1.  Title: Reproductive health knowledge and practices in northern Nigeria: challenging misconceptions. Author: Pathfinder International. Reproductive Health / Family Planning Service Delivery Project in Northern Nigeria Source: Abuja, Nigeria, Pathfinder International, [2008]. [31] p. Abstract: Pathfinder International's Reproductive Health/Family Planning Service Delivery Project, funded by the David and Lucile Packard Foundation, aims to improve the Reproductive Health (RH) status of adults and adolescents in northern Nigeria, and to increase the utilization of services through a network of public- and private-sector facilities and community-based providers. In the third phase, the project sought to respond more positively to its target communities by conducting a community survey to inform implementation of its future interventions in six states of northern Nigeria (Borno, Kaduna, Kano, Katsina, Niger, and Sokoto) and the Federal Capital Territory. Pathfinder is implementing the project in northern Nigeria to address the region's depressed socioeconomic conditions and low demand for and use of services, as compared to the southern region. The community survey used qualitative methods (including focus group discussions, key informant interviews, and in-depth interviews) to elicit information from 511 respondents on their knowledge, practices, and beliefs about RH and Family Planning (FP). It also served to establish the stakeholders' level of awareness of the project in target communities. (excerpt) Language: English Keywords: NIGERIA | RESEARCH REPORT | OPERATIONS RESEARCH | BASELINE SURVEYS | KAP SURVEYS | COMMUNITY SURVEYS | REPRODUCTIVE HEALTH | FAMILY PLANNING | KNOWLEDGE | ATTITUDES | AWARENESS | PROGRAM ACCEPTABILITY | PROGRAM SUSTAINABILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Program Evaluation | Programs | Organization and Administration | Research Methodology | Surveys | Sampling Studies | Studies | Health | Sociocultural Factors | Psychological Factors | Behavior Document Number: 325036 |
| 2. Title: Validation of neonatal tetanus elimination in Bangladesh by lot quality-assurance cluster sampling. Validation de l'elimination du tetanos neonatal au Bangladesh a l'aide d'un sondage en grappes pour le controle de la qualite des lots. Author: World Health Organization [WHO] Source: Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 2008 Aug 22;83(34):301-307. Abstract: In the 1980s, Bangladesh, a country of 146 million inhabitants and more than 4 million births annually, had one of the highest neonatal tetanus (NT) mortality rates in the world. Community-based surveys showed that before widespread introduction of immunization, mortality rates from NT were 20-40/1000 live births in some parts of the country. According to these surveys, NT was responsible for 21-56% of all neonatal deaths. After the introduction of vaccination in 1979, NT rates fell sharply: surveys showed that NT rates had fallen from 6 cases/1000 live births in 1994 to 2.3/1000 live births in 2000. In May 2008, the Ministry of Health and Family Welfare, in collaboration with WHO and UNICEF, carried out an evaluation to determine whether NT had been eliminated in Bangladesh. Two community-based surveys were performed in the 2 districts where children were considered to be at the highest risk from NT. (excerpt) Language: EnglishFrench Keywords: BANGLADESH | RESEARCH REPORT | EVALUATION REPORT | COMMUNITY SURVEYS | INFANT | NEONATAL MORTALITY | TETANUS | IMMUNIZATION | INTERVENTIONS | PROGRAM EVALUATION | PROGRAM EFFECTIVENESS | Developing Countries | Asia, Southern | Asia | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Infections | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration Document Number: 327997 |
3.  Peer Reviewed Title: Exclusive breastfeeding in Vietnam: an attainable goal. Author: Almroth S; Arts M; Nguyen Dinh Quang; Pham Thi Thuy Hoa; Williams C Source: Acta Paediatrica. 2008;97(8):1066-1069. Abstract: The aim was to explore community views on the feasibility of exclusive breastfeeding in Vietnam. A total of 118 interviews were conducted with mothers, grandmothers, fathers, health workers and 'oldest women' in rural and urban areas in the north and south of Vietnam. Special issues were further examined through 12 'strategic interviews'. Exclusive breastfeeding was rare because it was poorly understood and little appreciated, by health professionals as well as lay persons, as the best way to feed an infant during the first 6 months. Early fluid supplementation was the rule and most infants received water and milk in addition to breast milk. While a majority of the women worked, they had found ways to manage their work so that it did not need to interfere with exclusive breastfeeding. Family members expressed a readiness to support exclusive breastfeeding when it was explained to them. Exclusive breastfeeding in Vietnam, while currently uncommon, is an attainable goal. Establishing exclusive breastfeeding as the norm in the general population would make it easier for HIV-infected women, for whom replacement feeding is not acceptable, feasible, affordable, sustainable and safe, to breastfeed exclusively. (author's) Language: English Keywords: VIETNAM | RESEARCH REPORT | COMMUNITY SURVEYS | BREASTFEEDING, EXCLUSIVE | ATTITUDES | KNOWLEDGE | INFANT NUTRITION | HIV | AIDS | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Breastfeeding | Nutrition | Health | Psychological Factors | Behavior | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases Document Number: 326621 |
| 4. Peer Reviewed Title: Changes in prevalence and incidence of HIV-1, HIV-2 and dual infections in urban areas of Bissau, Guinea-Bissau: Is HIV-2 disappearing? Author: da Silva ZJ; Oliveira I; Andersen A; Dias F; Rodrigues A Source: AIDS. 2008 Jun 19;22(10):1195-1202. Abstract: The objective of this study was to assess the changes in HIV prevalence and incidence between 1996 and 2006 in urban areas of Bissau. The design was a cross-sectional survey of 384 randomly selected houses within a community-based follow-up study of HIV-1 and HIV-2. A total of 3242 individuals aged at least 15 years were eligible for inclusion. Participants were interviewed about behavioral and socio-economic factors and had a blood sample drawn. A total of 2548 individuals were tested for antibodies to HIV-1 and HIV-2, of whom 649 had taken part in a similar survey in 1996. With 0.5% HIV dual reactions included, the overall HIV-1 prevalence was 4.6% (118 out of 2548) and the HIV-2 prevalence was 4.4% (112 out of 2548). The prevalence of HIV-1 increased more for women than men especially in the 25-34-year age group. HIV-2 prevalence decreased below 45 years of age but not for individuals more than 45 years old. The incidence rate between 1996 and 2006 was 0.5 per 100 person-years for HIV-1 and 0.24 per 100 person-years for HIV-2. Compared with a previous period from 1987 to 1996, the incidence of HIV-2 is declining whereas no significant increase in the incidence of HIV-1 was observed. The present study shows an increasing prevalence of HIV-1 and a decreasing prevalence of HIV-2 in Guinea-Bissau. HIV is generally a bigger problem for women. Despite the general decline in prevalence, HIV-2 may continue as an infection in older people, especially women. (author's) Language: English Keywords: GUINEA-BISSAU | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | COMMUNITY SURVEYS | URBAN POPULATION | HIV | PREVALENCE | INCIDENCE | TIME FACTORS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Measurement | Population Dynamics Document Number: 327017 |
| 5. Peer Reviewed Title: Adult mortality in a rural area of Senegal: Non-communicable diseases have a large impact in Mlomp. Author: Duthe G; Pison G Source: Demographic Research. 2008 Aug 1;19(37):1419-1448. Abstract: This study provides original estimates of adult mortality in Mlomp, a rural population of Senegal which has been monitored for twenty years. Causes of death are assessed through verbal autopsies which are completed by medical information. Between ages 15 and 60, male mortality is much higher than female mortality. Globally, AIDS mortality does not have the tragic impact observed in other regions of Africa, and maternal mortality is relatively low for a rural area, unlike injuries which are common among men. In Mlomp, non-communicable diseases, especially cancers, are predominant. In addition to behavioural factors, infectious diseases may contribute to this situation. (author's) Language: English Keywords: SENEGAL | RESEARCH REPORT | MORTALITY | DEATH RECORDS | ESTIMATION TECHNIQUES | AUTOPSY | CAUSES OF DEATH | COMMUNITY SURVEYS | SEX FACTORS | DISEASES | NEOPLASMS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Population Dynamics | Demographic Factors | Population | Vital Statistics | Population Statistics | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surveys | Sampling Studies | Studies | Population Characteristics Document Number: 327944 |
| 6. Title: Aetiology of stillbirths and neonatal deaths in rural Ghana: Implications for health programming in developing countries. Author: Edmond KM; Quigley MA; Zandoh C; Danso S; Hurt C Source: Paediatric and Perinatal Epidemiology. 2008 Sep;22(5):430-437. Abstract: In developing countries many stillbirths and neonatal deaths occur at home and cause of death is not recorded by national health information systems. A community-level verbal autopsy tool was used to obtain data on the aetiology of stillbirths and neonatal deaths in rural Ghana. Objectives were to describe the timing and distribution of causes of stillbirths and neonatal deaths according to site of death (health facility or home). Data were collected from 1 January 2003 to 30 June 2004; 20 317 deliveries, 696 stillbirths and 623 neonatal deaths occurred over that time. Most deaths occurred in the antepartum period (28 weeks gestation to the onset of labour) (33.0%). However, the highest risk periods were during labour and delivery (intrapartum period) and the first day of life. Infections were a major cause of death in the antepartum (10.1%) and neonatal (40.3%) periods. The most important cause of intrapartum death was obstetric complications (59.3%). There were significantly fewer neonatal deaths resulting from birth asphyxia in the home than in the health facilities and more deaths from infection. Only 59 (20.7%) mothers of neonates who died at home reported that they sought care from an appropriate health care provider (doctor, nurse or health facility) during their baby's illness. The results from this study highlight the importance of studying community-level data in developing countries and the high risk of intrapartum stillbirths and infectious diseases in the rural African mother and neonate. Community-level interventions are urgently needed, especially interventions that reduce intrapartum deaths and infection rates in the mother and infant. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | NEONATAL MORTALITY | FETAL DEATH | DEATH RECORDS | AUTOPSY | COMMUNITY SURVEYS | CAUSES OF DEATH | MATERNAL HEALTH | MORBIDITY | COMMUNICABLE DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Population | Vital Statistics | Population Statistics | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surveys | Sampling Studies | Studies | Diseases | Infections Document Number: 327929 |
| 7. Peer Reviewed Title: Ethical approaches to adolescent participation in sexual health research. Author: Flicker S; Guta A Source: Journal of Adolescent Health. 2008 Jan;42(1):3-10. Abstract: In this paper we make the case for the importance of adolescent sexual health research, and argue that requiring parental consent for adolescent participation may (a) be unwarranted, (b) be inconsistent with the principles of justice and inclusiveness, (c) be confusing, and (d) serve to silence young people who most need to have a voice in sexual health research. Through a case study of the Toronto Teen Survey, we offer concrete suggestions and alternatives for protecting adolescent health research participants in community-based settings and promoting ethical research approaches. Strategies suggested include: (1) adopting a community-based participatory research approach, (2) careful attention to youth-friendly protocols and consent procedures, (3) proper training of all research staff and peer researchers, (4) partnering with experienced community based youth-serving agencies, (5) paying maximum attention to issues of confidentiality and anonymity, and (6) valuing participation appropriately. Institutional review boards and researchers should be encouraged to adopt localized context-dependent strategies that attend to the unique vulnerabilities of their particular study populations. Attention to flexibility, vulnerability, and community-specific needs is necessary to ensure appropriate ethical research practices that attend to the health and well-being of young people. (author's) Language: English Keywords: CANADA | RESEARCH REPORT | CASE STUDIES | COMMUNITY SURVEYS | ADOLESCENTS | ADOLESCENT HEALTH | REPRODUCTIVE HEALTH | RESEARCH ACTIVITIES | ETHICS | PARENTAL CONSENT | INFORMED CONSENT | CONFIDENTIAL INFORMATION | North America, Northern | Americas | Developed Countries | Studies | Research Methodology | Surveys | Sampling Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Sociocultural Factors | Political Factors | Health Services | Delivery of Health Care Document Number: 325014 |
| 8. Peer Reviewed Title: Supporting orphans and vulnerable children affected by AIDS: Using community-generated definitions to explore patterns of children's vulnerability in Zambia. Author: Schenk KD; Ndhlovu L; Tembo S; Nsune A; Nkhata C Source: AIDS Care. 2008 Sep;20(8):894-903. Abstract: This study explores how communities in Zambia characterize vulnerable children in the context of HIV; demonstrates how estimates of vulnerability vary depending on definitions; and discusses the implications of these estimates for program delivery. Baseline research conducted in 2005 included cross-sectional community-based household surveys at six locations using multi-stage random sampling (totalling 1,503 households, reporting on 5,009 children) and participatory qualitative research (focus group and in-depth interviews) with adults and youth at four locations. Between 14 and 27% of children in the sample had experienced a parental death (2-5% maternal orphans, 7-13% paternal orphans, 4-10% double orphans). In addition, other characteristics that communities associated with children's vulnerability were prevalent: 26-34% had been taken into another household, 15-27% were living in female-headed households, and 11-28% were living in a household with someone who is chronically ill. Overall, 58-73% of children had one or more community-defined characteristics of vulnerability. This study highlights the need to carefully consider the meaning of "vulnerability" when targeting programmes to support children affected by HIV and AIDS. Local community input is vital to inform context-specific criteria for distributing programme resources. If used, eligibility criteria should be context-specific yet flexible to evolving community realities. In settings such as rural Zambia where levels of HIV-related vulnerability are high, it may be more efficient to target at the level of communities rather than assess individual households. (author's) Language: English Keywords: ZAMBIA | RESEARCH REPORT | ORPHANS AND VULNERABLE CHILDREN | AIDS | COMMUNITY SURVEYS | COMMUNITY PARTICIPATION | PROGRAMS | PROGRAM DESIGN | TERMINOLOGY | FOSTERING | PERSONS LIVING WITH HIV/AIDS | FAMILY AND HOUSEHOLD | FAMILY CHARACTERISTICS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Surveys | Sampling Studies | Studies | Research Methodology | Organization and Administration | Child Rearing | Behavior Document Number: 328165 |
| 9. Title: Reproductive health issues in rural western Kenya. Author: van Eijk AM; Lindblade KA; Odhiambo F; Peterson E; Sikuku E Source: Reproductive Health. 2008;5(1):[16] p. Abstract: We describe reproductive health issues among pregnant women in a rural area of Kenya with a high coverage of insecticide treated nets (ITNs) and high prevalence of HIV (15%). We conducted a community-based cross-sectional survey among rural pregnant women in western Kenya. A medical, obstetric and reproductive history was obtained. Blood was obtained for a malaria smear and haemoglobin level, and stool was examined for geohelminths. Height and weight were measured. Of 673 participants, 87% were multigravidae and 50% were in their third trimester; 41% had started antenatal clinic visits at the time of interview and 69% reported ITN-use. Malaria parasitemia and anaemia (haemoglobin less than 11 g/dl) were detected among 36% and 53% of the women, respectively. Geohelminth infections were detected among 76% of the 390 women who gave a stool sample. Twenty percent of women were underweight, and sixteen percent reported symptoms of herpes zoster or oral thrush in the last two months. Nineteen percent ofall women reported using a contraceptive method to delay or prevent pregnancy before the current pregnancy (injection 10%, pill 8%, condom 0.4%). Twenty-three percent of multigravidae conceived their current pregnancy within a year of the previous pregnancy. More than half of the multigravidae (55%) had ever lost a live born child and 21% had lost their last singleton live born child at the time of interview. In this rural area with a high HIV prevalence, the reported use of condoms before pregnancy was extremely low. Pregnancy health was not optimal with a high prevalence of malaria, geohelminth infections, anaemia and underweight. Chances of losing a child after birth were high. Multiple interventions are needed to improve reproductive health in this area. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | COMMUNITY SURVEYS | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | REPRODUCTIVE HEALTH | MALARIA | HIV | BODY WEIGHT | CONDOM USE | CONTRACEPTIVE USAGE | ANTENATAL CARE | BED NETS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Health | Parasitic Diseases | Diseases | HIV Infections | Viral Diseases | Physiology | Biology | Risk Reduction Behavior | Behavior | Contraception | Family Planning | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Parasite Control | Public Health Document Number: 325394 |
| 10. Title: Factors influencing teen mothers' enrollment and participation in prevention of mother-to-child HIV transmission services in Limpopo Province, South Africa. Author: Varga C; Brookes H Source: Qualitative Health Research. 2008;18(6):786-802. Abstract: In this article, we examine barriers to HIV testing uptake and participation in prevention of mother-to-child HIV transmission (PMTCT) services among adolescent mothers aged 15 to 19 years in rural and urban Limpopo Province, South Africa. We used the narrative research method involving key informants constructing typical case studies of adolescent experiences with HIV testing and entry into PMTCT. Case studies formed the basis of a community-based questionnaire and focus group discussions with adolescent mothers. Client-counselor dynamics during pretest counseling were pivotal in determining uptake and participation, and counselor profile strongly influenced the nature of the interaction. Other factors found to influence adherence to PMTCT recommendations included HIV and early premarital pregnancy stigma, fear of a positive test result, and concerns over confidentiality and poor treatment by health care providers. Adolescents described elaborate strategies to avoid HIV disclosure to labor and delivery staff, despite knowing this would mean no antiretroviral therapy for their newborn infants. Theoretical, methodological, and programmatic implications of study findings are also discussed. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CASE STUDIES | COMMUNITY SURVEYS | FOCUS GROUPS | ADOLESCENTS, FEMALE | MOTHERS | HIV TESTING | VOLUNTARY COUNSELING AND TESTING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | OBSTACLES | STIGMA | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Surveys | Sampling Studies | Data Collection | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Diseases | Organization and Administration | Social Problems Document Number: 326890 |
| 11. Title: Measurement of HIV prevention indicators: a comparison of the PLACE method and a household survey in Zambia. Author: Tate J; Singh K; Ndubani P; Kamwanga J; Buckner B Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2007 Sep. 23 p. (MEASURE Evaluation Working Paper Series WP-07-96USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: This analysis compares data from three studies carried out in Zambia in 2005, where it was possible to coordinate instrument design, sampling, and timing of fieldwork for a biannual household survey with two PLACE studies. Taking advantage of this opportunity, we are able to compare district-level data from the household survey measuring HIV/AIDS prevention indicators with data from two PLACE studies carried out in the same districts. In the two districts compared, all household and PLACE method interviews were completed during the period of May 2005 to October 2005. The PLACE method "identifies, maps, and characterizes public venues where people meet new sexual partners, and estimates the extent of new partnership formation, concurrent partnerships, sexual mixing, and condom use among the population socializing at these venues". (excerpt) Language: English Keywords: ZAMBIA | RESEARCH REPORT | MEASUREMENT | RESEARCH METHODOLOGY | COMMUNITY SURVEYS | COMPARATIVE STUDIES | HOUSEHOLDS | HIV PREVENTION | POPULATION CHARACTERISTICS | SEXUAL PARTNERS | SEX BEHAVIOR | CONDOM USE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Behavior | Risk Reduction Behavior Document Number: 322550 |
| 12. Title: Jamaican Youth Risk and Resiliency Behaviour Survey 2006. Community-based survey on risk and resiliency behaviours of 15-19 year olds. Author: Wilks R; Younger N; McFarlane S; Francis D; Van Den Broeck J Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2007 Nov. [235] p. (TR-07-64USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: The Jamaica Youth Risk and Resiliency Behaviour Survey, a collaborative effort of the University of the West Indies (UWI), Mona, the Jamaican Ministry of Health (MoH), and United States Agency for International Development/Jamaica Caribbean (USAID/J-CAR), with technical assistance from the MEASURE Evaluation Project, gathered information from 1318 participants (599 males and 721 females) island-wide who were 15 - 19 years of age. The main objectives of the survey were to: describe lifestyle and behaviour patterns (exercise, cigarette smoking and alcohol consumption) by demographic and socio-economic characteristics; determine and document the context of adolescent reproductive and sexual health, including the magnitude, determinants and consequences for adolescents' lives; determine the association between resiliency and markers of abnormal mental health on risk-taking behaviours, including involvement in violence; obtain anthropometric measurements, fasting glucose levels and cholesterol levels in youth and relate these to chronic disease risks; and identify the sources of information influencing adolescents' health and health seeking behaviour. The study provides important data on the health status, health seeking behaviour, risk and resiliency factors affecting Jamaican youth. Protective factors, such as improved educational levels, parental involvement and expectations, and positive mental health trends should be augmented in order to improve reproductive and sexual health outcomes, reduce risky behaviors, and inform subsequent adolescent health policy and programmes. (excerpt) Language: English Keywords: JAMAICA | RESEARCH REPORT | COMMUNITY SURVEYS | YOUTH | RISK BEHAVIOR | REPRODUCTIVE HEALTH | DRUG USE AND ABUSE | DISEASES | ACCIDENTS AND INJURIES | STUDY DESIGN | DATA QUALITY | TRAINING ACTIVITIES | EDUCATION | DIET | PRIMARY HEALTH CARE | MENTAL HEALTH | EMOTIONS | RELIGION | VIOLENCE | ANTHROPOMETRY | RECOMMENDATIONS | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Health | Data Analysis | Training Programs | Nutrition | Health Services | Delivery of Health Care | Psychological Factors | Sociocultural Factors | Measurement Document Number: 322549 |
| 13. Title: Zambia Community Health Waiver Scheme: final evaluation. Author: Community Health Waiver Scheme [CHEWS]. Kafue District Team Source: Bethesda, Maryland, Abt Associates, Partners for Health Reform Plus, 2006 Feb. 37 p. (USAID Development Experience Clearinghouse DocID / Order No: PD-ACG-766) Abstract: This report is an evaluation of the Community Health Welfare Scheme (CHEWS) pilot implemented in Kafue, Zambia, from 2002 to 2004. The goal of CHEWS is to increase health care services utilization by the most vulnerable populations through the provision of a user fee voucher. The identification of beneficiaries and allocation of vouchers is done by a community-based institution (the community welfare assistance committees, CWAC) using a criteria matrix for identification. This evaluation report is based on a household survey of CHEWS and non-CHEWS households, and focus group discussions of health providers and CWACS members. The results show that there were no differences in health seeking behavior and in health status in CHEWS and non-CHEWS households, leading to the conclusion that the targeting matrix was not used correctly or was too complex to use at all. However, the evaluation did find that there was increased collaboration between the Ministry of Community Development and Ministry of Health and that health center personnel were attending to voucher clients without prejudice. It is posited that the inability or unwillingness to use the targeting criteria is a result of the complexity of the matrix, the difficulty of identifying and selecting the poorest in a generally poor population, and the lack of resources for support/supervision. It is recommended that the matrix and its use be reviewed and field-tested to improve upon it. Finally, an exemption mechanism needs adequate funding to function correctly; it cannot be implemented without appropriate investments. (author's) Language: English Keywords: ZAMBIA | SUMMARY REPORT | HEALTH SERVICES EVALUATION | COMMUNITY SURVEYS | COMMUNITY | HOUSEHOLDS | HEALTH SERVICES | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Program Evaluation | Programs | Organization and Administration | Surveys | Sampling Studies | Studies | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Family and Household | Sociocultural Factors | Delivery of Health Care | Health Document Number: 305460 |
| 14. Title: Is khat-chewing associated with HIV risk behaviour? A community-based study from Ethiopia. Author: Dawit A; Debella A; Dejene A; Abebe A; Mekonnen Y Source: African Journal of AIDS Research. 2006 May;5(1):61-69. Abstract: This study examines the possible association between the stimulant khat and risky sexual behaviour that might aggravate the spread of HIV. A community-based cross-sectional survey involving 4 000 individuals and focus group discussions were conducted to assess the attitudes and perceptions of an Ethiopian population towards the habit of khat-chewing and its possible association with risky sexual behaviour. All participants in the focus group discussions and 38% of the survey respondents were of the opinion that behaviours associated with the mild narcotic effects of khat are conducive to casual sex, and hence constitute an increased risk for contracting and spreading HIV. A significant shift towards casual sex practices was observed in response to the effects induced by the substance, and a strong association was observed between khat-chewing, indulgence in alcohol and recourse to risky sexual behaviours. There was no significant difference in the use or non-use of condoms among those male chewers who admitted resorting to casual sex after khat-chewing. We suggest that HIV/AIDS programmes in certain regions should address the habitual use of khat and other substances of potential abuse as part of their intervention efforts to curb the epidemic. (author's) Language: English Keywords: ETHIOPIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | COMMUNITY SURVEYS | FOCUS GROUPS | DRUG USE AND ABUSE | ALCOHOL USE AND ABUSE | SEX BEHAVIOR | RISK BEHAVIOR | CONDOM USE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Data Collection | Behavior | Risk Reduction Behavior Document Number: 302803 |
| 15. Peer Reviewed Title: Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Author: Mansergh G; Shouse RL; Marks G; Guzman R; Rader M Source: Sexually Transmitted Infections. 2006 Apr;82(2):131-134. Abstract: There is evidence that methamphetamine and sildenafil (Viagra) use are associated with sexual risk behaviour among men who have sex with men (MSM). We investigated the association of methamphetamine, sildenafil, and other substance use with unprotected receptive and insertive anal sex among MSM by conducting an encounter specific analysis. Data were from a cross sectional, community based survey of MSM in San Francisco regarding behaviour during their most recent anal sex encounter. Mulitvariate regression analysed independent associations of specific substance use and demographic variables with unprotected anal sex behaviours. The sample (n = 388) was diverse in race/ethnicity, age, income, education, HIV status, and homosexual/bisexual identification. More than half (53%) reported unprotected anal sex, including insertive (29%) and receptive (37%) during their most recent anal sex encounter; 12% reported unprotected insertive and 17% reported unprotected receptive anal sex with an HIV discordant or unknown partner. Methamphetamine was used by 15% and sildenafil was used by 6% of the men before or during the encounter; 2% used both drugs. In multivariate analysis controlling for demographic factors and other substance use, methamphetamine use was associated with unprotected receptive (odds ratio (OR), 2.03; 95% confidence interval (CI), 1.09 to 3.76) and sildenafil use was associated with unprotected insertive (OR, 6.51; CI, 2.46 to 17.24) anal sex. Effects were stronger with HIV discordant or unknown sex partners specifically. Encounter specific associations of methamphetamine and sildenafil use with unprotected receptive and insertive anal sex, respectively, indicate the importance of assessment specificity and tailoring risk reduction efforts to address certain drugs and sexual behavioural roles among MSM. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | COMMUNITY SURVEYS | MEN HAVING SEX WITH MEN | ANAL SEX | RISK BEHAVIOR | DRUG USE AND ABUSE | POPULATION CHARACTERISTICS | North America | Americas | Developed Countries | Research Methodology | Surveys | Sampling Studies | Studies | Sex Behavior | Behavior | Demographic Factors | Population Document Number: 299679 |
| 16. Peer Reviewed Title: Participation in three consecutive mass drug administrations in Leogane, Haiti. [Participation à trois administrations médicamenteuses de masse consécutives à Léogane, en Haïti] Author: Mathieu E; Direny AN; de Rochars MB; Streit TG; Addiss DG Source: Tropical Medicine and International Health. 2006 Jun;11(6):862-868. Abstract: In the global effort to eliminate lymphatic filariasis, mass drug administrations (MDAs) are organised annually. The success of this strategy depends on achieving high levels of drug coverage, which reduce the number of persons with circulating microfilariae and consequently transmission. Persons who consistently fail to participate in MDAs represent a potential threat to the goal of filariasis elimination. We wanted to know the drug coverage, the proportion of persons who were systematically noncompliant and factors associated with this behaviour. We conducted three surveys following the third annual MDA of a filariasis elimination program in Leogane, Haiti: (1) a total population survey to determine coverage; (2) an adult survey to determine non-compliance and associated factors and (3) an urban survey to make a rural--urban comparison. During the third MDA, the overall surveyed coverage was 78.5% [95% confidence interval (CI) 74.4--82.6] A survey among adult population showed coverage estimates for persons > 14 years old of 59.4% (95% CI 52.0--66.7), 61.0% (95% CI 55.0--67.4) and 67.3% (95% CI 60.5-- 74.0), for the first, second and third MDA respectively. The coverage in rural areas (78.3%) was significantly higher than in urban areas (68.3%, P < 0.05). Of the population > 14 years of age, 18% never took the drugs during any of three MDAs. These persons did not differ significantly from MDA participants by age, gender or other characteristics that we assessed. More research is needed to identify characteristics of systematically non-compliant persons in order to refine health education messages and improve distribution strategies to increase drug coverage. (author's) French Abstract: Dans le cadre de l'effort mondial pour éliminer la filariose lymphatique, des administrations médicamenteuses de masse sont organisées annuellement. Le succès de cette stratégie est lié à un haut niveau d'administration du médicament qui réduit ainsi le nombre de personnes porteuses de microfilaires et donc leur transmission. Les personnes qui sont régulièrement absentes des administrations médicamenteuses de masse représentent une menace potentielle pour l'objectif d'éradication de la filariose. Nous voulions connaître le nombre de personnes auxquelles étaient administré le médicament, la proportion de personnes qui étaient régulièrement absentes et les facteurs liés à ce comportement. Nous avons réalisé trois enquêtes à la suite de la troisième administration médicamenteuse de masse annuelle effectuée dans le cadre d'un programme d'éradication de la filariose à Léogane, en Haïti : (1) une enquête sur la population totale pour déterminer le nombre de personnes recevant les médicaments, (2) une enquête auprès des adultes pour déterminer la non-conformité et les facteurs connexes et (3) une enquête urbaine pour faire une comparaison milieu urbain/milieu rural. Au cours de la troisième administration médicamenteuse de masse, le nombre global de sujets traités était de 78,5% [intervalle de confiance de 95% : 74,4 - 82,6]. Une enquête auprès de la population adulte donne des estimations du nombre de sujets traités pour les personnes âgées de > 14 ans de 59,4% (intervalle de confiance de 95% : 52,0 - 66,7), 61,0% (intervalle de confiance de 95% : 5,0 - 67,4) et 67,3% (intervalle de confiance de 95% : 60,5 - 74,0) pour la première, deuxième et troisième administration médicamenteuse de masse, respectivement. Le nombre de sujets traités dans les zones rurales (78,3%) était significativement plus élevé que dans les zones urbaines (68,3%, P < 0,05). Dans la population de > 14 ans, 18% des sujets n'ont jamais pris les médicaments au cours des trois administrations médicamenteuses de masse. Ces personnes ne différaient pas de façon significative des participants aux administrations médicamenteuses de masse en terme d'âge, de sexe ou d'autres caractéristiques que nous avons évaluées. Afin de perfectionner les messages d'éducation en matière de santé et d'améliorer les stratégies de distribution en vue d'augmenter le nombre de personnes qui prennent les médicaments, il est nécessaire de procéder à d'autres recherches pour identifier les caractéristiques des personnes qui refusent systématiquement de se conformer. (de l'auteur) Language: English Keywords: HAITI | RESEARCH REPORT | COMMUNITY SURVEYS | COMMUNITY-BASED DISTRIBUTION | FILARIASIS | PREVENTION AND CONTROL | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Parasitic Diseases | Diseases Document Number: 301963 |
| 17. Title: Use of postpartum health services in rural Uganda: knowledge, attitudes, and barriers. Author: Nabukera SK; Witte K; Muchunguzi C; Bajunirwe F; Batwala VK Source: Journal of Community Health. 2006 Apr;31(2):84-93. Abstract: The purpose of this study was to explore the knowledge, attitudes and barriers to use of postpartum care service among rural communities in Uganda. Study was a part of a larger reproductive health evaluation project, and was cross-sectional in nature utilizing qualitative research methods using the narrative inquiry. Two matched rural communities were used in this study; Semuto in Luwero district, and Lwamaggwa in Rakai district. Fifty key informants who were purposefully selected from each study site were interviewed. They included community leaders, political leaders, health care providers, women leaders and community members. One-on-one interviews were conducted with key community informants using an interview guide. The purpose of the interview was explained to each participant, and written informed consent was obtained before the start of the interview. Respondents were allowed to express their views, opinions and observations on several health issues including postpartum health care services. There was a low level of knowledge about postpartum care services among the respondents of the two communities. There was lack of awareness about postpartum care and it's benefits. The main barriers to use of services were; misconceptions regarding the importance of postpartum care, distance to health facilities, poverty, and health system factors notably; poor facilities, lack of essential drugs, and poor attitudes of health workers. In the effort to improve reproductive health care services, there is an urgent need to improve postpartum services, and make them more accessible and user friendly. The training of providers at all levels is essential, in addition to educating families on the importance of postpartum care services. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | QUALITATIVE RESEARCH | COMMUNITY SURVEYS | INFLUENTIALS | PUBLIC OPINION | HEALTH SERVICES | KNOWLEDGE | ATTITUDES | POVERTY | NEEDS | QUALITY OF HEALTH CARE | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Surveys | Sampling Studies | Studies | Knowledge Sources | Communication | Psychological Factors | Behavior | Delivery of Health Care | Health | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 307627 |
| 18. Peer Reviewed Title: Wealth, mother's education and physical access as determinants of retail sector net use in rural Kenya. Author: Noor AM; Omumbo JA; Amin AA; Zurovac D; Snow RW Source: Malaria Journal. 2006 Jan 26;5(5):[10] p.. Abstract: Insecticide-treated bed nets (ITN) provide real hope for the reduction of the malaria burden across Africa. Understanding factors that determine access to ITN is crucial to debates surrounding the optimal delivery systems. The influence of homestead wealth on use of nets purchased from the retail sector is well documented, however, the competing influence of mother's education and physical access to net providers is less well understood. Between December 2004 and January 2005, a random sample of 72 rural communities was selected across four Kenyan districts. Demographic, assets, education and net use data were collected at homestead, mother and child (aged < 5 years) levels. An assets-based wealth index was developed using principal components analysis, travel time to net sources was modelled using geographic information systems, and factors influencing the use of retail sector nets explored using a multivariable logistic regression model. Homestead heads and guardians of 3,755 children < 5 years of age were interviewed. Approximately 15% (562) of children slept under a net the night before the interview; 58% (327) of the nets used were purchased from the retail sector. Homestead wealth (adjusted OR = 10.17, 95% CI = 5.45-18.98), travel time to nearest market centres (adjusted OR = 0.51, 95% CI = 0.37- 0.72) and mother's education (adjusted OR = 2.92, 95% CI = 1.93-4.41) were significantly associated with use of retail sector nets by children aged less than 5 years. Approaches to promoting access to nets through the retail sector disadvantage poor and remote communities where mothers are less well educated. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | COMMUNITY SURVEYS | HEAD OF HOUSEHOLD | MOTHERS | CHILDREN | MALARIA PREVENTION | BED NETS | EDUCATIONAL STATUS | SOCIOECONOMIC STATUS | DISTANCE | UTILIZATION OF HEALTH CARE | INEQUALITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Households | Family and Household | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Socioeconomic Factors | Economic Factors | Geographic Factors | Health Services | Delivery of Health Care Document Number: 298407 |
| 19. Peer Reviewed Title: Is antenatal care effective in improving maternal health in rural Uttar Pradesh? Evidence from a district level household survey. Author: Ram F; Singh A Source: Journal of Biosocial Science. 2006 Jul;38(4):433-448. Abstract: Data from the District Level Household Survey (2002) conducted by the Reproductive and Child Health Project in India has been used to examine the impact of utilization of antenatal care services on improvement in maternal health in rural areas of Uttar Pradesh, India. Multilevel analysis shows that after controlling for other socioeconomic and demographic factors, utilization of antenatal care services may lead to the utilization of other maternal health related services such as institutional delivery, delivery assisted by trained professionals, seeking advice for pregnancy complications, and seeking advice for post-delivery complications. There is strong clustering of utilization of services within the primary sampling units (i.e. villages) and districts. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | COMMUNITY SURVEYS | HOUSEHOLDS | RURAL AREAS | ANTENATAL CARE | MATERNAL-CHILD HEALTH SERVICES | QUALITY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Geographic Factors | Population | Maternal Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 302356 |
| 20. Title: Refusal to be tested for HIV and the likelihood of infection: a potential, but unlikely source of bias in community-based studies of HIV prevalence. Author: Reniers G; Araya T; Berhane Y; Sanders EJ; Davey G Source: [Unpublished] 2006. Presented at the 2006 Annual Meeting of the Population Association of America, Los Angeles, California, March 30 - April 1, 2006. 22 p. Abstract: Population-based studies involving HIV serostatus testing are regularly used to evaluate HIV prevalence estimates derived from ANC sentinel surveillance sites or to provide alternative estimates altogether. Bias in community-based estimates is, however, also plausible because of shortcomings in the sampling frame and non-response due to population mobility and/or refusal. In this paper, we investigate the association between refusal and HIV infection in a large governmental hospital in Addis Ababa, and via a comparison of ordinary regression and regression models that account for sample selection, we quantify the magnitude of the ensuing bias in HIV prevalence estimates. We find that refusal is indeed correlated with the likelihood of infection, but the resulting bias in HIV prevalence estimates - in our study population as well as in community-based studies - is likely to be negligible. The latter will depend in great part on the study protocol and informed consent procedures. We also find that consent for testing increased since the introduction of antiretroviral treatment. (author's) Language: English Keywords: DEVELOPING COUNTRIES | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | ESTIMATION TECHNIQUES | SAMPLING STUDIES | SURVEY METHODOLOGY | HIV TESTING | HIV INFECTIONS | PREVALENCE | COMMUNITY SURVEYS | BIAS | DATA QUALITY | Research Methodology | Studies | Surveys | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Measurement | Error Sources | Data Analysis Document Number: 318892 |
| 21. Peer Reviewed Title: The economic burden of visceral leishmaniasis for households in Nepal. Author: Rijal S; Koirala S; Van der Stuyft P; Boelaert M Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2006 Sep;100(9):817-825. Abstract: Visceral leishmaniasis (VL) affects persons from the lowest socioeconomic strata of the community, but its economic impact is not precisely known. An exploratory survey to document the economic costs of VL to households was conducted in an endemic focus in eastern Nepal. Data were collected from the 20 households in this cluster. Cases of VL over the last 3 years were elicited and information on direct and indirect costs incurred due to the disease as well as income of the households over the last year was estimated. It was reported that 15.0% (16/107) of the residents had suffered from VL and that almost all of the patients had preferred, in the first instance, to visit the private services or local faith healers instead of visiting the local public health facility. Average total costs incurred per episode of VL were above the median annual per capita income, and six of the seven affected households either had to sell part of their livestock or to take a loan to cover the costs. Direct costs consisted of 53% of the total cost, with 75% of this cost incurred before the patients actually received any treatment for VL. This study demonstrates how VL can lead to catastrophic expenditure for affected households. (author's) Language: English Keywords: NEPAL | RESEARCH REPORT | COMMUNITY SURVEYS | LOW INCOME POPULATION | HOUSEHOLDS | ECONOMIC FACTORS | LEISHMANIASIS | POVERTY | PRIVATE SECTOR | HEALTH SERVICES | UTILIZATION OF HEALTH CARE | FEES | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Family and Household | Sociocultural Factors | Parasitic Diseases | Diseases | Macroeconomic Factors | Delivery of Health Care | Health | Financial Activities Document Number: 302783 |
| 22. Peer Reviewed Title: Spatial clustering and epidemiological aspects of visceral leishmaniasis in two endemic villages, Baringo District, Kenya. Author: Ryan JR; Mbui J; Rashid JR; Wasunna MK; Kirigi G Source: American Journal of Tropical Medicine and Hygiene. 2006 Feb;74(2):308-317. Abstract: Visceral leishmaniasis (VL) seroprevalence in Kenya is unknown because of the lack of a practical and accurate diagnostic test or surveillance system. A novel serological assay was used to estimate the seroprevalence of Leishmania-specific antibodies, and Global Information System and spatial clustering techniques were applied to study the presence of spatial clusters in Parkarin and Loboi villages in Baringo District in 2001. VL seroprevalences were 52.5% in Parkarin and 16.9% in Loboi. Significant associations among seropositivity and house construction, age, and proximity to domestic animal enclosures were found. A significant spatial cluster of VL was found in Loboi. The spatial distribution of cases in the two villages was different with respect to risk factors, such as presence of domestic animals. This study suggests that disease control efforts could be focused on elimination of sand fly habitat, placement of domestic animal enclosures, and targeted use of insecticides. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | EPIDEMIOLOGY | COMMUNITY SURVEYS | CHILD | ADOLESCENTS | GEOGRAPHIC FACTORS | LEISHMANIASIS | SEROCONVERSION | RISK FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Public Health | Health | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Immunity | Immune System | Physiology | Biology Document Number: 297353 |
| 23. Peer Reviewed Title: Antimicrobial self medication for reproductive tract infections in two provinces in Lao People's Democratic Republic. Author: Sihavong A; Lundborg CS; Syhakhang L; Akkhavong K; Tomson G Source: Sexually Transmitted Infections. 2006 Apr;82(2):182-186. Abstract: The objectives were to describe antimicrobial self medication for reproductive tract infections (RTI) including sexually transmitted infections (STI), and to explore the understanding and use of health information among the adult population self medicating with antimicrobials for RTI/STI in two provinces of Laos. This could contribute to quality improvement of RTI/STI management. Cross sectional community based study. Structured interviews (household survey) were conducted among 500 subjects aged 18 or more, who had used antimicrobials as self medication for RTI/ STI during the past year. They were recruited among 3056 family members in Vientiane capital and Champasak province, divided equally between the two study sites, and between urban and rural areas. Among the 500 respondents reporting self medication for RTI/STI, 91% had bought the antimicrobials from local private pharmacies without a physician's prescription. 58% of those were advised to buy the drugs from drug sellers. Ampicillin (not recommended as syndromic treatment for RTI/ STI) was used in 83% of all cases, in 28% combined with tetracycline. 79% of respondents used antimicrobials for a non-recommended duration of time. Most respondents had access to health messages for RTI/STI, largely from radio/television and drug sellers. However, only 17% of all respondents reported that they had ever used a condom. More than three quarters of respondents, self medicating for RTI/STI with antimicrobials, used inappropriate drugs bought from private pharmacies. There is a need to improve RTI/STI management, including health promotion, through interventions at community level, and to health providers, including private drug sellers. (author's) Language: English Keywords: LAOS | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | COMMUNITY SURVEYS | RESPONDENTS | REPRODUCTIVE TRACT INFECTIONS | SELF CARE | DRUGS | TREATMENT | ADMINISTRATION AND DOSAGE | RISK ASSESSMENT | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Document Number: 299684 |
| 24. Peer Reviewed Title: Knowing a medical doctor is associated with reduced mortality among sick children consulting a paediatric ward in Guinea-Bissau, West Africa. Author: Sodemann M; Biai S; Jakobsen MS; Aaby P Source: Tropical Medicine and International Health. 2006 Dec;11(12):1868-1877. Abstract: The objective was to examine equity in access to public health services in Guinea-Bissau. The study was conducted in 2000-2001 at the emergency clinic of the only paediatric ward in Bissau. Mothers of all children from the study area were interviewed about previous care seeking and relations with anybody working in the health sector. All management actions in the emergency clinic were registered. In-hospital and subsequent community mortality was ascertained through community surveillance. The measured outcome was mortality risk within 30 days of first consultation. We followed 1572 children with a first consultation. Of these, 8.2% died within 30 days. Acquaintance with a physician reduced 30-day mortality risk by 48% (95% CI: 18-66). The effect was strongest among post-neonatal children (54%; 95% CI: 18-74). Mortality within 30 days of consultation was also independently predicted by consultation after 7 pm, nurse team on duty, day of week and young mother. In a multivariate model, socioeconomic status and school education were not associated with 30-day mortality when acquaintance with a medical doctor was taken into account. Favouritism may be a significant factor for quality of care and child mortality in developing countries. Interventions to improve hospital and health worker performance should be given high priority. (author's) Language: English Keywords: GUINEA-BISSAU | RESEARCH REPORT | INTERVIEWS | COMMUNITY SURVEYS | MOTHERS | HOSPITALS | CHILD MORTALITY | HEALTH SERVICES | QUALITY OF HEALTH CARE | PERFORMANCE IMPROVEMENT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Surveys | Sampling Studies | Studies | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Health Facilities | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Management Document Number: 310930 |
| 25. Title: Working report. Measuring HIV stigma: results of a field test in Tanzania. Author: Tanzania Stigma-Indicators Field Test Group Source: [Washington, D.C.], Social and Scientific Systems, Synergy Project, 2005 Jun. [218] p. (USAID Contract No. HRN-C-00-99-00005-00USAID Development Experience Clearinghouse DocID / Order No. PN-ADE-801) Abstract: The demand for stigma indicators has continued to increase, particularly from USAID global missions and their partner agencies. Implementing agencies and donors need tested indicators by which they can reliably assess stigma in a given setting and measure progress in reducing it. In response to this need, USAID funded this first step, i.e., field-testing and validation of an initial set of stigma indicators at one site in Tanzania. This project builds expressly on the findings of the International Center for Research on Women (ICRW) and its partners in a multi-country study on stigma, and on the Horizons and POLICY Project work on stigma. The specific aim of this project is to examine, test, and validate selected stigma indicators from the Blue Book and the 2004 S&DIWG workshop. The results of this effort are found in this working report. (excerpt) Language: English Keywords: TANZANIA | SUMMARY REPORT | FIELD REPORT | QUESTIONNAIRES | COMMUNITY SURVEYS | DATA COLLECTION | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | STIGMA | CONFIDENTIAL INFORMATION | FEAR | POLICY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Ethics | Emotions | Psychological Factors | Behavior | Political Factors Document Number: 296275 |
| 26. Title: How do women identify health professionals at birth in Ghana? Author: Hussein J; Hundley V; Bell J; Abbey M; Asare GQ Source: Midwifery. 2005;21:36-43. Abstract: Objective: the percentage of births attended by health professionals is widely used to measure skilled attendance. This indicator is based on women’s reports of their birth attendant. This study explores how women identify health professionals attending their births. Design: exit interviews, focus groups, in-depth interviews and a community survey. Qualitative data were analysed by topic. Frequency of women’s responses on how they identify the birth attendant and other characteristics of birth care were generated through the community survey. Setting and participants: women in Ghana who had birthed with a health professional in the last 5 years. Measurements and findings: role, prior knowledge and uniform are the most common means by which women identify their attendant. These means of identification do not distinguish accurately between different types of health professional. Delivery events are more complex than is suggested through use of the indicator ‘percentage of deliveries with health professionals’. Fifty-five per cent of births were attended by more than one person. In 11.6% of births, women were attended only after the partial birth of their baby. Key conclusions and implications for practice: there is potential for incorrect identification of birth attendant by the use of women’s reports. None of the methods used could verify women’s reporting. Methodological developments in this area are necessary along with improved recording systems. Opportunities for women to identify health professionals should be enhanced. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | COMMUNITY SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | HEALTH PERSONNEL | MIDWIVES AND MIDWIFERY | CHILDBIRTH | UTILIZATION OF HEALTH CARE | PREGNANCY COMPLICATIONS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Health Services | Diseases Document Number: 282192 |
| 27. Peer Reviewed Title: The economic value of an improved malaria treatment programme in Zambia: results from a contingent valuation survey. Author: Masiye F; Rehnberg C Source: Malaria Journal. 2005 Dec 15;4:[9] p.. Abstract: Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP) was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of US$ 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed. (author's) Language: English Keywords: ZAMBIA | RESEARCH REPORT | COMMUNITY SURVEYS | HOUSEHOLDS | MALARIA | TREATMENT | COST BENEFIT ANALYSIS | RISK FACTORS | SOCIOECONOMIC STATUS | INEQUALITIES | ECONOMIC FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Quantitative Evaluation | Evaluation | Biology | Socioeconomic Factors Document Number: 298403 |
| 28. Peer Reviewed Title: Chronic fatigue in developing countries: population based survey of women in India. Author: Patel V; Kirkwood B; Weiss H; Pednekar S; Fernandes J Source: BMJ. British Medical Journal. 2005 May 21;330(7501):[8] p.. Abstract: The objectives were to describe the prevalence of and risk factors for chronic fatigue in a developing country; in particular, to determine the association of anaemia, mental health, and gender disadvantage factors with chronic fatigue. Design: Community survey. Setting: Primary health centre catchment area in Goa, India. Participants: 3000 randomly sampled women aged 18 to 50 years. Data on the primary outcome (reporting of fatigue for at least six months) and psychosocial exposures elicited by structured interview; presence of anaemia determined from a blood sample. 2494 (83%) women consented to participate; 12.1% (95% confidence interval 10.8 to 13.4%) complained of chronic fatigue. In multivariate analyses, older women (P = 0.03) and those experiencing socioeconomic deprivation—less education (P < 0.001), families in debt (P = 0.09), or hunger in the past three months (P = 0.03)—were more likely to report chronic fatigue. After adjustment for these factors, factors indicating gender disadvantage (notably sexual violence by the husband; P < 0.001) and poor mental health (P < 0.001) were strongly associated with chronic fatigue. Although women with a high body mass index had a reduced risk, suggesting an influence of poor nutrition, no association was found between chronic fatigue and haemoglobin concentrations. Chronic fatigue was commonly reported by women in this community study from India. The strongest associations with chronic fatigue were for psychosocial factors indicative of poor mental health and gender disadvantage. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | COMMUNITY SURVEYS | WOMEN | CHRONIC DISEASES | FATIGUE | PREVALENCE | RISK FACTORS | ANEMIA | PSYCHOLOGICAL FACTORS | SOCIOECONOMIC FACTORS | MENTAL HEALTH | MENTAL DISORDERS | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Diseases | Signs and Symptoms | Measurement | Biology | Behavior | Economic Factors | Health Document Number: 287836 |
| 29. Peer Reviewed Title: Does where we live matter? Community characteristics and HIV and sexually transmitted disease prevalence in southwestern China. Author: Yang X Source: International Journal of STD and AIDS. 2005;16:31-37. Abstract: Studies of HIV/sexually transmitted diseases (STDs) in China have paid little attention to community characteristics that may be conducive to HIV/STD risky behaviours and to the spread of the epidemics. Using data from a community survey and employing both correlation and multiple regression analysis, this paper examines the county-level determinants of the prevalence of HIV/STD risky behaviours and infections. The results suggest that community social and behavioural norms predict significantly the prevalence of illicit drugs and commercial sex and that the prevalence of the two HIV/STD risky behaviours reinforces each other. The analysis also shows that migration significantly increases prevalence of HIV and STDs, as does prevalence of injecting drug use and commercial sex. Overall, HIV and STDs are found not to be diseases of poverty but more likely byproducts of social and behaviour changes associated with development and urbanization. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | COMMUNITY SURVEYS | SEX WORKERS | IV DRUG USERS | MIGRANTS | COMMUNITY | RISK BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | PREVALENCE | SOCIOECONOMIC FACTORS | Developing Countries | Asia, Eastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Sex Behavior | Behavior | Drug Use and Abuse | Migration | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Measurement | Economic Factors Document Number: 280528 |
| 30. Peer Reviewed Title: Qualitative assessment of venues for purposive sampling of hard-to-reach youth. An illustration in a Latino community. Author: Auerswald CL; Greene K; Minnis A; Doherty I; Ellen J Source: Sexually Transmitted Diseases. 2004 Feb;31(2):133-138. Abstract: Latino youth suffer disproportionately from unintended pregnancy and sexually transmitted infections (STIs), but studies of the social context of their sexual behaviors are lacking. Our qualitative assessment of recruitment venues in a Latino neighborhood had 3 objectives: to identify venues where youth at risk of unintended pregnancy and STIs could be found; to describe different youth “crowds”; and to investigate how and where youth meet their sex partners. We conducted ethnographic interviews with 62 youth recruited primarily from street sites. Mapping of venues was conducted with Map-Info. Youth crowds included the Regulars, gang-related crowds, street-economy affiliated crowds, and female crowds. Maps demonstrated the dominance of the venues in the Mission by gang members. Street sites are important venues for meeting sexual partners. The qualitative assessment produced insights and hypotheses that can contribute to the planning of research, outreach, testing, and interventions with Latino youth. (author's) Language: English Keywords: CALIFORNIA | RESEARCH REPORT | QUALITATIVE RESEARCH | COMMUNITY SURVEYS | HISPANICS | YOUTH | SEXUALLY TRANSMITTED DISEASES | PREGNANCY, UNPLANNED | SOCIAL NETWORKS | CROWDS | RISK FACTORS | Developed Countries | United States of America | North America | Americas | Research Methodology | Surveys | Sampling Studies | Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Age Factors | Reproductive Tract Infections | Infections | Diseases | Reproductive Behavior | Fertility | Population Dynamics | Friends and Relatives | Family and Household | Social Behavior | Behavior | Biology Document Number: 190290 |
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