1.  Title: Iraq Family Health Survey 2006/7. Author: Iraq. Ministry of Health; Iraq. Central Organization for Statistics and Information Technology; Iraq. Kurdistan. Ministry of Health; Iraq. Kurdistan. Regional Statistics Office; World Health Organization [WHO] Source: [Amman, Jordan], WHO, [2008]. [64] p. Abstract: The Iraq Family Health Survey (IFHS) 2006/7 is a nationally representative survey of 9,345 households and 14,675 women of reproductive age and covers all governorates in Iraq. This is the second nationally representative health survey since the Family Gulf Survey in 1989, although it is the first survey to disseminate the results. The IFHS 2006/7 was conducted in the central and southern governorates during August and September 2006, in Anbar during October and November 2006, while fieldwork in the Kurdistan region was carried out during February and March 2007. The survey had gone through a detailed and intensive planning and preparatory phases which was particularly important given the dire security situation in Iraq at the time of the survey. Not only were rigorous training and pre-testing undertaken, but a planning approach based on a number of different scenarios was adopted to respond to anticipated challenges. All interview teams were carefully supervised and given continuous support through out the period of the survey. The principle objective of the survey is to provide critical information for policy-makers and programme managers working in health and development. It complements other surveys recently conducted in Iraq on the situation of women and children, namely the Iraq Child and Maternal Mortality Survey (ICMMS 1999), the Iraq Living Conditions Survey ILCS 2004, and the Multiple Indicators Cluster Survey MICS III 2006. Also the survey results will present data on a wide range of indicators related to women's and family health. It is also the first national survey ever conducted to present data on adult mortality, including the causes of deaths. The IFHS is the first national survey in Iraq to investigate domestic violence, as well as chronic illnesses. Detailed information was also collected on health expenditures and health care seeking behaviour, as well as a range of other health and demographic indicators. Blood test was carried out to measure the level of anaemia among women of reproductive age including pregnant and lactating women. (excerpt) Language: English Keywords: IRAQ | RESEARCH REPORT | HEALTH SURVEYS | HEALTH | HEALTH STATUS INDEXES | HEALTH AND WELFARE PLANNING | MORTALITY | MORBIDITY | DOMESTIC VIOLENCE | ANEMIA | MENTAL HEALTH | TOBACCO USE | PREGNANCY OUTCOMES | HIV | AIDS | SEXUALLY TRANSMITTED DISEASES | KNOWLEDGE | UTILIZATION OF HEALTH CARE | MARRIAGE PATTERNS | Middle East | Developing Countries | Social Planning | Economic Factors | Population Dynamics | Demographic Factors | Population | Diseases | Crime | Social Problems | Sociocultural Factors | Behavior | Pregnancy | Reproduction | HIV Infections | Viral Diseases | Reproductive Tract Infections | Infections | Health Services | Delivery of Health Care | Marriage | Nuptiality Document Number: 327824 |
| 2. Title: AIDS Strategy and Action Plan (ASAP): a service of UNAIDS. Business plan 2008-2009. Author: Joint United Nations Programme on HIV / AIDS [UNAIDS]. AIDS Strategy and Action Plan [ASAP] Source: Geneva, Switzerland, UNAIDS, ASAP, 2008. 30 p. Abstract: This ASAP Business Plan sets out the operational direction for 2008-2009 of the UNAIDS AIDS Strategy and Action Plan service. It presents the history of ASAP, explains how ASAP is governed, and describes operational achievements to date. These have included delivery of 15 peer reviews, provision of technical support to 29 countries, development of four technical tools for country use and initiation of a capacity building program. The document also presents conclusions of the ASAP Assessment which found that: ASAP had generally met the expectations set out in the ASAP Business Plan for 2006-07 in terms of the quantity and quality of work and adherence to agreed operating principles; ASAP is on track to meet the quantitative goal for technical support, development of tools, and capacity building; The mix of technical support has been stronger than anticipated on broad strategic planning and less on action planning, reflecting the relatively low demand received by ASAP in this area to date; ASAP outputs have been good, especially the peer reviews, the Self-Assessment Tool, and the planning effort for the capacity building program; The review noted that is was not possible to assess ASAP's impact on the quality of strategic and action planning at this early stage in the program; Finally, the assessment pointed out that since ASAP has already fully committed funds for capacity building and for the MEAN program, there is sufficient funding for new country requests only through the second quarter of 2008. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | RECOMMENDATIONS | PEER REVIEW | POLICYMAKERS | UNAIDS | ECONOMIC FACTORS | TECHNICAL ASSISTANCE | CAPACITY BUILDING | HEALTH AND WELFARE PLANNING | HIV PREVENTION | Evaluation | Administrative Personnel | Organization and Administration | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Programs | Program Sustainability | Social Planning | HIV Infections | Viral Diseases | Diseases Document Number: 326308 |
| 3. Title: Report to Congress: Health-related research and development activities at USAID. An update on the Five-Year Strategy, 2006-2010. Author: United States. Agency for International Development [USAID] Source: Washington, D.C., USAID, 2008 Sep. 57 p. (USAID Development Experience Clearinghouse DocID / Order No: PD-ACL916) Abstract: With this report, USAID provides an update on its five-year health research strategy, for using research funds to stimulate the development and introduction of key products. Significant progress has been made in many areas, influencing policies and programming on the ground in real time. Examples of progress toward the goals of the health research strategy outlined in the 2006 report include the completion of: 1) a study that demonstrated the equivalence of home treatment of severe pneumonia in young children to facility-based care, potentially significantly changing the way the illness is managed in developing countries, saving a significant number of lives every year, and taking pressure off health systems; 2) introduction trials in several countries providing an understanding of how to increase the availability and uptake of zinc treatment in the public and private sectors, while also increasing the uptake of oral rehydration salts for reduced childhood morbidity and mortality from diarrhea; and 3) a new tool, Sampling at Service Sites (SSS), which measures the rates of maternal mortality in the community and offers potential lower cost and time savings over traditional house-to-house surveys for the evaluation of safe motherhood interventions. Some findings during the past year have initiated changes in the strategy, specifically in vaccine and microbicide development. Because of the technical leadership at USAID and the development process of the original strategy, alternative pathways were anticipated. USAID and our partners were ready to adjust next steps and quickly move forward with alternative activities to maintain momentum toward our goals. The activities highlighted in this document represent approximately 80 percent ($142 million) of the total amount USAID used in 2008 for the main areas of research on product development and introduction. This report does not cover an estimated $35.5 million for research that is mainly funded by USAID field Missions on local questions and needs, such as formative research on child feeding practices, measurements of local disease burdens, or improvements in district health services. This report leads with an update on maternal, newborn, and child health research. With a new Maternal and Child Health Strategic Approach and the support of Congress, USAID is committed to accelerating the development, introduction, and scale-up of the delivery of effective interventions in high-mortality countries to help them achieve the Millennium Development Goals for maternal and child health. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | UNITED STATES OF AMERICA | GOVERNMENT PUBLICATION | RESEARCH PROPOSAL | EVALUATION | POLICYMAKERS | USAID | RESEARCH AND DEVELOPMENT | RESEARCH ACTIVITIES | HEALTH AND WELFARE PLANNING | DEVELOPMENT PLANS | FIVE-YEAR PLANS | TUBERCULOSIS | HIV INFECTIONS | MALARIA | Developed Countries | North America | Americas | Administrative Personnel | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Technology | Economic Factors | Research Methodology | Social Planning | Development Planning | Infections | Diseases | Viral Diseases | Parasitic Diseases Document Number: 329542 |
| 4. Title: The U.S. commitment to global health: recommendations for the new administration. Author: United States. Committee on the U.S. Commitment to Global Health. Board on Global Health Source: Washington, D.C., The National Academies Press, 2008 Dec 15. [64] p. Abstract: At this historic moment, the incoming Obama administration and leaders of the U.S. Congress have the opportunity to advance the welfare and prosperity of people within and beyond the borders of the United States through intensified and sustained attention to better health. The United States can improve the lives of millions around the world, while reflecting America's values and protecting and promoting the nation's interests. The Institute of Medicine-with the support of four U.S. government agencies and five private foundations-formed an independent committee to examine the United States' commitment to global health and to articulate a vision for future U.S. investments and activities in this area. Language: English Keywords: UNITED STATES OF AMERICA | GLOBAL | DEVELOPING COUNTRIES | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | GOVERNMENT | HEALTH POLICY | INTERNATIONAL COOPERATION | FOREIGN AID | WHO | HEALTH STATUS INDEXES | GOVERNMENT FINANCING | COORDINATION | HEALTH AND WELFARE PLANNING | Developed Countries | North America | Americas | Administrative Personnel | Organization and Administration | Political Factors | Sociocultural Factors | Policy | Financial Activities | Economic Factors | UN | International Agencies | Organizations | Health | Social Planning Document Number: 328213 |
| 5. Title: The World Bank's commitment to HIV / AIDS in Africa: Our agenda for action, 2007-2011. Author: World Bank Source: Washington, D.C., World Bank, 2008. [140] p. Abstract: The World Bank is committed to support Sub-Saharan Africa in responding to the HIV/AIDS epidemic. This Agenda for Action (AFA) is a road map for the next five years to guide Bank management and staff in fulfilling that commitment. It underscores the lessons learned and outlines a line of action. HIV/AIDS remains - and will remain for the foreseeable future - an enormous economic, social, and human challenge to Sub-Saharan Africa. This region is the global epicenter of the disease. About 22.5 million Africans are HIV positive, and AIDS is the leading cause of premature death on the continent. HIV/AIDS affects young people and women disproportionately. Some 61 percent of those who are HIV positive are women, and young women are three times as likely to be HIV positive than are young men. As a result of the epidemic, an estimated 11.4 million children under age 18 have lost at least one parent. Its impact on households, human capital, the private sector, and the public sector undermines the alleviation of poverty, the Bank's overarching mandate. In sum, HIV/AIDS threatens the development goals in the region unlike anywhere else in the world. (excerpt) Language: English Keywords: AFRICA | RECOMMENDATIONS | EPIDEMIOLOGIC METHODS | POLICYMAKERS | WORLD BANK | HIV PREVENTION | AIDS PREVENTION | HEALTH AND WELFARE PLANNING | FIVE-YEAR PLANS | PROGRAM SUSTAINABILITY | LOGISTICS | PREVALENCE | DEVELOPMENT PLANS | Developing Countries | Research Methodology | Administrative Personnel | Organization and Administration | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Social Planning | Economic Factors | Development Planning | Programs | Management | Measurement Document Number: 326779 |
6.  Peer Reviewed Title: HIV and family planning service integration and voluntary HIV counselling and testing client composition in Ethiopia. Author: Bradley H; Bedada A; Tsui A; Brahmbhatt H; Gillespie D Source: AIDS Care. 2008 Jan;20(1):61-71. Abstract: Integrating voluntary HIV counselling and testing (VCT) with family planning and other reproductive health services may be one effective strategy for expanding VCT service delivery in resource poor settings. Using 30,257 VCT client records with linked facility characteristics from Ethiopian non-governmental, non-profit, reproductive health clinics, we constructed multi-level logistic regression models to examine associations between HIV and family planning service integration modality and three outcomes: VCT client composition, client-initiated HIV testing and client HIV status. Associations between facility HIV and family planning integration level and the likelihood of VCT clients being atypical family planning client-types, versus older (at least 25 years old), ever-married women were assessed. Relative to facilities co-locating services in the same compound, those offering family planning and HIV services in the same rooms were 2-13 times more likely to serve atypical family planning client-types than older, ever-married women. Facilities where counsellors jointly offered HIV and family planning services and served many repeat family planning clients were significantly less likely to serve single clients relative to older, married women. Younger, single men and older, married women were most likely to self-initiate HIV testing (78.2 and 80.6% respectively), while the highest HIV prevalence was seen among older, married men and women (20.5 and 34.2% respectively). Compared with facilities offering co-located services, those integrating services at room- and counselor-levels were 1.9-7.2 times more likely to serve clients initiating HIV testing. These health facilities attract both standard maternal and child health (MCH) clients, who are at high risk for HIV in these data, and young, single people to VCT. This analysis suggests that client types may be differentially attracted to these facilities depending on service integration modality and other facility-level characteristics. (author's) Language: English Keywords: ETHIOPIA | RESEARCH REPORT | LOGISTIC MODEL | VOLUNTARY COUNSELING AND TESTING | HIV/FP INTEGRATION | SOCIOECONOMIC STATUS | MARITAL STATUS | AGE FACTORS | PROGRAM ACCEPTABILITY | HEALTH AND WELFARE PLANNING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Mathematical Model | Theoretical Models | Research Methodology | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Socioeconomic Factors | Economic Factors | Nuptiality | Demographic Factors | Population | Population Characteristics | Program Evaluation | Social Planning Document Number: 324155 |
| 7. Peer Reviewed Title: The World Health Organization and its work. 1993. Author: Bynum WF; Porter R Source: American Journal of Public Health. 2008 Sep;98(9):1594-7. Abstract: In 1948, after its first World Health Assembly, the WHO took action to form a Secretariat in Geneva. It was given space for its initial years in the Palais des Nations, which had been the last home of the League of Nations. As stated in Chapter I of its Constitution, WHO was "to act as the directing and coordinating authority on international health work." This was a much broader scope than any other international agency in the orbit of the UN. (excerpt) Language: English Keywords: GLOBAL | HISTORICAL REVIEW | WHO | ORGANIZATION AND ADMINISTRATION | PUBLIC HEALTH | HEALTH POLICY | HEALTH AND WELFARE PLANNING | INTERNATIONAL AGENCIES | UN | Organizations | Political Factors | Sociocultural Factors | Health | Policy | Social Planning | Economic Factors Document Number: 328449 |
| 8. Peer Reviewed Title: Halting the toll of malaria in Africa. Author: Campbell CC Source: American Journal of Tropical Medicine and Hygiene. 2008 Jun;78(6):851-853. Abstract: A renaissance in commitment to malaria control is transforming the perspectives and aspirations of the global community, prompting a consideration of goals for confronting a disease that is responsible for legendary death and suffering in Africa. The results in several countries are producing confidence that current control interventions can result in a dramatic reduction in the burden that malaria causes. However, the complexities of the challenges that must be addressed for comprehensive Africa programming are formidable in terms of the time required and the resources that will have to be mobilized. Progress toward elimination of the malaria burden in the African region in the next 5 years will be the critical benchmark for the feasibility of a comprehensive global campaign to eliminate and potentially eradicate malaria. (author's) Language: English Keywords: AFRICA | CRITIQUE | RECOMMENDATIONS | EVALUATION | TARGET POPULATION | POLICYMAKERS | MALARIA PREVENTION | TIME FACTORS | FOREIGN AID | PROGRAM EVALUATION | HEALTH AND WELFARE PLANNING | Developing Countries | Program Design | Programs | Organization and Administration | Administrative Personnel | Malaria | Parasitic Diseases | Diseases | Population Dynamics | Demographic Factors | Population | Financial Activities | Economic Factors | Social Planning Document Number: 308644 |
| 9. Peer Reviewed Title: The need for priority reproductive health services for displaced Iraqi women and girls. Author: Chynoweth SK Source: Reproductive Health Matters. 2008 May;16(31):93-102. Abstract: Disregarding reproductive health in situations of conflict or natural disaster has serious consequences, particularly for women and girls affected by the emergency. In an effort to protect the health and save the lives of women and girls in crises, international standards for five priority reproductive health activities that must be implemented at the onset of an emergency have been established for humanitarian actors: humanitarian coordination, prevention of and response to sexual violence, minimisation of HIV transmission, reduction of maternal and neonatal death and disability, and planning for comprehensive reproductive health services. The extent of implementation of these essential activities is explored in this paper in the context of refugees in Jordan fleeing the war in Iraq. Significant gaps in each area exist, particularly coordination and prevention of sexual violence and care for survivors. Recommendations for those responding to this crisis include designating a focal point to coordinate implementation of priority reproductive health services, preventing sexual exploitation and providing clinical care for survivors of sexual violence, providing emergency obstetric care for all refugees, including a 24-hour referral system, ensuring adherence to standards to prevent HIV transmission, making condoms free and available, and planning for comprehensive reproductive health services. (author's) Language: English Keywords: IRAQ | RESEARCH REPORT | CASE STUDIES | INTERVIEWS | WOMEN | ADOLESCENTS, FEMALE | REFUGEES | INTERNALLY DISPLACED PERSONS | REPRODUCTIVE HEALTH | HEALTH SERVICES | NEEDS ASSESSMENT | DELIVERY OF HEALTH CARE | HUMANITARIAN ASSISTANCE | VIOLENCE AGAINST WOMEN | OBSTETRICS | HIV TRANSMISSION | HEALTH AND WELFARE PLANNING | RECOMMENDATIONS | Middle East | Developing Countries | Studies | Research Methodology | Data Collection | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Migrants | Migration | Population Dynamics | Settlement and Resettlement | Health | Evaluation | Financial Activities | Economic Factors | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Medicine | HIV Infections | Viral Diseases | Diseases | Social Planning Document Number: 327194 |
| 10. Peer Reviewed Title: Health-sector responses to intimate partner violence in low- and middle-income settings: A review of current models, challenges and opportunities. Author: Colombini M; Mayhew S; Watts C Source: Bulletin of the World Health Organization. 2008 Aug;86(8):635-642. Abstract: There is growing recognition of the public-health burden of intimate partner violence (IPV) and the potential for the health sector to identify and support abused women. Drawing upon models of health-sector integration, this paper reviews current initiatives to integrate responses to IPV into the health sector in low- and middle-income settings. We present a broad framework for the opportunities for integration and associated service and referral needs, and then summarize current promising initiatives. The findings suggest that a few models of integration are being replicated in many settings. These often focus on service provision at a secondary or tertiary level through accident and emergency or women's health services, or at a primary level through reproductive or family-planning health services. Challenges to integration still exist at all levels, from individual service providers' attitudes and lack of knowledge about violence to managerial and health systems' challenges such as insufficient staff training, no clear policies on IPV, and lack of coordination among various actors and departments involved in planning integrated services. Furthermore, given the variety of locations where women may present and the range and potential severity of presenting health problems, there is an urgent need for coherent, effective referral within the health sector, and the need for strong local partnership to facilitate effective referral to external, non-health services. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | VIOLENCE AGAINST WOMEN | HEALTH SERVICES | HEALTH SERVICES ADMINISTRATION | INTEGRATED PROGRAMS | BEST PRACTICES | HEALTH AND WELFARE PLANNING | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Delivery of Health Care | Health | Management | Organization and Administration | Programs | Social Planning | Economic Factors Document Number: 327932 |
| 11. Peer Reviewed Title: HIV/AIDS in children: a disaster in the making. Author: Coovadia HM; Schaller JG Source: Lancet. 2008 Jul 26;372(9635):271-3. Abstract: The Countdown to 2015 meeting earlier this year identified HIV/AIDS as a factor or a leading cause of preventable death in children in the 42 countries with lack of progress towards the target of Millennium Development Goal 4. The identification of HIV/AIDS as a leading cause of death is a particular tragedy because HIV/AIDS in children is almost entirely preventable. 90% of childhood HIV infections now occur in sub-Saharan Africa. Without treatment, HIV in children is lethal. There are large and unacceptable inequities in access to HIV prevention and treatment for children. 420,000 children worldwide were newly infected with HIV in 2007; 330,000 children died of AIDS, mostly in sub-Saharan Africa. In the 2008 Countdown statistics, high HIV prevalence was associated with the highest rates of child mortality in those aged under 5 years and with increases in mortality between 1990 and 2006. Maternal HIV infection also has a vast impact on child health. Loss of mothers affects the overall welfare of children and families; loss of one or both parents to AIDS leaves millions of orphans. How can these issues be addressed? High priority should be given to preventing HIV infection in young women and offering termination of unwanted pregnancies. These cost-effective measures approximate outcomes achieved through direct interventions in mother-to-child transmission of HIV. The high levels of antenatal coverage reported in Countdown 2008 offer an opportunity to integrate HIV-prevention services with routine prenatal and adolescent care. Interventions aimed at mother-to-child transmission vary widely between countries. Only 9% of HIV-infected African women receive antiretroviral drugs (country range, 1-59%); not a single country has attained the target of 80% coverage set by the 2001 Declaration of Commitment on HIV/AIDS Global Targets for low-income and middle-income countries. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | CRITIQUE | CHILDREN | HIV | AIDS | CHILD MORTALITY | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PROGRAM ACCESSIBILITY | INEQUALITIES | CHILD HEALTH SERVICES | HEALTH AND WELFARE PLANNING | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Mortality | Population Dynamics | Disease Transmission Control | Prevention and Control | Program Evaluation | Programs | Organization and Administration | Socioeconomic Factors | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Social Planning Document Number: 328272 |
| 12. Peer Reviewed Title: Saving newborn lives in Asia and Africa: Cost and impact of phased scale-up of interventions within the continuum of care. Author: Darmstadt GL; Walker N; Lawn JE; Bhutta ZA; Haws RA Source: Health Policy and Planning. 2008 Mar;23(2):101-117. Abstract: Policy makers and programme managers require more detailed information on the cost and impact of packages of evidenced-based interventions to save newborn lives, particularly in South Asia and sub-Saharan Africa, where most of the world's 4 million newborn deaths occur. We estimated the newborn deaths that could be averted by scaling up 16 interventions in 60 countries. We bundled the interventions in a variety of existing maternal and child health packages according to time period of delivery and service delivery mode, and calculated the additional running costs of implementing these interventions at scale (90% coverage) in sub-Saharan Africa and South Asia. The phased introduction and expansion of interventions was modelled to represent incremental strategies for scaling up neonatal care in developing country health systems. Increasing coverage of 16 interventions to 90% could save 0.59-1.08 million lives in South Asia annually at an additional cost of US$0.90-1.76 billion. In sub-Saharan Africa, 0.45-0.80 million lives saved would cost US$0.68-1.32 billion. Additional costs for increased antenatal interventions are low, but given relatively high baseline coverage and lower impact, fewer additional newborn lives can be saved through this package (5-10%). Intrapartum care has higher impact (19-34% of deaths averted) but is costly (US$1.66-3.25 billion). Postnatal family-community care, with potential for high impact at low cost (10-27%, US$0.38-0.75 billion), has been neglected. A first phase of scaling up care in 36 high (NMR 30-45) and 15 very high (NMR greater than 45) mortality countries would cost approximately US$0.56-1.10 and US$0.09-0.17 billion annually, respectively, and would avert 15-32% and 13-29% of neonatal deaths, respectively, in these countries. Full coverage with all interventions in the 51 high and very high mortality countries would cost US$2.23-4.37 billion, and avert 38-68% of neonatal deaths (1.13-2.05 million), at an extra cost per death averted of US$1100-3900. Low-cost, effective newborn health interventions can save millions of lives, primarily in South Asia and sub-Saharan Africa. Modelling costs and impact of intervention packages scaled up incrementally as health systems capacity increases can assist programme planning and help policy makers and donors identify stepwise targets for investments in newborn health. (author's) Language: English Keywords: ASIA, SOUTHERN | AFRICA, SUB SAHARAN | RESEARCH REPORT | INFANT MORTALITY | INFANT HEALTH | PREVENTION AND CONTROL | INTERVENTIONS | DELIVERY OF HEALTH CARE | COST BENEFIT ANALYSIS | COST EFFECTIVENESS | IMPACT | THEORETICAL MODELS | PROGRAM DESIGN | HEALTH AND WELFARE PLANNING | HEALTH POLICY | Developing Countries | Asia | Africa | Mortality | Population Dynamics | Demographic Factors | Population | Child Health | Health | Diseases | Programs | Organization and Administration | Quantitative Evaluation | Evaluation | Evaluation Indexes | Communication | Research Methodology | Social Planning | Economic Factors | Policy | Political Factors | Sociocultural Factors Document Number: 324154 |
| 13. Title: The lost years: The challenge of delivering reproductive health care to young adults [editorial] Author: Dominguez L; Shields W Source: Contraception. 2008 Jul;78(1):1-3. Abstract: Young adults - loosely defined as people in their late teens to mid-20s-are a fluid group in an exploratory phase of their lives, with their own language and style of communicating. These "20-somethings" are continuously experimenting, testing new concepts and acculturating in ways that mesh with their developing identities. These individuals are more mobile than children or older adults, many are newly independent and less rooted in their communities than other age groups, and they do not have as many societal or familial support systems as adolescents. Complicating matters, there is a paucity of medical literature about contraceptive use and misuse in young adults. While the body of research on teens, contraception and pregnancy is fairly robust, more investigation is sorely needed to better understand barriers to care for these 20-something adults. As members of the reproductive health care team, our challenge is to make it as easy as possible for this elusive population to receive the reproductive care they need. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | ADULTS | YOUTH | REPRODUCTIVE HEALTH | HEALTH SERVICES | DELIVERY OF HEALTH CARE | HEALTH AND WELFARE PLANNING | HEALTH PERSONNEL | Developed Countries | North America | Americas | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Social Planning | Economic Factors Document Number: 327960 |
| 14. Peer Reviewed Title: Role of cash in conditional cash transfer programmes for child health, growth, and development: An analysis of Mexico's Oportunidades. Author: Fernald LC; Gertler PJ; Neufeld LM Source: Lancet. 2008 Mar 8;371(9615):828-837. Abstract: Many governments have implemented conditional cash transfer (CCT) programmes with the goal of improving options for poor families through interventions in health, nutrition, and education. Families enrolled in CCT programmes receive cash in exchange for complying with certain conditions: preventive health requirements and nutrition supplementation, education, and monitoring designed to improve health outcomes and promote positive behaviour change. Our aim was to disaggregate the effects of cash transfer from those of other programme components. In an intervention that began in 1998 in Mexico, low-income communities (n=506) were randomly assigned to be enrolled in a CCT programme (Oportunidades, formerly Progresa) immediately or 18 months later. In 2003, children (n=2449) aged 24-68 months who had been enrolled in the programme their entire lives were assessed for a wide variety of outcomes. We used linear and logistic regression to determine the effect size for each outcome that is associated witha doubling of cash transfers while controlling for a wide range of covariates, including measures of household socioeconomic status. A doubling of cash transfers was associated with higher height-for-age Z score (beta 0.20, 95% CI 0.09-0.30; p less than 0.0001), lower prevalence of stunting (-0.10, -0.16 to -0.05; p less than 0.0001), lower body-mass index for age percentile (-2.85, -5.54 to -0.15; p=0.04), and lower prevalence of being overweight (-0.08, -0.13 to -0.03; p=0.001). A doubling of cash transfers was also associated with children doing better on a scale of motor development, three scales of cognitive development, and with receptive language. Our results suggest that the cash transfer component of Oportunidades is associated with better outcomes in child health, growth, and development. (author's) Language: English Keywords: MEXICO | RESEARCH REPORT | INTERVENTIONS | INCENTIVES | CHILD HEALTH | HEALTH SERVICES | POVERTY | FAMILY ALLOWANCES | HEALTH AND WELFARE PLANNING | GOVERNMENT PROGRAMS | PROGRAM EFFECTIVENESS | North America | Americas | Developing Countries | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Health | Delivery of Health Care | Socioeconomic Factors | Economic Factors | Family Policy | Social Policy | Social Planning | Program Evaluation Document Number: 325023 |
| 15. Title: Human Resources for Health (HRH) action workshop assessment. Author: Fogarty L Source: Chapel Hill, North Carolina, IntraHealth International, Capacity Project, 2008 Jul. 21 p. Abstract: The Joint Learning Initiative (JLI) meetings in Abuja (December 2004) and Oslo (February 2005) and other meetings in South Africa (May 2005) and Brazzaville (July 2005) focused global attention on critical human resources for health (HRH) issues, providing much needed high-level support and calls for action to address the HRH crisis. The Capacity Project's HRH Action Workshop series was intended to extend this work by focusing on specific HRH actions and experiences-what is being done in countries, what is working and what is not. The Capacity Project assessed the influence of the workshop on subsequent country-level HRH activities, and found that a combination of the workshop methodology and a meeting of the right participants led to notable HRH action in several countries. Language: English Keywords: AFRICA, SUB SAHARAN | PROGRESS REPORT | KAP SURVEYS | HEALTH PERSONNEL | HUMAN RESOURCES | WORKSHOPS | USAID | CAPACITY BUILDING | HEALTH SERVICES | NEEDS ASSESSMENT | MANPOWER NEEDS | HEALTH AND WELFARE PLANNING | INFORMATION RETRIEVAL SYSTEMS | TRAINING PROGRAMS | PERFORMANCE IMPROVEMENT | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Economic Factors | Education | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | Evaluation | Social Planning | Data Storage and Retrieval | Information Processing | Information | Management Document Number: 308935 |
| 16. Peer Reviewed Title: Universal access to HIV prevention, treatment and care: Assessing the inclusion of human rights in international and national strategic plans. Author: Gruskin S; Tarantola D Source: AIDS. 2008;22 Suppl 2:S123-S132. Abstract: Rhetorical acknowledgment of the value of human rights for the AIDS response continues, yet practical application of human rights principles to national efforts appears to be increasingly deficient. We assess the ways in which international and national strategic plans and other core documents take into account the commitments made by countries to uphold human rights in their efforts towards achieving Universal Access. Key documents from the Joint United Nations Programme on HIV and AIDS (UNAIDS), the World Health Organization (WHO), the World Bank, the Global Fund to Fight AIDS, TB and Malaria (GFATM) and the US President's Emergency Plan for AIDS Relief (PEPFAR) were reviewed along with 14 national HIV strategic plans chosen for their illustration of the diversity of HIV epidemic patterns, levels of income and geographical location. Whereas human rights concepts overwhelmingly appeared in both international and national strategic documents, their translation into actionable terms or monitoring frameworks was weak, unspecific or absent. Future work should analyse strategic plans, plans of operation, budgets and actual implementation so that full advantage can be taken, not only of the moral and legal value of human rights, but also their instrumental value for achieving Universal Access. (Author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | HEALTH POLICY | HIV INFECTIONS | HIV PREVENTION | CARE AND SUPPORT | HUMAN RIGHTS | GOVERNMENT PROGRAMS | PROGRAM EVALUATION | HEALTH AND WELFARE PLANNING | PLANNING METHODOLOGY | PROGRAM DEVELOPMENT | Policy | Political Factors | Sociocultural Factors | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Social Planning | Economic Factors | Planning Document Number: 327865 |
| 17. Peer Reviewed Title: Universal access to HIV/AIDS treatment: promise and problems. Author: Jaffe HW Source: JAMA. Journal of the American Medical Association. 2008 Aug 6;300(5):573-5. Abstract: The 21st century has witnessed unprecedented increases in funding for global health, driven mainly by efforts to address the HIV/AIDS epidemic. The US President's Emergency Plan for AIDS Relief (PEPFAR) is the largest single donor, having allocated approximately $13 billion for AIDS prevention, treatment, and care in developing countries and contributed $3 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria since the plan's inception in 2003. For the next 5 years, the president is seeking a $30 billion appropriation for PEPFAR while Congress is proposing to increase the appropriation to $50 billion and add funding for malaria and tuberculosis programs. In contrast, the World Health Organization (WHO) smallpox eradication program, conducted from 1967 through 1979, cost less than $2 billion (adjusted for inflation). Funding to provide antiretroviral treatment (ART) for HIVinfected individuals in developing countries is saving lives. The Joint United Nations Programme on HIV/AIDS (UNAIDS) and WHO have reported that global deaths due to AIDS peaked in 2005 and then decreased over the next 2 years, a decline at least partially attributed to ART. By the end of 2007, about 3 million individuals living in low- and middle-income countries were receiving ART, representing approximately 31% of individuals needing treatment in those areas. While acknowledging the undeniable successes of these treatment programs, it is also important to examine some of the problems they may have inadvertently created or magnified: i.e., their unintended consequences, as well as their potential for long-term sustainability. This Commentary focuses on PEPFAR and sub-Saharan Africa, the region most severely affected by HIV/AIDS. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | HIV | HIV INFECTIONS | AIDS | TREATMENT | ANTIRETROVIRAL THERAPY | PROGRAM ACCESSIBILITY | HIV PREVENTION | HEALTH AND WELFARE PLANNING | INTERNATIONAL COOPERATION | NONGOVERNMENTAL ORGANIZATIONS | FUNDS | Africa | Developing Countries | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Social Planning | Economic Factors | Political Factors | Sociocultural Factors | Organizations | Financial Activities Document Number: 328227 |
| 18. Peer Reviewed Title: Evaluation of staining techniques, antigen detection and nested PCR for the diagnosis of cryptosporidiosis in HIV seropositive and seronegative patients. Author: Kaushik K; Khurana S; Wanchu A; Malla N Source: Acta Tropica. 2008 Jul;107(1):1-7. Abstract: The study was designed to determine the efficacy of modified Ziehl-Neelsen (ZN), safranine methylene blue (SM) staining, antigen detection ELISA and a nested PCR assay (specific for Cryptosporidium parvum) for detection of Cryptosporidium in HIV seropositive and seronegative patients with diarrhoea. Cryptosporidium was detected in 10 (4.9%), 9 (4.4%), 39 (18.9%) and 27 (13.1%) of 206 HIV seropositive and 7 (4.6%), 6 (3.9%), 21 (13.7%) and 17 (11.1%) of 153 HIV seronegative patients by ZN staining, SM staining, antigen detection ELISA and PCR, respectively. None of the 50 apparently healthy control subjects was found to be infected with Cryptosporidium by any of the techniques. Based on the criteria of 'true positive' samples positive by at least any two techniques out of ZN staining, antigen detection and PCR, sensitivity of ZN and SM staining techniques was 37% and 33.3% in HIV seropositive and 41.2% and 35.3% in seronegative patients, respectively. Sensitivity of antigen detection ELISA was 92.6% and 94.1% in HIV seropositive and seronegative patients, respectively, while sensitivity of PCR was 100% each in HIV seropositive and seronegative patients. Specificity of all three techniques, i.e. ZN, SM staining and PCR was 100% in both HIV seropositive and seronegative patients while specificity of antigen detection was 92.2% and 96.3% in HIV seropositive and seronegative patients, respectively. The staining techniques were found less sensitive as compared to antigen detection and PCR for detection of Cryptosporidium in HIV seropositive patients with CD4 count greater than 200 cells/microl. (author's) Language: English Keywords: INDIA | METHODOLOGICAL STUDIES | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | SEROCONVERSION | HEALTH AND WELFARE PLANNING | DIARRHEA | PREVALENCE | ANTIGENS | HIV INFECTIONS | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Immunity | Immune System | Physiology | Biology | Social Planning | Economic Factors | Measurement | Immunologic Factors Document Number: 308645 |
| 19. Peer Reviewed Title: Maternal healthcare needs assessment survey at Rabia Balkhi Hospital in Kabul, Afghanistan. Author: Khorrami H; Karzai F; Macri CJ; Amir A; Laube D Source: International Journal of Gynecology and Obstetrics. 2008 Jun;101(3):259-263. Abstract: Since the Department of Health and Human Services chose Rabia Balkhi Hospital (RBH) in Kabul, Afghanistan, as a site for intervention in 2002, the status of women's health there has been of interest. This study created a tool to assess accessibility and quality of care of women admitted from May to July, 2005. A 39-item questionnaire was created in English and translated into Dari. Hospital staff administered the survey to 292 women admitted to RBH for obstetric and gynecological complaints. Approximately 40% of the women traveled between 1 and 5 hours to reach RBH. Only 54% (158/292) of women reported having their blood pressure monitored during their pregnancy. About one-third of women reported that they had never received an immunization. This survey tool ascertained that women who received care at RBH traveled great lengths to reach the facility. Preventative measures such as blood pressure checks and immunizations are areas that need improvement. (author's) Language: English Keywords: AFGHANISTAN | RESEARCH REPORT | SURVEYS | MATERNAL HEALTH SERVICES | NEEDS ASSESSMENT | QUALITY OF HEALTH CARE | HEALTH AND WELFARE PLANNING | Asia, Southern | Asia | Developing Countries | Sampling Studies | Studies | Research Methodology | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Evaluation | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Social Planning | Economic Factors Document Number: 326606 |
| 20. Title: Prevalence of exclusive breastfeeding at 3, 4 and 6 months in Bangkok Metropolitan Administration Medical College and Vajira Hospital. Author: Laisiriruangrai P; Wiriyasirivaj B; Phaloprakarn C; Manusirivithaya S Source: Journal of the Medical Association of Thailand. 2008 Jul;91(7):962-7. Abstract: OBJECTIVE: To determine the prevalence of exclusive breastfeeding at 3, 4, and 6 months postpartum in women who delivered at Bangkok Metropolitan Administration Medical College and Vajira Hospital, and to evaluate the potential factors for continuation of exclusive breastfeeding. MATERIAL AND METHOD: A prospective descriptive study was performed in 210 mothers who delivered in the authors' institution between December 1, 2006 and February 28, 2007. All eligible subjects were interviewed before discharge from the hospital. The successive postpartum interviews were then conducted via telephone at 3, 4, and 6 months after delivery. RESULTS: Average maternal age was 27 years and over half (54.3%) were primipara. Rates of exclusive breastfeeding at 3, 4, and 6 months were 48%, 26%, and 11% respectively. Significant factors for exclusive breastfeeding were duration allowed for work absence and intended time to breastfeed. CONCLUSION: Approximately half of the mothers in the present study provided exclusive breastfeeding to their babies in the first 3-month postpartum. The prevalence of exclusive breastfeeding at 6 months was lower than the 30% goal of the 9th National Economic and Social Development Plan. The need to return to work and intended time to breastfeed were the significant factors affecting duration of exclusive breastfeeding. Language: English Keywords: THAILAND | RESEARCH REPORT | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | MOTHERS | PREVALENCE | BREASTFEEDING, EXCLUSIVE | MATERNITY BENEFITS | TIME FACTORS | HEALTH AND WELFARE PLANNING | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Economic Development | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Measurement | Breastfeeding | Infant Nutrition | Nutrition | Health | Microeconomic Factors | Population Dynamics | Demographic Factors | Population | Social Planning Document Number: 329102 |
| 21. Title: Adolescent refugees and migrants: A reproductive health emergency. Author: Lane C Source: Watertown, Massachusetts, Pathfinder International, 2008 Apr. 15 p. Abstract: As young people transition from childhood to adulthood, threats to their health shift from infectious disease that can easily be prevented or treated through vaccinations, improved hygiene, and access to antibiotics, to illnesses and injuries that are grounded in their behaviors. Unsafe reproductive health behaviors in youth, such as early age of sexual debut and low rates of condom and contraceptive use, result in high rates of unwanted pregnancies, Sexually Transmitted Infections (STIs) and HIV/AIDS. Young people who are displaced from their homes and communities may suddenly experience a lack of social support from family, friends, and mentors, as well as increased exposure to violence, coercion, and new sources of pressure. These factors can affect the ability of youth to practice safe reproductive health behaviors and create risky situations that may lead to unhealthy and potentially fatal choices. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | TECHNICAL REPORT | RECOMMENDATIONS | ADOLESCENTS | REFUGEES | INTERNALLY DISPLACED PERSONS | MIGRANTS | REPRODUCTIVE HEALTH | HEALTH SERVICES | HEALTH AND WELFARE PLANNING | INTERVENTIONS | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Migration | Population Dynamics | Settlement and Resettlement | Health | Delivery of Health Care | Social Planning | Economic Factors | Programs | Organization and Administration Document Number: 326592 |
| 22. Peer Reviewed Title: Combining evidence for access to and benefits from antiretroviral treatment to inform planning. Author: Marlink R; Forsythe S; Bertozzi SM; Muirhead D; Holmes M Source: AIDS. 2008 Jul;22 Suppl 1:S121-2. Abstract: The era of economic evaluations focusing on antiretroviral treatment (ART) versus a status quo of no treatment for HIV/AIDS is passing. With access to treatment expanding across developing countries, there is a growing, albeit insufficient, amount of research on the benefits to individuals, communities, companies, the workforce and economies. These benefits are broad, ranging from impacts on numbers of new HIV infections, quality of life, individual and social functioning, human capital investment, labour productivity and micro and macroeconomic performance. Policymakers attending the HIV/AIDS Interventions in Resource-Scarce Settings Conference called for economic analyses that consider the full range of HIV/AIDS intervention inputs and impacts, rather than traditional cost-effectiveness ratios alone. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | CRITIQUE | ANTIRETROVIRAL THERAPY | COST BENEFIT ANALYSIS | HEALTH AND WELFARE PLANNING | QUALITY OF LIFE | HIV | HIV Infections | Viral Diseases | Diseases | Quantitative Evaluation | Evaluation | Social Planning | Economic Factors | Social Welfare Document Number: 328250 |
| 23. Peer Reviewed Title: Informing scale-up and resource allocation: the use of economic analysis. Author: Marlink R; Forsythe S; Bertozzi SM; Muirhead D; Holmes M; Sturchio J Source: AIDS. 2008 Jul;22 Suppl 1:S5-6. Abstract: The papers in this section address a subset of the challenges for policymakers and planners that are critical to achieving universal access to comprehensive HIV prevention, treatment and care. These issues were posed in the 2006 'Making the money work' the Joint United Nations Programme on HIV/AIDS (UNAIDS) Annual Report. Some of the topics include the successful mobilization of financial resources to sustain the rapid expansion of prevention, treatment and care programmes in developing countries, the strategic placement of labor, capital and financial resources needed to scale up programmes in developing countries, and the efficient implementation of alternative strategies identified by sound and practical research methodology to achieve the maximum positive impact on HIV-infected populations. The following papers demonstrate how economic analysis may be able to assist in overcoming these challenges and it can inform programme scale-up and resource allocation decisions. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | CRITIQUE | HIV INFECTIONS | ECONOMIC FACTORS | COST BENEFIT ANALYSIS | RESOURCE ALLOCATION | HEALTH AND WELFARE PLANNING | Viral Diseases | Diseases | Quantitative Evaluation | Evaluation | Financial Activities | Social Planning Document Number: 328242 |
| 24. Peer Reviewed Title: Working with communities, governments and academic institutions to make pregnancy safer. Author: Mathai M Source: Best Practice and Research Clinical Obstetrics and Gynaecology. 2008;22(3):465-476. Abstract: The major medical causes of maternal death and the effective interventions to prevent maternal death due to these causes are known. Yet, every year, an estimated 529,000 women die during and following pregnancy and childbirth. Most of these deaths occur in developing countries where other non-medical determinants of maternal health influence the accessibility to these interventions. Improvements in maternal health can be achieved through a health systems approach. Care should be provided as a continuum throughout the life cycle and across health facilities through the health system. Communities, professional organizations and academic institutions should work actively with the government to: provide a package of service, based on population health needs, that is close to home; ensure availability of essential medicines and commodities; address financial barriers to receiving care; strengthen the health workforce; and gather and use information to improve maternal health. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | CRITIQUE | MATERNAL MORTALITY | MATERNAL HEALTH | MATERNAL HEALTH SERVICES | SAFE MOTHERHOOD | COMMUNITY PARTICIPATION | COMMUNITY HEALTH SERVICES | GOVERNMENT PROGRAMS | HEALTH AND WELFARE PLANNING | HEALTH SERVICES ADMINISTRATION | ANTENATAL CARE | PROGRAM ACCESSIBILITY | Mortality | Population Dynamics | Demographic Factors | Population | Health | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Organization and Administration | Programs | Social Planning | Economic Factors | Management | Program Evaluation Document Number: 326415 |
| 25. Peer Reviewed Title: The outcomes and outpatient costs of different models of antiretroviral treatment delivery in South Africa. Author: Rosen S; Long L; Sanne I Source: Tropical Medicine and International Health. 2008 Aug;13(8):1005-1015. Abstract: The objective of this study was to estimate the average outpatient cost per patient in care and responding to treatment 1 year after initiation of antiretroviral therapy (ART) under different models of treatment delivery in South Africa. At each site, medical records for a sample patients of were reviewed 1 year after ART initiation. Each subject was assigned to one outcome category: in care and responding (IC); in care but not responding (NR); or no longer in care at study site (NIC). Average cost per outcomes category was estimated based on resource utilisation. Site 1 was an urban public hospital; Site 2 a programme that contracts private general practitioners; Site 3 a rural non-governmental (NGO) AIDS clinic; and Site 4 a peri-urban NGO primary care clinic. At month 12, IC, NR and NIC rates were 67%, 7% and 26% (Site 1); 52%, 3%, and 45% (Site 2); 63%, 9% and 28% (Site 3); and 76%, 11%, and 13% (Site 4). The average outpatient cost per patient initiated was $756 (Site 1), $896 (Site 2), $932 (Site 3) and $1,126 (Site 4). When all costs and all outcomes were taken into account, the average cost to produce an IC patient was $1,128 (Site 1), $1,723 (Site 2), $1,480 (Site 3), and $1,482 (Site 4). If all ART patients remain in care and responding, total costs will increase but the average cost to produce an IC patient will fall. The cost per ART patient treated varies moderately among sites. Cost differences increase markedly when patient outcomes are taken into account. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | COST BENEFIT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | DELIVERY OF HEALTH CARE | HEALTH AND WELFARE PLANNING | COST EFFECTIVENESS | ECONOMIC FACTORS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Quantitative Evaluation | Evaluation | HIV Infections | Viral Diseases | Diseases | HIV | Health | Social Planning | Evaluation Indexes Document Number: 327939 |
| 26. Peer Reviewed Title: Health and survival of young children in southern Tanzania. Author: Schellenberg JR; Mrisho M; Manzi F; Shirima K; Mbuya C Source: BMC Public Health. 2008;8(194):[33] p. Abstract: With a view to developing health systems strategies to improve reach to high-risk groups, we present information on health and survival from household and health facility perspectives in five districts of southern Tanzania. We documented availability of health workers, vaccines, drugs, supplies and services essential for child health through a survey of all health facilities in the area. We did a representative cluster sample survey of 21,600 households using a modular questionnaire including household assets, birth histories, and antenatal care in currently pregnant women. In a subsample of households we asked about health of all children under two years, including breastfeeding, mosquito net use, vaccination, vitamin A, and care-seeking for recent illness, and measured haemoglobin and malaria parasitaemia. In the health facility survey, a prescriber or nurse was present on the day of the survey in about 40% of 114 dispensaries. Less than half of health facilities had all seven 'essential oraltreatments', and water was available in only 22%. In the household survey, antenatal attendance (88%) and DPT-HepB3 vaccine coverage in children (81%) were high. Neonatal and infant mortality were 43.2 and 76.4 per 1000 live births respectively. Infant mortality was 40% higher for teenage mothers than older women (RR 1.4, 95% confidence interval (CI) 1.1-1.7), and 20% higher for mothers with no formal education than those who had been to school (RR 1.2, CI 1.0-1.4). The benefits of education on survival were apparently restricted to post-neonatal infants. There was no evidence of inequality in infant mortality by socio-economic status. Vaccine coverage, net use, anaemia and parasitaemia were inequitable: the least poor had a consistent advantage over children from the poorest families. Infant mortality was higher in families living over 5km from their nearest health facility compared to those living closer (RR 1.25, CI 1.0-1.5): 75% of households live within this distance. Relatively short distances to health facilities, high antenatal and vaccine coverage show that peripheral health facilities have huge potential to make a difference to health and survival at household level in rural Tanzania, even with current human resources. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | SURVEYS | HOUSEHOLDS | HEALTH FACILITIES | RURAL AREAS | INFANT HEALTH | CHILD HEALTH | CHILD HEALTH SERVICES | ANTENATAL CARE | QUALITY OF HEALTH CARE | PROGRAM ACCESSIBILITY | VACCINES | HEALTH AND WELFARE PLANNING | HEALTH FACILITY PLANNING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Delivery of Health Care | Health | Geographic Factors | Population | Maternal-Child Health Services | Primary Health Care | Health Services | Maternal Health Services | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Medical Procedures | Medicine | Social Planning | Economic Factors | Health Services Administration | Management Document Number: 327023 |
| 27. Title: Women's social position and health-seeking behaviors: Is the health care system accessible and responsive in Pakistan? Author: Shaikh BT; Haran D; Hatcher J Source: Health Care for Women International. 2008 Sep;29(8-9):945-959. Abstract: To make the health care system more accessible and responsive to women particularly in developing countries, it is imperative to study the health-seeking behaviors and factors determining utilization of health care services. This study was carried out in close collaboration with Aga Khan Health Services, Pakistan (AKHSP) and the Health Department of Northern Areas of Pakistan. Key findings indicate that more than one-third of women did not know the cause of their reported illness. There is a median delay of 3 days before a consultation. Local women utilize AKHSP services far more than other health services due to the quality of services offered and the availability of female health staff. The perception of receiving the required treatment is lowest for government health services. Consulting faith healers is a common practice. Health education and health promotion campaigns are needed to change existing health-seeking behaviors among women. Social arrangements should be thoughtfully considered to make the health system more responsive. More female staff needs to be deployed in government health facilities. A public-private partnership seems to provide a means to strengthen the health care system and consequently to promote women's health. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | SURVEYS | WOMEN | UTILIZATION OF HEALTH CARE | WOMEN'S HEALTH | AWARENESS | SOCIOECONOMIC STATUS | SOCIAL CLASS | WOMEN'S STATUS | HEALTH AND WELFARE PLANNING | HEALTH SERVICES ADMINISTRATION | Developing Countries | Asia, Southern | Asia | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Knowledge | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Social Planning | Management | Organization and Administration Document Number: 328151 |
| 28. Title: The HIV epidemic: squeezing out the African voice [letter] Author: Simms C Source: Journal of Internal Medicine. 2008 Nov;264(5):504-8. Abstract: Had there been a strong African voice contributing to World Bank decisions, it is unlikely that deliberate sidelining of HIV by health sector reforms would have taken place. However, given Bank's architecture and processes, an adequate response to the crisis was a nonstarter; unlike mediocre responses to Africa's other health needs, it has been less easy for the IDC to duck its responsibility and place the blame on its so-called African partners. Nevertheless, the lack of an African voice distorts historical analyses of the crisis often reflecting a western perspective, emphasizing the lack of political will and African governments' failure to act, whilst underplaying the IDC's shortcomings. The notion itself that the epidemic is 25 years old rather than the more accurate 75 years old reflects this distortion. Most of the responsibility rests with the Bank's Board and top management. OED reports that it 'could find no evidence that other top management raised the issue with borrowers or pushed the issue to a higher level internally'. Where there was positive response by the bank at the country level, 'the initiative for AIDS strategies and lending came primarily from individual health staff in the regional and technical operational groupings of the Bank, but not in any coherent way from the Bank's HNP leadership or top-level management. The current initiative by the British House of Commons Committee for International Development to reform the World Bank effectively reverses the notion that the reform was all but impossible because it was a zero sum game. Today, however, its donor members may find the demonstrable unfairness and ineffectiveness less tolerable. It is unlikely that the next president of the Bank will be chosen solely by the United States. Reformers will now need to revise its constitutional rules, their balancing of stakeholder rights, their decision-making rules and practices and their staffing and expertise. The course of the HIV epidemic means that the status quo is no longer acceptable. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | KAP SURVEYS | POLICYMAKERS | INFLUENTIALS | INTERNATIONAL COOPERATION | HIV PREVENTION | FOREIGN AID | WORLD BANK | PERCEPTION | DECISION MAKING | POLICY DEVELOPMENT | PARTICIPATION | HEALTH POLICY | HEALTH AND WELFARE PLANNING | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Administrative Personnel | Organization and Administration | Knowledge Sources | Communication | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Financial Activities | Economic Factors | International Agencies | Organizations | Psychological Factors | Behavior | Planning | Social Behavior | Policy | Social Planning Document Number: 329202 |
| 29. Peer Reviewed Title: Scaling-up antiretroviral treatment in Southern African countries with human resource shortage: How will health systems adapt? Author: Van Damme W; Kober K; Kegels G Source: Social Science and Medicine. 2008 May;66(10):2108-2121. Abstract: Scaling-up antiretroviral treatment (ART) to socially meaningful levels in low-income countries with a high AIDS burden is constrained by (1) the continuously growing caseload of people to be maintained on long-term ART; (2) evident problems of shortage and skewed distribution in the health workforce; and (3) the heavy workload inherent to presently used ART delivery models. If we want to imagine how health systems can react to such challenges, we need to understand better what needs to be done regarding the different types of functions ART requires, and how these can be distributed through the care supply system, knowing that different functions rely on different rationales (professional, bureaucratic, social) for which the human input need not necessarily be found in formal healthcare supply systems. Given the present realities of an increasingly pluralistic healthcare supply and highly eclectic demand, we advance three main generic requirements for ART interventions to be successful: trustworthiness, affordability and exclusiveness - and their constituting elements. We then apply this analytic model to the baseline situation (no fundamental changes) and different scenarios. In Scenario A there are no fundamental changes, but ART gets priority status and increased resources. In Scenario B the ART scale-up strengthens the overall health system: we detail a B1 technocratic variant scenario, with profoundly re-engineered ART service production, including significant task shifting, away from classical delivery models and aimed at maximum standardisation and control of all operations; while in the B2 community-based variant scenario the typology of ART functions is maximally exploited to distribute the tasks over a human potential pool that is as wide as possible, including patients and possible communities. The latter two scenarios would entail a high degree of de-medicalisation of ART. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | THEORETICAL MODELS | ANTIRETROVIRAL THERAPY | HEALTH SERVICES | HEALTH AND WELFARE PLANNING | HEALTH SERVICES ADMINISTRATION | NEEDS | Developing Countries | Africa | Research Methodology | HIV | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | Social Planning | Economic Factors | Management | Organization and Administration Document Number: 326092 |
| 30. Title: Procurement primer for health and family planning programs in Bangladesh. Author: Woodle D; Dickens T; Fox J Source: Arlington, Virginia, JSI, DELIVER, 2008 Jun. 104 p. (USAID Contract No. GPO-I-01-06-00007-00) Abstract: This 100-page booklet provides a simple overview of goods and services procurement for health-sector projects in Bangladesh that have been financed wholly or in part by the World Bank and the International Development Association (IDA). It is intended for individuals with little or no procurement background and no need to acquire more than a basic understanding of theprocess, procedures, and rules. Color, graphics, and low-density text support a lighthearted approach to this material. Language: English Keywords: BANGLADESH | MANUAL | EVALUATION | ADMINISTRATIVE PERSONNEL | LOGISTICS | EQUIPMENT AND SUPPLIES | FAMILY PLANNING PROGRAMS | HEALTH AND WELFARE PLANNING | PLANNING METHODOLOGY | TECHNICAL ASSISTANCE | FINANCIAL ACTIVITIES | MANAGEMENT | Developing Countries | Asia, Southern | Asia | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Family Planning | Social Planning | Economic Factors | Planning | Programs Document Number: 329536 |
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