula-repair-access-global", + "pack_title": "Obstetric Fistula Repair Backlog And Prevention Access In High-Burden Countries", + "pack_status": "scoped", + "domain": ["public-health"], + "region": ["global"], + "task_id": "source-inventory", + "title": "Inventory obstetric fistula prevalence, repair, and prevention data sources", + "owner_role": "literature-scout", + "reviewer_needed": "domain-reviewer", + "safety_risk": "low", + "outcome": "A dated source inventory separating usable, limited, and rejected obstetric fistula sources by measurement family and allocation use.", + "expected_artifact": "datasets.md update plus evidence.json records for each accepted source.", + "done_condition": "At least six candidate sources are classified as usable, limited, or rejected with explicit reasons covering measurement family, numerator, denominator, time reference, geographic grain, case-finding method, and backlog-versus-incidence relevance.", + "tasks_file": "problem-packs/public-health/obstetric-fistula-repair-access-global/tasks.json", + "problem_file": "problem-packs/public-health/obstetric-fistula-repair-access-global/problem.md" + }, { "pack_id": "public-health/prison-health-tb-hiv-global", "pack_title": "Prison Health Tuberculosis And HIV Service Gaps In Low- And Middle-Income Countries",