1.  Title: Human resources for health in the low-resource world: collaborative practice and task shifting in maternal and neonatal care. Author: FIGO Safe Motherhood and Newborn Health Committee Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):74-6. Abstract: An important barrier to the attainment of Millennium Development Goals (MDGs) 4 and 5 in many countries is the lack of trained and skilled clinical staff who can provide timely and high-quality care to mothers with pregnancy complications. This article presents guidelines and recommendations on how to better make use of existing health human resources in order to improve maternal and neonatal care. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | MATERNAL-CHILD HEALTH SERVICES | HUMAN RESOURCES | GYNECOLOGY | OBSTETRICS | OBSTETRICAL SURGERY | TRAINING PROGRAMS | Delivery of Health Care | Health | Primary Health Care | Health Services | Economic Factors | Medicine | Surgery | Treatment | Medical Procedures | Education Document Number: 341381 |
2.  Title: Human resources for health: Tools and publications. Author: Futures Group International. Health Policy Initiative Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Mar. [2] p. (USAID Contract No. GPO-I-01-05-00040-00) Abstract: The USAID | Health Policy Initiative, Task Order 1, fosters an enabling policy environment for improved health, especially HIV, family planning / reproductive health, and maternal health programs. Having adequate human resources is essential for scaling up and sustaining effective, accessible, high-quality health programs. To help ensure human resources, the project assists program planners to estimate human resource and training needs; identifies policy reforms to enable task-shifting and better workforce recruitment, training, and distribution; and mobilizes a multisectoral response by strengthening HIV-related human resources in workplaces, NGOs, and networks of people living with HIV (PLHIV). The project has also designed a Stigma Index that measures stigmatizing and discriminatory attitudes and behaviors among healthcare providers, highlighting an area that must be addressed by provider training initiatives. This flyer lists the project's computer models and publications on strengthening HIV-related human resource capacity. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | PERSONS LIVING WITH HIV/AIDS | HEALTH PERSONNEL | FAMILY PLANNING | REPRODUCTIVE HEALTH | MATERNAL HEALTH | WORKERS | RECRUITMENT ACTIVITIES | POLICY | COMPUTER PROGRAMS AND PROGRAMMING | STIGMA | SOCIAL DISCRIMINATION | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | Labor Force | Human Resources | Economic Factors | Program Activities | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Information Processing | Information | Social Problems Document Number: 331545 |
| 3. Title: Delivering services and influencing policy: health care professionals join forces to improve maternal, newborn, and child health. Author: Health Care Professional Association Writing Group Source: International Journal of Gynaecology and Obstetrics. 2009 Jun;105(3):271-4. Abstract: This article reviews the major activities of health care professional organizations (HCPAs), and emphasizes the role they can play in advocating for women and children and influencing maternal, newborn, and child health (MNCH) programs and policies. The ICM/FIGO joint effort to prevent postpartum hemorrhage and the 40-year partnership between the American Academy of Pediatrics (AAP) and the Indian Health Service (IHS) are highlighted as examples of how and why HCPAs should assume a leadership role in advocacy work. The action-oriented multicountry HCPA workshops organized by the Partnership for Maternal, Newborn, and Child Health (PMNCH) and the international HCPAs are also described. These capacity building workshops are aimed at strengthening the ability of HCPAs to organize, coordinate activities, and become more involved in program and policy development. Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH PERSONNEL | CAPACITY BUILDING | MATERNAL HEALTH | CHILD HEALTH | ANTENATAL CARE | HEALTH POLICY | Asia, Southern | Asia | Developing Countries | Delivery of Health Care | Health | Program Sustainability | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Policy | Political Factors | Sociocultural Factors Document Number: 341372 |
| 4. Title: Global action for health system strengthening: Policy recommendations to the G8 Task Force on Global Action for Health System Strengthening. Author: Japan Center for International Exchange. Task Force on Global Action for Health System Strengthening Source: Tokyo, Japan, Japan Center for International Exchange, 2009. 131 p. Abstract: On January 16, 2009, a high-level working group on global health convened by the Japan Center for International Exchange (JCIE) released a report to the Japanese government outlining measures that the G8 countries should take to set them on a path toward fulfilling their existing commitments to contributing to an overall improvement in the health of individuals and communities around the world. The Working Group on Challenges in Global Health and Japan's Contributions (the "Takemi Working Group") is chaired by Japan's former Senior Vice Minister for Health, Labour and Welfare Keizo Takemi and directed by JCIE President Tadashi Yamamoto. The Japanese government will pass the report to the Italian government, encouraging them to put these recommendations on the agenda of the 2009 G8 Summit in Italy. The report includes chapters by an international team of researchers and advisors on three specific building blocks of health systems-health financing, health information, and the health workforce-that are generally acknowledged to be critical components of any strong health system. While each paper offers specific recommendations for improvements that can be made in each individual building block, they also come to several common conclusions: 1.) While there is still a dire need for more resources-financial, human, and knowledge resources-in the global health field, there is also a critical need to use existing resources more efficiently and more effectively. Recognizing that the current global financial environment will make it even more difficult to secure the resources needed to make health systems work better for everyone, the paper writers recommend complementing the quest for more resources with creative thinking on ways to achieve better health outcomes with the resources we already have. 2.) The human security concept, which has become a pillar of Japan's foreign policy, is identified as a promising approach that can be adopted globally for strengthening health systems. Human security's emphasis on the wellbeing of individuals and communities is very much in line with the ultimate goal of health system strengthening: improving people's health and making health services available to all so that they can be healthy, productive members of society. Human security also responds to the complexity of health system strengthening with its focus on integrating community empowerment with protection strategies and its recognition of the dynamic way in which health is interconnected with many other human security challenges. 3.) In all areas of health system strengthening, donor countries tend to tell their partners in developing countries how they should behave and make decisions. This can lead to confusion, with contradicting instructions often coming from multiple donors and even from single donors, and loss of motivation for stakeholders in partner countries to take ownership of processes to improve their own health sectors. Contributing to this challenge, capacity for making informed decisions on health is often weak, further discouraging domestic decision making in planning and management of health systems. The paper writers all recommend that donor countries invest in capacity building for health sector decision making at the national and local levels and, at the same time, encourage stakeholders in partner countries to drive their own planning and implementation processes. 4.) Finally, the paper writers all recommend that the G8 follow through on its commitment to accountability by establishing an annual review of its activities and accomplishments within each of these three building blocks. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | CONFERENCES AND CONGRESSES | RECOMMENDATIONS | SYSTEMS ANALYSIS | HEALTH PERSONNEL | LABOR FORCE | HEALTH POLICY | FOREIGN AID | CAPACITY BUILDING | GOVERNMENT FINANCING | INFORMATION SERVICES | PRIMARY HEALTH CARE | INTERNATIONAL COOPERATION | COORDINATION | Research Methodology | Delivery of Health Care | Health | Human Resources | Economic Factors | Policy | Political Factors | Sociocultural Factors | Financial Activities | Program Sustainability | Programs | Organization and Administration | Information | Health Services Document Number: 328416 |
| 5. Title: mHealth for development: The opportunity of mobile technology for healthcare in the developing world. Author: Vital Wave Consulting Source: Washington, D.C., United Nations Foundation, 2009. 66 p. Abstract: Mounting interest in the field of mHealth -- the provision of health-related services via mobile communications -- can be traced to the evolution of several interrelated trends. In many parts of the world, epidemics and a shortage of healthcare workers continue to present grave challenges for governments and health providers. Yet in these same places, the explosive growth of mobile communications over the past decade offers a new hope for the promotion of quality healthcare. Among those who had previously been left behind by the 'digital divide,' billions now have access to reliable technology. There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services -- even in some of the most remote and resource-poor environments. This report examines issues at the heart of the rapidly evolving intersection of mobile phones and healthcare. It helps the reader to understand mHealth's scope and implementation across developing regions, the health needs to which mHealth can be applied, and the mHealth applications that promise the greatest impact on heath care initiatives. It also examines building blocks required to make mHealth more widely available through sustainable implementations. Finally, it calls for concerted action to help realize mHealth's full potential. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | PUBLIC HEALTH | TELECOMMUNICATIONS | INFORMATION DISTRIBUTION | EDUCATION | AWARENESS | DATA COLLECTION | PRIMARY HEALTH CARE | TRAINING ACTIVITIES | HEALTH PERSONNEL | DISEASE PREVENTION | TECHNOLOGY | TREATMENT | ADMINISTRATION AND DOSAGE | DRUGS | HIV TESTING | HIV PREVENTION | Health | Broadcast Media | Mass Media | Communication | Knowledge | Sociocultural Factors | Research Methodology | Health Services | Delivery of Health Care | Training Programs | Prevention and Control | Diseases | Economic Factors | Medical Procedures | Medicine | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | HIV Infections | Viral Diseases Document Number: 331450 |
| 6. Peer Reviewed Title: PMTCT, HAART, and childbearing in Mozambique: an institutional perspective. Author: Agadjanian V; Hayford SR Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S103-S112. Abstract: Maternal and Child Health (MCH) units, where VCT/PMTCT/HAART have been integrated with traditional services, play a critical role in the connection between the massive HAART rollout and reproductive behavior. In this article, we use data from semi-structured interviews with MCH workers and ethnographic observations carried out in southern Mozambique to explore this role from the institutional perspective. We find that, along with logistical and workload problems, the de facto segregation of PMTCT/HAART clients within the “integrated” MCH system and the simplistic and uncompromising message discouraging further fertility and stressing condom-based contraception may pose serious challenges to a successful formulation and implementation of reproductive goals among seropositive clients. Although the recency of PMTCT/HAART services may partly explain these challenges, we argue that they are due largely to cultural miscommunication between providers and clients. We show how the cultural gap between the two is bridged by community activists and peer interactions among clients. Language: English Keywords: MOZAMBIQUE | RESEARCH REPORT | HEALTH PERSONNEL | SUPPORT GROUPS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | MATERNAL-CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | HEALTH SERVICES ADMINISTRATION | INTERVIEWS | FERTILITY PREFERENCES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Delivery of Health Care | Health | Social Networks | Friends and Relatives | Family and Household | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Diseases | HIV | HIV Infections | Viral Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Primary Health Care | Programs | Organization and Administration | Management | Data Collection | Research Methodology | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 341906 |
| 7. Title: Attitudes of healthcare providers towards patients with HIV/AIDS in Bandar Abbas. Author: Aghamolaei T; Tavafian SS; Hasani L; Zare S Source: Archives of Iranian Medicine. 2009 May;12(3):298-301. Abstract: We aimed to investigate the attitudes of healthcare providers towards patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in Bandar Abbas, south of Iran. In this cross-sectional study, a random sample of 250 healthcare providers completed a 20-item questionnaire from January first through February 30th, 2007. There were five domains of attitudes towards patients with HIV. The items measured as a five-point Likert scale ranging from strongly disagree to strongly agree. The mean age of the healthcare providers was 31.3 (SD=7.3) years. Of them 24.4% were males, 42.4% had received Bachelor of Science degree, 19.2% were physicians, 63.2% were nurses, and 17.6% were laboratory technicians. The respondents had fairly positive attitudes towards patients with HIV. Men, older age, more educated participants, and laboratory technicians had more favorable attitude towards HIV (P<0.05). Language: English Keywords: IRAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HEALTH PERSONNEL | CLIENTS | PERSONS LIVING WITH HIV/AIDS | STAFF ATTITUDE | HIV INFECTIONS | AIDS | LABORATORY PROCEDURES | Middle East | Developing Countries | Research Methodology | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services Document Number: 342660 |
| 8. Title: Compensation for the brain drain from developing countries [editorial] Author: Agwu K; Llewelyn M Source: Lancet. 2009 May 16;373(9676):1665-6. Abstract: This article examines the consequences and roots of health-worker migration from Sub-Saharan Africa to the developed world, especially to UK, USA and Canada. It explores the results of the major transfer of riches from poor societies to the affluent and discusses a compensation proposal for global justice. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | BRAIN DRAIN | RISK FACTORS | MATERNAL MORTALITY | INFANT MORTALITY | EMPLOYMENT | IMPACT | Delivery of Health Care | Health | International Migration | Migration | Population Dynamics | Demographic Factors | Population | Mortality | Macroeconomic Factors | Economic Factors | Communication Document Number: 341604 |
| 9. Title: Experience with side effects among users of injectables, the IUD, and oral contraceptive pills in four urban areas of Honduras. Author: Barden-O'Fallon J; Speizer I; Rodriguez F; Calix J Source: Health Care For Women International. 2009 Jun;30(6):475-83. Abstract: Contraceptive side effects are often the most commonly reported reason for method discontinuation, particularly of modern methods. We use data from eight focus groups and 800 exit interviews to examine women's experiences with contraceptive side effects in four urban areas of Honduras. Ease of treatment and differences in motivation to avoid pregnancy are suggested explanations for why side effects cause some women to continue and others to discontinue. Although side effects are a common reason for discontinuation in this population, less than half of the surveyed women were informed about potential side effects by a health worker on the day of the interview. Language: English Keywords: HONDURAS | RESEARCH REPORT | FOCUS GROUPS | URBAN AREAS | HEALTH PERSONNEL | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | INJECTABLES | IUD SIDE EFFECTS | PROGRAM ACCEPTABILITY | Developing Countries | Central America | Latin America | Americas | Data Collection | Research Methodology | Geographic Factors | Population | Delivery of Health Care | Health | Demographic Factors | Contraceptive Safety | Safety | Public Health | Contraceptive Methods | Contraception | Family Planning | IUD | Program Evaluation | Programs | Organization and Administration Document Number: 341018 |
| 10. Peer Reviewed Title: "Conditional scholarships" for HIV/AIDS health workers: educating and retaining the workforce to provide antiretroviral treatment in sub-Saharan Africa. Author: Barnighausen T; Bloom DE Source: Social Science and Medicine. 2009 Feb;68(3):544-51. Abstract: Without large increases in the number of health workers to treat HIV/AIDS (HAHW) many countries in sub-Saharan Africa will be unable to achieve universal coverage with antiretroviral treatment (ART), leading to large numbers of avoidable deaths among people living with HIV/AIDS. We conduct a cost-benefit analysis of a health care education scholarship that is conditional on the recipient committing to work for several years after graduation delivering ART in sub-Saharan Africa. Such a scholarship could address two of the main reasons for the low numbers of health workers in sub-Saharan Africa: low education rates and high emigration rates. We use Markov Monte Carlo microsimulation to estimate the expected net present value (eNPV) of "conditional scholarships" in sub-Saharan Africa. The scholarships are highly eNPV-positive under a wide range of assumptions. Conditional scholarships for a HAHW team sufficient to provide ART for 500 patients have an eNPV of 1.24 million year-2000 US dollars, assuming that the scholarship recipients are in addition to the health workers who would have been educated without scholarships and that the scholarships reduce annual HAHW emigration probabilities from 15% to 5% for five years. The eNPV of the education effect of the scholarships is larger than eNPV of the migration effect. Policy makers should consider implementing "conditional scholarships" for HAHW, especially in countries where health worker education capacity is currently underutilized or can be rapidly expanded. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | MARKOV CHAIN | LABOR FORCE | HEALTH PERSONNEL | HUMAN RESOURCES | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | AIDS | COST BENEFIT ANALYSIS | MANAGEMENT | Africa | Developing Countries | Probability | Statistical Studies | Studies | Research Methodology | Economic Factors | Delivery of Health Care | Health | HIV | Viral Diseases | Diseases | Quantitative Evaluation | Evaluation | Organization and Administration Document Number: 330870 |
| 11. Peer Reviewed Title: Provision of abortion by mid-level providers: international policy, practice and perspectives. Author: Berer M Source: Bulletin of the World Health Organization. 2009 Jan;87(1):58-63. Abstract: Based on articles found on the PubMed and Popline databases on the provision of first-trimester abortion by mid-level providers, this article describes policies on type of abortion provider, comparative studies of different types of abortion provider, provider perspectives, and programmatic experience in Bangladesh, Cambodia, France, Mozambique, South Africa, Sweden, the United States of America and Viet Nam. It shows that it is safe and beneficial for suitably trained mid-level health-care providers, including nurses, midwives and other non-physician clinicians, to provide first-trimester vacuum aspiration and medical abortions. Moreover, it finds that projects in Kenya, Myanmar and Uganda have successfully trained nurse-midwives to provide post-abortion care for incomplete abortion with manual vacuum aspiration, and that studies in Ethiopia and India have recommended that providers such as auxiliary nurse-midwives should be trained in abortion service delivery to ensure that they provide safe abortions for low-income women. The paper recommends the authorization of all qualified mid-level health-care providers to carry out first-trimester abortions, and it also recommends the integration of training in providing first-trimester abortion care into basic education and clinical training for all mid-level providers and medical students interested in obstetrics and gynaecology. Finally, it calls for documentation of the role of mid-level providers in managing second-trimester medical abortions to further inform policy and practice. Language: English Keywords: DEVELOPING COUNTRIES | DEVELOPED COUNTRIES | RECOMMENDATIONS | COMPARATIVE STUDIES | CLINICAL RESEARCH | HEALTH PERSONNEL | ABORTION | PREGNANCY, FIRST TRIMESTER | POSTABORTION CARE | TRAINING PROGRAMS | Studies | Research Methodology | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Health Services | Education Document Number: 341127 |
| 12. Title: Task-shifting: exposing the cracks in public health systems [editorial] Author: Berer M Source: Reproductive Health Matters. 2009 May;17(33):4-8. Abstract: This editorial piece discusses the innovative efforts to increase access to skilled reproductive health care especially in resource-poor settings where physicians are in short supply or physicians are not necessary due to trained mid-level providers performing procedures. It also examines the lack of capacity or failure of developing countries to build and strengthen their health systems and develop a strong, well-trained public health workforce. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | PUBLIC HEALTH | PRIMARY HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | HUMAN RESOURCES | TRAINING ACTIVITIES | HEALTH POLICY | DELIVERY OF HEALTH CARE | ANTIRETROVIRAL THERAPY | FINANCIAL ACTIVITIES | QUALITY OF HEALTH CARE | Health | Health Services | Economic Factors | Training Programs | Education | Policy | Political Factors | Sociocultural Factors | HIV | HIV Infections | Viral Diseases | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 342010 |
| 13. Peer Reviewed Title: Barriers to research and capacity building at Hispanic-serving institutions: the case of HIV/AIDS research at the University of Puerto Rico. Author: Bernal G; Ortiz-Torres B Source: American Journal of Public Health. 2009 Apr;99 Suppl 1:S60-5. Abstract: Substantive barriers to research, such as cultural, language, and methodological variables, exist in Hispanic-serving institutions. Historical and contextual variables account for the differences between academic settings with research-intensive centers and those with limited infrastructure for competitive research. We provide a case example to serve as a model for developing and strengthening the research infrastructure in Hispanic-serving institutions and for providing the mentorship Latino investigators may need to compete with other investigators in research-intensive centers. We present recommendations to reduce these barriers. Language: English Keywords: PUERTO RICO | CRITIQUE | RECOMMENDATIONS | CASE STUDIES | EXPERIMENTAL MODELS | HISPANICS | HEALTH PERSONNEL | UNIVERSITIES | RESEARCH ACTIVITIES | HIV | AIDS | CAPACITY BUILDING | CULTURE | LANGUAGE | PARTICIPATION | Caribbean | Americas | Developed Countries | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Schools | Education | HIV Infections | Viral Diseases | Diseases | Program Sustainability | Programs | Organization and Administration | Sociocultural Factors | Communication | Social Behavior | Behavior Document Number: 330955 |
| 14. Title: Acquiring allergen information from condom manufacturers: a questionnaire survey. Author: Blyumin ML; Rouhani P; Avashia NJ; Jacob SE Source: Dermatitis. 2009 May-Jun;20(3):161-70. Abstract: BACKGROUND: Allergic contact dermatitis from condoms is a problem that carries significant morbidity and that has been increasingly reported due to the use of condoms to prevent sexually transmitted diseases as well as for birth control. OBJECTIVE: The purpose of the study is to evaluate the process by which condom manufacturing companies divulge product allergen information to health care professionals. METHODS: An interviewer-administered telephone questionnaire eliciting the staff member's knowledge of condom allergens was utilized. Eligible respondents were condom manufacturers' service staff over 18 years of age. RESULTS: Complete surveys were obtained regarding 36 (85.7%) of the 42 subtypes of condoms. Telephoning was the primary (75%) method of obtaining allergen information. The majority (63.9%) of the information was obtained within minutes to hours of the initial contact. Nearly two-thirds of the interviews evaluated the condom manufacturers' service staff as good and effective in their knowledge base and in providing product information. CONCLUSION: The study determined that the extent of knowledge, helpfulness, and effectiveness of the customer service personnel in relaying product allergen information to clinicians were generally good. The study additionally generated a reference table outlining the common allergens in major manufactured condoms. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | HEALTH PERSONNEL | FAMILY PLANNING PERSONNEL | CONDOMS | ALLERGIC REACTION | DERMATITIS | INFORMATION | KNOWLEDGE | INTERVIEWS | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Barrier Methods | Contraceptive Methods | Contraception | Signs and Symptoms | Diseases | Sociocultural Factors | Data Collection Document Number: 341311 |
| 15. Title: Placing learning needs in context: distance learning for clinical officers in Tanzania. Author: Brigley S; Hosein I; Myemba I Source: Medical Teacher. 2009 Apr;31(4):e169-76. Abstract: BACKGROUND: Poor public health indicators in Tanzania have led to the upgrading of nursing and clinical personnel who currently have just core training. Clinical officers (COs) have 3 years training in basic and applied medicine and are responsible for healthcare of large and dispersed rural populations. AIMS: UNESCO-Wales has funded colleagues in Wales (UK) to assist the upgrade of COs. An inquiry into their learning needs and the Tanzanian context has produced a framework for design of a module for COs on sexually transmissible infections and HIV & AIDS by distance learning. METHODS: Face-to-face discussions were held with the Ministry of Health, healthcare workers, educators and administrators in Tanzania; a review of training documents was carried out; and a follow-up questionnaire issued to COs. RESULTS: The discussions and review highlighted teacher-centred approaches, and management, infrastructure and resources obstacles to curriculum change. Principal learning needs of COs around STIs were: counselling, syndromic management, drugs management, laboratory diagnosis, health education, resources, staffing and service morale. CONCLUSIONS: Placing learning needs in context in dialogue with Tanzanian colleagues was an advance on simple transfer of educational technologies and expertise. The inquiry resulted in a draft study guide and resources pack that were positively reviewed by Tanzanian tutors. Management and resources issues raised problems of sustainability in the module implementation. Language: English Keywords: TANZANIA | SUMMARY REPORT | HEALTH PERSONNEL | DISTANCE EDUCATION | TRAINING PROGRAMS | NEEDS | UNESCO | CURRICULUM | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | AIDS | TREATMENT | OBSTACLES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Delivery of Health Care | Health | Education | Economic Factors | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Organization and Administration Document Number: 341949 |
| 16. Peer Reviewed Title: Two-year virologic outcomes of an alternative AIDS care model: evaluation of a peer health worker and nurse-staffed community-based program in Uganda. Author: Chang LW; Alamo S; Guma S; Christopher J; Suntoke T; Omasete R; Montis JP; Quinn TC; Juncker M; Reynolds SJ Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Mar 1;50(3):276-82. Abstract: BACKGROUND: There is growing concern about the human resources needed to care for increasing numbers of patients receiving antiretroviral therapy in resource-limited settings. We evaluated an alternative model, community-based, comprehensive antiretroviral program staffed primarily by peer health workers and nurses. METHODS: We conducted a retrospective cohort study of patients receiving antiretroviral therapy during the first 10 months of program enrollment beginning in late 2003. Virologic, immunologic, clinical, and adherence data were collected. RESULTS: Of 360 patients started on treatment, 258 (72%) were active and on therapy approximately 2 years later. Viral load testing demonstrated that 86% of active patients (211/246 tested) had a viral load <400 copies per milliliter. The median CD4 increase for active patients was 197 cells per cubic millimeter (interquartile range, 108-346). Patients with either a history of antiretroviral use or lack of CD4 response were more likely to experience virologic failure. Survival was 84% at 1 year and 82% at 2 years. World Health Organization stage 4 was predictive of both not sustaining therapy and increased mortality. CONCLUSIONS: A community-based antiretroviral treatment program in a resource-limited setting can provide excellent AIDS care over at least a 2-year period. A comprehensive program based upon peer health workers and nurses provides an effective alternative model for AIDS care. Language: English Keywords: UGANDA | RESEARCH REPORT | COHORT ANALYSIS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HEALTH PERSONNEL | ANTIRETROVIRAL THERAPY | AIDS | HEALTH SERVICES | USER COMPLIANCE | TREATMENT | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | HIV | Behavior | Medical Procedures | Medicine Document Number: 330892 |
| 17. Peer Reviewed Title: Evaluation of uptake and attitude to voluntary counseling and testing among health care professional students in Kilimanjaro region, Tanzania. Author: Charles MP; Kweka EJ; Mahande AM; Barongo LR; Shekalaghe S; Nkya HM; Lowassa A; Mahande MJ Source: BMC Public Health. 2009 May;9(128):1-9. Abstract: A structured questionnaire was used among health care professional students aged 18-25 years who were enrolled in degree, diploma, and certificate courses at Kilimanjaro Christian Medical College and all other allied health schools. A total of 309 students were recruited; among these 197 (63.8%) were females. All respondents were aware of the benefits of voluntary counseling and testing (VCT). Only 107 (34.6%) of students had previously gone to VCT. Risk perception among the students was low (37.2%) even though they were found to have higher risk behaviors that predisposed them to becoming infected with HIV. Language: English Keywords: TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | HEALTH PERSONNEL | VOLUNTARY COUNSELING AND TESTING | AWARENESS | PROGRAM ACCEPTABILITY | SEX BEHAVIOR | RISK BEHAVIOR | ATTITUDES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Education | Delivery of Health Care | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Knowledge | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Behavior | Psychological Factors Document Number: 341407 |
| 18. Title: Impact of a peer-group intervention on occupation-related behaviors for urban hospital workers in Malawi. Author: Chimango JL; Kaponda CN; Jere DL; Chimwaza A; Crittenden KS; Kachingwe SI; Norr KF; Norr JL Source: Journal of the Association of Nurses In AIDS Care. 2009 Jul-Aug;20(4):293-307. Abstract: Using a pre- and posttest design with no control group, the authors evaluated the impact of a peer-group intervention on work related knowledge and behavior for health workers at an urban hospital in Malawi. The authors surveyed unmatched random samples of health workers, observed workers on the job, and interviewed clients about hospital services at baseline and at 6 months after the intervention. Universal precautions knowledge, reported hand washing, and reported client teaching were significantly higher at the final evaluation. The outcome differences remained robust in multivariate analyses with controls for demographic factors of age, gender, education, food security, and job category. Observations reported consistently greater use of universal precautions, more respectful interactions, and more client teaching at final evaluation. Patient surveys reported more discussion with health workers about HIV at the final evaluation. Peer-group interventions can prepare health workers in Malawi for HIV prevention and offer a potential model for other African countries. Language: English Keywords: MALAWI | RESEARCH REPORT | SAMPLING STUDIES | URBAN POPULATION | HEALTH PERSONNEL | PEER EDUCATORS | HIV PREVENTION | INTERVENTIONS | HOSPITALS | TRAINING PROGRAMS | UNIVERSAL PRECAUTIONS | KNOWLEDGE | HANDWASHING | INTERPERSONAL RELATIONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Education | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Health Facilities | Safety | Public Health | Sociocultural Factors | Hygiene | Behavior Document Number: 342814 |
| 19. Peer Reviewed Title: Surgical task shifting in Sub-Saharan Africa. Author: Chu K; Rosseel P; Gielis P; Ford N Source: PLoS Medicine. 2009 May 19;6(5):e1000078. Abstract: Surgically treatable problems account for a significant proportion of disease burden in resourcelimited settings, but are neglected due to lack of skilled professionals, adequate infrastructure and equipment, and the perception that surgical services are complex and expensive. In the absence of trained surgeons, surgical tasks are often performed by non-specialist physicians and non-physician clinicians. While evaluations have proven the effectiveness of such task shifting, this is often done de facto, with little supervisory or training framework in place. As efforts increase to scale up surgical care in the developing world, a number of important lessons from task shifting in the field of HIV/AIDS care could serve to support task shifting in surgery. These include clearly defining the limits of task shifting, ensuring adequate training and supervision, providing adequate recognition and remuneration, developing simplified tools and guidelines, ensuring engagement with regulatory bodies, and mobilizing community health workers. Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | HEALTH PERSONNEL | SURGERY | ANESTHESIA | HUMAN RESOURCES | TRAINING PROGRAMS | AIDS | HIV INFECTIONS | REFERRAL AND CONSULTATION | SUPERVISION | ETHICS | Africa | Developing Countries | Delivery of Health Care | Health | Treatment | Medical Procedures | Medicine | Health Services | Economic Factors | Education | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Management | Sociocultural Factors Document Number: 341772 |
| 20. Title: Healthcare responsibilities and conscientious objection. Author: Cook RJ; Olaya MA; Dickens BM Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):249-52. Abstract: The Constitutional Court of Colombia has issued a decision of international significance clarifying legal duties of providers, hospitals, and healthcare systems when conscientious objection is made to conducting lawful abortion. The decision establishes objecting providers' duties to refer patients to non-objecting providers, and that hospitals, clinics, and other institutions have no rights of conscientious objection. Their professional and legal duties are to ensure that patients receive timely services. Hospitals and other administrators cannot object, because they do not participate in the procedures they are obliged to arrange. Objecting providers, and hospitals, must maintain knowledge of non-objecting providers to whom their patients must be referred. Accordingly, medical schools must adequately train, and licensing authorities approve, non-objecting providers. Where they are unavailable, midwives and perhaps nurse practitioners may be trained, equipped, and approved for appropriate service delivery. The Court's decision has widespread implications for how healthcare systems must accommodate conscientious objection and patients' legal rights. Language: English Keywords: COLOMBIA | CRITIQUE | HEALTH PERSONNEL | HOSPITAL PERSONNEL | ABORTION LAW | COURT DECISION | CONSTITUTION | REFERRAL AND CONSULTATION | HUMAN RIGHTS | ETHICS | Developing Countries | South America, Northern | South America | Latin America | Americas | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Litigation | Political Factors | Sociocultural Factors | Program Activities | Programs | Organization and Administration Document Number: 341638 |
| 21. Peer Reviewed Title: Factors associated with low early uptake of a national program to prevent mother to child transmission of HIV (PMTCT): results of a survey of mothers and providers, Botswana, 2003. Author: Creek T; Ntumy R; Mazhani L; Moore J; Smith M; Han G; Shaffer N; Kilmarx PH Source: AIDS and Behavior. 2009 Apr;13(2):356-364. Abstract: In Francistown, Botswana, approximately 40% of pregnant women are HIV positive. PMTCT has been available since 1999, antiretroviral (ARV) therapy since 2001, and 95% of women have antenatal care (ANC) and deliver in hospital. However, in 2002, only 33% of ANC clients were tested for HIV, and not all women with HIV received services. In 2003, we conducted a survey of 504 pregnant and postpartum women to explore reasons for poor program uptake, and interviewed 82 health providers about PMTCT. Most women (95%) believed that all pregnant women should be tested for HIV. In multivariate analysis, factors associated with having an HIV test included being interviewed at an urban site, having a high PMTCT knowledge score, knowing someone receiving PMTCT or ARV therapy, and having a partner who had been tested for HIV. Neither fear of stigma nor resistance from partners were frequent reasons for refusing an HIV test. Providers of HIV services reported discomfort with their knowledge and skills, and 84% believed HIV testing should be routine. Ensuring adequate knowledge about HIV and PMTCT, creating systems whereby HIV-positive women receiving care can educate and support other women, and making HIV testing routine for pregnant women may improve the uptake of HIV testing. Language: English Keywords: BOTSWANA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | SEXUAL PARTNERS | POSTPARTUM WOMEN | URBAN POPULATION | HEALTH PERSONNEL | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | GOVERNMENT PROGRAMS | ANTENATAL CARE | KNOWLEDGE | HIV TESTING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Puerperium | Reproduction | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 340126 |
| 22. Peer Reviewed Title: Validation of community health workers' assessment of neonatal illness in rural Bangladesh. Author: Darmstadt GL; Baqui AH; Choi Y; Bari S; Rahman SM; Mannan I; Ahmed AS; Saha SK; Rahman R; Chang S; Winch PJ; Black RE; Santosham M; El Arifeen S Author: Bangladesh Projahnmo-2 (Mirzapur) Study Group Source: Bulletin of the World Health Organization. 2009 Jan;87(1):12-9. Abstract: OBJECTIVE: To estimate the validity (sensitivity, specificity, and positive and negative predictive values) of a clinical algorithm as used by community health workers (CHWs) to detect and classify neonatal illness during routine household visits in rural Bangladesh. METHODS: CHWs evaluated breastfeeding and symptoms and signs of illness in 395 neonates selected randomly from neonatal illness surveillance during household visits on postnatal days 0, 2, 5 and 8. Neonates classified with very severe disease (VSD) were referred to a community-based hospital. Within 12 hours of CHW assessments, physicians independently evaluated all neonates seen in a given day by one CHW, randomly chosen from among 36 project CHWs. Physicians recorded symptoms and signs of illness, classified the illness, and determined whether the newborn needed referral-level care at the hospital. Physicians' identification and classification were used as the gold standard in determining the validity of CHWs' identification of symptoms and signs of illness and its classification. FINDINGS: CHWs' classification of VSD showed a sensitivity of 73%, a specificity of 98%, a positive predictive value of 57% and a negative predictive value of 99%. A maternal report of any feeding problem as ascertained by physician questioning was significantly associated (P < 0.001) with 'not sucking at all' and 'not attached at all' or 'not well attached' as determined clinically by CHWs during feeding assessment. CONCLUSION: CHWs identified with high validity the neonates with severe illness needing referral-level care. Home-based illness recognition and management, including referral of neonates with severe illness by CHWs, is a promising strategy for improving neonatal health and survival in low-resource developing country settings. Language: English Keywords: BANGLADESH | RESEARCH REPORT | VALIDITY | RURAL POPULATION | HEALTH PERSONNEL | NEONATAL DISEASES AND ABNORMALITIES | HOME CARE | PERFORMANCE IMPROVEMENT | CHILD SURVIVAL | CHILD HEALTH | EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Diseases | Care and Support | Health Services | Management | Organization and Administration | Survivorship | Length of Life | Mortality | Population Dynamics | Medical Procedures | Medicine Document Number: 341189 |
| 23. Peer Reviewed Title: Task shifting for emergency obstetric surgery in district hospitals in Senegal. Author: De Brouwere V; Dieng T; Diadhiou M; Witter S; Denerville E Source: Reproductive Health Matters. 2009 May;17(33):32-44. Abstract: Due to a long-term shortage of obstetricians, the Ministry of Health of Senegal and Dakar University Obstetric Department agreed in 1998 to train district teams consisting of an anaesthetist, general practitioner and surgical assistant in emergency obstetric surgery. An evaluation of the policy was carried out in three districts in 2006, covering trends in rates of major obstetric interventions, outcomes in newborns and mothers, and the views of key informants, community members and final year medical students. From 2001 to 2006, 11 surgical teams were trained but only six were functioning in 2006. The current rate of training is not rapid enough to cover all districts by 2015. An increase in the rate of interventions was noted as soon as a team had been put in place, but unmet need persisted. Central decision-makers considered the policy more viable than training gynaecologists for district hospitals, but resistance from senior academic clinicians, a perceived lack of career progression among the doctors trained, and lack of programme coordination were obstacles. Practitioners felt the work was valuable, but complained of low additional pay and not being replaced during training. Communities appreciated that the services saved lives and money, but called for improved information and greater continuity of care. Spanish Abstract: Debido a la prolongada escasez de obstetras, el Ministerio de Salud de Senegal y el Departamento Obstétrico de la Universidad de Dakar acordaron, en 1998, capacitar a equipos distritales integrados por un anestesista, un médico general y un auxiliar quirúrgico en cirugía obstétrica de emergencia. En 2006, se realizó una evaluación de la política en tres distritos, donde se examinaron las tendencias en las tasas de intervenciones obstétricas importantes, los resultados en recién nacidos y madres, y los puntos de vista de informantes clave, miembros de la comunidad y estudiantes de medicina en su último año académico. Del 2000 al 2006, 11 equipos quirúrgicos fueron capacitados, pero sólo seis funcionaban en 2006. El ritmo actual de capacitación no es suficientemente rápido para abarcar todos los distritos al cabo del 2015. Se observó un aumento en el índice de intervenciones tan pronto se establecía un equipo, pero la necesidad insatisfecha persistió. Las autoridades decisorias centrales estimaron que esta política era más viable que capacitar ginecólogos en los hospitales distritales. Entre los obstáculos figuraban la resistencia de los médicos académicos sénior, la percibida falta de ascenso profesional entre los médicos capacitados y la falta de coordinación del programa. Los médicos estimaron el trabajo valioso, pero se quejaban de la baja paga adicional y de no ser sustituidos durante la capacitación. Las comunidades estaban agradecidas porque los servicios salvaron vidas y ahorraron dinero, pero solicitaron mejor información y mayor continuidad de servicios. French Abstract: Face au manque d'obstétriciens à long terme, le Ministère sénégalais de la santé et le Département d'obstétrique de l'Université de Dakar ont convenu en 1998 de former des équipes de district composées d'un anesthésiste, d'un médecin généraliste et d'un assistant en chirurgie obstétricale d'urgence. En 2006, une évaluation de la politique a été menée dans trois districts pour analyser les tendances des principales interventions obstétricales, les résultats pour les nouveau-nés et les mères et les opinions des informateurs clés, des membres des communautés et des étudiants en dernière année de médecine. De 2001 à 2006, 11 équipes chirurgicales ont été formées mais six seulement fonctionnaient encore en 2006. Le rythme actuel de formation n'est pas assez rapide pour couvrir tous les districts d'ici à 2015. Une augmentation du taux d'interventions a été notée dès la mise en place d'une équipe, mais les besoins insatisfaits demeuraient. Pour les décideurs centraux, cette politique était plus viable que la formation de gynécologues pour les hôpitaux de district, mais elle se heurtait à la résistance des professeurs cliniciens, à un manque perçu de possibilités d'avancement pour les médecins formés et à une coordination insuffisante entre programmes. Les praticiens estimaient que le travail était utile, mais déploraient la faible rémunération complémentaire et regrettaient de ne pas être remplacés pendant la formation. Les communautés se félicitaient que les services sauvent des vies et économisent de l'argent, mais demandaient davantage d'information et une plus grande continuité des soins. Language: English Keywords: SENEGAL | RESEARCH REPORT | HEALTH PERSONNEL | EMERGENCY SERVICES | OBSTETRICAL SURGERY | HOSPITALS | CESAREAN SECTION | TRAINING PROGRAMS | PROGRAM EVALUATION | HEALTH POLICY | OBSTACLES | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Delivery of Health Care | Health | Health Services | Surgery | Treatment | Medical Procedures | Medicine | Health Facilities | Education | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors Document Number: 342013 |
| 24. Title: Adolescent contraceptive care for the practicing pediatrician. Author: Duffy K; Wimberly Y; Brooks C Source: Adolescent Medicine. 2009 Apr;20(1):168-87, x. Abstract: Improved use of contraception has been intrinsic in the decline of teenaged pregnancies in the United States. Recent advances in contraception, including the development of new progestins and longer-acting reversible methods, have greatly increased the options available for adolescents. By frankly discussing adverse effects, offering clear explanations of noncontraceptive benefits, and developing strategies for improving compliance, providers can play a key role in facilitating successful contraceptive use in young patients. Language: English Keywords: GEORGIA | UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS | HEALTH PERSONNEL | ADOLESCENT HEALTH | HEALTH SERVICES | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONTRACEPTION | CONFIDENTIAL INFORMATION | EMERGENCY CONTRACEPTION | ORAL CONTRACEPTIVES | PHYSICIAN-PATIENT RELATIONS | VAGINAL RING | INJECTABLES | IUD | COUNSELING | Developing Countries | Asia, Southwestern | Asia | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Family Planning | Ethics | Sociocultural Factors | Contraceptive Methods | Interpersonal Relations | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341530 |
| 26. Title: A learning agenda. Author: Eichler R; Levine R Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :79-86. Abstract: What elements of performance incentive programs lead to success? What pitfalls can be avoided? When do performance-based programs generate more bang for the buck than other approaches? What tools are needed to help governments and nongovernmental organizations (NGOs) put performance-based financing in place? Moving beyond the monitoring and evaluation that should be a part of any performance-based program (chapter 4), here we propose an agenda for learning that extends beyond any individual country or program. It is about developing knowledge and tools that can be used widely, rigorously measuring and understanding what works across settings, and creating an ongoing way to share and learn among those who are implementing and studying performance-based programs. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | HEALTH PERSONNEL | NEEDS ASSESSMENT | WAGES | HEALTH SERVICES | EVALUATION | HEALTH SERVICES ADMINISTRATION | Delivery of Health Care | Health | Macroeconomic Factors | Economic Factors | Management | Organization and Administration Document Number: 331464 |
| 27. Peer Reviewed Title: An evaluation of a brief motivational interviewing training course for HIV/AIDS counsellors in Western Cape Province, South Africa. Author: Evangeli M; Engelbrecht SK; Swartz L; Turner K; Forsberg L; Soka N Source: AIDS Care. 2009 Feb;21(2):189-96. Abstract: HIV/AIDS counselling in South Africa covers a range of areas of prevention and treatment with a commonly used model of lay counsellors trained by non-governmental organisations and working alongside professionals in public health settings. This study presents a single group evaluation of a six-session (12-hour) course of Motivational Interviewing (MI) delivered to 17 HIV/AIDS lay counsellors working in peri-urban settings in Western Cape Province, South Africa. Counsellors reported that they used MI techniques both at the start and at the end of the training. In addition, they reported confidence in their ability to influence their clients' motivation at both time points. The results from the ratings of role play performance showed that there was a marked change in emphasis over the group of counsellors from MI non-adherent practice before training (with advice giving, directiveness, control and confrontation) to more MI adherent practice (asking permission before giving advice, emphasising client autonomy, affirming the client and stressing the client's responsibility to change) at the end of the training. Only a small proportion of the counsellors reached the level of beginning proficiency (according to the Motivational Interviewing Treatment Integrity code) on the measure of the ratio of MI adherent to non-adherent responses. The ratio of reflections to questions and the percentage of open questions also showed improvements in performance across the group but generally to levels below that suggesting beginning proficiency in MI. There was no evidence of any change on global therapist ratings (of empathy and the spirit of MI, i.e. collaboration, evocation and autonomy support) or the percentage of complex reflections across the group of counsellors. Possible explanations for the results and public health implications are discussed. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | EVALUATION | INTERVIEWS | HEALTH PERSONNEL | COUNSELING | TRAINING ACTIVITIES | MOTIVATION | HIV INFECTIONS | AIDS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Delivery of Health Care | Health | Clinic Activities | Program Activities | Programs | Organization and Administration | Training Programs | Education | Psychological Factors | Behavior | Viral Diseases | Diseases Document Number: 330807 |
| 28. Title: Family Health Program professionals' view on family structures and health implications. Author: Gabardo RM; Junges JR; Selli L Source: Revista De Saude Publica. 2009 Feb;43(1):91-7. Abstract: OBJECTIVE: To describe perception of family structures and understanding of a healthy family by Programa Saude da Familia (Family Health Program) team members. METHODS: Research with a qualitative approach, employing the focus group technique, and involving the Program professionals from the city of Campo Bom, Southern Brazil, between June and August 2005. Sample was comprised of 12 professionals, including doctors, nurses, nursing technicians and community health agents. The following issues were investigated: the meaning of family; the meaning of the role of family; type of family most frequently cared for by professionals; the meaning of a healthy family; and types of family causing more difficulties of care. The methodological instrument used was content analysis. RESULTS: Two main categories were observed: family structures, where a great diversity of arrangements was found; and healthy family, where the predominance of speech is consistent with a multifaceted view on health, involving political, social, economic and cultural aspects. Professionals identify and respect distinct family structures and adapt medical treatment accordingly. CONCLUSIONS: Findings reveal that professionals are willing to deal with the different family structures present in their routine. Language: EnglishPortuguese Keywords: BRAZIL | URBAN AREAS | RESEARCH REPORT | FOCUS GROUPS | HEALTH PERSONNEL | FAMILY AND HOUSEHOLD | PERCEPTION | SOCIOCULTURAL FACTORS | HEALTH SERVICES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Data Collection | Research Methodology | Delivery of Health Care | Health | Psychological Factors | Behavior Document Number: 341989 |
| 29. Title: Should healthcare professionals be advocating long-acting reversible contraception? [editorial] Author: Glasier A Source: Women's Health. 2009 Jan;5(1):1-4. Abstract: The author comments on the reasons healthcare professionals should advocate long-acting reversible contraception (LARC). The three issues discussed are: cost--some providers and program managers find long-acting methods expensive; coercion--excessive enthusiasm for any method of contraception may risk potential users being pressured or coerced into using it; and STIs--some argue that increasing the use of LARC will decrease the use of condoms and so will put more people at risk of STIs. Language: English Keywords: GLOBAL | SUMMARY REPORT | HEALTH PERSONNEL | PREGNANCY, UNPLANNED | CONTRACEPTION | PROMOTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | Delivery of Health Care | Health | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Marketing | Economic Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases Document Number: 330873 |
| 30. Title: Technological profile assessment of voluntary HIV counseling and testing centers in Brazil. Author: Grangeiro A; Escuder MM; Wolffenbuttel K; Pupo LR; Nemes MI; Monteiro PH Source: Revista de Saude Publica. 2009 Jun;43(3):427-36. Abstract: OBJECTIVE: To characterize and analyze technological profiles of voluntary HIV counseling and testing centers in Brazil. METHODS: A structured self-completion questionnaire with 78 questions was used. This questionnaire was answered by 320 (83.6%) of the 383 Brazilian centers, in 2006. Responses that characterized the services' technological profile were analyzed using K-means clustering technique. Associations between the profiles described and the municipal contexts were analyzed using the chi-square and residue analysis for proportions, and ANOVA and Bonferroni for means. RESULTS: Centers showed significant deficiencies to guarantee adequate services. A total of four technological profiles were identified. The 'care' profile (21.6%) predominated among the services instituted before 1993, in areas with high AIDS incidence and in large cities. The 'prevention' profile (30.0%), prevalent between 1994 and 1998, was the type that best complies with the Ministry of Health's norms, with better readiness and productivity indicators. The 'care and prevention' profile (26.9%), included in the AIDS services, predominated between 1999 and 2002, and developed the most comprehensive set of activities, including STD treatment. The 'testing' profile (21.6%) was the most precarious, found where the epidemic is most recent and with a lower number of people tested. CONCLUSIONS: Counseling and testing centers constitute a set of heterogeneous services. In addition, service implementation guidelines have not been completely incorporated in Brazil, thus having and influence on low resolution and productivity indicators and also the inadequate development of prevention activities. Language: EnglishPortuguese Keywords: BRAZIL | RESEARCH REPORT | HEALTH PERSONNEL | VOLUNTARY COUNSELING AND TESTING | HIV PREVENTION | AIDS PREVENTION | HEALTH SERVICES EVALUATION | QUESTIONNAIRES | SEXUALLY TRANSMITTED DISEASES | TREATMENT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Delivery of Health Care | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | HIV Infections | Viral Diseases | Diseases | AIDS | Program Evaluation | Programs | Organization and Administration | Reproductive Tract Infections | Infections Document Number: 342658 |
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