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Peer Reviewed

Title: ACOG Committee Opinion No. 434: induced abortion and breast cancer risk.
Author: Committee on Gynecologic Practice
Source: Obstetrics and Gynecology. 2009 Jun;113(6):1417-8.
Abstract: The Relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.
Language: English
Keywords:
GLOBAL | CRITIQUE | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | ABORTION | BREAST CANCER | RISK FACTORS | EPIDEMIOLOGY | BIAS | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Cancer | Neoplasms | Diseases | Health | Public Health | Error Sources | Measurement
Document Number: 341807 Notification

Title: Human resources for health in the low-resource world: collaborative practice and task shifting in maternal and neonatal care.
Author: FIGO Safe Motherhood and Newborn Health Committee
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):74-6.
Abstract: An important barrier to the attainment of Millennium Development Goals (MDGs) 4 and 5 in many countries is the lack of trained and skilled clinical staff who can provide timely and high-quality care to mothers with pregnancy complications. This article presents guidelines and recommendations on how to better make use of existing health human resources in order to improve maternal and neonatal care.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | MATERNAL-CHILD HEALTH SERVICES | HUMAN RESOURCES | GYNECOLOGY | OBSTETRICS | OBSTETRICAL SURGERY | TRAINING PROGRAMS | Delivery of Health Care | Health | Primary Health Care | Health Services | Economic Factors | Medicine | Surgery | Treatment | Medical Procedures | Education
Document Number: 341381

Title: How to put an end to the practice of female genital mutilation (FGM)? Panel discussion report (6 February 2008).
Author: Inter-Parliamentary Union; International Organization for Migration [IOM]; Inter-African Committee on Traditional Practices Affecting the Health of Women and Children; Switzerland. Geneva. Departement des Institutions
Source: Geneva, Switzerland, Inter-Parliamentary Union, 2009. 32 p.
Abstract: Every 10 seconds, somewhere in the world, a little girl is a victim of genital mutilation. Three million girls are excised every year. To mark the International Day of Zero Tolerance to FGM on 6 February 2008, more than 100 representatives of international organizations, civil society, media, diplomatic missions and the local authorities in Geneva gathered at The House of Parliaments to discuss ways of putting an end to this harmful practice. The IPU, the Departement des Institutions de l?Etat de Geneve (Geneva Department of Institutions), the International Organization for Migration and the Inter-African Committee on Traditional Practices decided to join forces to put an end to this human tragedy. This publication contains the experts' contributions, extracts of the debates and conclusions of the seminar. (Excerpts)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | POLICYMAKERS | ADOLESCENTS, FEMALE | FEMALE GENITAL CUTTING | POLITICAL FACTORS | ADVOCACY | RELIGION | LEADERSHIP | SOCIAL POLICY | WOMEN'S RIGHTS | CULTURE | Economic Development | Economic Factors | Administrative Personnel | Organization and Administration | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Harmful Traditional Practices | Traditional Health Practices | Sociocultural Factors | Communication | Policy | Human Rights
Document Number: 331363

Peer Reviewed

Title: Assessment of childhood immunisation coverage [letter]
Author: Aaby P; Benn CS
Source: Lancet. 2009 Apr 25;373(9673):1428.
Abstract: Stephen Lim and colleagues scrutinise coverage with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) in 193 countries. With donor emphasis on DTP3 coverage, it is not surprising that the national estimates might be inflated. Still, there is little doubt that DTP3 coverage has increased in recent decades. But maybe we should be more concerned about the health implications of this trend than about the accuracy of the estimate. From a public health perspective, the fact that DTP3 coverage is now higher than measles vaccine coverage in most African countries is of questionable value. Numerous studies have shown that measles vaccine is beneficial for child survival, but there are conflicting data about the effect of DTP. DTP has frequently been associated with increased mortality in situations with herd immunity. Furthermore, as a result of the drive to increase the DTP3 coverage, more children receive DTP simultaneously with or after measles vaccine. We have found consistently that DTP given simultaneously with measles vaccine (table) or after it is associated with increased mortality compared with having measles vaccine alone as the most recent vaccine. In a study from Bangladesh, children who received DTP/BCG after the age of measles vaccine administration had around threefold higher mortality than unvaccinated children. These observations have not been contradicted. If they are true, the drive to boost the DTP3 coverage could lead to increased child mortality. Current policy is based on the assumption that receiving three DTP vaccines is associated with decreased child mortality. It should be a major priority to determine whether this assumption is correct. (full-text)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGIC METHODS | CHILDREN | IMMUNIZATION | PERTUSSIS | TETANUS | DIPHTHERIA | Comparative Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Bacterial and Fungal Diseases | Infections | Diseases
Document Number: 341150

Title: The morning-after pill [letter]
Author: Abell S
Source: Clinical Pediatrics. 2009 Apr;48(3):341-2; discussion 342.
Abstract: This is a question from a reader to the journal's Medical Doctor about the morning-after pill. The Dr. clearly confirms that the morning-after pill is not causing abortion. Her description helps us better understand how this pill (usually levonorgestrel), a progestin, works in preventing a pregnancy. This approach, which is now known as Plan B�, has received strong support in the prevention of unplanned pregnancies from both the American College of Obstetrics and Gynecology and the American Academy of Pediatrics in also circumventing the need for abortions in women of all ages, especially in adolescent girls. Some pharmacists have resisted filling these Plan B prescriptions, so it will be important for pediatricians to know which pharmacies in your community will accept your Plan B� prescriptions. Sadly, teenage pregnancies continue to have a major impact on disadvantaged teenagers. This group of individuals also may have limited access to Plan B prescriptions, which requires that they should be taken within 5 days of unprotected intercourse in order for them to be effective in preventing unwanted pregnancies.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE MODE OF ACTION | ABORTION | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | NAUSEA | VOMITING | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Fertility Control, Postconception | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases
Document Number: 331244 Notification

Title: Building laboratory infrastructure to support scale-up of HIV/AIDS treatment, care, and prevention: in-country experience.
Author: Abimiku AG
Author: Institute of Human Virology, University of Maryland School of Medicine PEPFAR
Source: American Journal of Clinical Pathology. 2009 Jun;131(6):875-86.
Abstract: An unprecedented influx of funds and support through large programs such as the Global Fund for AIDS, Malaria and Tuberculosis and the World Health Organization's and President's Emergency Plan for AIDS Relief (PEPFAR) has made it possible for more than 1 million persons in resource-limited settings to access AIDS treatment and several million more to be in care and prevention programs. Nevertheless, there remain major challenges that prevent AIDS drugs and care from reaching many more in need, especially in rural settings. The roll-out of a high-quality treatment, care, and prevention program depends on an effective and reliable laboratory infrastructure. This article presents a strategy used by the Institute of Human Virology (IHV)-University of Maryland and its affiliate IHV-Nigeria to establish a multifaceted, integrated tier laboratory program to support a PEPFAR-funded scale-up of its AIDS Care Treatment in Nigeria program, in collaboration with the Centers for Disease Control and Prevention and the Nigerian government, as a possible model for overcoming a key challenge that faces several resource-limited countries trying to roll out and scale-up their HIV/AIDS treatment, care, and prevention program.
Language: English
Keywords:
NIGERIA | CRITIQUE | HIV INFECTIONS | CARE AND SUPPORT | TREATMENT | HIV PREVENTION | LABORATORY | EQUIPMENT AND SUPPLIES | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | TUBERCULOSIS | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | STANDARDS | QUALITY CONTROL | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Examinations and Diagnoses | Measurement | Research Methodology | Infections | Programs | Organization and Administration | Training Programs | Education
Document Number: 341766

10.

Title: Compensation for the brain drain from developing countries [editorial]
Author: Agwu K; Llewelyn M
Source: Lancet. 2009 May 16;373(9676):1665-6.
Abstract: This article examines the consequences and roots of health-worker migration from Sub-Saharan Africa to the developed world, especially to UK, USA and Canada. It explores the results of the major transfer of riches from poor societies to the affluent and discusses a compensation proposal for global justice.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | BRAIN DRAIN | RISK FACTORS | MATERNAL MORTALITY | INFANT MORTALITY | EMPLOYMENT | IMPACT | Delivery of Health Care | Health | International Migration | Migration | Population Dynamics | Demographic Factors | Population | Mortality | Macroeconomic Factors | Economic Factors | Communication
Document Number: 341604

11.

Peer Reviewed

Title: Expanding access to intrauterine contraception.
Author: Allen RH; Goldberg AB; Grimes DA
Source: American Journal of Obstetrics and Gynecology. 2009 Jun 13;
Abstract: The intrauterine device is a safe, highly effective, long-lasting, yet reversible method of contraception. Expanding access to intrauterine contraception is an important measure to reduce the rate of unintended pregnancy in the United States. Clinicians should consider intrauterine contraception in appropriate candidates, including women who are nulliparous, adolescent, immediately postpartum or postabortal, and desiring emergency contraception, and as an alternative to permanent sterilization. Barriers to intrauterine contraception such as requiring cervical cancer screening before insertion, routine testing for gonorrhea and chlamydial infection in low-risk women, or scheduling insertion only during menses are unnecessary.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | ADOLESCENTS, FEMALE | IUD | CONTRACEPTIVE AVAILABILITY | MISINFORMATION | CONTRAINDICATIONS | INSERTION | PAIN | IUD EXPULSION | NULLIPARITY | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Communication | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics
Document Number: 341709

13.

Peer Reviewed

Title: Structural barriers and human rights related to HIV prevention and treatment in Zimbabwe.
Author: Amon JJ; Kasambala T
Source: Global Public Health. 2009 Mar 26;:1-17.
Abstract: There has long been recognition that individual risk factors can only partially explain vulnerability to HIV infection, and that a broader range of socioeconomic, cultural and political factors must be taken into account. More recently this understanding has been applied to addressing obstacles to accessing HIV treatment. Yet, while structural interventions aimed at contextual factors related to HIV prevention and treatment have been shown to be effective, they have not been widely implemented. Using the situation of Zimbabwe as an example, we will present an illustration of how contextual barriers can be understood in human rights terms, and how using a human rights analysis can specifically help define 'structural-rights' interventions and compel their implementation.
Language: English
Keywords:
ZIMBABWE | CRITIQUE | EVALUATION | PERSONS LIVING WITH HIV/AIDS | POLICYMAKERS | HUMAN RIGHTS | HIV PREVENTION | AIDS PREVENTION | SOCIOECONOMIC FACTORS | CULTURE | POLITICAL FACTORS | INTERVENTIONS | SOCIAL PROBLEMS | HEALTH POLICY | SOCIAL POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Administrative Personnel | Organization and Administration | Sociocultural Factors | AIDS | Economic Factors | Programs | Policy
Document Number: 341476

14.
Title: Counsellors are human [letter]
Author: Anand V
Source: Indian Journal of Medical Ethics. 2009 Jul-Sep;6(3):169-70.
Abstract: This letter touches on the subject of the medical knowledge of physicians in India. It first discusses male circumcision and then moves on to India not having an established system for sharing medical information and updates. It asks that better systems of regularly updating the medical knowledge of Indian physicians be developed.
Language: English
Keywords:
INDIA | CRITIQUE | PROVIDERS WITH CLIENTS | MALE CIRCUMCISION | KNOWLEDGE | INFORMED CONSENT | FEES | INFORMATION DISTRIBUTION | Asia, Southern | Asia | Developing Countries | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Sociocultural Factors | Financial Activities | Economic Factors | Communication
Document Number: 342876

15.

Title: Undernutrition malnutrition in infants in developing countries [letter]
Author: Ashorn P; Phuka JC; Maleta K; Thakwalakwa C; Cheung YB; Briend A; Manary MJ
Source: Archives of Pediatrics and Adolescent Medicine. 2009 Feb;163(2):186.
Abstract: We commend Dr Humphrey on an insightful and well-written editorial on infant underweight malnutrition and thank her for her interest in our study on this topic. In our trial, provision of fortified spread, a novel lipid-based nutrient supplement, to Malawian infants was associated with a markedly reduced incidence of severe stunting between 6 and 18 months of age. Yet, there was a large decrease in mean height-for-age, indicating that even the infants given supplementation often failed to maintain normal growth during this critical age. Dr Humphrey proposes 2 explanations for how this might be linked to insufficient dietary intakes: breast-milk displacement and increased energy and nutrient needs due to high rates of disease. Whereas the former has been documented in other settings, we found little evidence supporting this theory in our study area. Diarrhea, malaria, and respiratory infections, on the other hand, are common and associated with infant stunting in this population. Malaria incidence has recently declined, apparently owing to the frequent use of bed nets, but other childhood infections may well have contributed to the growth faltering of our study participants. Besides events after birth, we would like to emphasize the importance of antenatal factors for linear growth failure in many low-income countries. Due to a high proportion of preterm births and the frequency of intrauterine growth retardation, Malawian children are already shorter than expected at birth. In the present trial, mean length-for-age was below a -1 z score by age 6 months.1 In such conditions, it is difficult to prevent growth faltering solely with postnatal interventions; instead, these interventions need to be complemented with others that address antenatal problems, such as maternal undernutrition and infections. On the other hand, when fetal conditions are less distressing and stunting has not started by 6 months of age, an isolated nutrition intervention may prove sufficient. This was illustrated in a recent trial in Ghana, where infants who were given a lipid-based nutrient supplement that was not very different from the one we used in Malawi lost no length-for-age between 6 and 12 months of age. (full-text)
Language: English
Keywords:
MALAWI | CRITIQUE | INFANT | MALNUTRITION | CALORIC INTAKE | SUPPLEMENTARY FEEDING | INTRAUTERINE GROWTH RETARDATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Nutrition | Health | Infant Nutrition | Congenital Abnormalities | Neonatal Diseases and Abnormalities
Document Number: 330227

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Title: On what diseases and health conditions should new economic research on health and development focus?
Author: Behrman JR; Behrman JA; Perez NM
Source: Health Economics. 2009 Apr;18 Suppl 1:S109-28.
Abstract: Given the public goods nature of research, economic research on health in developing countries is likely to have the highest returns by focusing, inter alia, on diseases and health conditions that are relatively widespread and costly and that are relatively rapidly growing. This article first summarizes the time patterns in economic research on diseases and health in developing countries for 1990-2005. It then compares those time patterns with the distribution of disability-adjusted life years (DALYs) for diseases and health conditions in developing countries estimated for 2005 and for 2030. These comparisons suggest relatively overemphasis on HIV/AIDS and underemphasis on noncommunicable diseases (NCDs). This opens the possibility for individuals or organizations initiating, re-evaluating, or increasing their economic research on health and development to make a significant contribution by focusing particularly on the analysis of behaviour and policy choices related to NCDs. Careful consideration must, of course, be given to other demands, but on the basis of these two criteria, potential contributions are likely to be greatest from research with such a focus.
Language: English
Keywords:
GLOBAL | CRITIQUE | LITERATURE REVIEW | RESEARCH ACTIVITIES | ECONOMICS | ECONOMIC DEVELOPMENT | HEALTH | HIV INFECTIONS | DISEASES | INTERVENTIONS | COST BENEFIT ANALYSIS | LENGTH OF LIFE | Research Methodology | Social Sciences | Science | Sociocultural Factors | Economic Factors | Viral Diseases | Programs | Organization and Administration | Quantitative Evaluation | Evaluation | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 341823

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Peer Reviewed

Title: Right conclusion, wrong method [letter]
Author: Berger VW
Source: European Journal of Contraception and Reproductive Health Care. 2009 Aug;14(4):317-8; author reply 319-20.
Abstract: This letter to the editor takes issue with an article written by Ferreira et al regarding contraceptive counseling after an abortion. It agrees that there is no evidence indicating contraceptive counseling is effective in increasing acceptance and use of contraceptive methods after an abortion, but disagrees with the method used to arrive at that conclusion. It specifically finds the combination of the Jadad score to evaluate trial quality and the cutoff of three as indicating a high quality trial as flawed.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RESEARCH METHODOLOGY | CLINICAL TRIALS | POSTABORTION CARE | COUNSELING | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHOD ACCEPTABILITY | VALIDITY | Developed Countries | North America | Americas | Clinical Research | Health Services | Delivery of Health Care | Health | Clinic Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Measurement
Document Number: 342949

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Title: Laboratory challenges in the scaling up of HIV, TB, and malaria programs: The interaction of health and laboratory systems, clinical research, and service delivery.
Author: Birx D; de Souza M; Nkengasong JN
Source: American Journal of Clinical Pathology. 2009 Jun;131(6):849-51.
Abstract: Strengthening national health laboratory systems in resource-poor countries is critical to meeting the United Nations Millennium Development Goals. Despite strong commitment from the international community to fight major infectious diseases, weak laboratory infrastructure remains a huge rate-limiting step. Some major challenges facing laboratory systems in resource-poor settings include dilapidated infrastructure; lack of human capacity, laboratory policies, and strategic plans; and limited synergies between clinical and research laboratories. Together, these factors compromise the quality of test results and impact patient management. With increased funding, the target of laboratory strengthening efforts in resource-poor countries should be the integrating of laboratory services across major diseases to leverage resources with respect to physical infrastructure; types of assays; supply chain management of reagents and equipment; and maintenance of equipment.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | HIV INFECTIONS | TUBERCULOSIS | MALARIA | LABORATORY | NEEDS | INTEGRATED PROGRAMS | HUMAN RESOURCES | LOGISTICS | TRAINING ACTIVITIES | STANDARDS | QUALITY CONTROL | Viral Diseases | Diseases | Infections | Parasitic Diseases | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Economic Factors | Programs | Organization and Administration | Management | Training Programs | Education | Research Methodology
Document Number: 341768

24.

Title: Integrating population, health, and environment in Uganda.
Author: Bremner J; Zuehlke E
Source: Washington, D.C., Population Reference Bureau [PRB], 2009 Jun. 6 p. (Policy Brief)
Abstract: After decades of instability and civil conflict, Uganda has enjoyed relative stability, sustained economic growth, and great improvements in health over the last 20 years. During the same period, Uganda's population has grown rapidly, and in 2009 surpassed 30 million people. This rapid population growth is contributing to the degradation of Uganda's natural resources, the backbone of the country's economy and household livelihoods. Continued reductions in poverty depend in large part on finding innovative and integrated solutions to the complex population, health, and environment problems affecting Uganda's poorest people.
Language: English
Keywords:
MIDDLE EAST | AFRICA, NORTH | CRITIQUE | EVALUATION | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | ABORTION | PREGNANCY, UNWANTED | ABORTION LAW | FAMILY PLANNING POLICY | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS CHOSEN | POSTABORTION CARE
Document Number: 342029

26.
Title: The abortion-breast cancer connection.
Author: Brind J
Source: Specialty Law Digest. Health Care Law. 2009 Jan;(340):9-35.
Abstract: This article examines the abortion breast cancer link in some historical scientific detail, offering a perspective on an issue that is at the center of a long-running public policy debate that plays out in legislatures, courtrooms, and newspaper editorials, as well as in scientific and medical journals. Even as politically correct studies have been promulgated to neutralize the data proving the abortion breast cancer link, even stronger data have emerged in recent years that firmly link abortion to premature births in subsequent pregnancies, which in turn raise the risk of breast cancer in mothers and cerebral palsy in prematurely born children.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RESEARCH ACTIVITIES | ABORTION | BREAST CANCER | RISK FACTORS | EPIDEMIOLOGY | HORMONES | PREMATURE BIRTH | POLITICAL FACTORS | Developed Countries | North America | Americas | Research Methodology | Fertility Control, Postconception | Family Planning | Cancer | Neoplasms | Diseases | Health | Public Health | Endocrine System | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Reproduction | Sociocultural Factors
Document Number: 341317

27.
Title: Conflicting policies in China's fight against HIV/AIDS.
Author: Burki T
Source: Lancet Infectious Diseases. 2009 Feb;9(2):84.
Abstract: The police and security forces are hampering Chinese efforts to address the HIV/AIDS epidemic, according to a Human Rights Watch (HRW) report published on Dec 9. "The government has expanded prevention and treatment programmes for drug users" said Joe Amon, HIV/AIDS programme director at HRW, "but at the same time, police are detaining drug users trying to access these services, and putting drug users in so-called drug rehabilitation centres where they are provided no drug dependency treatment". The report focuses on Guangxi province in southern China, but noted that the issues with which it dealt "stem from national laws and policies". HRW claim that police routinely wait outside methadone clinics and pharmacies to arrest suspected drug users. By placing them in mandatory confinement, the report says, the Chinese authorities were discouraging intravenous drug users from engaging with voluntary drug treatment programmes. HRW commented that the rehabilitation centres-which have a country wide population of over 340 000-"subject drug users to abusive, inhuman, and degrading treatment. They not only fail to provide HIV prevention and treatment to drug users, but facilitate its spread". The report added that HIV-positive detainees do not have their CD4 count monitored. According to official figures, there are roughly 700 000 cases of HIV/AIDS in China, and between 3 and 6 million drug users. Unsafe injection practices are a major source of HIV transmission, accounting for nearly half of new cases. "China has been very open-minded in rolling out drug substitution policies" Joseph Schumacher (University of Alabama, USA) told TLID. Since 2000, over 500 methadone clinics have been established in the country. Several nongovernmental organisations run needle exchange programmes. "More NGOs are opening and making voluntary HIV testing and counselling available", Schumacher pointed out. In China, drug addiction is widely regarded as an offence against society. The rehabilitation centres-some of which are known as "re-education through labour" centres-are emblematic of this. Schumacher suggests adjusting their function. "Instead of using these camps or re-education programmes as punishment", he says "integrate evidence-based therapies into the programmes. Use them more as treatment than as incarceration". In a related story, researchers report that improper care and the overuse of anti-tuberculosis drugs, throughout the country, have propelled Chinese rates of drug-resistant tuberculosis to almost twice the global average. (full-text)
Language: English
Keywords:
CHINA | CRITIQUE | EVALUATION | POLICE | POLICYMAKERS | IV DRUG USERS | HIV PREVENTION | AIDS PREVENTION | HEALTH POLICY | DRUG USE AND ABUSE | VOLUNTARY COUNSELING AND TESTING | Asia, Eastern | Asia | Developing Countries | Corrections Officers | Government | Political Factors | Sociocultural Factors | Administrative Personnel | Organization and Administration | Behavior | HIV Infections | Viral Diseases | Diseases | AIDS | Policy | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 330595

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Peer Reviewed

Title: Surgical task shifting in Sub-Saharan Africa.
Author: Chu K; Rosseel P; Gielis P; Ford N
Source: PLoS Medicine. 2009 May 19;6(5):e1000078.
Abstract: Surgically treatable problems account for a significant proportion of disease burden in resourcelimited settings, but are neglected due to lack of skilled professionals, adequate infrastructure and equipment, and the perception that surgical services are complex and expensive. In the absence of trained surgeons, surgical tasks are often performed by non-specialist physicians and non-physician clinicians. While evaluations have proven the effectiveness of such task shifting, this is often done de facto, with little supervisory or training framework in place. As efforts increase to scale up surgical care in the developing world, a number of important lessons from task shifting in the field of HIV/AIDS care could serve to support task shifting in surgery. These include clearly defining the limits of task shifting, ensuring adequate training and supervision, providing adequate recognition and remuneration, developing simplified tools and guidelines, ensuring engagement with regulatory bodies, and mobilizing community health workers.
Language: English
Keywords:
AFRICA, SUB SAHARAN | CRITIQUE | HEALTH PERSONNEL | SURGERY | ANESTHESIA | HUMAN RESOURCES | TRAINING PROGRAMS | AIDS | HIV INFECTIONS | REFERRAL AND CONSULTATION | SUPERVISION | ETHICS | Africa | Developing Countries | Delivery of Health Care | Health | Treatment | Medical Procedures | Medicine | Health Services | Economic Factors | Education | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Management | Sociocultural Factors
Document Number: 341772


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