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Title: Expanding access to injectable contraceptives.
Author: United States. Agency for International Development [USAID]
Source: [Washington, D.C.], USAID, [2009]. [2] p.
Abstract: A technical consultation, co-sponsored by the World Health Organization (WHO), USAID, and Family Health International (FHI), was held June 15-17, 2009, at the WHO in Geneva to review the evidence and programmatic experience for community-based provision of injectable contraceptives. Thirty technical and program experts from countries and organizations reviewed the scientific evidence and experiences from programs that provided injectable contraceptives through community-based health workers (CHWs). This evidence and programmatic experience came from Africa, Asia, and Latin America and focused on depotmedroxyprogesterone acetate (DMPA). The evidence consistently showed that given appropriate training, CHWs can screen clients effectively, provide DMPA injections safely, and counsel on side effects appropriately, demonstrating competence equivalent to higher level facility-based providers of DMPA. Continuation of use of DMPA by clients of CHWs was as long as those of clients receiving injections at clinics. In addition, the vast majority of clients expressed satisfaction with CHW provision of DMPA. The Consultation concluded that sufficient evidence existed for national policies to support the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives, especially DMPA. Provision of DMPA by CHWs will expand choice for underserved populations and contribute to reducing the unmet need for family planning. Operational guidelines for family planning should therefore reflect that appropriately trained CHWs can safely initiate use of DMPA and provide reinjection. (Excerpt)
Language: English
Keywords:
GLOBAL | SUMMARY REPORT | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | COUNSELING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Public Health | Contraceptive Usage | Training Programs | Education | Clinic Activities | Program Activities | Programs | Organization and Administration | Population Policy | Social Policy | Policy
Document Number: 331839

Title: Community-based health workers can safely and effectively administer injectable contraceptives: Conclusions from a technical consultation.
Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2009. 4 p.
Abstract: In June 2009, a technical consultation held at the World Health Organization (WHO) in Geneva concluded that evidence supports the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives. The group of 30 technical and programme experts reviewed scientific and programmatic experience, which largely focused on the progestin-only injectable, depot-medroxyprogesterone acetate (DMPA). The experts found that community-based provision of progestin-only injectable contraceptives by appropriately trained community health workers (CHWs) is safe, effective, and acceptable. Such services should be part of a family planning programme offering a range of contraceptive methods. (Excerpt)
Language: English
Keywords:
GLOBAL | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | NEEDS | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | MONITORING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Economic Factors | Public Health | Contraceptive Usage | Training Programs | Education | Evaluation | Population Policy | Social Policy | Policy
Document Number: 331834

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Peer Reviewed

Title: Community-based skilled birth attendants in Bangladesh: attending deliveries at home.
Author: Ahmed T; Jakaria SM
Source: Reproductive Health Matters. 2009 May;17(33):45-50.
Abstract: Only 15% of births in Bangladesh in 2007 were delivered at health facilities, but the increase over previous years has been significant, and treatment-seeking from a medically trained provider for obstetric complications has also increased. A programme to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh in 2004. The training, for community-based health and family planning fieldworkers, covers 74 essential midwifery skills and danger signs for referral. Training of trainers and supervisors for the fieldworkers was also initiated. By the end of 2008 an estimated 4,000 out of a proposed 13,500 skilled birth attendants and 50 of 4,000 proposed supervisors had been trained and were working in 56 districts. There needs to be a full evaluation of the programme and whether it has reduced maternal deaths. Bangladesh now needs to decide how long to invest in this programme and/or whether to train a new cadre of fully qualified midwives, as proposed by the Nursing Council. We believe this programme can only be an interim measure, not a long-term solution, as more women decide to seek institutional delivery and professional midwifery care. For the moment, though, task-shifting seems to have yielded beneficial results and important insights into human resources planning for safe motherhood in Bangladesh.
Spanish Abstract: En 2007, s�lo el 15% de los partos en Bangladesh ocurrieron en establecimientos de salud. En comparaci�n con a�os anteriores, este porcentaje ha aumentado considerablemente, al igual que la b�squeda de tratamiento de complicaciones obst�tricas brindado por un profesional m�dico capacitado. En 2004, el Gobierno de Bangladesh lanz� un programa para crear una categor�a de asistentes de partos calificados que ayudaran con los partos domiciliares. La capacitaci�n de trabajadores comunitarios de la salud y de planificaci�n familiar, abarca 74 habilidades esenciales de parter�a y los signos de alarma para dar referencias. Tambi�n se inici� la capacitaci�n de capacitadores y supervisores de los trabajadores de campo. A finales de 2008, aproximadamente 4,000 de los 13,500 asistentes de partos calificados y 50 de los 4,000 supervisores propuestos hab�an recibido capacitaci�n y estaban trabajando en 56 distritos. Es necesario realizar una evaluaci�n completa del programa y determinar si �ste ha logrado disminuir la tasa de muertes maternas. Bangladesh debe decidir por cu�nto tiempo continuar invirtiendo en este programa y/o si capacitar a un nuevo grupo de parteras profesionales plenamente cualificadas, como propone el Consejo de Enfermer�a. Estimamos que este programa es s�lo una medida provisional, no una soluci�n de largo plazo, ya que cada vez m�s aumenta el n�mero de mujeres que deciden buscar atenci�n institucional y cuidados de parter�a profesionales. No obstante, por ahora la reasignaci�n de tareas parece haber dado buenos resultados e importantes datos sobre los recursos humanos en la planificaci�n de la maternidad sin riesgos en Bangladesh.
French Abstract: Au Bangladesh, en 2007, 15% seulement des naissances avaient eu lieu dans un �tablissement de sant�, mais la hausse par rapport aux pr�c�dentes ann�es �tait sensible et le recours aux services d'un prestataire form� m�dicalement pour les complications obst�tricales avait aussi augment�. En 2004, le Gouvernement a lanc� un programme de cr�ation d'un groupe d'accoucheuses qualifi�s pour les naissances � domicile. La formation des agents de sant� et de planification familiale communautaires couvre 74 comp�tences obst�tricales essentielles et les signes de danger exigeant le transfert de la patiente. La formation des formateurs et des superviseurs des agents de terrain a aussi �t� lanc�e. Fin 2008, environ 4000 des 13 500 accoucheuses qualifi�s envisag�s et 50 des 4000 superviseurs pr�vus avaient �t� form�s et travaillaient dans 56 districts. Il faut mener une �valuation compl�te du programme et d�terminer s'il a diminu� les d�c�s maternels. Le Bangladesh doit maintenant d�cider pendant combien de temps investir dans ce programme et/ou s'il souhaite former un nouveau groupe de sages-femmes pleinement qualifi�es, ainsi que l'a propos� le Conseil des infirmi�res. Nous pensons que ce programme ne peut �tre qu'une mesure provisoire et non une solution � long terme, � mesure que davantage de femmes opteront pour un accouchement institutionnel et des soins de sages-femmes professionnelles. Pour le moment, n�anmoins, la d�l�gation des t�ches semble avoir produit des r�sultats positifs et des connaissances pr�cieuses sur la planification des ressources humaines pour une maternit� � moindre risque au Bangladesh.
Language: English
Keywords:
BANGLADESH | PROGRESS REPORT | PILOT PROJECTS | COMMUNITY WORKERS | MIDWIVES AND MIDWIFERY | CHILDBIRTH | REFERRAL AND CONSULTATION | GOVERNMENT PROGRAMS | TRAINING OF TRAINERS | MEDICAL SUPERVISION | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Program Activities | Programs | Organization and Administration | Training Programs | Education | Supervision | Management
Document Number: 342014

4.
Peer Reviewed

Title: Potential role of traditional birth attendants in neonatal healthcare in rural southern Nepal.
Author: Falle TY; Mullany LC; Thatte N; Khatry SK; LeClerq SC; Darmstadt GL; Katz J; Tielsch JM
Source: Journal of Health, Population, and Nutrition. 2009 Feb;27(1):53-61.
Abstract: The potential for traditional birth attendants (TBAs) to improve neonatal health outcomes has largely been overlooked during the current debate regarding the role of TBAs in improving maternal health. Randomly-selected TBAs (n=93) were interviewed to gain a more thorough understanding of their knowledge, attitudes, and practices regarding maternal and newborn care. Practices, such as using a clean cord-cutting instrument (89%) and hand-washing before delivery (74%), were common. Other beneficial practices, such as thermal care, were low. Trained TBAs were more likely to wash hands with soap before delivery, use a clean delivery-kit, and advise feeding colostrum. Although mustard oil massage was a universal practice, 52% of the TBAs indicated their willingness to consider alternative oils. Low-cost, evidence-based interventions for improving neonatal outcomes might be implemented by TBAs in this setting where most births take place in the home and neonatal mortality risk is high. Continuing efforts to define the role of TBAs may benefit from an emphasis on their potential as active promoters of essential newborn care.
Language: English
Keywords:
NEPAL | RESEARCH REPORT | RURAL AREAS | TRADITIONAL BIRTH ATTENDANTS | COMMUNITY WORKERS | KNOWLEDGE | ATTITUDES | NEONATAL MORTALITY | PERCEPTION | CHILDBIRTH | INTERVENTIONS | DELIVERY OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Health Personnel | Health | Sociocultural Factors | Psychological Factors | Behavior | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Programs | Organization and Administration
Document Number: 331129

Peer Reviewed

Title: Do women increase their use of reproductive health care when it becomes more available? Evidence from Indonesia.
Author: Frankenberg E; Buttenheim A; Sikoki B; Suriastini W
Source: Studies in Family Planning. 2009 Mar;40(1):27-38.
Abstract: Data from the Indonesia Family Life Survey are used to investigate the impact of a major expansion in access to midwifery services on women's use of antenatal care and delivery assistance. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in poor communities that were distant from health-care centers. We analyze information from pregnancy histories to relate changes in the choices that individual women make across pregnancies to the arrival of a trained midwife in the village. We show that regardless of a woman's educational level, the placement of village midwives in communities is associated with significant increases in women's receipt of iron tablets and in their choices about care during delivery-changes that reflect their moving away from reliance on traditional birth attendants. For women with relatively low levels of education, the presence of village midwives has the additional benefit of increasing use of antenatal care during the first trimester of pregnancy. The results of the study suggest that bringing services closer to women can change their patterns of use.
Language: English
Keywords:
INDONESIA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | COMMUNITY WORKERS | UTILIZATION OF HEALTH CARE | CHILDBIRTH | WOMEN'S HEALTH | PROGRAM ACCESSIBILITY | DECISION MAKING | COMMUNITY HEALTH SERVICES | ANTENATAL CARE | TRADITIONAL BIRTH ATTENDANTS | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Health Services | Pregnancy Outcomes | Pregnancy | Reproduction | Program Evaluation | Programs | Organization and Administration | Behavior | Primary Health Care | Maternal Health Services | Maternal-Child Health Services
Document Number: 341081

Peer Reviewed

Title: Exploring health stakeholders' perceptions on moving towards comprehensive primary health care to address childhood malnutrition in Iran: a qualitative study.
Author: Javanparast S; Coveney J; Saikia U
Source: BMC Health Services Research. 2009;9:36.
Abstract: BACKGROUND: Due to the multifaceted aspect of child malnutrition, a comprehensive approach, taking social factors into account, has been frequently recommended in health literature. The Alma-Ata declaration explicitly outlined comprehensive primary health care as an approach that addresses the social, economic and political causes of poor health and nutrition. Iran as a signatory country to the Alma Ata Declaration has established primary health care since 1979 with significant progress on many health indicators during the last three decades. However, the primary health care system is still challenged to reduce inequity in conditions such as child malnutrition which trace back to social factors. This study aimed to explore the perceptions of the Iranian health stakeholders with respect to the Iranian primary health care performance and actions to move towards a comprehensive approach in addressing childhood malnutrition. Health stakeholders are defined as those who affect or can be affected by health system, for example health policy-makers, health providers or health service recipients. METHODS: Stakeholder analysis approach was undertaken using a qualitative research method. Different levels of stakeholders, including health policy-makers, health providers and community members were interviewed as either individuals or focus groups. Qualitative content analysis was used to interpret and compare/contrast the viewpoints of the study participants. RESULTS: The results demonstrated that fundamental differences exist in the perceptions of different health stakeholders in the understanding of comprehensive notion and action. Health policy-makers mainly believed in the need for a secure health management environment and the necessity for a whole of the government approach to enhance collaborative action. Community health workers, on the other hand, indicated that staff motivation, advocacy and involvement are the main challenges need to be addressed. Turning to community stakeholders, greater emphasis has been placed on community capabilities, informal link with other social sectors based on trust and local initiatives. CONCLUSION: This research provided a picture of the differences in the perceptions and values of different stakeholders with respect to primary health care concepts. The study suggests that a top-down approach, which still exists among health policy-makers, is a key obstacle that delays, and possibly worse, undermines the implementation of the comprehensive strategy codified by the Alma-Ata Declaration. A need to revitalize primary health care to use its full potential and to combine top-down and bottom-up approaches by narrowing the gap between perceptions of policy makers and those who provide and receive health-related services is crucial.
Language: English
Keywords:
IRAN | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CHILDREN | POLICYMAKERS | COMMUNITY | COMMUNITY WORKERS | HEALTH PERSONNEL | PRIMARY HEALTH CARE | CHILD NUTRITION | MALNUTRITION | PERCEPTION | HEALTH POLICY | COMMUNITY HEALTH SERVICES | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Delivery of Health Care | Health | Health Services | Nutrition | Nutrition Disorders | Diseases | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors
Document Number: 331083

7.
Title: Challenges impacting on the quality of care to persons living with HIV/AIDS and other terminal illnesses with reference to Kanye community home-based care programme.
Author: Kang'ethe SM
Source: SAHARA J. 2009 Mar;6(1):24-32.
Abstract: HIV/AIDS has been found to be a challenging disease to humanity, its challenge spin-offs falling especially on to the caregivers of those infected and affected by the virus. This paper aims to discuss the challenges influencing the state of caregiving in the Kanye community home-based care (CHBC) programme in Botswana. The study was qualitative in design and explorative in nature, involving 82 primary caregivers in focus group discussions, and 5 CHBC nurses in individual interviews. Caregivers were found challenged by lack of community networks support, inadequate sanitary and care packages, poor shelter compromising privacy, inadequate income and food for their clients, inadequate care motivation as their volunteerism does not attract any payment, inadequate health personnel to offer psychosocial support like counselling, and an unconducive caring environment generally. Putting in place policies to redress caregivers' poverty, helping caregivers start income-generating projects, increasing community assistance and caregiving facilities are recommended as factors to address caregiver challenges.
Language: English
Keywords:
BOTSWANA | RESEARCH REPORT | QUALITATIVE RESEARCH | COMMUNITY WORKERS | HOME CARE | QUALITY OF HEALTH CARE | AIDS | HIV INFECTIONS | POVERTY | INCOME GENERATION PROGRAMS | INCENTIVES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Health Personnel | Delivery of Health Care | Health | Care and Support | Health Services | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Viral Diseases | Diseases | Socioeconomic Factors | Economic Factors | Economic Development | Policy | Political Factors | Sociocultural Factors
Document Number: 341415

Title: Food insecurity among volunteer AIDS caregivers in Addis Ababa, Ethiopia was highly prevalent but buffered from the 2008 food crisis.
Author: Maes KC; Hadley C; Tesfaye F; Shifferaw S; Tesfaye YA
Source: Journal of Nutrition. 2009 Sep;139(9):1758-64.
Abstract: Our objective in this study was to assess the validity and dependability of the Household Food Insecurity Access Scale (HFIAS), which was developed for international use, among community health volunteers in Addis Ababa, Ethiopia. The HFIAS was translated into Amharic and subsequently tested for content and face validity. This was followed by a quantitative validation study based on a representative sample (n = 99) of female community volunteers (HIV/AIDS home-based caregivers), with whom the HFIAS was administered at 3 time points over the course of 2008, in the context of the local and global "food crisis." By pooling observations across data collection rounds and accounting for intra-individual correlation in repeated measures, we found that the HFIAS performed well according to standards in the field. We also observed slight amelioration in reported food insecurity (FI) status over time, which seems paradoxical given the increasing inaccessibility of food over the same time period due to inflating prices and disappearing food aid. We attempted to resolve this paradox by appealing to self-report-related phenomena that arise in the context of longitudinal study designs: 1) observation bias, in which respondents change their reports according to changing expectations of the observer-respondent relationship or change their behavior in ways that ameliorate FI after baseline self-reports; and 2) "response shift," in which respondents change their reports according to reassessment of internal standards of FI. Our results are important for the validation of FI tools and for the sustainability of community health programs reliant on volunteerism in sub-Saharan Africa.
Language: English
Keywords:
ETHIOPIA | RESEARCH REPORT | MEASUREMENT | SAMPLING STUDIES | COMMUNITY WORKERS | VOLUNTEERS AND VOLUNTARISM | FOOD SECURITY | VALIDITY | AIDS | HOME CARE | HOUSEHOLD CONSUMPTION | DIET | INCOME | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Health Personnel | Delivery of Health Care | Health | Organization and Administration | Food Supply | Natural Resources | Environment | HIV Infections | Viral Diseases | Diseases | Care and Support | Health Services | Microeconomic Factors | Economic Factors | Nutrition | Socioeconomic Factors
Document Number: 342809

Title: Alleviating the burden of responsibility: report on a study of men as providers of community-based HIV/AIDS care and support in Lesotho.
Author: Newman C; Makoae N; Reavely E; Fogarty L
Source: Chapel Hill, North Carolina, IntraHealth International, Capacity Project, 2009 Jan. 101 p.
Abstract: This study demonstrates a range of perspectives about gender and HIV/AIDS care from those participating in and potentially affected by health care initiatives, and makes recommendations for increasing the number of male community-based providers of HIV/AIDS care. The objectives of the study were as follows: 1. Determine the need to bring men into community-based HIV/AIDS care and Support; 2. Determine the feasibility of engaging men as providers of community-based HIV/AIDS care and support, especially the gender-related and cultural factors that need to be addressed to increase male involvement in community-based care, based on an analysis of gender relations in Lesotho; 3. Identify factors that facilitate or hinder substantive and sustained male involvement in community-based HIV/AIDS care and support; and 4. Make recommendations for feasible gender-redistributive recruitment, training, support or retention strategies to increase the number of male communitybased providers of HIV/AIDS care and support in Lesotho.
Language: English
Keywords:
LESOTHO | EVALUATION REPORT | KAP SURVEYS | MEN | HEALTH PERSONNEL | LABOR FORCE | COMMUNITY WORKERS | HIV INFECTIONS | COMMUNITY HEALTH SERVICES | CAPACITY BUILDING | GENDER ISSUES | SEX DISCRIMINATION | NEEDS ASSESSMENT | MEN'S INVOLVEMENT | TRADITIONAL HEALTH PRACTICES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Delivery of Health Care | Health | Human Resources | Economic Factors | Viral Diseases | Diseases | Primary Health Care | Health Services | Program Sustainability | Programs | Organization and Administration | Sociocultural Factors | Social Discrimination | Social Problems | Culture
Document Number: 325235

10.

11.

Title: Community support and disclosure of HIV serostatus to family members by public-sector antiretroviral treatment patients in the Free State Province of South Africa.
Author: Wouters E; van Loon F; van Rensburg D; Meulemans H
Source: AIDS Patient Care and STDs. 2009 May;23(5):357-64.
Abstract: Recent studies have indicated that the support of close relatives is fundamental in coping with HIV/AIDS and in accessing the emotional and material support necessary for sustained adherence to treatment. Because disclosure to family members is imperative to ensure their support, identifying tools or resources that can minimize the possible risks and maximize the potential benefits of disclosure should be useful in improving the lives of people living with HIV/AIDS. Where health systems require strengthening, engaging the community in HIV/AIDS care could potentially create an environment that encourages disclosure to family members. This study investigated the impact of community support initiatives (community health workers and treatment support groups), patient characteristics (age, gender, and education), and time since first diagnosis on the disclosure of serostatus to family members by a sample of 268 public-sector antiretroviral treatment patients in a province of South Africa between August 2004 and July 2007. Whereas gender, age, and education only weakly influenced disclosure, there was a strong and stable positive association between community support and disclosure to family members. The immediate and long-term impact of community support on the disclosure by seropositive patients to family members indicates that initiatives such as community health workers and HIV support groups run by people living with HIV/AIDS should be strengthened, especially for those patients who cannot disclose their status to immediate family and close friends.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLIENTS | FRIENDS AND RELATIVES | COMMUNITY WORKERS | SUPPORT GROUPS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | CARE AND SUPPORT | INTERPERSONAL COMMUNICATION | NOTIFICATION | INTERVIEWS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | Family and Household | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Social Networks | HIV | HIV Infections | Viral Diseases | Diseases | Behavior | Health Services | Communication | Political Factors | Data Collection | Research Methodology
Document Number: 342181

12.

Title: Checklist for screening clients who want to initiate combined oral contraceptives.
Author: Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2008. [3] p.
Abstract: Research findings have established that combined oral contraceptives (COCs) are safe and effective for use by most women, including those who are at risk of sexually transmitted infections (STIs) and those living with or at risk of HIV infection. However, for some women with certain medical conditions -- such as breast cancer, ischemic heart disease, or stroke -- COC use is not recommended. Women who wish to use COCs should therefore be screened for such medical conditions in order to determine if they are appropriate candidates for this method. Based on the recently revised recommendations from Medical Eligibility Criteria for Contraceptive Use (WHO, 2004; updated 2008), Family Health International (FHI) has developed a simple checklist for use by both clinical and nonclinical health care providers, including community-based distributors, to help screen clients who have made an informed decision to use COCs. The COC Checklist consists of 17 questions designed to identify medical conditions that would prevent safe COC use or require further screening. It also provides further guidance and directions based on clients' responses.
Language: English
Keywords:
GLOBAL | MANUAL | STANDARDS | PARAMEDICAL PERSONNEL | COMMUNITY WORKERS | WOMEN | CLIENTS | COUNSELING | CLINICAL DISTRIBUTION | SCREENING | ORAL CONTRACEPTIVES, COMBINED | SAFETY | BREASTFEEDING | TOBACCO USE | HEADACHE | DIABETES | TUBERCULOSIS | SIGNS AND SYMPTOMS | Research Methodology | Health Personnel | Delivery of Health Care | Health | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Clinic Activities | Distributional Activities | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Public Health | Infant Nutrition | Nutrition | Behavior | Diseases | Infections
Document Number: 331507

13.

Title: Introducing the community-based distribution of injectable contraceptive in Uganda.
Author: Family Health International [FHI]
Source: Research Triangle Park, North Carolina, Family Health International [FHI], 2008. 2 p. (USAID Contract No. GPO-A-00-05-00022-0Research Utilization Case Studies)
Abstract: Research has shown that properly trained paramedical personnel can safely provide injectable contraceptives, yet the community-based distribution (CBD) of injectables remains controversial in many parts of Africa. Save the Children USA, Family Health International (FHI), and the Uganda Ministry of Health collaborated to introduce the CBD of the injectable depot-medroxyprogesterone acetate (DPMA) in Uganda. The intervention included a safety and feasibility study in the district of Nakasongola, scale-up in additional districts, and advocacy efforts. The intervention confirmed that CBD workers in Uganda can safely and effectively provide DMPA. Contraceptive prevalence increased by an estimated two to three percentage points in Nakasongola, and a follow-on evaluation of the project in three districts showed high continuation rates for women who received DMPA from CBD workers. Scale-up continues in additional districts and with new service-delivery organizations.
Language: English
Keywords:
UGANDA | SUMMARY REPORT | PILOT PROJECTS | HEALTH PERSONNEL | COMMUNITY WORKERS | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTIVE USAGE | INJECTABLES | CLINIC ACTIVITIES | TRAINING ACTIVITIES | IMPACT | INTERVENTIONS | PROGRAM EFFECTIVENESS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Contraceptive Methods | Training Programs | Education | Communication | Program Evaluation
Document Number: 325366

14.

Title: Promoting community-based distribution / community reproductive health worker provision of DMPA. Educational visit to Uganda - summary report, 20-22 March, 2007.
Author: Family Health International [FHI]
Source: Kampala, Uganda, FHI, 2008. [21] p. (USAID Development Experience Clearinghouse Doc. ID / Order No. PD-ACL-828USAID Cooperative Agreement No. GPO-A-00-05-00022-00)
Abstract: An educational visit to Uganda by Kenyan reproductive health professionals was held from March 20 to 22, 2007. This visit was funded by USAID under FHI's Promoting DMPA Provision by Community Health Providers project (FCO 113108). Delegates were invited from cooperating agencies (CAs) and professional associations that had participated in one-on-one advocacy meetings led by the Kenya DRH. These organizations were represented: KOGS, NNAK, The Nursing Council, the Kenya MOH/GTZ CBD programme, KCOA, and JHPIEGO. The objectives of the trip were: 1) To gain first-hand experience of Uganda's efforts at using CBDs to provide injectable Depo-Provera/DMPA at the community level; 2) To identify lessons learned from the Uganda initiative and approaches used to overcome challenges and obstacles; 3) To identify specific issues and concerns that would need to addressed in replicating a similar initiative in Kenya; and 4) To gather lessons, suggestions, and recommendations that will be presented at a larger stakeholders' meeting on CBD of DMPA in Kenya in 2007. The following key activities were carried out: 5) Sessions with key stakeholders in the Uganda CBD of DMPA project, including NGOs with RH activities and Uganda MOH officials; 6) Field visit to the Nakasongola district, where Save the Children (SC) has implemented a CBD of DMPA programme since 2004; and 7) The Kenyan team's wrap-up session and agreement on "take home" messages. The tour exposed the delegates to the details of the Uganda CBD programme and to the reality of CBDs providing DMPA. The main "take home" message was that CBD provision of DMPA was feasible and should be pilot-tested in Kenya. Each of the organizations represented pledged their support for a pilot study in Kenya and recommended that a project advisory committee be formed. This committee will be responsible for reviewing the process of conducting the pilot study, and the study's outcomes.
Language: English
Keywords:
UGANDA | CONFERENCES AND CONGRESSES | RECOMMENDATIONS | EVALUATION | COMMUNITY WORKERS | FAMILY PLANNING PERSONNEL | COMMUNITY-BASED DISTRIBUTION WORKERS | COMMUNITY-BASED DISTRIBUTION | DEPO-PROVERA | INJECTABLES | BEST PRACTICES | PROGRAM SUSTAINABILITY | CONTRACEPTIVE DISTRIBUTION | COMMUNITY PARTICIPATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health Personnel | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Contraceptive Methods
Document Number: 329880

15.

Title: Promoting community-based distribution / community reproductive health worker provision of DMPA. Educational visit to Uganda - summary report, February 18 - 20, 2008.
Author: Family Health International [FHI]
Source: Kampala, Uganda, FHI, 2008. [32] p. (USAID Development Experience Clearinghouse Doc. ID / Order No. PD-ACL-827USAID Cooperative Agreement No. GPO-A-00-05-00022-00)
Abstract: An educational tour to Uganda on February 18-20 provided delegates from other countries with an introduction to the community-based distribution (CBD) of the injectable contraceptive DMPA (depot medroxyprogesterone acetate, or Depo Provera). The goal was to learn about Uganda's experiences with the CBD of DMPA and to forge relationships between the delegates so that they could exchange information about such programs in their home countries. The tour was funded by USAID through a project-Promoting DMPA Provision by Community Health Providers-which is managed by Family Health International (FHI). The delegates hoped to achieve several objectives: 1. learn about the organizational network of the program, including the roles and responsibilities of various stakeholders; 2. identify the costs of launching a CBD of DMPA program; 3. identify and understand potential ethical and regulatory issues; 4. learn best practices for providing the service; 5. examine strategies for sustainability and ownership, including remuneration, incentives, and community involvement; 6. learn how to monitor and supervise a program; and 7. identify weaknesses, strengths, and impediments associated with implementation Delegates met key stakeholders in Uganda who have supported and implemented the CBD of DMPA program since 2003. The delegates also learned about the program in Uganda from the staff at the Uganda Ministry of Health, FHI, and Save the Children. The delegates visited the districts of Luwero and Nakaseke, where Save the Children had implemented a CBD of DMPA program. The delegates met with district health officials, local family planning champions, Save the Children staff, and CBD workers who support and implement the program in these districts. The delegates asked questions of the district officials and CBD workers, and they observed a CBD worker provide an injection to a client. On the final day, the delegates participated in group planning sessions where they outlined the steps needed to implement the CBD of DMPA in their respective countries.
Language: English
Keywords:
UGANDA | SUMMARY REPORT | CONFERENCES AND CONGRESSES | EVALUATION | COMMUNITY WORKERS | FAMILY PLANNING PERSONNEL | COMMUNITY-BASED DISTRIBUTION WORKERS | COMMUNITY-BASED DISTRIBUTION | DEPO-PROVERA | INJECTABLES | BEST PRACTICES | PROGRAM SUSTAINABILITY | CONTRACEPTIVE DISTRIBUTION | COMMUNITY PARTICIPATION | ETHICS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health Personnel | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Contraceptive Methods | Sociocultural Factors
Document Number: 329879

16.

Title: Our future. Preparing to teach sexuality and life-skills: An awareness training manual for teachers and community workers.
Author: International HIV / AIDS Alliance
Source: Brighton, United Kingdom, International HIV / AIDS Alliance, 2008 Jan. 89 p.
Abstract: Before teachers can teach their pupils about HIV, sexuality, gender and life-skills, they need an opportunity to explore their own values, hopes and fears, knowledge and skills related to this area of life. HIV and AIDS affects us all and our personal and professional lives affect each other. This manual outlines a process and activities to provide this opportunity to teachers. It is intended as a contribution to the education sector strategy and is the result of collaborative work with trainers, teachers and sexual and reproductive health experts in Zambia. The activities in the manual equip teachers with a stronger understanding of sexuality, gender, sexual and reproductive health and HIV and AIDS and the self-awareness, values and skills to play an effective role in HIV prevention, care and mitigation in their schools and the community. This includes providing supportive, positive role-models, creating a safe environment, reducing stigma and discrimination and teaching sexuality and life-skillseffectively. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | ZAMBIA | MANUAL | TEACHERS | COMMUNITY WORKERS | SEXUALITY | HIV PREVENTION | AIDS PREVENTION | SEX EDUCATION | SCHOOLS | Africa, Southern | Africa, Sub Saharan | Africa | Education | Health Personnel | Delivery of Health Care | Health | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Diseases | AIDS
Document Number: 323745

17.

Title: Service delivery-based training for long-acting family planning methods: client / provider satisfaction assessment.
Author: Pathfinder International
Source: [Addis Ababa], Ethiopia, Pathfinder International, 2008 Jan. 6 p. (Pathfinder No. 4)
Abstract: In 2007, the RH/FP Project surveyed current LAFP users, LAFP discontinuers, CBRHAs who refer potential clients, health care providers who deliver LAFPs, and managers of those facilities where such services are provided. The survey sought to understand the quality of care issues surrounding the use and delivery of LAFP. A total of 806 current users, (795 implant and 11 IUCD), were selected from the regions of Oromiya, Amhara, Tigray, and SNNP, following a multi-stage sampling procedure. Twenty-nine former users of implants were interviewed, as were 42 CBRHAs, 19 providers (nurses and midwives) trained by the program, and 21 health facility managers. The findings are being used to design activities to improve the training and quality of care of LAFP. (excerpt)
Language: English
Keywords:
ETHIOPIA | EVALUATION REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | FAMILY PLANNING PERSONNEL | WOMEN IN DEVELOPMENT | COMMUNITY WORKERS | SATISFACTION | CONTRACEPTIVE METHODS | TIME FACTORS | USAID | CONTRACEPTIVE DISTRIBUTION | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTION TERMINATION | CONTRACEPTIVE IMPLANTS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Evaluation | Family Planning Surveys | Family Planning | Family Planning Programs | Economic Development | Economic Factors | Health Personnel | Delivery of Health Care | Health | Psychological Factors | Behavior | Contraception | Population Dynamics | Demographic Factors | Population | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraceptive Usage
Document Number: 325472

18.

Title: Saints and sinners: training Papua New Guinean (PNG) Christian Clergy to respond to HIV and AIDS using a model of care.
Author: Benton KW
Source: Journal of Religion and Health. 2008 Sep;47(3):314-25.
Abstract: Papua New Guinea has experienced a growing HIV/AIDS epidemic. The Christian Churches have played a vital role in responding to HIV, through community support, encouragement and social change. Strong, effective Church leadership can help create safe environments of care and support for those infected and for prevention of HIV. Method A series of trainings in capacity development for clergy were undertaken by the National AIDS Council Secretariat (NACS)/National HIV/AIDS Support Project (NHASP). Results A model "Church's Response to HIV and AIDS in a Care Continuum" was developed to assist the training. This paper discusses the model and the lessons learned.
Language: English
Keywords:
PAPUA NEW GUINEA | RESEARCH REPORT | COMMUNITY WORKERS | PERSONS LIVING WITH HIV/AIDS | CHRISTIANITY | RELIGION | INFLUENTIALS | TRAINING ACTIVITIES | DELIVERY OF HEALTH CARE | Developing Countries | Oceania | Health Personnel | Health | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Knowledge Sources | Communication | Training Programs | Education
Document Number: 330822

19.

Peer Reviewed

Title: Effectiveness of zinc supplementation plus oral rehydration salts compared with oral rehydration salts alone as a treatment for acute diarrhea in a primary care setting: a cluster randomized trial.
Author: Bhandari N; Mazumder S; Taneja S; Dube B; Agarwal RC; Mahalanabis D; Fontaine O; Black RE; Bhan MK
Source: Pediatrics. 2008 May;121(5):e1279-85.
Abstract: OBJECTIVE: The purpose of this work was to evaluate whether education about zinc supplements and provision of zinc supplements to caregivers is effective in the treatment of acute diarrhea and whether this strategy adversely affects the use of oral rehydration salts. PATIENTS AND METHODS: Six clusters of 30,000 people each in Haryana, India, were randomly assigned to intervention and control sites. Government and private providers and village health workers were trained to prescribe zinc and oral rehydration salts for use in diarrheal episodes in 1-month-old to 5-year-old children in intervention communities; in the control sites, oral rehydration salts alone was promoted. In 2 cross-sectional surveys commencing 3 months (survey 2) and 6 months (survey 3) after the start of the intervention, care-seeking behavior, drug therapy, and oral rehydration salts use during diarrhea, diarrheal and respiratory morbidity, and hospitalization rates were measured. RESULTS: In the 2 surveys, zinc was used in 36.5% (n = 1571) and 59.8% (n = 1649) and oral rehydration salts in 34.8% (n = 1571) and 59.2% (n = 1649) of diarrheal episodes occurring in the 4 weeks preceding interviews in the intervention areas. In control areas, oral rehydration salts were used in 7.8% (n = 2209) and 9.8% (n = 2609) of episodes. In the intervention communities, care seeking for diarrhea reduced by 34% (survey 3), as did the prescription of drugs of unknown identity (survey 3) and antibiotics (survey 3) for diarrhea. The 24-hour prevalences of diarrhea and acute lower respiratory infections were lower in the intervention communities (survey 3). All-cause, diarrhea, and pneumonia hospitalizations in the preceding 3 months were reduced in the intervention compared with control areas (survey 3). CONCLUSIONS: Diarrhea is more effectively treated when caregivers receive education on zinc supplementation and have ready access to supplies of oral rehydration salts and zinc, and this approach does not adversely affect the use of oral rehydration salts; in fact, it greatly increases use of the same.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | CROSS SECTIONAL ANALYSIS | CHILDREN | HEALTH PERSONNEL | COMMUNITY WORKERS | ORAL REHYDRATION | ZINC | TRAINING PROGRAMS | FOOD SUPPLEMENTATION | DIARRHEA | ANTIBIOTICS | UTILIZATION OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Treatment | Medical Procedures | Medicine | Health Services | Metals | Vitamins and Minerals | Physiology | Biology | Education | Nutrition Programs | Primary Health Care | Diseases | Drugs
Document Number: 328041

20.

Peer Reviewed

Title: Alma-Ata: Rebirth and Revision 6 Interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make?
Author: Bhutta ZA; Ali S; Cousens S; Ali TM; Haider BA; Rizvi A; Okong P; Bhutta SZ; Black RE
Source: Lancet. 2008 Sep 13;372(9642):972-89.
Abstract: Several recent reviews of maternal, newborn, and child health (MNCH) and mortality have emphasised that a large range of interventions are available with the potential to reduce deaths and disability. The emphasis within MNCH varies, with skilled care at facility levels recommended for saving maternal lives and scale-up of community and household care for improving newborn and child survival. Systematic review of new evidence on potentially useful interventions and delivery strategies identifies 37 key promotional, preventive, and treatment interventions and strategies for delivery in primary health care. Some are especially suitable for delivery through community support groups and health workers, whereas others can only be delivered by linking community-based strategies with functional first-level referral facilities. Case studies of MNCH indicators in Pakistan and Uganda show how primary health-care interventions can be used effectively. Inclusion of evidence-based interventions in MNCH programmes in primary health care at pragmatic coverage in these two countries could prevent 20-30% of all maternal deaths (up to 32% with capability for caesarean section at first-level facilities), 20-21% of newborn deaths, and 29-40% of all postneonatal deaths in children aged less than 5 years. Strengthening MNCH at the primary health-care level should be a priority for countries to reach their Millennium Development Goal targets for reducing maternal and child mortality.
Language: English
Keywords:
DEVELOPING COUNTRIES | RECOMMENDATIONS | CASE STUDIES | WOMEN IN DEVELOPMENT | CHILDREN | PREGNANT WOMEN | COMMUNITY WORKERS | HEALTH PERSONNEL | MATERNAL-CHILD HEALTH SERVICES | CHILD SURVIVAL | NEONATAL DISEASES AND ABNORMALITIES | COMMUNITY HEALTH SERVICES | PREVENTIVE HEALTH CARE | SUPPORT GROUPS | CESAREAN SECTION | Studies | Research Methodology | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Primary Health Care | Health Services | Survivorship | Length of Life | Mortality | Population Dynamics | Diseases | Social Networks | Friends and Relatives | Family and Household | Sociocultural Factors | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine
Document Number: 328497

21.

Peer Reviewed

Title: Community-based newborn care: are we there yet?
Author: Bhutta ZA; Soofi S
Source: Lancet. 2008 Sep 27;372(9644):1124-6.
Abstract: Achieving the Millennium Development Goal of reducing child mortality by two-thirds by 2015 will not be possible without targeting the 4 million deaths of newborn babies every year. Most deaths of newborn babies occur at home, among poor people, and are associated with inadequate maternal health care during pregnancy and childbirth. Although lack of skilled birth attendants is a large part of the problem, maternal and newborn health is also related to complex issues, such as maternal empowerment, sociocultural taboos, and care-seeking practices and behaviours during pregnancy and child-birth. Progress is also hampered by the limited repertoire of interventions for treating birth asphyxia, prematurity, and serious neonatal infections in com munity settings. Despite a fair amount of advocacy around maternal and newborn care, real progress on the ground remains slow. Notwithstanding these barriers and limitations, the evidence base for strategies and interventions for newborn care in community settings has substantially improved, with a range of interventions that can be potentially packaged for delivery at different times during pregnancy, childbirth, and after birth, through various health-care providers. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EVALUATION | INFANT | COMMUNITY WORKERS | HEALTH PERSONNEL | CHILD SURVIVAL | RISK FACTORS | SOCIAL MOBILIZATION | COMMUNITY PARTICIPATION | HEALTH EDUCATION | COMMUNITY HEALTH SERVICES | NEONATAL DISEASES AND ABNORMALITIES | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Survivorship | Length of Life | Mortality | Population Dynamics | Biology | Social Change | Sociocultural Factors | Organization and Administration | Education | Primary Health Care | Health Services | Diseases
Document Number: 329078

22.

Peer Reviewed

Title: Pharmacovigilance of antimalarial treatment in Uganda: community perceptions and suggestions for reporting adverse events.
Author: Bukirwa H; Nayiga S; Lubanga R; Mwebaza N; Chandler C
Source: Tropical Medicine and International Health. 2008 Sep;13(9):1143-52.
Abstract: OBJECTIVES: The deployment of new antimalarials in Africa provides an important opportunity to develop systems for pharmacovigilance. To inform strategies for reporting adverse events in Uganda, we investigated local perceptions and experiences with antimalarial treatment, and evaluated existing and potential systems for pharmacovigilance. METHODS: Focus group discussions (FGD) were conducted with community members and health workers from urban and rural Uganda exploring knowledge of fever/malaria, perceptions and expectations of treatment, understanding of adverse effects, and experiences with adverse events. Sessions were recorded, transcribed into English, and analysed using a coding scheme developed from pre-defined topics together with themes emerging from the data. RESULTS: Between April and July 2006, we conducted 25 FGDs; 16 with community members and nine with health workers. All respondents had extensive experience with malaria and its treatment. Community members commonly recognized adverse effects of antimalarial therapy. However, events were uncommonly reported, and certain events were often interpreted as signs of successful treatment. Community members often felt that the costs of reporting or seeking additional care outweighed the potential benefits. Health workers were unfamiliar with formal pathways for reporting, and were deterred by the additional work of reporting and fear of incrimination. Respondents provided suggestions for incentives and methods of reporting, emphasizing that pharmacovigilance should ideally encompass the public and private sector, and the community. CONCLUSIONS: To be successful, pharmacovigilance relying on voluntary reporting will require active participation of patients and health workers. Addressing the costs and benefits of reporting, and providing sensitization, training and feedback will be important.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | FOCUS GROUPS | COMMUNITY | HEALTH PERSONNEL | COMMUNITY WORKERS | ANTIMALARIAL DRUGS | PERCEPTION | KNOWLEDGE | FEVER | PUBLIC OPINION | USER COMPLIANCE | SIDE EFFECTS | FEAR | STIGMA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Delivery of Health Care | Health | Malaria | Parasitic Diseases | Diseases | Psychological Factors | Behavior | Sociocultural Factors | Body Temperature | Physiology | Biology | Attitudes | Treatment | Medical Procedures | Medicine | Health Services | Emotions | Social Problems
Document Number: 328968

23.

Title: Postpartum care survey results from Sub-Saharan Africa.
Author: Charurat E; Nash-Mercado A
Source: Baltimore, Maryland, Jhpiego, Access to Clinical and Community Maternal, Neonatal and Women�s Health Services Program [ACCESS], 2008 Dec. 37 p. (USAID Cooperative Agreement No. GHS-A-00-04-00002-00)
Abstract: This report assembles survey results conducted between March and June of 2008 to identify, document, and share information on the status of postpartum care services implemented through USAID and our partners. The survey results indicate a number of opportunities to integrate postpartum family planning with many programs. A total of 37 projects in sub-Saharan Africa responded to the survey; most were working in family planning, HIV/AIDS, child survival/child health and maternal and newborn health. Training, service delivery, behavior change communication and community approaches were the main intervention areas of the projects surveyed. Since most of the projects work with women of reproductive age and children under five years, there are opportunities to integrate postpartum family planning (PPFP) with routine immunization, well-child and sick-child visits. Opportunities to include postpartum family planning (PPFP) in trainings also exist in a number of the projects. Survey results indicated that there are a number of opportunities to integrate postpartum family planning (PPFP) with many programs. Recommendations include: 1) Utilize community-based volunteers in PPFP interventions; 2) Emphasize the Lactational Amenorrhea Method (LAM) as a transition method; and 3) Advocate for policies that effectively promote PPFP.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | POSTPARTUM WOMEN | WOMEN IN DEVELOPMENT | COMMUNITY WORKERS | POSTPARTUM PROGRAMS | USAID | ANTENATAL CARE | FAMILY PLANNING PROGRAM EVALUATION | BEST PRACTICES | MONITORING | INTEGRATED PROGRAMS | IMMUNIZATION | LACTATIONAL AMENORRHEA METHOD | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Puerperium | Reproduction | Economic Development | Economic Factors | Health Personnel | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Programs | Organization and Administration | Evaluation | Family Planning, Behavioral Methods
Document Number: 328582

24.

Peer Reviewed

Title: Evolution of couples' voluntary counseling and testing for HIV in Lusaka, Zambia.
Author: Chomba E; Allen S; Kanweka W; Tichacek A; Cox G
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Jan;47(1):108-115.
Abstract: We describe promotional strategies for couples' voluntary HIV counseling and testing (CVCT) and demographic risk factors for couples in Lusaka, Zambia, where an estimated two thirds of new infections occur in cohabiting couples. CVCT attendance as a function of promotional strategies is described over a 6-year period. Cross-sectional analyses of risk factors associated with HIV in men, women, and couples are presented. Community workers (CWs) recruited from couples seeking CVCT promoted testing in their communities. Attendance dropped when CW outreach ended, despite continued mass media advertisements. In Lusaka, 51% of 8500 cohabiting couples who sought HIV testing were concordant negative for HIV (M-F-) and 26% concordant positive (M+F+); 23% had 1 HIV-positive partner and one HIV-negative partner, with 11% HIV-positive man/HIV-negative woman (M+F-) and 12% HIV-negative man/HIV-positive woman (F+M-). HIV infection was associated with men's age 30 to 39, women's age 25 to 34, duration of union < 3 years, and number of children < 2. Even among couples with either 1 or 2 or no risk factors, HIV prevalence was 45% and 29%, respectively. Many married African adults do not have high-risk profiles, nor realize that only 1 may be HIV positive. Active and sustained promotion is needed to encourage all couples to be jointly tested and counseled. (author's)
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | COUPLES | COMMUNITY WORKERS | HIV TESTING | COUNSELING | HIV PREVENTION | PROMOTION | DEMOGRAPHIC FACTORS | RISK FACTORS | PREVALENCE | TIME FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Clinic Activities | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Marketing | Economic Factors | Population | Biology | Measurement | Population Dynamics
Document Number: 323202

25.

Peer Reviewed

Title: HIV disclosure and discussions about grief with Shona children: a comparison between health care workers and members in Eastern Zimbabwe.
Author: De Baets AJ; Sifovo S; Parsons R; Pazvakavambwa IE
Source: Social Science and Medicine. 2007 Jan;66(2):479-491.
Abstract: Research in HIV-related counseling for African children has concentrated on urban tertiary hospitals, but most children have their first health care encounter at a rural primary health care center. This study investigated perceptions about the acceptability of disclosing the parents' or child's HIV status to a child and talking about grief with children, as well as the preferred time, type and setting for HIV disclosure. An anonymous survey was taken from 64 primary health care workers and 131 community members from rural Eastern Zimbabwe. The results expressed a high need and desire for such communications and should be interpreted against a background of high perceived confidence to talk about grief with adults and a high degree of familiarity with child bereavement and foster care. The participants preferred that partial disclosure occurs from the age of 10.8 (+or-4.2) years and full disclosure from the age of 14.4 (+or-4.5) years. Compared to community members, health care workers were significantly more open to full disclosure and disclosure at a younger age but were slightly less open to discussing grief. The different preferred combinations of persons to initiate such communications included a health care worker in up to 56% of the responses and a family member in up to 52%. The most commonly preferred family members were father's sister (up to 37%) and grandmother (up to 40%) rather than the partner (up to 15%). Southern African family dynamics may hinder a mother initiating HIV disclosure and discussions about grief, even though she is traditionally present during HIV diagnosis, counseling and health education. A more culturally adapted approach than the standard Western 'couple approach' may thus be required. Consequently, counseling training models may need to be adapted. Further research into empowering mothers to involve significant members from the extended family may be highly beneficial. (author's)
Language: English
Keywords:
ZIMBABWE | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CHILDREN | COMMUNITY | HEALTH PERSONNEL | COMMUNITY WORKERS | PERSONS LIVING WITH HIV/AIDS | NOTIFICATION | EMOTIONS | COUNSELING | HIV INFECTIONS | CLIENT-STAFF RELATIONS | CULTURE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Delivery of Health Care | Health | Viral Diseases | Diseases | Political Factors | Sociocultural Factors | Psychological Factors | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration | Interpersonal Relations
Document Number: 322354

26.

Title: Evaluation and community prevention coalitions: Validation of an integrated web-based / technical assistance consultant model.
Author: Feinberg ME; Gomez BJ; Puddy RW; Greenberg MT
Source: Health Education and Behavior. 2008 Feb;35(1):9-21.
Abstract: Community coalitions (CCs) have labored with some difficulty to demonstrate empirical evidence of effectiveness in preventing a wide range of adolescent problem behaviors. Training and technical assistance (TA) have been identified as important elements in promoting improved functioning of CCs. A reliable, valid, and inexpensive method to assess functioning of CCs has been developed and is tested in this article in the context of Pennsylvania's Communities That Care (CTC) model. A CC Web-based questionnaire was developed and administered to more than 79 communities (867 participants) and the validity and reliability were assessed through multiple means, including the use of a companion TA implementation feed back questionnaire completed by TAs assigned to each of the sites. Results indicated adequate to good psychometric properties on internal reliability of the Web-based questionnaire, moderate construct validity across different reports of functioning, and relative stability through out the course of 1 year. Implications for a variety of community prevention coalitions interested in a relatively low-cost, user friendly, and suitable methodology for evaluating coalition functioning are discussed. In addition, areas of application for future research including linking coalition functioning with the quality and nature of technical assistance, levels of risk and protective factors, and large data sets of youth risk factor and problem behavior data are highlighted. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | EVALUATION | ADOLESCENTS | COMMUNITY WORKERS | RISK REDUCTION BEHAVIOR | TECHNICAL ASSISTANCE | COMMUNITY PARTICIPATION | INTERNET | QUESTIONNAIRES | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Behavior | Programs | Organization and Administration | Information Networks | Communication
Document Number: 324659

27.

Peer Reviewed

Title: A tool box for operational mosquito larval control: Preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania.
Author: Fillinger U; Kannady K; William G; Vanek MJ; Dongus S
Source: Malaria Journal. 2008 Jan 25;7:20.
Abstract: As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed. A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs). New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards. The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6-37.6%; p = 0.04). This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience. (author's)
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | DATA ANALYSIS | COMMUNITY WORKERS | MALARIA PREVENTION | PARASITE CONTROL | MONITORING | PROGRAM EVALUATION | PROGRAM DESIGN | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Health Personnel | Delivery of Health Care | Health | Malaria | Parasitic Diseases |