2.  Peer Reviewed Title: Rapid scale-up of antiretroviral treatment in Ethiopia: successes and system-wide effects. Author: Assefa Y; Jerene D; Lulseged S; Ooms G; Van Damme W Source: PLoS Medicine. 2009 Apr 28;6(4):e1000056. Abstract: There has been substantial expansion of access to ART and HIV counseling and testing in Ethiopia, whilst maintaining the performance of other health programs such as tuberculosis and maternal and child health services. Task shifting to the health officers, nurses, and health extension workers is thought to be responsible for these successes. However, HIV prevention interventions and management of chronic care patients are lagging behind. This may be due to lack of attention to these health care areas and to physicians leaving the public sector for NGOs, including AIDS-related NGOs. Prevention of HIV infection, retention of patients in chronic care, and retention of physicians in the public sector need urgent attention for effective and sustainable HIV/AIDS and health systems responses in the long term. Language: English Keywords: ETHIOPIA | EVALUATION REPORT | ANTIRETROVIRAL THERAPY | PUBLIC HEALTH | PROGRAM ACCESSIBILITY | DECENTRALIZATION | HIV TESTING | HIV PREVENTION | AIDS PREVENTION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | HIV | HIV Infections | Viral Diseases | Diseases | Health | Program Evaluation | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | AIDS Document Number: 341678 |
| 3. Title: Evaluation of commercial HIV test kits used in Nigeria. Author: Banwat EB; Peter JY; Egah DZ Source: Nigerian Journal of Clinical Practice. 2009 Mar;12(1):11-4. Abstract: BACKGROUND:Accurate and reliable diagnosis of HIV plays a central role in any effective HIV intervention. We decided to evaluate 4 commercial HIV test kits to determine their reliability for use in developing countries. METHODS: Serum samples obtained from clients accessing tertiary health services at the STI clinic, Jos University Teaching Hospital were used to evaluate Sdbioline, Diaspot, Determine and DIALAB Elisa kits. A Western blot was used as the reference kit. RESULTS: DETERMINE kit gave 34 positive and 58 negative reactions and the positive sera were all confirmed by Western blot while DIASPOT kit gave 27 false negative results, which was at variance with the reference kit result. Other kits were SDBIOLINE with 5 false positive and DIALAB Elisa kit, which gave one false positive, and one false negative result. CONCLUSION: We conclude that Determine, SDbioline and DIALAB Elisa kits are reliable for HIV antibody testing in Nigeria and other developing countries. Language: English Keywords: NIGERIA | EVALUATION REPORT | CLIENTS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | HIV TESTING | EQUIPMENT AND SUPPLIES | RELIABILITY | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | SCREENING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Program Activities | Programs | Organization and Administration | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 342689 |
4.  Title: Malawi. Laboratory services and supply chain assessment. Author: Butao D; Felling B; Msipa P Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009 Feb. [95] p. (USAID Contract No. GPO-I-01-06-00007-00) Abstract: In January and February 2009, the Ministry of Health (MOH), with technical assistance from the USAID | DELIVER PROJECT, Task Order 1, conducted an assessment of laboratory services and the management of the supply chain for laboratory commodities and equipment in government and Christian Health Association of Malawi (CHAM) health facilities in Malawi. The assessment’s overall objective was to provide the MOH with information on the current status of laboratory services and the supporting supply chain that could be used to develop the Five-Year Strategic Laboratory Plan. During the assessment, a quantitative baseline was established on which to measure future improvements to laboratory services and the supporting supply chain. This report presents the methodology and findings of the assessment, as well as recommendations to improve the supply chain to support laboratory services in Malawi. Language: English Keywords: MALAWI | EVALUATION REPORT | GOVERNMENT AGENCIES | USAID | LABORATORY | LOGISTICS | EQUIPMENT AND SUPPLIES | INFORMATION RETRIEVAL SYSTEMS | QUALITY CONTROL | STORAGE AND WAREHOUSES | TRANSPORTATION | PERFORMANCE IMPROVEMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Organizations | Political Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Management | Organization and Administration | Data Storage and Retrieval | Information Processing | Information | Economic Factors Document Number: 331662 |
| 5. Title: Evaluation of berhane hewan: a program to delay child marriage in rural ethiopia. Author: Erulkar AS; Muthengi E Source: International Perspectives On Sexual and Reproductive Health. 2009 Mar;35(1):6-14. Abstract: CONTEXT: Early marriage limits girls' opportunities and compromises their health, yet in Sub-Saharan Africa many girls are married before the age of 18, and few programs have sought to increase the age at marriage on the continent. METHODS: Berhane Hewan was a two-year pilot project conducted in 2004-2006 that aimed to reduce the prevalence of child marriage in rural Ethiopia, through a combination of group formation, support for girls to remain in school and community awareness. A quasi-experimental research design with baseline and endline surveys was used to measure changes in social and educational participation, marriage age, reproductive health knowledge and contraceptive use. Chi-square tests, proportional hazards models and logistic regressions were conducted to assess changes associated with the project. RESULTS: The intervention was associated with considerable improvements in girls' school enrollment, age at marriage, reproductive health knowledge and contraceptive use. Particularly among girls aged 10-14, those exposed to the program were more likely than those in the control area to be in school at the endline survey (odds ratio, 3.0) and were less likely to have ever been married (0.1). However, among girls aged 15-19, those in the intervention area had an elevated likelihood of having gotten married by the endline (2.4). Sexually experienced girls exposed to the intervention had elevated odds at endline of having ever used contraceptives (2.9). CONCLUSIONS: The success of the Berhane Hewan program, one of the first rigorously evaluated interventions to delay marriage in Sub-Saharan Africa, suggests that well-designed and effectively implemented programs can delay the earliest marriages until later adolescence. Language: English Keywords: ETHIOPIA | RURAL AREAS | EVALUATION REPORT | PILOT PROJECTS | CHILD MARRIAGE | PREVALENCE | SCHOOL ENROLLMENT | CONTRACEPTIVE USAGE | MARRIAGE POSTPONEMENT | REPRODUCTIVE HEALTH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Evaluation | Studies | Research Methodology | Marriage Patterns | Marriage | Nuptiality | Demographic Factors | Measurement | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Contraception | Family Planning | Health Document Number: 341413 |
| 6. Peer Reviewed Title: Evaluating nurses' implementation of an infant-feeding counseling protocol for HIV-infected mothers: The Ban Study in Lilongwe, Malawi. Author: Ferguson YO; Eng E; Bentley M; Sandelowski M; Steckler A; Randall-David E; Piwoz EG; Zulu C; Chasela C; Soko A; Tembo M; Martinson F; Tohill BC; Ahmed Y; Kazembe P; Jamieson DJ; van der Horst C Source: AIDS Education and Prevention. 2009 Apr;21(2):141-55. Abstract: A process evaluation of nurses' implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of mother-to-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIV-infected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Study's outcomes. Language: English Keywords: MALAWI | EVALUATION REPORT | SAMPLING STUDIES | NURSES AND NURSING | MOTHERS | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | IMPLEMENTATION | COUNSELING | BREASTFEEDING, EXCLUSIVE | COMMUNICATION | USER COMPLIANCE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Clinic Activities | Program Activities | Breastfeeding | Infant Nutrition | Nutrition | Behavior Document Number: 341680 |
| 7. Peer Reviewed Title: Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana. Author: Fiscian VS; Obeng EK; Goldstein K; Shea JA; Turner BJ Source: AIDS Education and Prevention. 2009;21(1):67-79. Abstract: A U.S. HIV prevention program was adapted to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection. (author's) Language: English Keywords: GHANA | UNITED STATES OF AMERICA | EVALUATION REPORT | THEORETICAL MODELS | KAP SURVEYS | ADOLESCENTS, FEMALE | WOMEN IN DEVELOPMENT | SEX WORKERS | HIV PREVENTION | SEX EDUCATION | KNOWLEDGE | COMPUTER PROGRAMS AND PROGRAMMING | SELF ESTEEM | RISK BEHAVIOR | PARTNER COMMUNICATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Developed Countries | North America | Americas | Evaluation | Research Methodology | Surveys | Sampling Studies | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Education | Sociocultural Factors | Information Processing | Information | Psychological Factors | Interpersonal Relations Document Number: 325287 |
| 8. Peer Reviewed Title: Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana. Author: Fiscian VS; Obeng EK; Goldstein K; Shea JA; Turner BJ Source: AIDS Education and Prevention. 2009 Feb;21(1):67-79. Abstract: We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection. Language: English Keywords: UNITED STATES OF AMERICA | GHANA | EVALUATION REPORT | THEORETICAL MODELS | ADOLESCENTS, FEMALE | SUGAR DADDIES | SEX WORKERS | FAITH-BASED ORGANIZATION | HEALTH EDUCATION | SEX EDUCATION | HIV PREVENTION | CULTURE | COMPUTER PROGRAMS AND PROGRAMMING | ABSTINENCE | BEHAVIOR CHANGE COMMUNICATION | Developed Countries | North America | Americas | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Organizations | Political Factors | Sociocultural Factors | Education | HIV Infections | Viral Diseases | Diseases | Information Processing | Information | Family Planning, Behavioral Methods | Family Planning | Communication Programs | Communication | Behavior Change Document Number: 331081 |
| 9. Peer Reviewed Title: Successful integration of tuberculosis and HIV treatment in rural South Africa: the Sizonq'oba study. Author: Gandhi NR; Moll AP; Lalloo U; Pawinski R; Zeller K; Moodley P; Meyer E; Friedland G Author: Tugela Ferry Care and Research (TFCaRes) Collaboration Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Jan 1;50(1):37-43. Abstract: BACKGROUND: Tuberculosis (TB) is the leading cause of death among HIV-infected patients worldwide. In KwaZulu-Natal, South Africa, 80% of TB patients are HIV coinfected, with high treatment default and mortality rates. Integrating TB and HIV care may be an effective strategy for improving outcomes for both diseases. METHODS: Prospective operational research study treating TB/HIV-coinfected patients in rural KwaZulu-Natal with once-daily antiretroviral (ARV) therapy concurrently with TB therapy by home-based, modified directly observed therapy. Patients were followed for 12 months after ARV initiation. RESULTS: Of 119 TB/HIV-coinfected patients enrolled, 67 (56%) were female, mean age was 34.0 years, and median CD4 count was 78.5 cells per cubic millimeter. After 12 months on ARVs, mean CD4 count increase was 211 cells per cubic millimeter, and 88% had an undetectable viral load; 84% completed TB treatment. Thirteen patients (11%) died; 10 (77%) with multidrug-resistant or extensively drug-resistant TB. There were few severe adverse events or immune reconstitution events. Adherence was high with 93% of study visits attended and 99% of ARV doses taken. CONCLUSIONS: Integration of TB and HIV treatment in a rural setting using concurrent home-based therapy resulted in excellent adherence and TB and HIV outcomes. This model may result in successful management of both diseases in other rural resource-poor settings. Language: English Keywords: SOUTH AFRICA | EVALUATION REPORT | PROSPECTIVE STUDIES | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RURAL POPULATION | INTEGRATED PROGRAMS | TUBERCULOSIS | AIDS PREVENTION | TREATMENT | RURAL HEALTH SERVICES | COMPLICATIONS | ANTIRETROVIRAL THERAPY | HOME VISITS | DRUG RESISTANCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Infections | AIDS | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Communication Document Number: 330981 |
| 10. Peer Reviewed Title: Emergency obstetric care and referral: experience of two midwife-led health centres in rural Rajasthan, India. Author: Iyengar K; Iyengar SD Source: Reproductive Health Matters. 2009 May;17(33):9-20. Abstract: This paper documents the experience of two health centres in a primary health service located in interior rural areas of southern Rajasthan, northern India, where trained nurse-midwives are providing skilled maternal and newborn care round the clock daily. The nurse-midwives independently detect and manage complications and decide when to refer women to the nearest hospital for emergency care, in telephonic consultation with a doctor if required. From 2000-2008, 2,771 women in labour and 202 women with maternal emergencies who were not in labour were attended by nurse-midwives. Of women in labour, 21% had a life-threatening complication or its antecedent condition and 16% were advised referral, of which two-thirds complied. Compliance with referral was higher for maternal conditions than fetal conditions. Among the 202 women who came with complications antenatally, post-abortion or post-partum, referral was advised for 70%, of whom 72% complied. The referral system included counselling, arranging transport, accompanying women, facilitating admission and supporting inpatient care, and led to higher referral compliance rates. There was only one maternal death in nine years. We conclude that trained nurse-midwives can significantly improve access to skilled maternal and neonatal care in rural areas, and manage maternal complications with and without the need for referral. Protocols must acknowledge that some families might not comply with referral advice, and also that initial care by nurse-midwives can reverse progression of certain complications and thereby avert the need for referral. Spanish Abstract: Este artículo documenta la experiencia de dos centros de salud de primer nivel situados en zonas rurales del interior de Rajasthan meridional, en la India septentrional, donde enfermeras-parteras profesionales capacitadas brindan atención calificada a madres y recién nacidos las 24 horas del día. Independientemente, ellas detectan y manejan complicaciones y deciden cuándo remitir a las mujeres al hospital más cercano para que reciban atención de urgencia, en consulta telefónica con un médico si es necesario. Desde 2000 a 2008, 2,771 mujeres en trabajo de parto y 202 con urgencias maternas, que no estaban de parto, fueron atendidas por enfermeras-parteras profesionales. De las que estaban de parto, el 21% presentó una complicación que puso en riesgo su vida, o su afección antecedente, y el 16% fueron aconsejadas referencia y, de éstas, dos terceras partes accedieron. El cumplimiento de la referencia fue más alto para las afecciones maternas que para las fetales. Entre las 202 mujeres que llegaron con complicaciones antenatales, se aconsejó referencia postaborto o posparto al 70%, de las cuales el 72% accedieron. El sistema de referencia incluyó consejería, planes de transporte, acompañar a las mujeres, facilitar admisión y atención con apoyo a las pacientes internadas, por lo cual aumentaron las tasas de cumplimiento de referencias. En nueve años hubo una sola muerte materna. Concluimos que las enfermeras-parteras profesionales capacitadas pueden mejorar considerablemente el acceso a la atención materna y neonatal calificada en zonas rurales, y manejar las complicaciones maternas con o sin la necesidad de referencias. Los protocolos deben reconocer la posibilidad de que algunas familias no sigan el consejo de referencia, y que la atención inicial brindada por enfermeras-parteras profesionales puede detener la evolución de algunas complicaciones y evitar la necesidad de referencia. French Abstract: Dans deux centres de santé d’un service de soins de santé primaires situé dans des zones rurales de l’intérieur du Rajasthan méridional, en Inde septentrionale, des infirmières sages-femmes formées assurent des soins de la mère et du nouveau-né tous les jours, 24 heures sur 24. Les infirmières sages-femmes décèlent et prennent en charge indépendamment les complications et décident quand transférer les femmes à l’hôpital le plus proche pour des soins d’urgence, si nécessaire en consultation téléphonique avec un médecin. De 2000 à 2008, les infirmières sages-femmes se sont occupées de 2771 femmes en couches et de 202 femmes avec d’autres urgences maternelles. Sur les femmes en couches, 21% présentaient une complication pouvant entraîner la mort ou son stade précédent ; et 16% se sont vu conseiller un transfert et les trois quarts l’ont accepté. L’acceptation du transfert était plus élevée pour les problèmes maternels que fœtaux. Un transfert a été conseillé à 70% des 202 femmes présentant des complications prénatales, post-avortement ou post-partum, et 72% d’entre elles l’ont accepté. Le système de transfert comprenait des conseils, l’organisation du transport, l’accompagnement des patientes, l’aide à l’admission et aux soins hospitaliers ; il a accru les taux d’acceptation du transfert. Un seul décès maternel a été enregistré en neuf ans. Nous en concluons que, dans les zones rurales, les infirmières sages-femmes formées peuvent notablement élargir l’accès à des soins maternels et néonatals compétents, et prendre en charge les complications maternelles nécessitant ou non un transfert. Les protocoles doivent reconnaître qu’il arrive que des familles ne suivent pas les recommandations de transfert et aussi que les soins donnés initialement par des infirmières sages-femmes peuvent régler certaines complications et éviter la nécessité d’un transfert de la patiente. Language: English Keywords: INDIA | EVALUATION REPORT | NURSE-MIDWIVES | EMERGENCY SERVICES | OBSTETRICS | PRIMARY HEALTH CARE | REFERRAL AND CONSULTATION | RURAL HEALTH CENTERS | MATERNAL-CHILD HEALTH SERVICES | PROGRAM ACCESSIBILITY | PREGNANCY COMPLICATIONS | COUNSELING | Asia, Southern | Asia | Developing Countries | Evaluation | Health Personnel | Delivery of Health Care | Health | Health Services | Medicine | Program Activities | Programs | Organization and Administration | Health Facilities | Program Evaluation | Diseases | Clinic Activities Document Number: 342011 |
| 11. Peer Reviewed Title: The Pediatric AIDS Corps: responding to the African HIV/AIDS health professional resource crisis. Author: Kline MW; Ferris MG; Jones DC; Calles NR; Mizwa MB; Schwarzwald HL Source: Pediatrics. 2009 Jan;123(1):134-6. Abstract: Health professional capacity for delivery of HIV/AIDS care and treatment is severely constrained across sub-Saharan Africa. African health professional expertise in pediatrics is in particularly short supply. Here we describe a Pediatric AIDS Corps program that was designed to place pediatricians and other physicians in Africa on a long-term basis to expand existing health professional capacity for pediatric and family HIV/AIDS care and treatment. In the first 2 years of this program, 76 physicians were placed in 5 African countries that have been hit hard by HIV/AIDS. Enrollment of HIV-infected children in care more than quadrupled over a 24-month period, to 26 590. We believe that this pilot program can serve as a model for larger-scale efforts to immediately expand access for African children and families to life-saving HIV/AIDS care and treatment. Language: English Keywords: AFRICA, SUB SAHARAN | EVALUATION REPORT | RECOMMENDATIONS | PILOT PROJECTS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | PHYSICIANS | HUMAN RESOURCES | CAPACITY BUILDING | HIV INFECTIONS | TREATMENT | PROGRAM DESIGN | TRAINING PROGRAMS | PROGRAM ACCESSIBILITY | DELIVERY OF HEALTH CARE | Africa | Developing Countries | Evaluation | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Health Personnel | Health | Economic Factors | Program Sustainability | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Education | Program Evaluation Document Number: 328038 |
| 12. Peer Reviewed Title: Directing diarrhoeal disease research towards disease-burden reduction. Author: Kosek M; Lanata CF; Black RE; Walker DG; Snyder JD; Salam MA; Mahalanabis D; Fontaine O; Bhutta ZA; Bhatnagar S; Rudan I Source: Journal of Health, Population, and Nutrition. 2009 Jun;27(3):319-31. Abstract: Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research questions; the efficacy and effectiveness of the intervention resulting from the research; the maximal potential for disease-burden reduction of the interventions derived from the research; the affordability, deliverability, and sustainability of the intervention supported by the research; and the overall effect of the research-derived intervention on equity. Experts scored each research option independently to delineate the best investments for diarrhoeal disease control in the developing world to reduce the burden of disease by 2015. Priority scores obtained for health policy and systems research obtained eight of the top 10 rankings in overall scores, indicating that current investments in health research are significantly different from those estimated to be the most effective in reducing the global burden of diarrhoeal disease by 2015. Language: English Keywords: DEVELOPING COUNTRIES | EVALUATION REPORT | RESEARCH ACTIVITIES | DIARRHEA | PREVENTION AND CONTROL | INTERVENTIONS | PROGRAM EFFECTIVENESS | PROGRAM SUSTAINABILITY | CHILD HEALTH | GOALS | DELIVERY OF HEALTH CARE | COST EFFECTIVENESS | Evaluation | Research Methodology | Diseases | Programs | Organization and Administration | Program Evaluation | Health | Planning | Evaluation Indexes | Quantitative Evaluation Document Number: 341924 |
| 13. Peer Reviewed Title: Peer-group support intervention improves the psychosocial well-being of AIDS orphans: cluster randomized trial. Author: Kumakech E; Cantor-Graae E; Maling S; Bajunirwe F Source: Social Science and Medicine. 2009 Mar;68(6):1038-43. Abstract: Accumulating evidence suggests that AIDS orphanhood status is accompanied by increased levels of psychological distress such as anxiety, depression, intense guilt, shame, and anger. However, few studies have examined the possible reduction of psychological distress in AIDS orphans through the help of interventions that promote well-being. The objective of the study was to evaluate the effects of a school-based peer-group support intervention combined with periodic somatic health assessments and treatment on the psychosocial well-being of AIDS orphans in the Mbarara District of southwestern Uganda. In a cluster randomized controlled design, 326 AIDS orphans aged 10-15 years were assigned to either peer-group support intervention combined with monthly somatic healthcare (n=159) or control group (n=167) for follow-up assessment. Baseline and 10 week follow-up psychological assessments were conducted in both groups using self-administered Beck Youth Inventories. Complete data were available for 298 orphans. After adjusting for baseline scores, follow-up scores for the intervention group in comparison with controls showed significant improvement in depression, anger, and anxiety but not for self-concept. This study demonstrated that peer-group support intervention decreased psychological distress, particularly symptoms of depression, anxiety and anger. Thus, the use of peer-group support interventions should be incorporated into existing school health programs. Language: English Keywords: UGANDA | EVALUATION REPORT | KAP SURVEYS | CASE CONTROL STUDIES | ORPHANS AND VULNERABLE CHILDREN | PEER GROUPS | SUPPORT GROUPS | PERSONS LIVING WITH HIV/AIDS | PSYCHOSOCIAL FACTORS | AIDS | STRESS | DEPRESSION | ANXIETY DISORDERS | SELF ESTEEM | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Knowledge Sources | Communication | Social Networks | Friends and Relatives | HIV Infections | Viral Diseases | Diseases | Behavior | Psychological Factors | Mental Disorders Document Number: 341167 |
| 14. Peer Reviewed Title: Early assessment of the implementation of a national programme for the prevention of mother-to-child transmission of HIV in Cameroon and the effects of staff training: a survey in 70 rural health care facilities. Author: Labhardt ND; Manga E; Ndam M; Balo JR; Bischoff A; Stoll B Source: Tropical Medicine and International Health. 2009 Mar;14(3):288-93. Abstract: OBJECTIVES: To assess the availability of equipment and the staff's knowledge to prevent Mother-To-Child Transmission (PMTCT) in rural healthcare facilities recently covered by the national PMTCT programme in Cameroon. METHODS: In eight districts inventories of antiviral drugs and HIV test kits were made on site, using a standardised check-list. Knowledge of HIV and PMTCT was evaluated with a multiple-choice (MC) questionnaire based on typical clinical PMTCT cases. Staff participated subsequently in a 2-day training on HIV/AIDS and the Cameroon PMTCT guidelines. Immediately after training and after 7 months, retention of knowledge was tested with the same questions but in different order and layout. RESULTS: Sixty two peripheral nurse-led clinics and the eight district hospitals were assessed. Whereas all district hospitals presented complete equipment, only six of the peripheral clinics (10%) were equipped with both complete testing materials and a full set of drugs to provide PMTCT. Thirty six peripheral facilities (58%) possessed full equipment for HIV-testing and 8 (13%) stocked all PMTCT drugs. Of 137 nurses, 102 (74%) agreed to the two knowledge tests. Fewer than 66% knew that HIV-diagnosis requires positive results in two different types of rapid tests and only 19% chose the right recommendation on infant-feeding for HIV-positive mothers. Correct answers on drug regimens in different PMTCT settings varied from 25% to 56%. All percentages of correct answers improved greatly with training (P < 0.001) and retention remained high 7 months after training (P < 0.001). CONCLUSIONS: Prevent Mother-To-Child Transmission programmes in settings such as rural Cameroon need to be adapted to the special needs of peripheral nurse-led clinics. Appropriate short training may considerably improve nurses' competence in PMTCT. Other important components are regular supervision and measures to guarantee supply of equipment in rural areas. Language: English Keywords: CAMEROON | EVALUATION REPORT | KAP SURVEYS | HEALTH PERSONNEL | INFANT | GOVERNMENT PROGRAMS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | TRAINING PROGRAMS | RURAL HEALTH SERVICES | KNOWLEDGE | HIV TESTING | ANTIRETROVIRAL DRUGS | EQUIPMENT AND SUPPLIES | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | HIV Infections | Viral Diseases | Education | Health Services | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Treatment Document Number: 330960 |
| 15. Peer Reviewed Title: Challenges for routine health system data management in a large public programme to prevent mother-to-child HIV transmission in South Africa. Author: Mate KS; Bennett B; Mphatswe W; Barker P; Rollins N Source: PloS One. 2009;4(5):e5483. Abstract: BACKGROUND: Recent changes to South Africa's prevention of mother-to-child transmission of HIV (PMTCT) guidelines have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. While programmatic efforts to reach this target are underway, obtaining complete and accurate data from clinical sites to track progress presents a major challenge. We assessed the completeness and accuracy of routine PMTCT data submitted to the district health information system (DHIS) in three districts of Kwazulu-Natal province, South Africa. METHODOLOGY/PRINCIPAL FINDINGS: We surveyed the completeness and accuracy of data reported for six key PMTCT data elements between January and December 2007 from all 316 clinics and hospitals in three districts. Through visits to randomly selected sites, we reconstructed reports for the same six PMTCT data elements from clinic registers and assessed accuracy of the monthly reports previously submitted to the DHIS. Data elements were reported only 50.3% of the time and were "accurate" (i.e. within 10% of reconstructed values) 12.8% of the time. The data element "Antenatal Clients Tested for HIV" was the most accurate data element (i.e. consistent with the reconstructed value) 19.8% of the time, while "HIV PCR testing of baby born to HIV positive mother" was the least accurate with only 5.3% of clinics meeting the definition of accuracy. CONCLUSIONS/SIGNIFICANCE: Data collected and reported in the public health system across three large, high HIV-prevalence Districts was neither complete nor accurate enough to track process performance or outcomes for PMTCT care. Systematic data evaluation can determine the magnitude of the data reporting failure and guide site-specific improvements in data management. Solutions are currently being developed and tested to improve data quality. Language: English Keywords: SOUTH AFRICA | EVALUATION REPORT | DATA ANALYSIS | SAMPLING STUDIES | GOVERNMENT PROGRAMS | HIV INFECTIONS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV TESTING | ANTIRETROVIRAL THERAPY | HEALTH FACILITIES | INFORMATION RETRIEVAL SYSTEMS | RELIABILITY | DATA REPORTING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Research Methodology | Studies | Programs | Organization and Administration | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Data Storage and Retrieval | Information Processing | Information | Measurement | Data Collection Document Number: 342171 |
| 16. Title: Alleviating the burden of responsibility: report on a study of men as providers of community-based HIV/AIDS care and support in Lesotho. Author: Newman C; Makoae N; Reavely E; Fogarty L Source: Chapel Hill, North Carolina, IntraHealth International, Capacity Project, 2009 Jan. 101 p. Abstract: This study demonstrates a range of perspectives about gender and HIV/AIDS care from those participating in and potentially affected by health care initiatives, and makes recommendations for increasing the number of male community-based providers of HIV/AIDS care. The objectives of the study were as follows: 1. Determine the need to bring men into community-based HIV/AIDS care and Support; 2. Determine the feasibility of engaging men as providers of community-based HIV/AIDS care and support, especially the gender-related and cultural factors that need to be addressed to increase male involvement in community-based care, based on an analysis of gender relations in Lesotho; 3. Identify factors that facilitate or hinder substantive and sustained male involvement in community-based HIV/AIDS care and support; and 4. Make recommendations for feasible gender-redistributive recruitment, training, support or retention strategies to increase the number of male communitybased providers of HIV/AIDS care and support in Lesotho. Language: English Keywords: LESOTHO | EVALUATION REPORT | KAP SURVEYS | MEN | HEALTH PERSONNEL | LABOR FORCE | COMMUNITY WORKERS | HIV INFECTIONS | COMMUNITY HEALTH SERVICES | CAPACITY BUILDING | GENDER ISSUES | SEX DISCRIMINATION | NEEDS ASSESSMENT | MEN'S INVOLVEMENT | TRADITIONAL HEALTH PRACTICES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Delivery of Health Care | Health | Human Resources | Economic Factors | Viral Diseases | Diseases | Primary Health Care | Health Services | Program Sustainability | Programs | Organization and Administration | Sociocultural Factors | Social Discrimination | Social Problems | Culture Document Number: 325235 |
| 17. Title: Management capacity assessment for national health programs: a study of RCH program in India. Author: Ramani KV; Mavalankar D Source: Journal of Health Organization and Management. 2009;23(1):133-42. Abstract: PURPOSE: This paper aims to focus on the management capacity assessment of the Reproductive and Child Health (RCH) program at the state level. DESIGN/METHODOLOGY/APPROACH: Based on an extensive literature survey, and discussions with senior officers in charge of RCH program at the central and state level, the authors have developed a conceptual framework for management capacity assessment. Central to their framework are a few determinants of management capacity, a set of indicators to estimate these determinants, and a management capacity assessment tool to be administered by each state. A pilot survey of the management tool in a few states helped the authors to refine each instrument and finalize the same. A suitable management structure is suggested for effective management of the RCH program based on the population in each state. FINDINGS: The assessment brought out the need to strengthen the planning and monitoring of RCH activities, HR management practices, and inter-departmental coordination. PRACTICAL IMPLICATIONS: The Ministry of Health and Family Welfare, Government of India has accepted the management tool and asked each state to administer it. The recommended management structure is used as a guideline by each state to identify the capacity gaps and take necessary steps to augment its management capacity. ORIGINALITY/VALUE: The authors' framework to assess the management capacity of RCH program is very comprehensive, the management tool is easy to administer, and assessment of capacity gaps can be made quickly. Language: English Keywords: INDIA | EVALUATION REPORT | MATERNAL-CHILD HEALTH SERVICES | FAMILY PLANNING PROGRAMS | GOVERNMENT PROGRAMS | HEALTH SERVICES ADMINISTRATION | CAPACITY BUILDING | MONITORING | PLANNING | IMPLEMENTATION | Asia, Southern | Asia | Developing Countries | Evaluation | Primary Health Care | Health Services | Delivery of Health Care | Health | Family Planning | Programs | Organization and Administration | Management | Program Sustainability Document Number: 341808 |
| 18. Peer Reviewed Title: Study of blood-transfusion services in Maharashtra and Gujarat States, India. Author: Ramani KV; Mavalankar DV; Govil D Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):259-70. Abstract: Blood-transfusion services are vital to maternal health because haemorrhage and anaemia are major causes of maternal death in South Asia. Unfortunately, due to continued governmental negligence, blood-transfusion services in India are a highly-fragmented mix of competing independent and hospital-based blood-banks, serving the needs of urban populations. This paper aims to understand the existing systems of blood-transfusion services in India focusing on Maharashtra and Gujarat states. A mix of methodologies, including literature review (including government documents), analysis of management information system data, and interviews with key officials was used. Results of analysis showed that there are many managerial challenges in blood-transfusion services, which calls for strengthening the planning and monitoring of these services. Maharashtra provides a good model for improvement. Unless this is done, access to blood in rural areas may remain poor. Language: English Keywords: INDIA | EVALUATION REPORT | BLOOD TRANSFUSION | EMERGENCY SERVICES | MATERNAL MORTALITY | BLOOD SUPPLY | SAFETY | HEALTH SERVICES ADMINISTRATION | ORGANIZATION AND ADMINISTRATION | BLOOD DONORS | MONITORING | TRAINING PROGRAMS | Asia, Southern | Asia | Developing Countries | Evaluation | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population | Equipment and Supplies | Public Health | Management | Education Document Number: 341930 |
| 19. Title: Making the case for U.S. international family planning assistance. Author: Speidel JJ; Sinding S; Gillespie D; Maguire E; Neuse M Source: [Chapel Hill, North Carolina, Ipas], 2009 Jan. 15 p. (Report) Abstract: This report documents the urgent need for greater U.S. assistance to family planning programs in the developing world and recommends targeted investment in such programs, primarily through the U.S. Agency for International Development. Five former directors of the Population and Reproductive Health Program of the United States Agency for International Development (USAID) issue a call for renewed U.S. political and financial commitment to international family planning programs. USAID has been the largest donor to international population and family planning efforts and a transformative source of leadership and innovation in the field. Its professional staff and technical resources are unparalleled among donor agencies. However, its funding peaked in 1995 and has declined in real terms ever since, even as the worldwide demand for family planning and other reproductive health services has grown. As a result, many successful programs in developing countries have stagnated and global fertility decline has slowed. At the beginning of a new administration and a new Congress, it is time to reverse the decline in U.S. political and financial commitment to this field of signature U.S. leadership and accomplishment, to satisfy the unmet need for services, and to improve women's reproductive health worldwide. We estimate that USAID's population budget should be increased to $1.2 billion. (Excerpts) Language: English Keywords: UNITED STATES OF AMERICA | DEVELOPING COUNTRIES | RECOMMENDATIONS | EVALUATION REPORT | EVALUATION | POLICYMAKERS | FAMILY PLANNING | FOREIGN AID | USAID | REPRODUCTIVE HEALTH | FAMILY PLANNING POLICY | POPULATION POLICY | GOVERNMENT PROGRAMS | GOVERNMENT FINANCING | Developed Countries | North America | Americas | Administrative Personnel | Organization and Administration | Financial Activities | Economic Factors | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Health | Social Policy | Policy | Programs Document Number: 331360 |
| 20. Peer Reviewed Title: Validation of an Integrated Management of Childhood Illness algorithm for managing common skin conditions in Fiji. Author: Steer AC; Tikoduadua LV; Manalac EM; Colquhoun S; Carapetis JR; Maclennan C Source: Bulletin of the World Health Organization. 2009 Mar;87(3):173-9. Abstract: OBJECTIVE: To assess the sensitivity of an Integrated Management of Childhood Illness (IMCI) algorithm to detect common skin conditions in children in Fiji. METHODS: We collected data from the assessments of children aged between 2 months and 5 years who presented to one of two health clinics. Every child was assessed by a nurse trained in the use of the IMCI algorithm and also an expert paediatrician. We used a kappa statistic to measure agreement between the nurse/algorithm assessment method and the paediatrician's diagnosis. FINDINGS: High sensitivity for identifying skin problems (sensitivity: 98.7%; 95% confidence interval, CI: 95.5-99.9) was found for the algorithm applied by IMCI-trained nurses, who were able to identify the one child with a severe skin infection and all three children with periorbital cellulitis. Sensitivity was high for the classification of abscess/cellulitis (sensitivity: 95%; 95% CI: 75.1-99.9) and infected scabies (sensitivity: 89.1%; 95% CI: 77.8-95.9), but lower for identification of impetigo, fungal infection and, in particular, non-infected scabies. CONCLUSION: The IMCI skin algorithm is a robust tool that should be incorporated into the IMCI after some modifications relating to scabies and impetigo. Its use by primary health-care workers will reduce the burden of skin diseases in children in Fiji through improved case identification and management. The algorithm should be considered in other countries where skin diseases in children are a priority, particularly in the Pacific region. Language: English Keywords: FIJI | EVALUATION REPORT | NURSES AND NURSING | PHYSICIANS | DERMATOLOGICAL EFFECTS | CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | SIGNS AND SYMPTOMS | PHYSICAL EXAMINATIONS AND DIAGNOSES | TREATMENT | TRAINING ACTIVITIES | Developing Countries | Oceania | Evaluation | Health Personnel | Delivery of Health Care | Health | Physiology | Biology | Maternal-Child Health Services | Primary Health Care | Health Services | Programs | Organization and Administration | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Training Programs | Education Document Number: 342353 |
| 21. Peer Reviewed Title: Addressing social factors of adolescent reproductive health in the Republic of Georgia. Author: Tavadze M; Bartel D; Rubardt M Source: Global Public Health. 2009;4(3):242-52. Abstract: The influence of social factors on reproductive health has been highlighted by researchers in the last decade, yet programmes to improve adolescent reproductive health (ARH) rarely address social factors such as gender discrimination. Beginning in 2004, CARE International implemented and evaluated a three-year ARH project to address individual behaviour change, institutional capacity and local social norms related to ARH in a rural district of the Republic of Georgia. Community engagement strategies included: promoting community support for ARH by adolescent/adult volunteer change agents; building health providers' capacity to better meet the needs of adolescents; and using 'Theatre for Development' to promote community dialogue about social norms. Project evaluation data demonstrated improved knowledge, attitudes, behaviour about family planning, improved institutional capacity to provide adolescent services and some evidence of shifts in gender norms. Community engagement is critical for successful strategies to influence social norms that promote healthy reproductive health. Language: English Keywords: GEORGIA | EVALUATION REPORT | RURAL POPULATION | ADOLESCENT HEALTH SERVICES | REPRODUCTIVE HEALTH | SOCIOCULTURAL FACTORS | VIOLENCE AGAINST WOMEN | COMMUNITY PARTICIPATION | CONTRACEPTION | INTERVENTIONS | BEHAVIOR CHANGE | Developing Countries | Asia, Southwestern | Asia | Evaluation | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Domestic Violence | Crime | Social Problems | Organization and Administration | Family Planning | Programs | Behavior Document Number: 341395 |
| 22. Peer Reviewed Title: Intervention to train physicians in rural China on HIV/STI knowledge and risk reduction counseling: preliminary findings. Author: Wang D; Operario D; Hong Q; Zhang H; Coates TJ Source: AIDS Care. 2009 Apr;21(4):468-72. Abstract: We evaluated an intervention to train physicians in rural China on knowledge of HIV/STI prevention, diagnosis, treatment options, and HIV/STI behavioral risk reduction counseling. This paper reports preliminary findings related to feasibility and acceptability of the program. Using a pre-post design, 69 physicians were recruited from rural county hospitals and participated in a 10-day group training program, followed by two months of clinical fieldwork and two additional weeks of training. Physicians completed baseline and six-month assessments. Patients' cohorts, recruited from clinic waiting areas of participating physicians, completed baseline and six-month HIV/STI risk assessments. Physicians reported increased knowledge of HIV biology and pathology, epidemiology, host immune response, opportunisitic infection and syndromic management, antiretroviral therapy, risk reduction counseling, and stigma reduction following the training. Patients reported improved knowledge of HIV, reduced HIV stigma, higher rates of HIV testing, and improved condom use at follow-up. The findings suggest that training physicians on HIV/STI-related knowledge and risk reduction counseling is a promising strategy for reducing HIV/STI epidemics in rural China. Language: English Keywords: CHINA | RURAL AREAS | EVALUATION REPORT | PROVIDERS WITH CLIENTS | PHYSICIANS | TRAINING PROGRAMS | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | KNOWLEDGE | RISK REDUCTION BEHAVIOR | COUNSELING | PROGRAM ACCEPTABILITY | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Evaluation | Health Services | Delivery of Health Care | Health | Health Personnel | Education | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration | Program Evaluation Document Number: 341835 |
| 23. Title: A multi-tiered approach to meeting family planning needs of the poor in Peru. Author: Constella Futures. Health Policy Initiative Source: Washington, D.C., Health Policy Initiative, Futures Group International, 2008 Apr. 4 p. (USAID Contract No. GPO-I-01-05-00040-00) Abstract: More than half of Peru's population lives in poverty, with significant disparities evident between urban and rural areas and between indigenous and non-indigenous populations. Disparities in access to health services among income groups, and ethnic groups are found in family planning (FP) use as well. The USAID | Health Policy Initiative identified barriers that restrict poor women's access to and use of FP services, and then designed interventions to address barriers related to existing financing mechanisms. This brief summarizes a full report on the approach applied in Peru. Language: English Keywords: PERU | EVALUATION REPORT | EVALUATION | LOW INCOME POPULATION | GOVERNMENT AGENCIES | GOVERNMENT FINANCING | CONTRACEPTIVE DISTRIBUTION | FAMILY PLANNING PROGRAM EVALUATION | NATIONAL HEALTH SERVICES | REPRODUCTIVE HEALTH | PERFORMANCE IMPROVEMENT | INTEGRATED PROGRAMS | HEALTH INSURANCE | FAMILY PLANNING POLICY | South America, Western | South America | Latin America | Americas | Developing Countries | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Organizations | Political Factors | Sociocultural Factors | Financial Activities | Distributional Activities | Program Activities | Programs | Organization and Administration | Family Planning Programs | Family Planning | Health Services | Delivery of Health Care | Health | Management | Population Policy | Social Policy | Policy Document Number: 308946 |
| 24. Title: AWARENESS Project. Introducing the Standard Days Method into public sector services in Peru. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [24] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: After seeing the yet-unpublished results of the Standard Days Method® (SDM) efficacy trial, Peruvian Ministry of Health (MOH) decision-makers expressed interest in adding the method to their regular family planning (FP) services. A three-year pilot introduction project was carried out, designed to develop and test a service delivery model appropriate for the local context and for replication elsewhere in the country. A study component was superimposed on the pilot project to answer key questions the MOH had regarding the SDM's performance in non-study circumstances: 1) if there would be enough demand for the method, 2) whether the SDM would siphon clients from other methods, 3) if pregnancy rates would be in the range of those seen in the efficacy trial, and 4) whether offering and providing the SDM would represent an excessive burden to FP providers. The SDM was offered and provided to clients at MOH facilities in the Department of San Martín, initially in two provinces, then expanded to most of the department. A cross sectional survey of SDM clients was conducted 18 months after the method became available. Some 1200 women were contacted and interviewed (of 1254 reported as SDM users at the time the interviews were conducted). On average, they had received counseling in the SDM 10 months before. Although the project had initially been planned for two years, at the request of the local MOH, it was extended for another 12 months. At the end of the project SDM services were available at over 300 facilities throughout the department, offered by over 700 trained providers (most of whom were trained by the MOH using their own personnel and resources). (excerpt) Language: English Keywords: PERU | EVALUATION REPORT | PILOT PROJECTS | COMPARATIVE STUDIES | GOVERNMENT AGENCIES | WOMEN IN DEVELOPMENT | DELIVERY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | FERTILITY AWARENESS | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE EFFECTIVENESS | FAMILY PLANNING EDUCATION | South America, Western | South America | Latin America | Americas | Developing Countries | Evaluation | Studies | Research Methodology | Organizations | Political Factors | Sociocultural Factors | Economic Development | Economic Factors | Health | Health Services | Family Planning | Contraceptive Usage | Contraception | Education Document Number: 327644 |
| 25. Title: Integrating the Standard Days Method into Ranchi district, Jharkhand: Key findings from household surveys. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [71] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: The Standard Days Method® (SDM) is a fertility awareness-based method developed and tested by the Institute for Reproductive Health at Georgetown University (IRH). The SDM was integrated into family planning programs in two blocks of Ranchi District in Jharkhand as part of a study of the effect SDM integration has on the quality and use of family planning services. This study was conducted by Krishi Gram Vikas Kendra (KGVK) in collaboration with the Ministry of Health and Family Welfare (MOH/FW) of Jharkhand, with technical assistance from CEDPA and IRH. Before incorporating the SDM into family planning programs in Ranchi, a baseline survey was conducted in three blocks (Kanke, Ormanjhi and Burmu). The Burmu block served as the control area and did not include SDM integration, while the SDM was introduced in the Kanke block and scaled up in Ormanjhi. Approximately two years after the baseline survey, an endline survey was conducted to assess the impact of SDM integration. Both the baseline and endline surveys used two-stage sampling. In the first stage, villages were selected from each block and then a selection of households from these villages was chosen. All villages included in the baseline survey were also included in the endline survey.. In total, 44, 49 and 68 villages (including hamlets) were selected from Burmu, Ormanjhi and Kanke blocks, respectively. Systematic random sampling was used to determine the required number of households (from the list of all existing households) included from each of the selected villages. In each of the three blocks, 600 women were selected randomly for the sample. Respondents were currently married women between 15-49 years of age. Two approaches were utilized to study the effect of including the SDM in family planning programs. The first approach assessed the effect (via endline survey results) in experimental blocks (Ormanjhi and Kanke) compared to the control block (Burmu). The second compared the key findings at endline with those of the baseline survey. This summary primarily describes the results from the endline survey; however, statistically significant differences between the baseline and endline surveys are mentioned. (excerpt) Language: English Keywords: SOUTH AFRICA | EVALUATION REPORT | PILOT PROJECTS | SURVEYS | GOVERNMENT AGENCIES | WOMEN IN DEVELOPMENT | DELIVERY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | FERTILITY AWARENESS | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE EFFECTIVENESS | FAMILY PLANNING EDUCATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Studies | Research Methodology | Sampling Studies | Organizations | Political Factors | Sociocultural Factors | Economic Development | Economic Factors | Health | Health Services | Family Planning | Contraceptive Usage | Contraception | Education Document Number: 327649 |
| 26. Title: Social marketing final report: three country overview. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Mar. [40] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: While unmet need is growing in sub-Saharan Africa, where contraceptive prevalence is lowest, unmet need remains even in countries where contraceptive prevalence is high, such as in Latin America. Due to rapid growth in the population and increase in the numbers of couples interested in planning and spacing births, reproductive health programs in developing countries face a major challenge: to provide a greater variety of products and services to a rapidly increasing number of users. This challenge must be met in the context of stagnant or decreasing donor funding for contraception. Thus, efforts to meet this unmet need must involve cost-effectively expanding options and access to couples. Social marketing concepts have been successfully applied to increase access and use of many modern contraceptives. The present study was conducted to research the potential of socially-marketing the Standard Days Method® (SDM) in three countries: Ecuador, Benin and the Democratic Republic of the Congo (DRC). The impact of mass media campaigns on knowledge, sales and distribution of the SDM, quality of information provided by pharmacists and providers, and correct use by pharmacy and clinic SDM users was assessed. The aim of the study was to answer the following research questions: What is the impact of a mass media campaign on knowledge, attitudes, sales and free distribution of the SDM?; Can pharmacists and health providers provide high quality information about the SDM?; How do characteristics of women who purchase the SDM from pharmacies compare with those obtain it at a lower or no cost from a clinic?; Can women who purchase the SDM from a pharmacy use the method correctly? (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | LATIN AMERICA | EVALUATION REPORT | CROSS-CULTURAL COMPARISONS | KAP SURVEYS | WOMEN IN DEVELOPMENT | SOCIAL MARKETING | FERTILITY AWARENESS | COST EFFECTIVENESS | MASS MEDIA | FAMILY PLANNING EDUCATION | PHARMACY DISTRIBUTION | CLINICAL DISTRIBUTION | CONTRACEPTIVE EFFECTIVENESS | Africa | Developing Countries | Americas | Evaluation | Comparative Studies | Studies | Research Methodology | Surveys | Sampling Studies | Economic Development | Economic Factors | Marketing | Family Planning | Evaluation Indexes | Quantitative Evaluation | Communication | Education | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception Document Number: 327650 |
| 27. Title: Service delivery-based training for long-acting family planning methods: client / provider satisfaction assessment. Author: Pathfinder International Source: [Addis Ababa], Ethiopia, Pathfinder International, 2008 Jan. 6 p. (Pathfinder No. 4) Abstract: In 2007, the RH/FP Project surveyed current LAFP users, LAFP discontinuers, CBRHAs who refer potential clients, health care providers who deliver LAFPs, and managers of those facilities where such services are provided. The survey sought to understand the quality of care issues surrounding the use and delivery of LAFP. A total of 806 current users, (795 implant and 11 IUCD), were selected from the regions of Oromiya, Amhara, Tigray, and SNNP, following a multi-stage sampling procedure. Twenty-nine former users of implants were interviewed, as were 42 CBRHAs, 19 providers (nurses and midwives) trained by the program, and 21 health facility managers. The findings are being used to design activities to improve the training and quality of care of LAFP. (excerpt) Language: English Keywords: ETHIOPIA | EVALUATION REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | FAMILY PLANNING PERSONNEL | WOMEN IN DEVELOPMENT | COMMUNITY WORKERS | SATISFACTION | CONTRACEPTIVE METHODS | TIME FACTORS | USAID | CONTRACEPTIVE DISTRIBUTION | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTION TERMINATION | CONTRACEPTIVE IMPLANTS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Evaluation | Family Planning Surveys | Family Planning | Family Planning Programs | Economic Development | Economic Factors | Health Personnel | Delivery of Health Care | Health | Psychological Factors | Behavior | Contraception | Population Dynamics | Demographic Factors | Population | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraceptive Usage Document Number: 325472 |
| 28. Title: Abortions averted through contraception. Author: Population Resource Center Source: [Washington, D.C.], Population Resource Center, [2008]. [4] p. Abstract: An estimated 26 million legal and 20 million illegal abortions were performed worldwide. The resulting overall abortion rate was 35 per 1,000 women aged 15-44. Among the sub regions of the world, Eastern Europe had the highest abortion rate (90 per 1,000) and Western Europe the lowest rate (11 per 1,000). In response to the findings of surveys, the United Nations Population Fund, the UNFPA, and USAID launched targeted family planning programs in Eastern Europe, as well as other high risk regions like Asia and Latin America. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | EVALUATION REPORT | COST BENEFIT ANALYSIS | PERIOD ANALYSIS | WOMEN IN DEVELOPMENT | CONTRACEPTIVE USAGE | ABORTION RATE | UNFPA | UNAIDS | FAMILY PLANNING PROGRAM EVALUATION | CONTRACEPTIVE PREVALENCE | FOREIGN AID | Evaluation | Quantitative Evaluation | Research Methodology | Economic Development | Economic Factors | Contraception | Family Planning | Fertility Control, Postconception | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Family Planning Programs | Financial Activities Document Number: 325658 Notification |
| 29. Peer Reviewed Title: Use of evidence-based practices in pregnancy and childbirth: South East Asia Optimising Reproductive and Child Health in Developing Countries project. Author: South East Asia Optimising Reproductive and Child Health in Developing Countries [SEA-ORCHID]. Study Group Source: PLoS One. 2008 Jul;3(7):[7] p. Abstract: The burden of mortality and morbidity related to pregnancy and childbirth remains concentrated in developing countries. SEA-ORCHID (South East Asia Optimising Reproductive and Child Health In Developing countries) is evaluating whether a multifaceted intervention to strengthen capacity for research synthesis, evidence-based care and knowledge implementation improves adoption of best clinical practice recommendations leading to better health for mothers and babies. In this study we assessed current practices in perinatal health care in four South East Asian countries and determined whether they were aligned with best practice recommendations. We completed an audit of 9550 medical records of women and their 9665 infants at nine hospitals; two in each of Indonesia, Malaysia and The Philippines, and three in Thailand between January- December 2005. We compared actual clinical practices with best practice recommendations selected from the Cochrane Library and the World Health Organization Reproductive Health Library. Evidence-based components of the active management of the third stage of labour and appropriately treating eclampsia with magnesium sulphate were universally practiced in all hospitals. Appropriate antibiotic prophylaxis for caesarean section, a beneficial form of care, was practiced in less than 5% of cases in most hospitals. Use of the unnecessary practices of enema in labour ranged from 1% to 61% and rates of episiotomy for vaginal birth ranged from 31% to 95%. Other appropriate practices were commonly performed to varying degrees between countries and also between hospitals within the same country. Whilst some perinatal health care practices audited were consistent with best available evidence, several were not. We conclude that recording of clinical practices should be an essential step to improve quality of care. Based on these findings, the SEA-ORCHID project team has been developing and implementing interventions aimed at increasing compliance with evidence-based clinical practice recommendations to improve perinatal practice in South East Asia. (author's) Language: English Keywords: INDONESIA | MALAYSIA | PHILIPPINES | THAILAND | RESEARCH REPORT | EVALUATION REPORT | |