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Peer Reviewed

Title: A new agenda for children affected by HIV/AIDS [editorial]
Source: Lancet. 2009 Feb 14;373(9663):517.
Abstract: As is so often the case in the provision of health care and deciding research agendas, children have been sidelined in the fight against HIV/AIDS. According to the latest UNAIDS figures, nearly 2 million children live with HIV worldwide, two-thirds in sub-Saharan Africa. In addition, 12 million children in sub-Saharan Africa have lost one or two parents due to HIV/AIDS. Many more live with a parent or carer with HIV. A very small proportion of infected children receive antiretroviral treatment, and prevention of mother-to-child transmission is only given to a third of women. Diagnosis in infancy is difficult and therefore often delayed. Child-friendly medication is lacking. 60% of children in southern Africa live in poverty. Now that HIV/AIDS is evolving from an acute emergency into a chronic epidemic, the way to deliver treatment and achieve prevention needs to change radically from an individualistic approach to a broader strategic one. Children and families need to take centre stage. In an excellent report, based on 2 years of research and analyses, the Joint Learning Initiative on Children and HIV/AIDS-an independent alliance of researchers, implementers, activists, policy makers, and people living with HIV-has presented recommendations for such a change in direction. Home Truths: Facing the Facts on Children, AIDS, and Poverty, released on Feb 10, points out three broad policies that will make an immediate and long lasting difference to children: support children through immediate or extended families and deliver integrated family-centred services; strengthen community action to support families; and address family poverty through national social protection. Such policies are AIDS-sensitive but not AIDS-directed. The family is the most important support structure for children. The report argues that the way orphans have been defined (as having lost one or both parents) and have become the centre of attention for many HIV/AIDS policies has been unhelpful, if not damaging. 88% of children labelled as orphans have a surviving parent and overall 95% continue to live with extended families. Additionally, children who live with HIV-positive parents have needs long before their parents die. Children need to stay within a family or kinship structure. Infected children usually live with others who are infected with the virus. The whole family, not the individual, needs to become the unit for support and treatment. The report advocates home health visiting and early childhood development interventions together with strategies to encourage children's education. The use of schools as intervention platforms misses the opportunity to reach children early and to reach those who are not in education-the majority in some countries. Economic strengthening of families has to be the basis to allow many of these programmes to fully succeed. The best immediate support for families is given by com munity groups. International donors need to work with these groups in partnership to avoid duplication, confusion, and waste of time and money. The authors suggest that coordination could be strengthened with a district committee that maintains an active register of community activities and devises a system of accountability that is understood by all and serves the com munity. All activities should be delivered within a framework that is based on best practice. Communities also have a crucial role to act as a backstop when families break down or when children live in an abusive environment. Family poverty and undernutrition can be addressed through income-transfer programmes, such as Mexico's Oportunidades programme or South Africa's child support grants. These projects are efficient and simple, empower women, and can act as a springboard for other more complex schemes, such as microfinance loans. Such economic support increases school attendance, reduces illnesses, improves growth, and encourages uptake of health services. The largest portion of money is usually used to purchase food. Extreme poverty, rather than HIV infection, should be used as a criterion to avoid stigma and resentment. The report argues that "any developing country, no matter how poor, can afford social protection packages for children". The positive effect of this policy is now established beyond doubt and no further pilot studies are needed. To integrate all these strategies, governments need to take the lead with national plans and frameworks to scale-up programmes for children and families. With this approach, society as a whole will be strengthened with intergenerational effects that will go a long way towards, but also go well beyond, tackling the effects of HIV/AIDS. Putting children and families at the centre will show long-term vision with guaranteed future benefits. (fulll-text)
Language: English
Keywords:
AFRICA, SUB SAHARAN | SUMMARY REPORT | CHILDREN | HIV INFECTIONS | AIDS | POVERTY | MALNUTRITION | CHILD HEALTH | HEALTH SERVICES | DELIVERY OF HEALTH CARE | TREATMENT | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Socioeconomic Factors | Economic Factors | Nutrition Disorders | Health | Medical Procedures | Medicine
Document Number: 341049

Title: FHI quality improvement guidelines for care and support programs for orphans and other vulnerable children.
Author: Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2009 Jan. 18 p.
Abstract: The guidelines are organized into nine areas of support that respond to the basic needs and human rights of children. They are also aligned with the core areas of support for programs for orphans and vulnerable children established by the U.S. government in the President's Emergency Plan for AIDS Relief (PEPFAR). The areas covered by the guidelines are cross-cutting issues, care coordination, health, food and nutrition, education, psychosocial support, shelter and care, protection, and household economic strengthening.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | STANDARDS | MANUAL | ORPHANS AND VULNERABLE CHILDREN | CHILD HEALTH | EDUCATION | NUTRITION | FOOD SECURITY | HOME CARE | MENTAL HEALTH | SOCIAL PROTECTION | IMPLEMENTATION | Research Methodology | Family and Household | Sociocultural Factors | Health | Food Supply | Natural Resources | Environment | Care and Support | Health Services | Delivery of Health Care | Political Factors | Programs | Organization and Administration
Document Number: 339984

Title: RAPID Mali: Population, development, and quality of life.
Author: Futures Group International. Health Policy Initiative; Mali. Minist�re de la Sant�
Source: [Bamako], Mali, Futures Group International, Health Policy Initiative, 2009 May. [56] p.
Abstract: Mali's population has tripled since it achieved independence in 1960. The country's fertility rate has remained stagnant for the past two decades and contraceptive prevalence rates remain much lower than in many other African countries. At the current rate of growth, the population would double in size in about 24 years. The purpose of this presentation is to examine some of the implications of this rapid growth for Mali's social and economic development. It is divided into six sections: Mali's Vision; Population Situation; Relationship Between Population and Economic Development; Population and Socioeconomic Development; Contraceptive Use, Unmet FP Need, and Effects of High Fertility on Maternal and Child Health; and Policy Response. This powerpoint presentation draws on analysis conducted using the RAPID model.
Language: English
Keywords:
MALI | SUMMARY REPORT | YOUTH | CONTRACEPTIVE USAGE | FERTILITY | FAMILY PLANNING | MATERNAL HEALTH | CHILD HEALTH | POLICY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Population Dynamics | Health | Political Factors | Sociocultural Factors
Document Number: 331558

Title: Delivering services and influencing policy: health care professionals join forces to improve maternal, newborn, and child health.
Author: Health Care Professional Association Writing Group
Source: International Journal of Gynaecology and Obstetrics. 2009 Jun;105(3):271-4.
Abstract: This article reviews the major activities of health care professional organizations (HCPAs), and emphasizes the role they can play in advocating for women and children and influencing maternal, newborn, and child health (MNCH) programs and policies. The ICM/FIGO joint effort to prevent postpartum hemorrhage and the 40-year partnership between the American Academy of Pediatrics (AAP) and the Indian Health Service (IHS) are highlighted as examples of how and why HCPAs should assume a leadership role in advocacy work. The action-oriented multicountry HCPA workshops organized by the Partnership for Maternal, Newborn, and Child Health (PMNCH) and the international HCPAs are also described. These capacity building workshops are aimed at strengthening the ability of HCPAs to organize, coordinate activities, and become more involved in program and policy development.
Language: English
Keywords:
INDIA | RESEARCH REPORT | HEALTH PERSONNEL | CAPACITY BUILDING | MATERNAL HEALTH | CHILD HEALTH | ANTENATAL CARE | HEALTH POLICY | Asia, Southern | Asia | Developing Countries | Delivery of Health Care | Health | Program Sustainability | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Policy | Political Factors | Sociocultural Factors
Document Number: 341372

Title: Sexual and reproductive health and HIV linkages: evidence review and recommendations.
Author: World Health Organization [WHO]; United Nations Population Fund [UNFPA]; International Planned Parenthood Federation [IPPF]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; University of California, San Francisco. Global Health Sciences
Source: Geneva, Switzerland, WHO, 2009 Apr. [8] p.
Abstract: The importance of linking sexual and reproductive health (SRH) and HIV is widely recognized. The international community agrees that the Millennium Development Goals will not be achieved without ensuring universal access to SRH and HIV prevention, treatment, care and support. In order to gain a clearer understanding of the effectiveness, optimal circumstances, and best practices for strengthening SRH and HIV linkages, a systematic review of the literature was conducted. The findings corroborate the many benefits gained from linking SRH and HIV policies, systems and services. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | CLIENTS | HIV TESTING | COUNSELING | HIV PREVENTION | FAMILY PLANNING | MATERNAL HEALTH | SEXUALLY TRANSMITTED DISEASE PREVENTION | CHILD HEALTH | MANAGEMENT | KNOWLEDGE | ATTITUDES | STIGMA | BEHAVIOR | FEES | HIV/FP INTEGRATION | INTERVENTIONS | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinic Activities | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors | Psychological Factors | Social Problems | Financial Activities | Economic Factors
Document Number: 331466

10.

Title: Eliminating world poverty: Building our common future.
Author: Akkerhuys Z; Allan T; Andreyeva R; Arthy B; Chalinder P
Source: Norwich, United Kingdom, The Stationery Office, 2009 Jul. 154 p.
Abstract: The White Paper represents a fundamental shift in the way the UK delivers development aid, refocusing resources onto fragile countries and for the first time treating security and justice as a basic service alongside health, education, water and sanitation. Fifty per cent of new bilateral funding will be committed to fragile countries. Key announcements in Building our Common Future include: A renewed commitment to 0.7 per cent of UK Gross National Income (GNI) for international development, meaning a contribution of �9bn per year by 2013; Measures to reduce maternal mortality rates and potentially save the lives of six million mothers and babies by 2015; Plans to support over eight million more children in Africa to go to school; Doubling of funding to �1bn for African infrastructure including transport, energy and trade in the region; A tripling of funding to support developing countries to recover stolen assets, and new resources to Interpol, as part of a major effort to stamp out corruption; Increased investment in the Central Emergency Response Fund for humanitarian aid at the UN.
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | POVERTY | ECONOMIC FACTORS | CHILD HEALTH | EDUCATION | Developed Countries | Europe, Western | Europe | Socioeconomic Factors | Health
Document Number: 331494

11.

Title: Breastfeeding and obesity among Kuwaiti preschool children.
Author: Al-Qaoud N; Prakash P
Source: Medical Principles and Practice. 2009;18(2):111-7.
Abstract: OBJECTIVES: To determine if breastfeeding and its duration are associated with a reduced risk of obesity among Kuwaiti preschool children. SUBJECTS AND METHODS: The sample consisted of 2,291 (1,092 males and 1,199 females) preschool children (3-6 years of age) and their mothers. The data were collected from September 2003 to June 2004. Height and weight measurements were used for defining weight status while other data were collected by questionnaire. RESULTS: There was no significant association of breastfeeding or its duration with either overweight or obesity among preschool children after adjusting for effects of the confounders. The child's gender, age and birth weight were the significant factors influencing current weight. Girls were at 32% higher risk of becoming obese than boys. Children aged 4-5 years were at nearly 3 times higher risk of overweight and obesity than children of less than 4 years. Children with higher birth weight (>or=4 kg) had double the risk of obesity than those of normal birth weight (>or=2.5 to <4.0 kg). Maternal obesity was a strong predictor of obesity in the children. A child with an obese mother had nearly 2 times higher risk of being overweight (BMI between the 85th the 95th percentiles) and 3 times of being obese (BMI >or=95th percentile) compared to a child born to a mother with a normal body weight. CONCLUSION: Breastfeeding and its duration are not associated with obesity status. However, there is a positive association between child and maternal obesity.
Language: English
Keywords:
KUWAIT | RESEARCH REPORT | PREVALENCE | CHILDREN | BREASTFEEDING | OBESITY | BODY WEIGHT | CHILD HEALTH | Middle East | Developed Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Physiology | Biology
Document Number: 341031

12.
Peer Reviewed

Title: [Opinions by physicians from the Family Health Program on four health care priorities proposed by the Agenda for Commitment to Comprehensive Child Health and Reduction of Infant Mortality] Perspectivas de medicos do Programa Saude da Familia acerca das linhas de cuidado
Author: Alves e Silva AC; Villar MA; Wuillaume SM; Cardoso MH
Source: Cadernos De Saude Publica. 2009 Feb;25(2):349-58.
Abstract: The aim of this study was to understand how physicians from a team in the Brazilian Family Health Program perceive their work in child health, as compared to the program's principles outlined in the Agenda for Commitment to Comprehensive Child Health and Reduction of Infant Mortality, under the Ministry of Health. The backdrop was the strategy for implementation of primary care under the Unified National Health System (SUS). Semi-structured interviews were held, and the material was submitted to content analysis. According to the findings, in general the Agenda is being met. However, there are difficulties with referral and counter-referral; the measures proposed by the Family Health Program require medical and sociological competence and face problems inherent to biomedical training; the infrastructure and inputs are precarious; and the training provided does not prepare physicians sufficiently for a more comprehensive approach. In conclusion, the primary care model in Brazil requires adjustments to the country's reality, and partnerships that transcend the system are necessary.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | PHYSICIANS | CHILD HEALTH | SELF-PERCEPTION | INFANT MORTALITY | PRIMARY HEALTH CARE | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Health Personnel | Delivery of Health Care | Health | Perception | Psychological Factors | Behavior | Mortality | Population Dynamics | Demographic Factors | Population | Health Services | Programs | Organization and Administration
Document Number: 342669

13.

Title: Does where you live influence what you know? Community effects on health knowledge in Ghana.
Author: Andrzejewski CS; Reed HE; White MJ
Source: Health and Place. 2009 Mar;15(1):228-38.
Abstract: This paper examines community effects on health knowledge in a developing country setting. We examine knowledge about the etiology and prevention of child illnesses using a unique 2002 representative survey of communities and households in Ghana. We find that community context matters appreciably, even after adjusting for the anticipated positive effects of an individual's education, literacy, media exposure and household socioeconomic status. The proportion of literate adults and the presence of a market in a community positively influence a person's health knowledge. In other words, even if a person herself is not literate, living in a community with high levels of literacy or a regular market can still positively affect her health knowledge. Our results suggest that social networks and diffusion play a key role in these community effects. In turn, these results offer policy implications for Ghana and sub-Saharan Africa.
Language: English
Keywords:
GHANA | RESEARCH REPORT | KAP SURVEYS | COMMUNITY | CHILDREN | SOCIAL NETWORKS | KNOWLEDGE | LOCALE | CHILD HEALTH | DISEASE PREVENTION | EDUCATIONAL STATUS | LITERACY | MASS MEDIA | SOCIOECONOMIC STATUS | SOCIAL POLICY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Friends and Relatives | Family and Household | Sociocultural Factors | Health | Prevention and Control | Diseases | Socioeconomic Factors | Economic Factors | Communication | Policy | Political Factors
Document Number: 330296

14.

15.

Title: Pediatric emergency and critical care in low-income countries.
Author: Baker T
Source: Paediatric Anaesthesia. 2009 Jan;19(1):23-7.
Abstract: The United Nations' Millennium Development Goal 4 is to reduce the global under-five mortality rate by two-thirds by 2015. Achieving this goal requires substantial strengthening of health systems in low-income countries. Emergency and critical care services are often one of the weakest parts of the health system and improving such care has the potential to significantly reduce mortality. Introducing effective triage and emergency treatments, establishing hospital systems that prioritize the critically ill and ensuring a reliable oxygen delivery system need not be resource intensive. Improving intensive care units, training health staff in the fundamentals of critical care concentrating on ABC - airway, breathing, and circulation - and developing guidelines for the management of common medical emergencies could all improve the quality of inpatient pediatric care. Integration with obstetrics, adult medicine and surgery in a combined emergency and critical care service would concentrate resources and expertise.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | GOALS | SOCIAL DEVELOPMENT | EMERGENCY SERVICES | INFANT HEALTH | CHILD HEALTH | HEALTH SERVICES | INFANT MORTALITY | CHILD MORTALITY | PREVENTION AND CONTROL | Planning | Organization and Administration | Economic Factors | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population | Diseases
Document Number: 330534

16.

Peer Reviewed

Title: The intergenerational impact of the African orphans crisis: a cohort study from an HIV/AIDS affected area.
Author: Beegle K; De Weerdt J; Dercon S
Source: International Journal of Epidemiology. 2009 Apr;38(2):561-8.
Abstract: BACKGROUND: In sub-Saharan Africa, the prevalence of orphanhood among children has been greatly exacerbated by the HIV/AIDS pandemic. If orphanhood harms a child's development and these effects perpetuate into adult life, then the African orphan crisis could seriously jeopardize the continent's future generations. Whether or not there exists an adverse, causal and intergenerational effect of HIV/AIDS on development is of crucial importance for setting medical priorities. This study is the first to empirically investigate the impact of orphanhood on health and schooling using long-term longitudinal data following children into adulthood. METHODS: We examined a cohort of 718 children interviewed in the early 1990s and again in 2004. Detailed survey questionnaires and anthropometric measurements were administered at baseline and during a follow-up survey. Final attained height and education (at adulthood) between children who lost a parent before the age of 15 and those who did not were compared. RESULTS: On average, children who lose their mother before the age of 15 suffer a deficit of around 2 cm in final attained height (mean 1.96; 95% CI 0.06-3.77) and 1 year of final attained schooling (mean 1.01; 95% CI 0.39-1.81). This effect is permanent and the hypothesis that it is causal cannot be rejected by our study. Although father's death is a predictor of lower height and schooling as well, we reject the hypothesis of a causal link. CONCLUSIONS: The African orphan crisis, exacerbated by the HIV/AIDS epidemic will have important negative intergenerational effects.
Language: English
Keywords:
AFRICA | RESEARCH REPORT | COHORT ANALYSIS | PREVALENCE | ORPHANS AND VULNERABLE CHILDREN | CHILD HEALTH | CHILD DEVELOPMENT | HIV | AIDS | HUMAN CAPITAL | IMPACT | Developing Countries | Research Methodology | Measurement | Family and Household | Sociocultural Factors | Health | Biology | HIV Infections | Viral Diseases | Diseases | Human Resources | Economic Factors | Communication
Document Number: 341016

17.

Peer Reviewed

Title: [Child health in poor areas: findings from a population-based study in Caracol, Piaui, and Garrafao do Norte, Para, Brazil] Saude infantil em areas pobres: resultados de um estudo de base populacional nos municipios de Caracol, Piaui, e Garrafao do Norte, Para, Brasil.
Author: Cesar JA; Chrestani MA; Fantinel EJ; Goncalves TS; Neumann NA
Source: Cadernos�de Saude Publica. 2009 Apr;25(4):809-818.
Abstract: The aim of this study was to evaluate child health indicators in the municipalities (counties) of Caracol, Piau� State, and Garraf�o do Norte, Par� State, Brazil. Through household visits using systematic sampling, previously trained interviewers applied a standard questionnaire to mothers of under-five children, investigating socioeconomic status, housing and environmental sanitation, demographic characteristics, disease patterns, and prenatal and childbirth care. The analysis used the t-test and chi-square test to compare indicators between the two municipalities. Of the 1,728 children studied, 60% were from families with incomes less than one monthly minimum wage (approximately U$200), 41% had no type of sewage treatment or disposal, 10% of mothers reported zero prenatal visits, 30% of the children were born in the same municipality, and 30% had been taken to a pediatric consultation in the previous 3 months; 20% had a height-for-age deficit > 2 standard deviations. All target indicators were deficient in both the municipalities (especially in Garraf�o do Norte). Expanding health care supply and improving housing and sanitation conditions are priorities in both municipalities.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | INTERVIEWS | MOTHERS | CHILD HEALTH | SOCIOECONOMIC STATUS | HOUSEHOLDS | SANITATION | POPULATION CHARACTERISTICS | ANTENATAL CARE | BEHAVIOR | UTILIZATION OF HEALTH CARE | INCOME | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Health | Socioeconomic Factors | Economic Factors | Public Health | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341867

18.
Peer Reviewed

Title: [Child health in poor areas: findings from a population-based study in Caracol, Piaui, and Garrafao do Norte, Para, Brazil] Saude infantil em areas pobres: resultados de um estudo de base populacional nos
Author: Cesar JA; Chrestani MA; Fantinel EJ; Goncalves TS; Neumann NA
Source: Cadernos De Saude Publica. 2009 Apr;25(4):809-18.
Abstract: The aim of this study was to evaluate child health indicators in the municipalities (counties) of Caracol, Piaui State, and Garrafao do Norte, Para State, Brazil. Through household visits using systematic sampling, previously trained interviewers applied a standard questionnaire to mothers of under-five children, investigating socioeconomic status, housing and environmental sanitation, demographic characteristics, disease patterns, and prenatal and childbirth care. The analysis used the t-test and chi-square test to compare indicators between the two municipalities. Of the 1,728 children studied, 60% were from families with incomes less than one monthly minimum wage (approximately U$200), 41% had no type of sewage treatment or disposal, 10% of mothers reported zero prenatal visits, 30% of the children were born in the same municipality, and 30% had been taken to a pediatric consultation in the previous 3 months; 20% had a height-for-age deficit > 2 standard deviations. All target indicators were deficient in both the municipalities (especially in Garrafao do Norte). Expanding health care supply and improving housing and sanitation conditions are priorities in both municipalities.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | EVALUATION | HOUSEHOLDS | LOW INCOME POPULATION | CHILD HEALTH | SOCIOECONOMIC STATUS | SANITATION | ANTENATAL CARE | INCOME | SOCIAL WELFARE | NEEDS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Family and Household | Sociocultural Factors | Social Class | Socioeconomic Factors | Economic Factors | Health | Public Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 342662

19.

Title: Mother's education and child health: is there a nurturing effect?
Author: Chen Y; Li H
Source: Journal of Health Economics. 2009 Mar;28(2):413-26.
Abstract: In this paper, we examine the effect of maternal education on the health of young children by using a large sample of adopted children from China. As adopted children are genetically unrelated to the nurturing parents, the educational effect on them is most likely to be the nurturing effect. We find that the mother's education is an important determinant of the health of adopted children even after we control for income, the number of siblings, health environments, and other socioeconomic variables. Moreover, the effect of the mother's education on the adoptee sample is similar to that on the own birth sample, which suggests that the main effect of the mother's education on child health is in post-natal nurturing. We also find suggestive evidence that the effect is causal. Our work provides new evidence to the general literature that examines the determinants of health and that examines the intergenerational immobility of socioeconomic status.
Language: English
Keywords:
CHINA | RESEARCH REPORT | CHILDREN | CHILD HEALTH | MATERNAL HEALTH | EDUCATION | EDUCATIONAL STATUS | IMPACT | Asia, Eastern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Communication
Document Number: 341556

20.
Peer Reviewed

Title: Validation of community health workers' assessment of neonatal illness in rural Bangladesh.
Author: Darmstadt GL; Baqui AH; Choi Y; Bari S; Rahman SM; Mannan I; Ahmed AS; Saha SK; Rahman R; Chang S; Winch PJ; Black RE; Santosham M; El Arifeen S
Author: Bangladesh Projahnmo-2 (Mirzapur) Study Group
Source: Bulletin of the World Health Organization. 2009 Jan;87(1):12-9.
Abstract: OBJECTIVE: To estimate the validity (sensitivity, specificity, and positive and negative predictive values) of a clinical algorithm as used by community health workers (CHWs) to detect and classify neonatal illness during routine household visits in rural Bangladesh. METHODS: CHWs evaluated breastfeeding and symptoms and signs of illness in 395 neonates selected randomly from neonatal illness surveillance during household visits on postnatal days 0, 2, 5 and 8. Neonates classified with very severe disease (VSD) were referred to a community-based hospital. Within 12 hours of CHW assessments, physicians independently evaluated all neonates seen in a given day by one CHW, randomly chosen from among 36 project CHWs. Physicians recorded symptoms and signs of illness, classified the illness, and determined whether the newborn needed referral-level care at the hospital. Physicians' identification and classification were used as the gold standard in determining the validity of CHWs' identification of symptoms and signs of illness and its classification. FINDINGS: CHWs' classification of VSD showed a sensitivity of 73%, a specificity of 98%, a positive predictive value of 57% and a negative predictive value of 99%. A maternal report of any feeding problem as ascertained by physician questioning was significantly associated (P < 0.001) with 'not sucking at all' and 'not attached at all' or 'not well attached' as determined clinically by CHWs during feeding assessment. CONCLUSION: CHWs identified with high validity the neonates with severe illness needing referral-level care. Home-based illness recognition and management, including referral of neonates with severe illness by CHWs, is a promising strategy for improving neonatal health and survival in low-resource developing country settings.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | VALIDITY | RURAL POPULATION | HEALTH PERSONNEL | NEONATAL DISEASES AND ABNORMALITIES | HOME CARE | PERFORMANCE IMPROVEMENT | CHILD SURVIVAL | CHILD HEALTH | EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Diseases | Care and Support | Health Services | Management | Organization and Administration | Survivorship | Length of Life | Mortality | Population Dynamics | Medical Procedures | Medicine
Document Number: 341189

21.

Title: Haiti: Going to scale with a performance incentive model.
Author: Eichler R; Auxila P; Antoine U; Desmangles B
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :165-188.
Abstract: Rewarding NGOs for increasing access to a package of basic services and paying them for achieving population-based performance targets can result in significant increases in essential services such as immunizations and assisted deliveries. Paying NGOs for results strengthens institutional capacity to deliver services from the bottom up. Changes in the design throughout the six years offer lessons for other contexts.
Language: English
Keywords:
HAITI | RESEARCH REPORT | PILOT PROJECTS | MATERNAL HEALTH | CHILD HEALTH | REPRODUCTIVE HEALTH | FAMILY PLANNING | MEASUREMENT | PERFORMANCE IMPROVEMENT | PROGRAM ACTIVITIES | NONGOVERNMENTAL ORGANIZATIONS | ORGANIZATION AND ADMINISTRATION | PROGRAM EVALUATION | MONITORING | Developing Countries | Caribbean | Americas | Studies | Research Methodology | Health | Management | Programs | Organizations | Political Factors | Sociocultural Factors | Evaluation
Document Number: 331456

22.

Title: Problems to solve.
Author: Eichler R; Levine R
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :11-21.
Abstract: In the vast majority of low-income countries, health system performance is way off the mark. Many of the individuals who could benefit most from preventive and therapeutic health services do not receive them, and when they do, the quality of the services is low. The most obvious reason for the deficiencies is limited resources. On average, low-income countries -- those with a gross national income of less than $1,095 in 2009 dollars -- spend about 4.1 percent of gross domestic product from both public and private sources. At current levels of spending, even adjusting for differences in the cost of labor and other inputs across countries, it is impossible for basic services of acceptable quality to reach the majority of the population. Beyond this, a range of systemic shortcomings is evident: quality control and supervision are absent, supply chains are broken, the transfer and use of information are weak, managerial skills are in short supply in both public and private sectors, and the absolute number of health workers at virtually all levels is lower than optimal by technical standards. To solve a problem, one must identify it and understand its underlying causes. Here we highlight both a set of important problems and the reasons to believe -- at least on conceptual grounds -- that introducing financial and other material incentives can improve health sector performance. (Excerpts)
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW INCOME POPULATION | HEALTH SERVICES | PERFORMANCE IMPROVEMENT | INCENTIVES | PREVENTIVE HEALTH CARE | QUALITY OF HEALTH CARE | CHILD HEALTH | MANAGEMENT | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Delivery of Health Care | Health | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Health Services Evaluation | Program Evaluation | Programs
Document Number: 331461

23.
Title: Reaching every district - development and testing of a health micro-planning strategy for reaching difficult to reach populations in Mongolia.
Author: Enkhtuya B; Badamusuren T; Dondog N; Khandsuren L; Elbegtuya N; Jargal G; Surenchimeg V; Grundy J
Source: Rural and Remote Health. 2009 Apr-Jun;9(2):1045.
Abstract: CONTEXT: Since the 1990s, Mongolia has undergone a rapid social and economic transition with migration to the urban areas of the national capital Ulaanbaatar. The main reasons for the migration are social sector decline in rural areas and the potential for employment opportunities in urban areas. There are also new internal patterns of migration in rural and remote areas relating to recent developments in the economic sector. Despite recent innovations in health system management in Mongolia, in some urban and rural and remote locations health services are not sufficiently accessed by the most socially and economically disadvantaged populations. These concerns provided the motivation for the Ministry of Health of Mongolia and development partners to attempt to access the most difficult to reach populations through the development of a micro-planning process referred to as the 'Reaching Every District strategy' (RED). This article describes and analyses RED micro-planning processes and content, and highlights the lessons learned. The main source of data for this planning system development was in the development and testing of the micro-planning process in Byanzurkh District, Ulaanbaatar in June 2008. INTERVENTION: The principal intervention developed and trialed was a health micro-planning strategy for improved access to immunization and maternal and child health services for difficult to reach populations. The planning methodology was a problem-solving approach progressing from health mapping to barrier analysis, to activity planning and costing and finally to monitoring and evaluation. LESSONS LEARNED: Main success factors in the development of the planning methodology were the use of barrier analysis and mapping approaches for data analysis and problem solving at the local level, and re-orientation of management approaches from 'inspection' to supportive supervision. Additionally, although the RED strategy is intended to be an immunization-specific intervention internationally, evidence from the development and trial of the process in Mongolia indicates its potential for wider health systems applications. This is particularly so for detecting and responding to the maternal and child health service needs of the more difficult to reach sub-populations.
Language: English
Keywords:
MONGOLIA | RESEARCH REPORT | CHILDREN | CHILD SURVIVAL | CHILD HEALTH | IMMUNIZATION | HEALTH SERVICES | PLANNING | MONITORING | Developing Countries | Asia, Northern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Survivorship | Length of Life | Mortality | Population Dynamics | Health | Primary Health Care | Delivery of Health Care | Organization and Administration | Evaluation
Document Number: 341537

24.

Peer Reviewed

Title: The HIV-exposed, uninfected African child.
Author: Filteau S
Source: Tropical Medicine and International Health. 2009 Mar;14(3):276-87.
Abstract: The increasing success of prevention of mother-to-child HIV transmission programmes means that in Africa, very large numbers of HIV-exposed, uninfected (HIV-EU) children are being born. Any health problems that these children may have will thus be of enormous public health importance, but to date have been largely neglected. There is some evidence that HIV-EU African children are at increased risk of mortality, morbidity and slower early growth than their HIV-unexposed counterparts. A likely major cause of this impaired health is less exposure to breast milk as mothers are either less able to breastfeed or stop breastfeeding early to protect their infant from HIV infection. Other contributing factors are parental illness or death resulting in reduced care of the children, increased exposure to other infections and possibly exposure to antiretroviral drugs. A broad approach for psychosocial support of HIV-affected families is needed to improve health of HIV-EU children. High quality programmatic research is needed to determine how to deliver such care.
Language: English
Keywords:
AFRICA | CRITIQUE | LITERATURE REVIEW | EVALUATION | CHILDREN | PERSONS LIVING WITH HIV/AIDS | ORPHANS AND VULNERABLE CHILDREN | BREASTFEEDING | TIME FACTORS | CHILD HEALTH | GROWTH | DEFICIENCY DISEASES | CHILD MORTALITY | ANTIRETROVIRAL DRUGS | INFECTIONS | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Population Dynamics | Child Development | Biology | Nutrition Disorders | Mortality | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 330961

25.

Peer Reviewed

Title: Stuips, spuits and prophet ropes: the treatment of abantu childhood illnesses in urban South Africa.
Author: Friend-du Preez N; Cameron N; Griffiths P
Source: Social Science and Medicine. 2009 Jan;68(2):343-51.
Abstract: With a paucity of data on health-seeking behaviour for childhood illnesses in urban South Africa, a mixed method approach was used to investigate the treatment of abantu childhood illnesses in Johannesburg and Soweto between March and June 2004. In-depth interviews were held with caregivers (n=5), providers of traditional (n=6) and Western (n=6) health care, as well as five focus groups with caregivers. A utilisation-based survey was conducted with 206 black African caregivers of children under 6 years of age from one public clinic in Soweto (n=50), two private clinics in Johannesburg (50 caregivers in total), two public hospitals from Johannesburg and Soweto (53 caregivers in total) and two traditional healers from Johannesburg and Orange Farm (53 caregivers in total), an informal settlement on the outskirts of Johannesburg. The symptoms of several childhood abantu health problems, their treatment with traditional, church and home remedies, and influences on such patterns of resort are described. Despite free primary health care for children under 6 years, the pluralistic nature of health-seeking in this urban environment highlights the need for community and household integrated management of childhood illnesses and a deeper understanding of how symptoms may be interpreted and treated in the context of the local belief system.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | URBAN POPULATION | TRADITIONAL MEDICINE | CHILD HEALTH | INFECTIONS | TREATMENT | BELIEFS | BEHAVIOR | PRIMARY HEALTH CARE | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Medical Procedures | Culture | Sociocultural Factors
Document Number: 331180

26.

27.

Title: Family planning and economic well-being: new evidence from Bangladesh.
Author: Gribble J; Maj-Lis V
Source: Washington, D.C., Population Reference Bureau, 2009 May. 4 p.
Abstract: A new policy brief from the Population Reference Bureau looks at the effects of long-term investment in an integrated family planning and maternal and child health program. Drawing on research and data that spans more than 30 years, the evidence reinforces the importance of sustained investment in reproductive health programs, showing that families in communities where the program was implemented became wealthier and healthier than families who lived in other, similar communities.
Language: English
Keywords:
BANGLADESH | SUMMARY REPORT | GOALS | HOUSEHOLDS | MATERNAL HEALTH | CHILD HEALTH | FAMILY PLANNING | POVERTY | PREVENTION AND CONTROL | ECONOMIC FACTORS | SOCIOECONOMIC FACTORS | DEVELOPMENT PLANS | INCOME | EDUCATION | WOMEN'S HEALTH | Developing Countries | Asia, Southern | Asia | Planning | Organization and Administration | Family and Household | Sociocultural Factors | Health | Diseases
Document Number: 328046

28.

Title: Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002-2003 El Salvador National Family Health Survey.
Author: Gribble JN; Murray NJ; Menotti EP
Source: Maternal and Child Nutrition. 2009 Jan;5(1):49-63.
Abstract: It is well understood that undernutrition underpins much of child morbidity and mortality in less developed countries, but the causes of undernutrition are complex and interrelated, requiring a multipronged approach for intervention. This paper uses a subsample of 3853 children under age 5 from the most recent family health survey in El Salvador to examine the relationship between birth spacing and childhood undernutrition (stunting and underweight). While recent research and guidance suggest that birth spacing of three to five years contributes to lower levels of infant and childhood mortality, little attention has been given to the possibility that short birth intervals have longer-term effects on childhood nutrition status. The analysis controls for clustering effects arising from siblings being included in the subsample, as well as variables that are associated with household resources, household structure, reproductive history and outcomes, and household social environment. The results of the multiple regression analyses find that in comparison to intervals of 36-59 months, birth intervals of less than 24 months and intervals of 24-35 months significantly increase the odds of stunting (<24 months Odds Ratio (OR) = 1.52; 95% confidence interval (CI): 1.21-1.92; 25-36 months OR = 1.30; 95% CI: 1.05-1.64). Other factors related to stunting and underweight include standard of living index quintile, child's age, mother's education, low birthweight, use of prenatal care, and region of the country where the child lives. Policy and program implications include more effective use of health services and outreach programs to counsel mothers on family planning, breastfeeding, and well child care.
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | ANTHROPOMETRY | CHILDREN | CHILD HEALTH | CHILD DEVELOPMENT | CHILD NUTRITION | BIRTH SPACING | BIRTH INTERVALS | LOW BIRTH WEIGHT | FAMILY PLANNING | BREASTFEEDING | NEEDS | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Biology | Nutrition | Fertility Measurements | Fertility | Population Dynamics | Birth Weight | Body Weight | Physiology | Infant Nutrition | Economic Factors | Programs | Organization and Administration
Document Number: 329593

29.
Title: Emergency maternal and child health training courses and advocacy to achieve millennium development goals in a poorly resourced country; challenges and opportunities.
Author: Hafeez A; Zafar S; Qureshi F; Mirza I; Bile K; Southall DP
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Apr;59(4):243-6.
Abstract: Our three years' experience of Essential Surgical Skills-Emergency Maternal and Child Health (ESS-EMCH) Programme in Pakistan suggests that despite a compromised healthcare delivery system, a tangible improvement in the management of emergencies in pregnancy, the neonate and children can be achieved by adopting a novel but robust mechanism of effective advocacy along with provision of innovative, evidence based and high quality training for healthcare staff.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | GOALS | CHILD HEALTH | CHILD MORTALITY | INFANT MORTALITY | TRAINING ACTIVITIES | IMPLEMENTATION | EMERGENCY SERVICES | QUALITY CONTROL | Developing Countries | Asia, Southern | Asia | Planning | Organization and Administration | Health | Mortality | Population Dynamics | Demographic Factors | Population | Training Programs | Education | Programs | Health Services | Delivery of Health Care
Document Number: 341536

30.
Title: Challenges in providing HIV care to paediatric age group in India.
Author: Haldar P; S Reddy DC
Source: Indian Journal of Medical Research. 2009 Jan;129(1):7-10.
Abstract: To ensure comprehensive paediatric HIV care in India, in addition to expansion of the availability of skilled paediatricians and laboratory infrastructure for diagnosis at specialist centres, the capacity building of health care workers at primary and secondary levels should be a priority. This would immensely improve access to treatment, care and co-trimoxazole (CTX) prophylaxis for children living with HIV/AIDS (CLHA) in India. Appropriate guidelines for management and referral at different levels need to be developed and distributed. An integrated approach with the ongoing scale up of Prevention of Parent to Child Transmission (PPTCT) in India would also be important to impart effective primary prevention for children since more than 95 per cent of children acquire HIV infection from mother by perinatal transmission. (excerpt)
Language: English
Keywords:
INDIA | SUMMARY REPORT | DATA COLLECTION | CHILDREN | PERSONS LIVING WITH HIV/AIDS | PRIMARY HEALTH CARE | CHILD HEALTH | EXAMINATIONS AND DIAGNOSES | TREATMENT | HIV INFECTIONS | AGE FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine
Document Number: 341546


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