1.  Title: After receiving USAID | DELIVER Project logistics training, access to health products improves in Nepal. Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009 Jul. [2] p. (Success Story) Abstract: Just three years ago, under the previous health commodity distribution system in Nepal, the average stockout rate for family planning was 8.2 percent; for maternal and child health commodities it was 22.9 percent. Many women and children did not have the health commodities they needed. To prevent stockouts and to increase the availability of health commodities nationwide, the USAID | DELIVER PROJECT partnered with the Government of Nepal / Ministry of Health and Population (Logistics Management Division / Department of Health Services [LMD / DOHS]) and others to develop a series of logistics training programs. The goal was to create an efficient pull system that the country could use to manage stock levels at all health facilities. The project and the LMD collaborated to successfully implement two training programs -- one for community logistics and one for web-based logistics management information systems (LMISs). Conducted by the Nepali government, the USAID | DELIVER PROJECT, and their partners, these trainings taught community and district health workers how to improve the national health commodity logistics system and how to ease the transition to the new district-level pull system, which allows each health facility to determine the amount of stock that it needs to order. As a result, after 25 of the poorly performing districts participated in the training programs, stockouts of key commodities in their health facilities -- condoms, vitamin A capsules, iron tablets, cotrimoxazole, oral rehydration salt, and oxytocin decreased, while product availability for the end user increased. (Excerpt) Language: English Keywords: NEPAL | SUMMARY REPORT | COMMUNITY-BASED DISTRIBUTION WORKERS | USAID | LOGISTICS | DISTRIBUTIONAL ACTIVITIES | TRAINING PROGRAMS | INFORMATION RETRIEVAL SYSTEMS | INTERNET | HEALTH FACILITIES | PERFORMANCE IMPROVEMENT | Developing Countries | Asia, Southern | Asia | Community Workers | Health Personnel | Delivery of Health Care | Health | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Program Activities | Programs | Education | Data Storage and Retrieval | Information Processing | Information | Information Networks | Communication Document Number: 331664 |
| 2. Title: Public health procurement guide 2010. Author: United States. Agency for International Development [USAID]; John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009. [45] p. (USAID Contract No. GPO-I-01-06-00007-00) Abstract: USAID's Public Health Procurement Guide 2010 is an annual publication of current contraceptive and condom ordering procedures for missions. It includes USAID contraceptive ordering procedures and guidance on how to use logistics data and forecasts to calculate contraceptive requirements. Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | STANDARDS | LOGISTICS | CONTRACEPTION | CONDOMS | COLD CHAIN | CONTRACEPTIVE DISTRIBUTION | DISTRIBUTIONAL ACTIVITIES | CONTRACEPTIVE SECURITY | Research Methodology | Management | Organization and Administration | Family Planning | Barrier Methods | Contraceptive Methods | Program Activities | Programs | Contraceptive Availability Document Number: 331472 |
3.  Peer Reviewed Title: Effect of preventive supplementation with ready-to-use therapeutic food on the nutritional status, mortality, and morbidity of children aged 6 to 60 months in Niger: a cluster randomized trial. Author: Isanaka S; Nombela N; Djibo A; Poupard M; Van Beckhoven D; Gaboulaud V; Guerin PJ; Grais RF Source: JAMA. 2009 Jan 21;301(3):277-85. Abstract: CONTEXT: Ready-to-use therapeutic foods (RUTFs) are an important component of effective outpatient treatment of severe wasting. However, their effectiveness in the population-based prevention of moderate and severe wasting has not been evaluated. OBJECTIVE: To evaluate the effect of a 3-month distribution of RUTF on the nutritional status, mortality, and morbidity of children aged 6 to 60 months in Niger. DESIGN, SETTING, AND PARTICIPANTS: A cluster randomized trial of 12 villages in Maradi, Niger. Six villages were randomized to intervention and 6 to no intervention. All children in the study villages aged 6 to 60 months were eligible for recruitment. INTERVENTION: Children with weight-for-height 80% or more of the National Center for Health Statistics reference median in the 6 intervention villages received a monthly distribution of 1 packet per day of RUTF (92 g [500 kcal/d]) from August to October 2006. Children in the 6 nonintervention villages received no preventive supplementation. Active surveillance for conditions requiring medical or nutritional treatment was conducted monthly in all 12 study villages from August 2006 to March 2007. MAIN OUTCOME MEASURES: Changes in weight-for-height z score (WHZ) according to the World Health Organization Child Growth Standards and incidence of wasting (WHZ <-2) over 8 months of follow-up. RESULTS: The number of children with height and weight measurements in August, October, December, and February was 3166, 3110, 2936, and 3026, respectively. The WHZ difference between the intervention and nonintervention groups was -0.10 z (95% confidence interval [CI], -0.23 to 0.03) at baseline and 0.12 z (95% CI, 0.02 to 0.21) after 8 months of follow-up. The adjusted effect of the intervention on WHZ from baseline to the end of follow-up was thus 0.22 z (95% CI, 0.13 to 0.30). The absolute rate of wasting and severe wasting, respectively, was 0.17 events per child-year (140 events/841 child-years) and 0.03 events per child-year (29 events/943 child-years) in the intervention villages, compared with 0.26 events per child-year (233 events/895 child-years) and 0.07 events per child-year (71 events/1029 child-years) in the nonintervention villages. The intervention thus resulted in a 36% (95% CI, 17% to 50%; P < .001) reduction in the incidence of wasting and a 58% (95% CI, 43% to 68%; P < .001) reduction in the incidence of severe wasting. There was no reduction in mortality, with a mortality rate of 0.007 deaths per child-year (7 deaths/986 child-years) in the intervention villages and 0.016 deaths per child-year (18 deaths/1099 child-years) in the nonintervention villages (adjusted hazard ratio, 0.51; 95% CI, 0.25 to 1.05). CONCLUSION: Short-term supplementation of nonmalnourished children with RUTF reduced the decline in WHZ and the incidence of wasting and severe wasting over 8 months. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00682708. Language: English Keywords: NIGER | RESEARCH REPORT | CLINICAL TRIALS | EPIDEMIOLOGIC METHODS | CHILDREN | FOOD SUPPLEMENTATION | CHILD MORTALITY | CHILD SURVIVAL | CHILD NUTRITION | PREVENTIVE HEALTH CARE | DISTRIBUTIONAL ACTIVITIES | BODY WEIGHT | GROWTH | MALNUTRITION | PREVALENCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Survivorship | Length of Life | Nutrition | Program Activities | Programs | Organization and Administration | Physiology | Biology | Child Development | Nutrition Disorders | Diseases | Measurement Document Number: 330049 |
| 4. Peer Reviewed Title: Free distribution of insecticide treated bed nets to pregnant women in Kinshasa: an effective way to achieve 80% use by women and their newborns. Author: Pettifor A; Taylor E; Nku D; Duvall S; Tabala M; Mwandagalirwa K; Meshnick S; Behets F Source: Tropical Medicine and International Health. 2009 Jan;14(1):20-8. Abstract: OBJECTIVE: To determine whether long lasting insecticide treated bed nets (LLINs) distributed free of charge to pregnant women at their first antenatal clinic visit in Kinshasa, DRC are used from the time of distribution to delivery and 6 months after delivery. METHODS: Women were enrolled into a cohort study at their first antenatal care (ANC) visit and provided LLINs free of charge. Reported use of these nets was then measured at the time of delivery (n = 328) and in a random sample of women (n = 100) 6 months post-delivery using an interviewer administered, structured questionnaire. RESULTS: At baseline, only 25% of women reported having slept under a bed net the night before the interview. At the time of delivery, after being provided an LLIN for free, this increased to 79%. Six months post-delivery (n = 100), 80% of women reported sleeping under a net with a child under the age of 5 the night before the interview. CONCLUSIONS: Freely distributed bed nets are acceptable, feasible and result in high usage. Free distribution of bed nets during antenatal clinic visits may be a highly effective way to rapidly increase the use of bed nets among both pregnant women and their newborn infants in areas with high levels of ANC attendance. Language: English Keywords: REPUBLIC OF THE CONGO | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | INFANT | MOTHERS | PREGNANT WOMEN | PESTICIDES | BED NETS | PRICES | DISTRIBUTIONAL ACTIVITIES | ANTENATAL CARE | PREVALENCE | MALARIA PREVENTION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Ingredients and Chemicals | Parasite Control | Public Health | Health | Commerce | Macroeconomic Factors | Program Activities | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Measurement | Malaria | Parasitic Diseases | Diseases Document Number: 330250 |
| 5. Peer Reviewed Title: The free condom initiative: promoting condom availability and use in New York City. Author: Renaud TC; Bocour A; Irvine MK; Bernstein KT; Begier EM; Sepkowitz KA; Kellerman SE; Weglein D Source: Public Health Reports. 2009 Jul-Aug;124(4):481-9. Abstract: In 2005, the New York City Department of Health and Mental Hygiene (DOHMH) made free condoms available to organizations through a Web-based ordering system. In 2006, we interviewed managers and patrons about free condom availability, acquisition, and use in venues where people at high risk for human immunodeficiency virus congregate. DOHMH condom distribution increased from 5.8 million in 2004 to 17.3 million in 2006. Overall, managers reported making condoms available at 76% (309/409) of high-priority venues, but only at 40% of gay bars. Among patrons who saw free condoms, 80% (280/351) reported taking them; 73% (205/280) of those who reported taking them also reported using them. A simple, Web-based ordering system dramatically increased condom distribution. In the venues we sampled, the majority of patrons acquired and used free condoms when available and visible, suggesting that increasing free condom availability may increase use. Special efforts are needed to ensure availability at gay bars. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | URBAN POPULATION | CONDOMS | PROMOTION | PROGRAM EVALUATION | DISTRIBUTIONAL ACTIVITIES | CLINICAL DISTRIBUTION | COMMUNITY-BASED DISTRIBUTION | INTERNET | CONDOM USE | INTERVIEWS | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Marketing | Economic Factors | Programs | Organization and Administration | Program Activities | Nonclinical Distribution | Information Networks | Communication | Risk Reduction Behavior | Behavior | Data Collection | Research Methodology Document Number: 342144 |
| 6. Peer Reviewed Title: Integration of immunization services with other health interventions in the developing world: what works and why? Systematic literature review. Author: Wallace A; Dietz V; Cairns KL Source: Tropical Medicine and International Health. 2009 Jan;14(1):11-9. Abstract: OBJECTIVE: To assess benefits, challenges and characteristics of integrating child and maternal health services with immunization programmes. METHODS: Literature review using journal databases and grey literature. Papers meeting the inclusion criteria were rated for the quality of methodology and relevant information was systematically abstracted. RESULTS: Integrated services were vitamin A supplementation, bednet distribution, deworming tablet distribution, Intermittent Preventive Therapy for infants and referrals for family planning services. Two key characteristics of success were compatibility between interventions and presence of a strong immunization service prior to integration. Overburdened staff, unequal resource allocation and logistical difficulties were mentioned as risks of integration, whereas rapid uptake of the linked intervention and less competition for resources were listed as two key benefits of integration. CONCLUSION: The theoretical strengths of integrating other health services with immunization services remain to be rigorously proved in practice. When additional interventions are carefully selected for compatibility and when they receive adequate support, coverage of these interventions may improve, provided immunization coverage is already high. Evidence for the effectiveness of integration in increasing efficiency of resource use was insufficient and most benefits and challenges were not statistically quantified. More substantive information about the costs of integrated vs. vertical programmes and full documentation of the impacts of integration on immunization services should be published. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CHILDREN | INTEGRATED PROGRAMS | IMMUNIZATION | MATERNAL-CHILD HEALTH SERVICES | VITAMIN A | FOOD SUPPLEMENTATION | BED NETS | DISTRIBUTIONAL ACTIVITIES | PARASITE CONTROL | PREVENTIVE HEALTH CARE | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Public Health | Program Activities Document Number: 330264 |
| 7. Peer Reviewed Title: A chorus of disapproval [editorial] Source: Nature. 2008 Jul 31;454(7204):551. Abstract: The fight against AIDS is losing ground, but the current spate of mud-slinging is far from helpful. The global conversation about AIDS is beginning to sound like a high-decibel exercise in finger-pointing and blame. This dangerous trend should be on the minds of the thousands of attendees convening in Mexico City this weekend for the XVII International AIDS Conference. Thirty-three million people around the world are HIV-positive, and more than 6,800 become infected every day. Tests on microbicides and vaccines have failed, and have put some volunteers at greater risk of HIV infection. Yet critics are attacking the very programmes and people trying to solve these problems, with some even calling for an end to government spending on the search for a vaccine. This is an overreaction. As many scientists point out, the search for a malaria vaccine has seen dozens of failed trials, whereas only three AIDS vaccines have so far been tested in efficacy studies. What is needed are better vaccine candidates to test, so it makes sense that the major backers of HIV vaccine trials, including the US National Institutes of Health, are now focusing on the basic research that could help the field move forward. Meanwhile, two books published last year claim that the United Nations AIDS programme, UNAIDS, has led an ineffective, politically motivated response to the disease and has distorted statistics in an effort to garner more money. And critics such as Roger England, who runs a small think tank in Grenada, argue that spending on AIDS has distorted poor countries' priorities and weakened their health systems. England proposes that UNAIDS be shut down, and the money spent on AIDS programmes shifted to general funding for health systems. Amid the debate on these questions, the founding director of UNAIDS, Peter Piot, announced in April that he would step down at the end of this year, throwing the agency into uncertainty at a crucial time. There is no doubt that many poor countries' health systems are struggling, but it is wrong to say that AIDS aid is responsible. In fact, AIDS programmes have shown how poor countries can use new models to deliver needed care, for instance by providing antiretroviral treatments effectively, putting to rest claims that the costly drugs could not be used correctly outside resource-rich nations. It is also wrong to assume that governments will spend money effectively to fight AIDS if given funds to support health systems overall, as England suggests. Today, many strategies for delivering AIDS treatment target groups such as women, homosexuals and intravenous drug users that have been ignored by governments in the past - neglect that fuelled the spread of the disease. More money should be spent on both AIDS and strengthening health-care systems. And this will be possible if donor governments live up to their promises, such as the pledges of general and disease-specific aid to Africa that were repeated this July at the G8 meeting in Japan. On that front, it is heartening that the US House and Senate have reauthorized $48 billion for the President's Emergency Plan for AIDS Relief ($9 billion of which is for fighting malaria and tuberculosis). If President Bush signs the bill as expected, the programme will also permit the US government to reverse the shameful and embarrassing policy that bans travellers with HIV from entering the country. That might serve as an example to other governments that still sanction discrimination against those who are HIV-positive. The world is still far from achieving the goal adopted in 2000 by UN member states, which pledged to provide universal access to AIDS treatment by 2010. Three million people now receive lifesaving antiretroviral drugs, but 70% of those in low- to middle-income countries who need them don't get them. Indeed, the example of wealthy nations themselves shows what happens when they lose focus on AIDS. In the United States, for instance, reports now indicate that HIV infection rates have begun to rise in Latinos and young gay men. The activists and scientists about to meet in Mexico City must demand that leaders keep their eye on the ball. The world now has models for providing treatment and care in the places that sorely need it, and is in a position to make more tangible gains against AIDS. This is no time to backslide, and the Mexico City meeting must deliver this message loud and clear. (full-text) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | AIDS | ANTIRETROVIRAL DRUGS | DISTRIBUTIONAL ACTIVITIES | ECONOMIC FACTORS | UNAIDS | PROGRAM EFFECTIVENESS | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Program Evaluation Document Number: 328254 |
| 8. Title: A decision tree for rapid quality assurance and control of rifampicin-containing oral dosage forms for global distribution for tuberculosis treatment. Author: Ashokraj Y; Agrawal S; Panchagnula R Source: Indian Journal of Pharmaceutical Sciences. 2008 Jan-Feb;70(1):1-4. Abstract: For centuries TB remained as a complex socioeconomic problem impeding human development. Directly observed treatment short-course and fixed dose combinations were implemented in TB therapy for maximum success of treatment. However, drug shortages primarily hindered the expansion of directly observed treatment short-course, which lead to development of the global TB drug facility. Since large geographical area is covered by the global TB drug facility for global drug supply for TB eradication programs, a rapid quality control and assurance has become necessary to ensure the quality and performance of supplied anti-TB drugs. In this manuscript a decision tree is proposed for facilitating rapid quality control (in vitro and in vivo) of anti-TB formulations procured by the global TB drug facility. This decision tree also predicted to be applicable at every stages of anti-TB drug product development, especially in identification of poor quality products and monitoring batch-to-batch variability. Further, it provides opportunity for effective quality control in resource poor settings and the gained knowledge is anticipated to be applicable for development and evaluation of antimalarial and anti-AIDS fixed dose combinations. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLIENTS | TUBERCULOSIS | PREVENTION AND CONTROL | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | QUALITY OF HEALTH CARE | DISTRIBUTIONAL ACTIVITIES | ANTIMALARIAL DRUGS | ANTIRETROVIRAL DRUGS | RESEARCH AND DEVELOPMENT | Developing Countries | Asia, Southern | Asia | Program Activities | Programs | Organization and Administration | Infections | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Malaria | Parasitic Diseases | Technology | Economic Factors Document Number: 326213 |
| 9. Peer Reviewed Title: Implementation of an oxygen concentrator system in district hospital paediatric wards throughout Malawi. Author: Enarson P; La Vincente S; Gie R; Maganga E; Chokani C Source: Bulletin of the World Health Organization. 2008 May;86(5):344-348. Abstract: Hypoxaemia in children with severe or very severe pneumonia is a reliable predictor of mortality, yet oxygen was not available in most paediatric wards in Malawi. The Child Lung Health Programme in Malawi made oxygen available by supplying oxygen concentrators and essential supplies to 22 district and 3 regional hospitals' paediatric wards. Five key steps were taken to introduce concentrators: (1) develop a curriculum and training materials; (2) train staff on use and maintenance; (3) retrain electromedical departments on maintenance and repair; (4) conduct training once concentrators arrived in the country; and (5) distribute concentrators once staff had been trained. The setting was the paediatric wards in 3 regional and 22 government district hospitals and 3 regional electromedical engineering departments in Malawi. Main changes were: (1) provision of a source of oxygen in every paediatric ward in all district hospitals; (2) training of electrical engineering and health personnel in the use, maintenance and repair of oxygen concentrators; and (3) setting-up of high-dependency rooms or areas for severely ill children where oxygen is administered. It is feasible to implement an oxygen system using concentrators throughout a low-income country. Oxygen delivery requires trained staff with necessary equipment and supplies. Regular maintenance and supervision are essential to ensure optimal utilization. (author's) Language: English Keywords: MALAWI | EVALUATION REPORT | CHILDREN | HOSPITAL PERSONNEL | HOSPITALS | PNEUMONIA | OXYGEN | EQUIPMENT AND SUPPLIES | TRAINING PROGRAMS | DISTRIBUTIONAL ACTIVITIES | LOGISTICS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Health Facilities | Pulmonary Effects | Physiology | Biology | Inorganic Chemicals | Ingredients and Chemicals | Medical Procedures | Medicine | Health Services | Education | Program Activities | Programs | Organization and Administration | Management Document Number: 326553 |
| 10. Peer Reviewed Title: Challenges in translating evidence to practice: The provision of intrauterine contraception. Author: Harper CC; Blum M; de Bocanegra HT; Darney PD; Speidel JJ Source: Obstetrics and Gynecology. 2008 Jun;111(6):1359-1369. Abstract: Intrauterine contraception is used by many women worldwide, however, it is rarely used in the United States. Although available at no cost from the state family planning program for low-income women in California, only 1.3% of female patients obtain intrauterine contraceptives annually. This study assessed knowledge and practice patterns of practitioners regarding intrauterine contraception. We conducted a survey among physicians, nurse practitioners, and physician assistants (n = 1,246) serving more than 100 contraceptive patients per year in the California State family planning program. The response rate was 65% (N = 816). We used multiple logistic regression to measure the association of knowledge with clinical practice among different provider types. Forty percent of providers did not offer intrauterine contraception to contraceptive patients, and 36% infrequently provided counseling, although 92% thought their patients were receptive to learning about the method. Regression analyses showed younger physicians and those trained in residency were more likely to offer insertions. Fewer than half of clinicians considered nulliparous women (46%) and postabortion women (39%) to be appropriate candidates. Evidence-based views of the types of patients who could be safely provided with intrauterine contraception were associated with more counseling and method provision, as well as with knowledge of bleeding patterns for the levonorgestrel-releasing intrauterine system and copper devices. Prescribing practices reflected the erroneous belief that intrauterine contraceptives are appropriate only for a restricted set of women. The scientific literature shows intrauterine contraceptives can be used safely by many women, including postabortion patients. Results revealed a need for training on updated insertion guidelines and method-specific side effects, including differences between hormonal and nonhormonal devices. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | PHYSICIANS | HEALTH PERSONNEL | KNOWLEDGE | IUD | PRESCRIPTIONS | DISTRIBUTIONAL ACTIVITIES | NEEDS | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Program Activities | Programs | Organization and Administration | Economic Factors | Program Evaluation Document Number: 327246 |
| 11. Title: Measuring family planning logistics system performance in developing countries: Working paper. Author: Karim AM; Bieze B; Chimnani J Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2008 May. 21 p. (USAID Contract No. GPO-I-01-06-00007-00) Abstract: Availability of commodities at service delivery points (SDPs) is essential for successful public health programs. The purpose of the family planning logistics system is to maintain availability of contraceptives at the SDPs. DELIVER, a worldwide public health supply chain improvement initiative, uses the logistics system assessment tool (LSAT) to measure and monitor the performance of contraceptive supply chains in developing countries. This study describes the LSAT and assesses its reliability and validity. The LSAT uses a battery of items to score the performance of 11 aspects of logistics systems through in-depth interviews with program managers and policymakers. The weighted sum of the items is used to construct performance indices for each of the 11 aspects of the supply chain. Reliability and validity analyses of the LSAT scores from 12 countries indicate that 7 of the 11 aspects of the logistics systems are efficiently measuring the family planning supply chain performance. The LSAT Index, constructed from the scores of the seven aspects of the supply chain, predicts contraceptive availability at the SDPs very well, indicating that the higher score of the index is associated with a better-performing family planning supply chain. Therefore, the LSAT is a reliable and valid tool for monitoring and evaluating family planning supply chain performance. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | MEASUREMENT | FAMILY PLANNING PROGRAMS | LOGISTICS | USAID | MONITORING | CONTRACEPTIVE AVAILABILITY | INFORMATION RETRIEVAL SYSTEMS | DISTRIBUTIONAL ACTIVITIES | STORAGE AND WAREHOUSES | RELIABILITY | CONTRACEPTIVE PREVALENCE | Research Methodology | Family Planning | Management | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Evaluation | Contraception | Data Storage and Retrieval | Information Processing | Information | Program Activities | Programs | Contraceptive Usage Document Number: 331674 |
| 12. Title: Measuring family planning logistics system performance in developing countries. Logistics brief. Author: Karim AM; Bieze B; Chimnani J Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, John Snow [JSI], DELIVER, [2008]. [5] p. (USAID Contract No. GPO-I-01-06-00007-00) Abstract: This logistics brief provides insight into whether the LSAT is an effective measure of logistics system performance by developing an index from the items the tool measures and then testing the reliability and validity of the index.. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | FAMILY PLANNING PROGRAMS | LOGISTICS | USAID | MONITORING | CONTRACEPTIVE AVAILABILITY | INFORMATION RETRIEVAL SYSTEMS | DISTRIBUTIONAL ACTIVITIES | STORAGE AND WAREHOUSES | RELIABILITY | CONTRACEPTIVE PREVALENCE | Family Planning | Management | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Evaluation | Contraception | Data Storage and Retrieval | Information Processing | Information | Program Activities | Programs | Measurement | Research Methodology | Contraceptive Usage Document Number: 331675 |
| 13. Peer Reviewed Title: Condom availability in Taiwanese gay bathhouses: the right things in the wrong places. Author: Ko NY; Lee HC; Chang JL; Lee NY; Chang CM Source: AIDS Education and Prevention. 2008 Aug;20(4):338-346. Abstract: Gay bathhouses were identified as public venues where men having sex with men are more likely to engage in risky sexual behaviors. This study applied Binson and Woods's (Journal of Homosexuality, 44, 2003) theoretical framework of risk environment/bathhouse setting to (a) describe four domains of bathhouse environments, (b) investigate condom availability in bathhouses, and (c) identify barriers of condom distribution. An ethnographic study was conducted at eight gay bathhouses in Taiwan, including environmental observations, interviews of 16 staff members, and self-administered questionnaires of 409 bathhouse patrons. Condoms were provided upon request in eight bathhouses. Environmental observations showed a poor match between the places where condoms were distributed and where men had sex. Cost and police harassment were two barriers of condom distribution in bathhouses. Our findings highlight the importance of the extension of condom distribution at places where men have sex in gay bathhouses.(author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | HOMOSEXUALS | MEN | MEN HAVING SEX WITH MEN | CONDOMS | CONDOM USE | DISTRIBUTIONAL ACTIVITIES | RISK BEHAVIOR | SEX BEHAVIOR | Asia, Eastern | Asia | Developed Countries | Behavior | Demographic Factors | Population | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Risk Reduction Behavior | Program Activities | Programs | Organization and Administration Document Number: 327957 |
| 14. Peer Reviewed Title: Cost-effectiveness analysis of insecticide-treated net distribution as part of the Togo Integrated Child Health Campaign. Author: Mueller DH; Wiseman V; Bakusa D; Morgah K; Dare A Source: Malaria Journal. 2008 Apr 29;7:73. Abstract: To evaluate the cost-effectiveness of the first nationwide delivery of long-lasting insecticide-treated nets (LLITNs) as part of the 2004 measles vaccination campaign in Togo to all children between nine months and five years. An incremental approach was used to calculate the economic costs and effects from a provider perspective. Effectiveness was estimated in terms of malaria cases averted, deaths averted and Disability-Adjusted Life Years (DALYs) averted. Malaria cases were modelled using regional estimates. Programme and treatment costs were derived through reviews of financial records and interviews with key stakeholders. Uncertain variables were subjected to a univariate sensitivity analysis. Assuming equal attribution of shared costs between the LLITN distribution and the measles vaccination, the net costs per LLITN distributed were 4.41 USD when saved treatment costs were taken into account. Assuming a constant utilization of LLITNs by the target group over three years, 1.2 million cases could be prevented at a net cost per case averted of 3.26 USD. The net costs were 635 USD per death averted and 16.39 USD per DALY averted, respectively. The costs per case, death and DALY averted are well within commonly agreed benchmarks set by other malaria prevention studies. Varying transmission levels are shown to have a significant impact on cost-effectiveness ratios. Results also suggest that substantial efficiency gains may be derived from the joint delivery of vaccination campaigns and malaria interventions. (author's) Language: English Keywords: TOGO | RESEARCH REPORT | COST BENEFIT ANALYSIS | CHILD | CHILD HEALTH | MALARIA | BED NETS | CAMPAIGNS | DISTRIBUTIONAL ACTIVITIES | MALARIA PREVENTION | PROGRAM EFFECTIVENESS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Parasitic Diseases | Diseases | Parasite Control | Public Health | Communication Programs | Communication | Program Activities | Programs | Organization and Administration | Program Evaluation Document Number: 326540 |
| 15. Peer Reviewed Title: Distribution systems of insecticide-treated bed nets for malaria control in rural Burkina Faso: cluster-randomized controlled trial. Author: Muller O; De Allegri M; Becher H; Tiendrebogo J; Beiersmann C; Ye M; Kouyate B; Sie A; Jahn A Source: PLoS One. 2008;3(9):e3182. Abstract: BACKGROUND: Insecticide-impregnated bed nets (ITNs) have been shown to be a highly effective tool against malaria in the endemic regions of sub-Saharan Africa (SSA). There are however different opinions about the role of ITN social marketing and ITN free distribution in the roll-out of ITN programmes. The objective of this study was to evaluate the effects of free ITN distribution through antenatal care services in addition to an ITN social marketing programme in an area typical for rural SSA. METHODS: A cluster-randomised controlled ITN trial took place in the whole Kossi Province in north-western Burkina Faso, an area highly endemic for malaria. Twelve clusters were assigned to long-term ITN (Serena brand) social marketing plus free ITN (Serena brand) distribution to all pregnant women attending governmental antenatal care services (group A), and 13 clusters to ITN social marketing only (group B). The intervention took place during the rainy season of 2006 and thereafter. The trial was evaluated through a representative household survey at baseline and after one year. Serena ITN household ownership was the primary outcome measure. FINDINGS: A total of 1052 households were visited at baseline in February 2006 and 1050 at follow-up in February 2007. Overall Serena ITN household ownership increased from 16% to 28% over the study period, with a significantly higher increase in group A (13% to 35%) than in group B (18% to 23%) (p<0.001). INTERPRETATION: The free distribution of ITNs to pregnant women through governmental antenatal care services in addition to ITN social marketing substantially improved ITN household ownership in rural Burkina Faso. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN07985309. Language: English Keywords: BURKINA FASO | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | HOUSEHOLDS | BED NETS | DISTRIBUTIONAL ACTIVITIES | LOGISTICS | PESTICIDES | MALARIA PREVENTION | SOCIAL MARKETING | ANTENATAL CARE | SEASONAL VARIATION | GOVERNMENT PROGRAMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Parasite Control | Public Health | Health | Program Activities | Programs | Organization and Administration | Management | Ingredients and Chemicals | Malaria | Parasitic Diseases | Diseases | Marketing | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Population Dynamics Document Number: 329184 |
| 16. Peer Reviewed Title: The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania. Author: Njau JD; Goodman CA; Kachur SP; Mulligan J; Munkondya JS Source: Malaria Journal. 2008 Jan 7;7:4. Abstract: The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT). However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC) materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best) estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita), which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD). In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. The costs of implementing ACT are substantial. Although drug purchases constituted a majority of total costs, non-drugcosts were also considerable. It is clear that substantial external resources will be required to facilitate and sustain effective ACT delivery across Tanzania and other malaria-endemic countries. (author's) Language: English Keywords: TANZANIA | RURAL AREAS | RESEARCH REPORT | MALARIA PREVENTION | ANTIMALARIAL DRUGS | DELIVERY OF HEALTH CARE | IMPLEMENTATION | EXPENDITURES | DRUG RESISTANCE | HEALTH POLICY | DISTRIBUTIONAL ACTIVITIES | TRAINING ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Malaria | Parasitic Diseases | Diseases | Health | Programs | Organization and Administration | Financial Activities | Economic Factors | Treatment | Medical Procedures | Medicine | Health Services | Policy | Political Factors | Sociocultural Factors | Program Activities | Training Programs | Education Document Number: 326264 |
| 17. Title: Distribution matters: Equity considerations among health planners in Tanzania. Author: Ottersen T; Mbilinyi D; Maestad O; Norheim OF Source: Health Policy. 2008 Feb;85(2):218-227. Abstract: Maximising health as the guiding principle for resource allocation in health has been challenged by concerns about the distribution of health outcomes. There are few empirical studies that consider these potentially divergent objectives in settings of extreme resource scarcity. The aim of this study is to help fill this knowledge gap by exploring distributional preferences among health planners in Tanzania. A deliberative group method was employed. Participants were health planners at district and regional level, selected by strategic sampling. The health planners alternated between group discussion and individual tasks. Respondents ranked health programmes with different target groups, and selected and ranked the reasons they thought should be given most importance in priority setting. A majority consistently assigned higher rankings to programmes where the initial life expectancy of the target group was lower. A high proportion of respondents considered "affect those with least life expectancy" to be the most important reason in priority setting. Distribution of health outcomes, in terms of life-years, matters. Specifically, the lower the initial life expectancy of the target group, the more important the programme is considered. Such preferences are compatible, within the sphere of health, with what ethicists call "prioritarianism". (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | QUESTIONNAIRES | POLICYMAKERS | HEALTH SERVICES | DISTRIBUTIONAL ACTIVITIES | INEQUALITIES | LIFE EXPECTANCY | ETHICS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Administrative Personnel | Organization and Administration | Delivery of Health Care | Health | Program Activities | Programs | Socioeconomic Factors | Economic Factors | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Sociocultural Factors Document Number: 323129 |
| 18. Title: Low ART adherence in Africa. Author: Wakabi W Source: Lancet Infectious Diseases. 2008 Feb;8(2):94. Abstract: Although the introduction of generic drugs and the boost in funding for HIV/AIDS programmes have enabled more patients in African countries to access antiretroviral therapy (ART), concern is mounting about the low levels of adherence in several countries. Causes of low adherence are the high costs of ART, long distances to clinics, lack of transport to dispensing facilities, intermittent drug supply, fear of stigmatisation, poor documentation, and lack of access to correct information. Additionally, drugs have side-effects, which may lead to patients missing or interrupting doses. Jean Nachega (Johns Hopkins University, Baltimore, MD, USA) told TLID: "In the early days of HIV treatment we found high levels of treatment adherence and concluded that routine HIV care is both feasible and successful in Africa...However, despite early excellent encouraging results, suboptimal levels of adherence have been reported and we can expect that adherence will decrease over time, particularly if patients are experiencing significant adverse events related to their medications or treatment interruptions caused by barriers such as cost of treatment, poor drug supply, or problems in terms of transport to the clinic". (excerpt) Language: English Keywords: AFRICA | UNITED STATES OF AMERICA | MARYLAND | SUMMARY REPORT | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | LOGISTICS | USER COMPLIANCE | HEALTH SERVICES | DELIVERY OF HEALTH CARE | DISTRIBUTIONAL ACTIVITIES | RESEARCH AND DEVELOPMENT | Developing Countries | Developed Countries | North America | Americas | HIV | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health | Management | Organization and Administration | Behavior | Program Activities | Programs | Technology | Economic Factors Document Number: 324038 |
| 19. Peer Reviewed Title: The distribution of people seeking STD services in the various types of health care facilities in Chao Yang district, Beijing, China. Author: Zhao G; Detels R; Gu F; Li D; Li X Source: Sexually Transmitted Diseases. 2008 Jan;35(1):65-67. Abstract: Rates of sexually transmitted diseases (STDs) in China have soared over the past decade. Effective management of STDs is one of the cornerstones of HIV control and provides a unique opportunity for targeted education about HIV prevention. A recent study in Thailand revealed that 60% of patients suffering from an STD did not seek treatment from an STD clinic. To reach STD patients, it is important to determine the venues where people seek services and to evaluate the quality of treatment and prevention services in those facilities. The objectives of this study were to identify the facilities in Beijing where most people seek STD treatment and evaluate their prevention services. The study was conducted in Chao Yang District, Beijing, where only large and moderate-sized hospitals are authorized to provide STD treatment. (excerpt) Language: English Keywords: CHINA | RESEARCH REPORT | SAMPLING STUDIES | CROSS SECTIONAL ANALYSIS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | CLINICS | HOSPITALS | PHARMACIES | DISTRIBUTIONAL ACTIVITIES | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Program Activities | Programs | Organization and Administration Document Number: 314027 |
| 20. Title: Female condoms improve public health in Madagascar. Author: Family Health International [FHI] Source: [Research Triangle Park, North Carolina], FHI, [2007]. [2] p. (Research Briefs on the Female Condom) Abstract: The availability of female condoms is associated with more condom use, and thus better protection against sexually transmitted infections (STIs), according to results of a USAID-supported study in Madagascar. When female condoms were added to a male-condom distribution system for sex workers, the use of protection with paying partners increased. The proportion of sex acts in which male or female condoms were used rose from 78 percent to 88 percent among paying partners. Use of protection with nonpaying partners remained steady at fewer than 30 percent of sex acts. The prevalence of STIs in the study population declined from 50 percent to 40 percent. The scientists also found that peer counseling was sufficient for successful promotion of the female condom. Participants who were randomly assigned to receive supplemental clinic-based counseling on male and female condoms did not experience further increases in condom use or reductions in STI prevalence. Although the study was not designed to prove a causal relationship between the use of female condoms and changes in condom use or STI prevalence, the findings suggest that increasing the availability of female condoms can improve public health. This study followed 1,000 sex workers for 18 months. Male condoms were promoted for the entire period and female condoms were introduced for the final 12 months. The study was a collaboration among scientists from Family Health International, the University of Antananarivo in Madagascar, the Madagascar Ministry of Health, and the University of North Carolina at Chapel Hill. (Excerpt) Language: English Keywords: MADAGASCAR | SUMMARY REPORT | SEX WORKERS | FEMALE CONDOMS | DISTRIBUTIONAL ACTIVITIES | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | PREVALENCE | COUNSELING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Sex Behavior | Behavior | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Program Activities | Programs | Organization and Administration | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Research Methodology | Clinic Activities Document Number: 331706 |
| 21. Title: Improving child health through the Accredited Drug Dispensing Outlet Program: baseline survey from five districts in Tanzania. Author: Management Sciences for Health [MSH]. Center for Pharmaceutical Management. Rational Pharmaceutical Management Plus; Tanzania. Centre for Enhancement of Effective Malaria Interventions [CEEMI]; Partnership for Child Health Care. Basic Support for Institutionalizing Child Survival [BASICS] Source: Arlington, Virginia, MSH, Center for Pharmaceutical Management, Rational Pharmaceutical Management Plus, 2007 Sep. [60] p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00) Abstract: In Tanzania, diarrhea, malaria, and pneumonia are the main causes of morbidity and mortality in young children. Together, they account for more than 50 percent of all childhood mortality in the country. Integrated Management of Childhood Illness (IMCI), first introduced in Tanzania in 1997, is a strategy to improve child health and ultimately reduce child mortality by addressing these three key common childhood conditions. In more than 60 percent of the health districts in Tanzania health workers have been trained in IMCI, and preliminary results show that the strategy has been effective in improving treatment of sick children. However, because accessibility to public health facilities is limited and essential medicines are frequently out of stock at those facilities, many caregivers of sick children seek medicines outside the public sector, particularly in private pharmacies. The Ministry of Health and Social Welfare (MOHSW) of Tanzania, through the Tanzania Food and Drugs Authority (TFDA) and with support from the U.S. Agency for International Development (USAID) through the Rational Pharmaceutical Management (RPM) Plus Program of Management Sciences for Health (MSH) and with technical support from the Basic Support for Institutionalizing Child Survival (BASICS) project for behavior change communication (BCC), is developing a child health component to integrate into the expanding network of accredited Duka la Dawa Muhimu private drug outlets, also known as the Accredited Drug Dispensing Outlet (ADDO) program. (excerpt) Language: English Keywords: TANZANIA | RESEARCH REPORT | BASELINE SURVEYS | KAP SURVEYS | CHILDREN | USAID | PHARMACY DISTRIBUTION | DISTRIBUTIONAL ACTIVITIES | ANTIBIOTICS | PARASITE CONTROL | CHILD HEALTH SERVICES | DIARRHEA | MALARIA PREVENTION | PNEUMONIA | COMMUNICABLE DISEASE CONTROL | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Nonclinical Distribution | Program Activities | Programs | Organization and Administration | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Maternal-Child Health Services | Primary Health Care | Diseases | Malaria | Parasitic Diseases | Pulmonary Effects | Physiology | Biology Document Number: 324249 |
| 22. Title: Managing medicines and supplies in child survival programs: action guide for program managers. Author: Management Sciences for Health [MSH]. Center for Pharmaceutical Management. Rational Pharmaceutical Management Plus; Partnership for Child Health Care. Basic Support for Institutionalizing Child Survival [BASICS] Source: Arlington, Virginia, MSH, Center for Pharmaceutical Management, Rational Pharmaceutical Management Plus, 2007 Jan. 41 p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00USAID Contract No. GHA-1-00-04-00002-00USAID Development Experience Clearinghouse DocID / Order No. PN-ADJ-299) Abstract: This Action Guide is designed for those involved in child survival, IMCI, malaria, ARI, diarrhea, or nutrition programs, and provides a structured way for you to expand your role and ability to solve the most common medicine availability and use problems. The steps in the Action Guide will help you determine to what extent you can become involved in improving the supply of medicines and supplies in your program. The Action Guide will give you the opportunity of learning something new and challenging as well as to achieve improved availability and use of the medicines essential for your child survival program. The actions are organized for you to carry them out step by step. Actions range from making a phone call, meeting someone, or gathering information. You may use any resources you have available. The actions you take and their sequence may vary according to your other activities and opportunities. You can use the Action Guide on your own or with a team and divide the work. In general, we suggest that when you plan your work for the week, you also make plans to complete one step of the Action Guide per week in the context of your everyday work. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | CHILD SURVIVAL | MEDICINE | EQUIPMENT AND SUPPLIES | DISTRIBUTIONAL ACTIVITIES | HEALTH SERVICES ADMINISTRATION | MANAGEMENT | Survivorship | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Medical Procedures | Program Activities | Programs | Organization and Administration Document Number: 321116 |
| 23. Title: AIDSMark regional lessons learned. West and Central Africa. Author: Population Services International [PSI]. AIDSMark Source: Washington, D.C., PSI, AIDSMark, 2007. [4] p. (USAID Award No. HRN-A-00-97-00021-00) Abstract: In West and Central Africa, poverty, ethnic diversity and political instability combine in countries that consistently rank among the least developed in the world. Sixty percent of the West African population struggles to survive on less than a dollar a day. The region is also home to remarkably diverse peoples, with more than 100 distinct languages spoken in Cameroon and the Democratic Republic of Congo (DRC), and a staggering 521 distinct languages spoken in Nigeria. Political strife has long ravaged West and Central Africa. The Rwandan genocide in 1994 destabilized the region, and the DRC's civil war has been one of the deadliest and most damaging in the world. Nigeria has experienced more military than civilian transfers of power since independence, while Cote d'Ivoire, long the economic powerhouse of West Africa, has recently been racked by civil war and instability. AIDSMark responded with funding and technical assistance to HIV epidemics in nine West and Central African countries: Benin, Burundi, Cameroon, Cote d'Ivoire, DRC, Guinea, Nigeria, Rwanda and Togo. Adult HIV prevalence in these countries ranges from 1.5 percent in Guinea to 5.4 percent in Cameroon and is largely concentrated among high-risk groups such as commercial sex workers (CSW), long-distance truck drivers and members of the armed forces. While these rates are low relative to those in Southern Africa, highly diverse populations, poor communication and transportation infrastructure, and civil unrest pose unique obstacles to HIV prevention programs in West and Central Africa. (excerpt) Language: English Keywords: AFRICA, WESTERN | AFRICA, CENTRAL | PROGRESS REPORT | PERSONS LIVING WITH HIV/AIDS | NONGOVERNMENTAL ORGANIZATIONS | SEX WORKERS | TRUCK DRIVERS | MILITARY PERSONNEL | WAR | DISTRIBUTIONAL ACTIVITIES | CONDOMS | INTERPERSONAL COMMUNICATION | Africa, Sub Saharan | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Organizations | Political Factors | Sociocultural Factors | Sex Behavior | Behavior | Labor Force | Human Resources | Economic Factors | Government | Program Activities | Programs | Organization and Administration | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Communication Document Number: 323000 |
| 24. Title: Two-year operational plan for procurement, storage and distribution of antimalarial medicines (January 2007 - December 2008). Author: Uganda. Ministry of Health Source: Kampala, Uganda, National Malaria Control Programme, 2007 Mar. 42 p. (http://pdf.usaid.gov/pdf_docs/PNADJ514.pdf) Abstract: Uganda's National Malaria Control Programme (NMCP) is currently working to implement a new treatment policy for malaria as part of its strategy to roll back malaria. This change involves the use of an artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria, in line with World Health Organisation (WHO) recommendations. The recommendation to change the treatment policy was made on May 17, 2004, by the Malaria Case Management Technical Working Group (MCMTWG) of the Inter-Agency Coordination Committee for Malaria (ICCM). Subsequently, the Ministry of Health (MoH) accepted the recommendations of the MCMTWG and initiated the process of implementing the policy change. To facilitate this implementation, the NMCP has developed detailed malaria standard treatment guidelines. The current recommended ACT is artemether-lumefantrine, or artesunate plus amodiaquine as an alternative first-line treatment, which replaces the combination therapy of SP plus chloroquine (SP+CQ). (excerpt) Language: English Keywords: UGANDA | RECOMMENDATIONS | EVALUATION | GOVERNMENT AGENCIES | MALARIA PREVENTION | PARASITE CONTROL | LOGISTICS | STORAGE AND WAREHOUSES | DISTRIBUTIONAL ACTIVITIES | HEALTH SERVICES ADMINISTRATION | HEALTH AND WELFARE PLANNING | MONITORING | EQUIPMENT AND SUPPLIES | MANAGEMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Organizations | Political Factors | Sociocultural Factors | Malaria | Parasitic Diseases | Diseases | Public Health | Health | Organization and Administration | Program Activities | Programs | Social Planning | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 324251 |
| 25. Title: Technical assistance to strengthen the medical supply system for HAART and DOTS-Plus programs in Peru: final consultancy report. Author: Cruzado R; Falistocco C; Mizuaray A; Quesada C; Schneider R Source: Arlington, Virginia, Management Sciences for Health [MSH], Center for Pharmaceutical Management, Rational Pharmaceutical Management Plus, 2007 Mar. [24] p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00USAID Cooperative Agreement No. GPO-1-00-05-00032-00) Abstract: In April 2006, a mission from the Global Fund, as a condition for the disbursement of funds for the purchase of health products (for both HIV/AIDS and multidrug-resistant TB [MDR-TB]), imposed the requirement that programming and management of stocks of the products financed by the Global Fund be substantially improved no later than October 2006, for purposes of dealing with deficiencies that had been identified by the mission. To comply with this requirement, an ad hoc committee-composed of representatives of the Multisectoral National Health Coordinator (CONAMUSA, the country's coordinating mechanism); the two National Health Strategies (for HIV/AIDS and TB); the General Directorate for Medicines, Supplies and Drugs (DIGEMID); and CARE Peru (Principal Recipient)-identified as the principal bottlenecks the existence of an excessive number of ARV treatment schemes and the serious difficulties in the acquisition process for medicines for both HIV/AIDS and MDR-TB. CONAMUSA requested technical assistance from the U.S. Agency for International Development to be able to confront the problems mentioned with the support of experts and to secure proposals for optimizing the purchases of ARV and anti-tuberculosis medicines, selecting ARVs and, in general, strengthening the supply system as a whole. (excerpt) Language: English Keywords: PERU | PROGRESS REPORT | EVALUATION | ADMINISTRATIVE PERSONNEL | ANTIRETROVIRAL THERAPY | AIDS PREVENTION | TECHNICAL ASSISTANCE | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | EQUIPMENT AND SUPPLIES | DISTRIBUTIONAL ACTIVITIES | STORAGE AND WAREHOUSES | LOGISTICS | MANAGEMENT | ANTIBIOTICS | South America, Western | South America | Latin America | Americas | Developing Countries | Organization and Administration | HIV | HIV Infections | Viral Diseases | Diseases | AIDS | Programs | Infections | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Program Activities | Drugs | Treatment Document Number: 324253 |
| 26. Peer Reviewed Title: Effect of expanded insecticide-treated bednet coverage on child survival in rural Kenya: a longitudinal study. Author: Fegan GW; Noor AM; Akhwale WS; Cousens S; Snow RW Source: Lancet. 2007 Sep 22;370(9592):1035-1039. Abstract: The potential of insecticide-treated bednets (ITNs) to contribute to child survival has been well documented in randomised controlled trials. ITN coverage has increased rapidly in Kenya from 7% in 2004 to 67% in 2006. We aimed to assess the extent to which this investment has led to improvements in child survival. A dynamic cohort of about 3500 children aged 1-59 months were enumerated three times at yearly intervals in 72 rural clusters located in four districts of Kenya. The effect of ITN use on mortality was assessed with Poisson regression to take account of potential effect-modifying and confounding covariates. 100 children died over 2 years. Overall mortality rates were much the same in the first and second years of the study (14.5 per 1000 person-years in the first year and 15.4 per 1000 person-years in the second). After adjustment for age, time period, and a number of other possible confounding variables, ITN use was associated with a 44% reduction in mortality (mortality rate ratio 0.56,95% CI 0.33-0.96; p=0.04). This level of protection corresponds to about seven deaths averted for every 1000 ITNs distributed. A combined approach of social marketing followed by mass free distribution of ITNs translated into child survival effects that are comparable with those seen in previous randomised controlled trials. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | LONGITUDINAL STUDIES | CHILD | INFANT | RURAL POPULATION | BED NETS | CHILD SURVIVAL | CHILD MORTALITY | INFANT MORTALITY | SOCIAL MARKETING | DISTRIBUTIONAL ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasite Control | Public Health | Health | Survivorship | Length of Life | Mortality | Population Dynamics | Marketing | Economic Factors | Program Activities | Programs | Organization and Administration Document Number: 321165 |
| 27. Title: Adherence to antiretroviral therapy in resource-limited settings: everything matters [editorial] Author: Hawkins C; Murphy R Source: AIDS. 2007 May 11;21(8):1041-1042. Abstract: Adherence is one of the major determinants of successful outcomes to antiretroviral therapy (ART) among HIV-infected individuals. In several studies, poor adherence, especially at levels < 95%, has been found to be associated with development of viral resistance, virological failure, progression of disease, and death. Adherence is particularly important in resource-limited settings. This is mainly because of poor access to care and monitoring and limited availability of alternative regimens. Despite numerous studies of outcomes with ART in resource-limited settings, surprisingly few have addressed adherence. Those that have report mostly encouraging results, with adherence rates similar to those observed in developed countries, although notable declines among individuals on more long-term therapy are beginning to be observed. Interesting findings concerning barriers to adherence have also been reported in these studies. More commonly, financial constraints and disruptions in the supply of medications are reported as the major barriers to adherence in resource-limited settings, contrasting significantly with the barriers typically reported in developed countries, such as side effects, stigma, or inconvenience. The findings should raise considerable concern given the uncertainty of long-term donor commitments in resource-limited settings and eventual probability of patients having to pay at least some if not all costs of therapy. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | PROGRAM ACCESSIBILITY | FEES | DRUGS | DISTRIBUTIONAL ACTIVITIES | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Program Evaluation | Programs | Organization and Administration | Financial Activities | Economic Factors | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Activities Document Number: 315504 |
| 28. Title: Health systems assessment approach: a how-to manual. Author: Islam M Source: Arlington, Virginia, Management Sciences for Health [MSH], 2007. [370] p. (USAID Cooperative Agreement No. GHS-A-00-06-00010-00USAID Contract No. HRN-C-00-00-00019-00USAID Contract No. GHPH-C-00-02-00004-00USAID Cooperative Agreement No. HRN-A-00-00-00016-00) Abstract: The U.S. Agency for International Development (USAID) Office of Health, Infectious Diseases and Nutrition (HIDN) requested the development of a Health Systems Assessment Approach as part of its global Mainstreaming Health Systems Strengthening Initiative. The approach is meant to serve the following purposes: to enable USAID Missions to assess a country's health system, possibly during early phases of program development or sector planning; this assessment will diagnose the relative strengths and weaknesses of the health system, prioritize key weakness areas, and identify potential solutions or recommendations for interventions to inform Population, Health, and Nutrition (PHN) officers and USAID Mission health teams about the basic elements and functions of health systems to improve the capacity of bilateral projects to achieve USAID's health impact objectives through increased use of health systems interventions to aid health systems officials at USAID to conceptualize key issues, increase the use of health systems interventions in technical program design and implementation, and to improve the role of the Health Systems Division to inform Ministries of Health and other stakeholders on the relative strengths and weaknesses of the health system, priority issues, and potential solutions or recommendations for interventions and programs. (excerpt) Language: English Keywords: GLOBAL | MANUAL | USAID | HEALTH SERVICES EVALUATION | INTERVENTIONS | HEALTH SERVICES ADMINISTRATION | FINANCIAL ACTIVITIES | DELIVERY OF HEALTH CARE | HUMAN RESOURCES | DRUGS | DISTRIBUTIONAL ACTIVITIES | INFORMATION RETRIEVAL SYSTEMS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Management | Economic Factors | Health | Treatment | Medical Procedures | Medicine | Health Services | Program Activities | Data Storage and Retrieval | Information Processing | Information Document Number: 323008 |
| 29. Peer Reviewed Title: The impact of a small steady stream of income for women on family health and economic well-being. Author: Katz J; West KP Jr; Pradhan EK; Leclerq SC; Khatry SK Source: Global Public Health. 2007 Jan;2(1):35-52. Abstract: Our primary aim to evaluate the impact of a small steady stream of income on family health and well-being among rural women employed part-time in a health project in Sarlahi district, Nepal. All 870 women applying for the job of distributing nutritional supplements in their villages completed a questionnaire prior to selection for employment, 350 of whom were hired and 520 who were not. A total of 736 women completed a second questionnaire 2 years later, 341 (97.4%) of whom had been continuously employed during this period, and 395 (76.0%) who had never been employed by the project. Changes in health and well-being over 2 years were compared between women who were and were not hired. Women who were hired were younger and better educated, but were similar in other regards. After adjusting for selection differences, employed women were more likely to save cash, buy jewellery, and buy certain discretionary household goods over 2 years than those who were not hired. Expenditures on children's clothingincreased more for employed women, and their children were more likely to be in private schools at follow-up, but there was no impact on health and survival of children. Women with a small steady stream of income did improve their personal economic situation by savings and increased expenditures for children and the household. Longer follow-up may reveal impacts on health access and expenditures, although these were not evident in 2 years of employment. (author's) Language: English Keywords: NEPAL | RESEARCH REPORT | RURAL POPULATION | WOMEN | COMMUNITY PARTICIPATION | INCOME | DISTRIBUTIONAL ACTIVITIES | VITAMINS AND MINERALS | EXPENDITURES | HOUSEHOLD CONSUMPTION | MICROECONOMIC FACTORS | Developing Countries | Asia, Southern | Asia | Population Characteristics | Demographic Factors | Population | Organization and Administration | Socioeconomic Factors | Economic Factors | Program Activities | Programs | Physiology | Biology | Financial Activities Document Number: 325369 |
| 30. Peer Reviewed Title: Programme diversity is key to the success of insecticide-treated bednets. Author: Lengeler C; de Savigny D Source: Lancet. 2007 Sep 22;370(9592):1009-1010. Abstract: In today's Lancet, Greg Fegan and colleagues, from the Kenyan Medical Research Institute, provide important mortality data from a large national programme on insecticide-treated bednets in Kenya. They report an impressive 44% reduction in the risk of dying in children who used the bednets. Their work confirms earlier findings from The Gambia and Tanzania, which evaluated smaller, shorter, and less diversified programmes. The public release of these data coincides with the new WHO Position Statement on insecticide-treated bednets. With this work, the use of insecticide-treated bednets is confirmed as a major child-survival intervention in malaria-endemic settings in sub-Saharan Africa. The ongoing switch to long-lasting insecticidal bednets will further reinforce this intervention. (excerpt) Language: English Keywords: KENYA | ADMINISTRATIVE DISTRICTS | CRITIQUE | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | CHILDREN | BED NETS | MALARIA PREVENTION | CHILD SURVIVAL | HUMAN GEOGRAPHY | SOCIAL MARKETING | DISTRIBUTIONAL ACTIVITIES | |