Inmagic CS/WebPublisher PRO found 4399 records

Your search found 4399 record(s).
New Basic Search | New Advanced Search | POPLINE Document Delivery Policy

Title: Integrating multiple gender strategies to improve HIV and AIDS interventions: a compendium of programs in Africa.
Author: John Snow [JSI]. AIDS Support and Technical Resources [AIDSTAR-One]
Source: Washington, D.C., International Center for Research on Women [ICRW], 2009 May. [220] p. (USAID Contract No. GHH-I-00-07-00059-00)
Abstract: The United States Agency for International Development (USAID) AIDSTAR-One project created this compendium of selected HIV programs in sub-Saharan Africa that integrate multiple gender strategies. Featured programs address at least two of the following gender strategies: 1) reducing violence and sexual coercion; 2) addressing male norms and behaviors; 3) increasing women's legal protection; and 4) increasing women's access to income and productive resources. The compendium describes each of the 31 selected programs, and synthesizes trends and findings to provide initial insights on using multiple gender strategies in HIV programming, including how strategies are employed together, where gaps exist, and what lessons and experiences are common across programs. Though not meant to be exhaustive, the compendium represents the depth and breadth of current HIV programming that includes multiple gender strategies. Overall, we found that many innovative programs exist in sub-Saharan Africa and that implementers are successfully integrating multiple gender approaches into HIV programs. Program implementers report numerous benefits of combining gender strategies, including ensuring project salience and relevance, extending project reach, and reflecting the multiple, interrelated needs of beneficiaries. (Excerpts)
Language: English
Keywords:
AFRICA | SUMMARY REPORT | CASE STUDIES | RECOMMENDATIONS | HIV PREVENTION | INCOME GENERATION PROGRAMS | TREATMENT | CARE AND SUPPORT | FINANCIAL ACTIVITIES | VIOLENCE AGAINST WOMEN | GENDER ISSUES | PROGRAM ACTIVITIES | PROGRAM DESIGN | INTEGRATED PROGRAMS | POLICY | Developing Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Programs | Organization and Administration | Political Factors
Document Number: 331479

Subscription may be needed for full text

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

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

Title: Philani program: a case study of an integrative approach of empowerment and social and economic development.
Author: Austin SA; Mbewu N
Source: Social Work In Public Health. 2009 Jan-Apr;24(1-2):148-60.
Abstract: This article reports a case study of a South African nongovernmental organization's role in implementing maternal and child health care services for families in Khayelitsha, an informal township in the Western Cape. The township is an extremely poor community with high unemployment and many other social indicators of high need. The case study explores how services were enhanced to respond to the service needs of children and families. The role of economic development as a means of empowering the mothers is examined within the context of nongovernmental organization services. The implications of developing services that integrate social and economic development are discussed as a model for social work practice in the United States.
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | CASE STUDIES | NONGOVERNMENTAL ORGANIZATIONS | MATERNAL-CHILD HEALTH SERVICES | NEEDS | POVERTY | ECONOMIC DEVELOPMENT | SOCIAL DEVELOPMENT | WOMEN'S EMPOWERMENT | INTEGRATED PROGRAMS | SOCIAL POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Organizations | Political Factors | Sociocultural Factors | Primary Health Care | Health Services | Delivery of Health Care | Health | Economic Factors | Socioeconomic Factors | Women's Status | Programs | Organization and Administration | Policy
Document Number: 341952

5.
Title: Integrating syndromic case management of sexually transmitted diseases into primary healthcare services in Nigeria.
Author: Banwat EB; Egah DZ; Peter J; Barau C; Majang Y; Mafuyai S; Imade GE; Bukbuk DN
Source: Nigerian Journal of Medicine. 2009 Apr-Jun;18(2):215-8.
Abstract: BACKGROUND: Sexually transmitted diseases (STDs) are a huge public health problem; both the aetiological and clinical approaches to management have limitations. WHO has therefore developed an alternative strategy--the syndromic case management approach. This paper reports a training of healthcare providers at the Primary Health Centers aimed at integrating STD care into other services in the PHCs to improve management at the community level. METHODS: Sixteen nurses, from eight PHCs were trained on this new strategy. The training included: identification of STDs, use of flow charts, patient education and counseling, clinic management issues and record keeping and reporting. RESULTS: Over a period of eight weeks post training, about 731 clients were attended to, 451 (61.7%) had signs and symptoms of various STDs (genital discharge, genital ulcer, genital warts and lower abdominal pains). They were treated using the syndromic case approach. About 18.6% (84/451) were males and 81.4% (367/451) were Females. Singles (never married) constituted 32.8% (148/451) while 28.6% were married. About 26.6% and 12.0% were divorced and separated respectively. Age group 20-35 years was at highest risk of infection CONCLUSION: Syndromic case management of STDs can be conveniently integrated into the primary health care delivery system in Nigeria.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | NURSES AND NURSING | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | TREATMENT | PRIMARY HEALTH CARE | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | EXAMINATIONS AND DIAGNOSES | COUNSELING | PRE-POST TESTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Health Personnel | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Programs | Organization and Administration | Training Programs | Education | Clinic Activities | Program Activities | Program Evaluation
Document Number: 342684

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

Peer Reviewed

Title: Fertility intentions and reproductive health care needs of people living with HIV in Cape Town, South Africa: implications for integrating reproductive health and HIV care services.
Author: Cooper D; Moodley J; Zweigenthal V; Bekker LG; Shah I; Myer L
Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S38-S46.
Abstract: Tailoring sexual and reproductive health services to meet the needs of people living with the human immuno-deficiency virus (HIV) is a growing concern but there are few insights into these issues where HIV is most prevalent. This cross-sectional study investigated the fertility intentions and associated health care needs of 459 women and men, not sampled as intimate partners of each other, living with HIV in Cape Town, South Africa. An almost equal proportion of women (55%) and men (43%) living with HIV, reported not intending to have children as were open to the possibility of having children (45 and 57%, respectively). Overall, greater intentions to have children were associated with being male, having fewer children, living in an informal settlement and use of antiretroviral therapy. There were important gender differences in the determinants of future childbearing intentions, with being on HAART strongly associated with women's fertility intentions. Gender differences were also apparent in participants' key reasons for wanting children. A minority of participants had discussed their reproductive intentions and related issues with HIV health care providers. There is an urgent need for intervention models to integrate HIV care with sexual and reproduction health counseling and services that account for the diverse reproductive needs of these populations.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | URBAN POPULATION | PERSONS LIVING WITH HIV/AIDS | FERTILITY PREFERENCES | REPRODUCTIVE HEALTH | HEALTH SERVICES | NEEDS | COUNSELING | ANTIRETROVIRAL THERAPY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | FERTILITY DETERMINANTS | SEX FACTORS | HIV/FP INTEGRATION | INTEGRATED PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Fertility | Population Dynamics | Health | Delivery of Health Care | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | HIV | Disease Transmission Control | Prevention and Control
Document Number: 341901

10.

Peer Reviewed

Title: Intensified case finding for tuberculosis in prevention of mother-to-child transmission programs: a simple and potentially vital addition for maternal and child health.
Author: Deluca A; Chaisson RE; Martinson NA
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Feb 1;50(2):196-9.
Abstract: The intersection of HIV and tuberculosis (TB) poses a serious threat to HIV-infected women and their children. The majority of patients with TB in sub-Saharan Africa are infected with HIV, and together the overlapping epidemics synergistically accelerate illness and death. Escalating case rates, increased mortality, and the recent emergence of extensively drug-resistant TB highlights how catastrophic a once preventable and curable disease has become among people with HIV/AIDS. The HIV epidemic requires new strategies to control TB in high-burden areas especially as women of reproductive age are disproportionately affected by the epidemic. Intensified case finding for TB has the potential to reduce morbidity and mortality for people living with HIV, especially pregnant women, their families, and infants. (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | LITERATURE REVIEW | RECOMMENDATIONS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | COMPLICATIONS | INTEGRATED PROGRAMS | PREVALENCE | INCIDENCE | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infections | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Measurement
Document Number: 330367

11.

12.

Peer Reviewed

Title: Successful integration of tuberculosis and HIV treatment in rural South Africa: the Sizonq'oba study.
Author: Gandhi NR; Moll AP; Lalloo U; Pawinski R; Zeller K; Moodley P; Meyer E; Friedland G
Author: Tugela Ferry Care and Research (TFCaRes) Collaboration
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Jan 1;50(1):37-43.
Abstract: BACKGROUND: Tuberculosis (TB) is the leading cause of death among HIV-infected patients worldwide. In KwaZulu-Natal, South Africa, 80% of TB patients are HIV coinfected, with high treatment default and mortality rates. Integrating TB and HIV care may be an effective strategy for improving outcomes for both diseases. METHODS: Prospective operational research study treating TB/HIV-coinfected patients in rural KwaZulu-Natal with once-daily antiretroviral (ARV) therapy concurrently with TB therapy by home-based, modified directly observed therapy. Patients were followed for 12 months after ARV initiation. RESULTS: Of 119 TB/HIV-coinfected patients enrolled, 67 (56%) were female, mean age was 34.0 years, and median CD4 count was 78.5 cells per cubic millimeter. After 12 months on ARVs, mean CD4 count increase was 211 cells per cubic millimeter, and 88% had an undetectable viral load; 84% completed TB treatment. Thirteen patients (11%) died; 10 (77%) with multidrug-resistant or extensively drug-resistant TB. There were few severe adverse events or immune reconstitution events. Adherence was high with 93% of study visits attended and 99% of ARV doses taken. CONCLUSIONS: Integration of TB and HIV treatment in a rural setting using concurrent home-based therapy resulted in excellent adherence and TB and HIV outcomes. This model may result in successful management of both diseases in other rural resource-poor settings.
Language: English
Keywords:
SOUTH AFRICA | EVALUATION REPORT | PROSPECTIVE STUDIES | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RURAL POPULATION | INTEGRATED PROGRAMS | TUBERCULOSIS | AIDS PREVENTION | TREATMENT | RURAL HEALTH SERVICES | COMPLICATIONS | ANTIRETROVIRAL THERAPY | HOME VISITS | DRUG RESISTANCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Infections | AIDS | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Communication
Document Number: 330981

13.

Title: Disclosure of HIV status: experiences of patients enrolled in an integrated TB and HAART pilot programme in South Africa.
Author: Gebrekristos HT; Lurie MN; Mthethwa N; Karim QA
Source: African Journal of AIDS Research. 2009 Apr;8(1):1-6.
Abstract: The convergence between the tuberculosis (TB) and HIV epidemics has led to studies investigating strategies for integrated HIV and TB care. We present the experiences of a cohort of 17 patients enrolled in the first integrated TB and HIV treatment pilot programme, conducted in Durban, South Africa, as a precursor to a pivotal trial to answer the question of when to start antiretroviral treatment (ART) in patients co-infected with HIV and TB. Patients' experiences with integrated TB and HIV care can provide insight about the problems or benefits of introducing HIV treatment into existing TB care in resource-constrained settings, where stigma and discrimination are often pervasive and determining factors influencing treatment uptake and coverage. Individual interviews, focus group discussions, and observations were used to understand patients' experiences with integrated TB and HIV treatment. The patients described incorporating highly active antiretroviral therapy (HAART) into their daily routine as 'easy'; however, the patients experienced difficulties with disclosing their HIV status. Non-disclosure to sexual partners may jeopardise safer-sex practices and enhance HIV transmission. Being on TB treatment created a safe space for all patients to conceal their HIV status from those to whom they did not wish to disclose. The data suggest that the context of directly observed therapy (DOT) for TB may have the added benefit of creating a safe space for introducing ART to patients who would benefit most from treatment initiation but who are not ready or prepared to disclose their HIV status to others.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | QUALITATIVE RESEARCH | PILOT PROJECTS | CLIENTS | ANTIRETROVIRAL THERAPY | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | INTEGRATED PROGRAMS | AIDS | STIGMA | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | HIV | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Social Problems | Sociocultural Factors | Behavior
Document Number: 341282

14.

Peer Reviewed

Title: Fertility decline in Paraguay.
Author: Ishida K; Stupp P; Melian M
Source: Studies in Family Planning. 2009 Sep;40(3):227-234.
Abstract: Recent reproductive health survey show that the fertility rate in Paraguay decreased precipitously from 4.3 lifetime births per woman in 1995-98 to 2.9 births in 2001-04. In this study, we establish data consistency between the 1998 and 2004 surveys by comparing a series of cohort-specific period rates and use the Bongaarts framework of proximate determinants of fertility to demonstrate that an increase in the contraceptive prevalence rate (CPR) between 1998 and 2004 fully accounts for the fertility decline. Decomposition of rates shows that changes in group-specific CPRs explain a greater proportion of the change in the overall CPR than do changes in population composition by educational attainment, urban residence, region, and language spoken at home. Finally, we show that younger cohorts of women in 2004 reported ideal completed fertility desires of less than 2.9 births, suggesting that the fertility rate is likely to continue to decrease.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASES | FAMILY PLANNING | TREATMENT | HEALTH SERVICES | DELIVERY OF HEALTH CARE | INTEGRATED PROGRAMS | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Medical Procedures | Medicine | Health | Programs | Organization and Administration
Document Number: 339704

15.

Peer Reviewed

Title: The effect of interrupted 5-day training on Integrated Management of Neonatal and Childhood Illness on the knowledge and skills of primary health care workers.
Author: Kumar D; Aggarwal AK; Kumar R
Source: Health Policy and Planning. 2009 Mar;24(2):94-100.
Abstract: The conventional 8-day Integrated Management of Neonatal and Childhood Illness (IMNCI) training package poses several operational constraints, particularly due to its long duration. A 5-day training package was developed and administered in an interrupted mode of 3 days and 2 days duration with a break of 4 days in-between, in a district of Haryana state in northern India. Improvement in the knowledge and skills of 50 primary health care workers following the interrupted 5-day training was compared with that of 35 primary health care workers after the conventional 8-day IMNCI training package. The average score increased significantly (P < 0.05) from 46.3 to 74.6 in 8-day training and from 40.0 to 73.2 in 5-day training. Knowledge score improved for all health conditions, like anaemia, diarrhoea, immunization, malnutrition, malaria, meningitis and possible severe bacterial infection, and for breastfeeding in 8-day as well as in 5-day training. Average skills score for respiratory problems increased from 38 to 57 in 8-day training and from 41 to 91 in 5-day training. Corresponding increases in skill scores for diarrhoea assessment were from 28 to 67 and 48 to 75, and for breastfeeding assessment from 33 to 84 and 42 to 86 in 8-day and 5-day training, respectively. Average counselling skill score also rose from 42 to 89 in 8-day and from 37 to 70 in 5-day training. A direct cost saving of US$813 for a batch of 25 trainees and an indirect cost saving of 3 days per trainee and resource person makes the interrupted 5-day IMNCI training more cost-effective.
Language: English
Keywords:
INDIA | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | COST BENEFIT ANALYSIS | HEALTH PERSONNEL | TRAINING PROGRAMS | NEONATAL DISEASES AND ABNORMALITIES | CHILD HEALTH | INTEGRATED PROGRAMS | TIME FACTORS | PRIMARY HEALTH CARE | KNOWLEDGE | EXAMINATIONS AND DIAGNOSES | COST EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Delivery of Health Care | Health | Education | Diseases | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Health Services | Sociocultural Factors | Medical Procedures | Medicine | Evaluation Indexes
Document Number: 331230

16.

Peer Reviewed

Title: Intersectoral debate on social research strengthens alliances, advocacy and action for maternal survival in Zambia.
Author: Manandhar M; Maimbolwa M; Muulu E; Mulenga MM; O'Donovan D
Source: Health Promotion International. 2009 Mar;24(1):58-67.
Abstract: The Health Promotion Research Centre of the National University of Ireland, Galway and the University of Zambia's School of Medicine conducted operational research to understand and address the socio-cultural and gender contexts of maternal survival. Together with an analytical policy and programming review and qualitative research, the project process also involved the convening of 'Interest Group' meetings involving intersectoral stakeholders at Central (Lusaka) and Provincial (Kasama) levels. These meetings aimed to catalyse debate and stimulate advocacy on the project theme by using discussion of qualitative research as entry point. Participants came from government departments, civil society groups, the indigenous health system, academia, technical provider associations, and media, advocacy and human rights organisations. We found that engagement in Interest Groups was successful at Provincial level with lively participation from civil society, media and advocacy stakeholders and strong engagement by the health system. The process was welcomed as an opportunity to fill gaps in understanding about underlying social determinants of health and jointly explore intervention approaches. Overburdened government staff at central level faced with disease-focused interventions rather than underlying contextual determinants, and a weak culture of health sector engagement with civil society, academics and activists, contributed to less successful functioning in Lusaka. Final Dissemination and Discussion Events incorporated material from Interest Group Meetings to stimulate wider discussion and make recommendations. This project highlights the potential value of intersectoral stakeholder discussions from the inception stage of research to stimulate intersectoral exchange and alliance building, inform advocacy, and catalyse the process of research into action.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | ACTION RESEARCH | MATERNAL HEALTH | ADVOCACY | INTEGRATED PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Health | Communication | Programs | Organization and Administration
Document Number: 330828

17.

Peer Reviewed

Title: The burden of non-communicable diseases in South Africa.
Author: Mayosi BM; Flisher AJ; Lalloo UG; Sitas F; Tollman SM; Bradshaw D
Source: Lancet. 2009 Sep 12;374(9693):934-47.
Abstract: 15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urban areas, most prominently in poor people living in urban settings, and are resulting in increasing pressure on acute and chronic health-care services. Major factors include demographic change leading to a rise in the proportion of people older than 60 years, despite the negative effect of HIV/AIDS on life expectancy. The burden of these diseases will probably increase as the roll-out of antiretroviral therapy takes effect and reduces mortality from HIV/AIDS. The scale of the challenge posed by the combined and growing burden of HIV/AIDS and non-communicable diseases demands an extraordinary response that South Africa is well able to provide. Concerted action is needed to strengthen the district-based primary health-care system, to integrate the care of chronic diseases and management of risk factors, to develop a national surveillance system, and to apply interventions of proven cost-effectiveness in the primary and secondary prevention of such diseases within populations and health services. We urge the launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | RURAL AREAS | RURAL POPULATION | LOW INCOME POPULATION | PRIMARY HEALTH CARE | DISEASES | HEALTH SERVICES | QUALITY OF HEALTH CARE | DEMOGRAPHIC TRANSITION | DEMOGRAPHIC AGING | HIV PREVENTION | AIDS PREVENTION | INTEGRATED PROGRAMS | GOVERNMENT PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Population Characteristics | Demographic Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Population Dynamics | HIV Infections | Viral Diseases | AIDS
Document Number: 342869

18.

Peer Reviewed

Title: Integrating quality postnatal care into PMTCT in Swaziland.
Author: Mazia G; Narayanan I; Warren C; Mahdi M; Chibuye P; Walligo A; Mabuza P; Shongwe R; Hainsworth M
Source: Global Public Health. 2009;4(3):253-70.
Abstract: Swaziland's prevention of mother-to-child transmission (PMTCT) programme is linked to maternal and newborn health (MNH) services, but is mainly focussed on HIV/AIDS. Existing MNH services are inadequate, especially postnatal care (PNC) of mothers and babies, with delayed postnatal visits occurring at 4-6 weeks after delivery. Fifty-seven percent of staff in seven Swazi health facilities were trained in promoting and providing early PNC. A final evaluation showed a 20-fold increase in the number of visits coming for an early postnatal visit (within the first three days after birth). A direct observation of the client-provider interaction showed a significant increase in the competence of the health workers related to postnatal examinations, and care of mothers and babies (p<0.05- < 0.01). The percentage of women breastfeeding within one hour of delivery increased by 41% in HIV-positive mothers and 52% in HIV-negative mothers. Cotrimoxazole prophylaxis for HIV-exposed infants increased by 24%. Although, health workers were observed providing counselling, maternal recall of messages was deficient, suggesting the need for additional strategies for promoting healthy behaviours. High-quality integrated PMTCT programmes and MNH postnatal services are feasible and acceptable, and can result in promoting early postnatal visits and improved care of both HIV-positive and HIV-negative mothers and their babies.
Language: English
Keywords:
SWAZILAND | RESEARCH REPORT | PILOT PROJECTS | PROVIDERS WITH CLIENTS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MATERNAL-CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | PROGRAM EFFECTIVENESS | TRAINING ACTIVITIES | KNOWLEDGE | CLINIC VISITS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Diseases | Primary Health Care | Programs | Organization and Administration | Program Evaluation | Training Programs | Education | Sociocultural Factors | Service Statistics | Program Activities
Document Number: 341394

19.

Title: Approaches to tuberculosis screening and diagnosis in people with HIV in resource-limited settings.
Author: Reid MJ; Shah NS
Source: Lancet Infectious Diseases. 2009 Mar;9(3):173-84.
Abstract: Tuberculosis is the main cause of morbidity and mortality in people living with HIV/AIDS worldwide. Early diagnosis and treatment is essential to addressing the dual epidemic of tuberculosis and HIV. Increasing recognition of the importance of integrating tuberculosis services--including screening--into HIV care has led to global policies and the beginnings of implementation of joint activities at the national level. However, debate remains about the best methods of screening for pulmonary tuberculosis among people living with HIV/AIDS in resource-limited settings. Mycobacterial culture, the gold standard for tuberculosis diagnosis, is too slow and complex to be a useful screening test in such settings. More widely available methods, such as symptom screening, sputum smear microscopy, chest radiography, and tuberculin skin testing have important shortcomings, especially in people living with HIV/AIDS. However, until simpler, cheaper, and more sensitive diagnostics for tuberculosis are available in peripheral healthcare settings, a strategy must be developed that uses current evidence to combine available screening tools.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EVALUATION | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | SCREENING | COMPLICATIONS | EXAMINATIONS AND DIAGNOSES | INTEGRATED PROGRAMS | LABORATORY EXAMINATIONS AND DIAGNOSES | TIME FACTORS | SIGNS AND SYMPTOMS | PHYSICAL EXAMINATIONS AND DIAGNOSES | COST EFFECTIVENESS | HIV Infections | Viral Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Evaluation Indexes | Quantitative Evaluation
Document Number: 330983

20.

Title: Multilevel perspectives on community intervention: an example from an Indo-US HIV prevention project in Mumbai, India.
Author: Schensul SL; Saggurti N; Singh R; Verma RK; Nastasi BK; Mazumder PG
Source: American Journal of Community Psychology. 2009 Jun;43(3-4):277-91.
Abstract: This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.
Language: English
Keywords:
INDIA | RESEARCH REPORT | URBAN POPULATION | INTERVENTIONS | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASES | CULTURE | INTEGRATED PROGRAMS | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors
Document Number: 342699

21.

Title: Trials of Improved Practices (TIPs): Determining feasible water and feces management small doable actions for HIV programs in Ethiopia.
Author: Seumo EF; Tesfay M; Rosenbaum J; Bery R
Source: Washington, D.C., Academy for Educational Development [AED], USAID Hygiene Improvement Project, 2009 Feb. 61 p. (Trials of Improved Practices (TIPs)USAID Contract No. GHS-I-00-04-00024-00)
Abstract: Diarrheal disease is the most common opportunistic infection in people living with HIV / AIDS (PLWHA) in resource limited settings. Diarrhea is very debilitating and negatively affects the PLWHA's quality of life. Household members and especially children are at risk of contracting diarrhea from PLWHA suffering from bouts of diarrhea. Improving water, hygiene, and sanitation (WASH) helps prevent diarrhea in PLWHA and their households and enhances the quality of life. The major challenge is how to integrate WASH into HIV programs. To address this challenge, USAID / HIP worked with NGOs providing home-based care services in Ethiopia to design and carry out a trial of improved practices (TIPs) to help identify the water, hygiene, and sanitation small doable actions (SDA) to be integrated into HIV programs. A rapid assessment was carried out in Amhara Region in December 2007. The SDA were reviewed with NGOs partners in Addis to identify the WASH behaviors to be explored in the TIPs. Water and feces management were the two areas that required more information and were thus selected for the TIPs. Further, despite the high risk of HIV transmission associated with menstrual blood, very little is known about HIV-positive women's hygiene practices during menstruation. To fill this gap, USAID / HIP also included this topic in the TIPs. For seven weeks trained data collectors and home-based care workers visited 62 PLWHA in Adama, Addis, Alemtena, and Wonji -- urban, peri-urban, and rural sites in the Oromo Region. USAID / HIP reviewed the findings from the Oromo and Amhara regions and developed recommendations on the WASH SDA to be integrated in the home-based care programs in Ethiopia. (Excerpts)
Language: English
Keywords:
ETHIOPIA | RESEARCH REPORT | DATA COLLECTION | PERSONS LIVING WITH HIV/AIDS | WATER QUALITY | HYGIENE | SANITATION | BEHAVIOR CHANGE | HOME CARE | INTEGRATED PROGRAMS | DIARRHEA | MENSTRUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Water | Natural Resources | Environment | Public Health | Health | Behavior | Care and Support | Health Services | Delivery of Health Care | Programs | Organization and Administration | Reproduction
Document Number: 331415

22.
Peer Reviewed

Title: Validation of an Integrated Management of Childhood Illness algorithm for managing common skin conditions in Fiji.
Author: Steer AC; Tikoduadua LV; Manalac EM; Colquhoun S; Carapetis JR; Maclennan C
Source: Bulletin of the World Health Organization. 2009 Mar;87(3):173-9.
Abstract: OBJECTIVE: To assess the sensitivity of an Integrated Management of Childhood Illness (IMCI) algorithm to detect common skin conditions in children in Fiji. METHODS: We collected data from the assessments of children aged between 2 months and 5 years who presented to one of two health clinics. Every child was assessed by a nurse trained in the use of the IMCI algorithm and also an expert paediatrician. We used a kappa statistic to measure agreement between the nurse/algorithm assessment method and the paediatrician's diagnosis. FINDINGS: High sensitivity for identifying skin problems (sensitivity: 98.7%; 95% confidence interval, CI: 95.5-99.9) was found for the algorithm applied by IMCI-trained nurses, who were able to identify the one child with a severe skin infection and all three children with periorbital cellulitis. Sensitivity was high for the classification of abscess/cellulitis (sensitivity: 95%; 95% CI: 75.1-99.9) and infected scabies (sensitivity: 89.1%; 95% CI: 77.8-95.9), but lower for identification of impetigo, fungal infection and, in particular, non-infected scabies. CONCLUSION: The IMCI skin algorithm is a robust tool that should be incorporated into the IMCI after some modifications relating to scabies and impetigo. Its use by primary health-care workers will reduce the burden of skin diseases in children in Fiji through improved case identification and management. The algorithm should be considered in other countries where skin diseases in children are a priority, particularly in the Pacific region.
Language: English
Keywords:
FIJI | EVALUATION REPORT | NURSES AND NURSING | PHYSICIANS | DERMATOLOGICAL EFFECTS | CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | SIGNS AND SYMPTOMS | PHYSICAL EXAMINATIONS AND DIAGNOSES | TREATMENT | TRAINING ACTIVITIES | Developing Countries | Oceania | Evaluation | Health Personnel | Delivery of Health Care | Health | Physiology | Biology | Maternal-Child Health Services | Primary Health Care | Health Services | Programs | Organization and Administration | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Training Programs | Education
Document Number: 342353

23.
Title: The cost of intensified case finding and isoniazid preventive therapy for HIV-infected patients in Battambang, Cambodia.
Author: Sutton BS; Arias MS; Chheng P; Eang MT; Kimerling ME
Source: International Journal of Tuberculosis and Lung Disease. 2009 Jun;13(6):713-8.
Abstract: SETTING: The current study evaluates one of four pilot sites initiated in Cambodia to establish feasible and effective ways to manage patients with human immunodeficiency virus (HIV) infection and tuberculosis (TB). OBJECTIVE: To measure the costs of intensified case finding (ICF) and isoniazid preventive therapy (IPT) services for HIV-infected patients in Battambang Province, Cambodia. DESIGN: We analyzed cost data retrospectively from September 2003 to February 2006 using a microcosting or ingredients-based approach and interviewed clinic personnel to determine the cost of ICF and IPT per person. RESULTS: Adherence to IPT at Battambang IPT clinic was high (86%) relative to other reported studies of IPT among HIV patients in developing countries. The estimated cost per TB case averted through ICF was US$363, while the estimated cost per TB case averted through IPT was US$955. CONCLUSION: Economic evaluations of TB-HIV integrated services are necessary as countries move to establish or scale-up these services. Based upon the estimated effectiveness of ICF and IPT used by other studies examining the provision of integrated HIV-TB services, the cost per TB case prevented by ICF and IPT in Battambang, Cambodia, is less than the reported cost of treating a new smear-positive TB case.
Language: English
Keywords:
CAMBODIA | RESEARCH REPORT | PILOT PROJECTS | RETROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | TUBERCULOSIS | SCREENING | INTEGRATED PROGRAMS | COST EFFECTIVENESS | DRUGS | USER COMPLIANCE | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Treatment | Behavior
Document Number: 342165

24.

Title: Promoting food security and well-being among poor and HIV/AIDS affected households: lessons from an interactive and integrated approach.
Author: Swaans K; Broerse J; Meincke M; Mudhara M; Bunders J
Source: Evaluation and Program Planning. 2009 Feb;32(1):31-42.
Abstract: Participatory and interdisciplinary approaches have been suggested to develop appropriate agricultural innovations as an alternative strategy to improve food security and well-being among HIV/AIDS affected households. However, sustainable implementation of such interactive approaches is far from easy and straight forward. This study reports of the Interactive Learning and Action (ILA) approach, a methodology for agricultural innovation which has been adapted to the context of HIV/AIDS. Role players in agriculture and health were brought together to stimulate and sustain innovation among three support groups for poor and affected households in a rural high HIV/AIDS prevalence area in South Africa. The effectiveness of the approach was evaluated using both outcome and process criteria. The results indicate that an interactive approach in which service providers/researchers engage themselves as actors to explore the livelihood system and develop appropriate solutions in joint collaboration with resource users has potential. However, it also revealed that cooperation among participants and stakeholders at the interface of agriculture and HIV/AIDS is complicated and sensitive to erosion. Of particular concern was the difficulty of mobilizing members from poor and affected households to participate and to overcome stigma and discrimination. Lessons and potential applications for the further development of interactive approaches are discussed.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | EVALUATION | LOW INCOME POPULATION | PERSONS LIVING WITH HIV/AIDS | FOOD SECURITY | AGRICULTURE | SUPPORT GROUPS | HIV INFECTIONS | AIDS | INTEGRATED PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Viral Diseases | Diseases | Food Supply | Natural Resources | Environment | Macroeconomic Factors | Social Networks | Friends and Relatives | Family and Household | Sociocultural Factors | Programs | Organization and Administration
Document Number: 341362

25.

Title: Evaluating integrated healthcare for refugees and hosts in an African context.
Author: Tuepker A; Chi C
Source: Health Economics Policy and Law. 2009;4:159-178.
Abstract: This paper argues on ethical and practical grounds for more widespread use of an integrated approach to refugee healthcare, and proposes a basic model of assessment for integrated systems. A defining element of an integrated approach is an equal ability by refugee and host nationals to access the same healthcare resources from the same providers. This differs fundamentally from parallel care, currently the predominant practice in Africa. The authors put forward a general model for evaluation of integrated healthcare with four criteria: (1) improved health outcomes for both hosts and refugees, (2) increased social integration, (3) increased equitable use of healthcare resources, and (4) no undermining of protection. Historical examples of integrated care in Ethiopia and Uganda are examined in light of these criteria to illustrate how this evaluative model would generate evidence currently lacking in debates on the merit of integrated healthcare.
Language: English
Keywords:
AFRICA | PHILOSOPHICAL OVERVIEW | CASE STUDIES | REFUGEES | HEALTH SERVICES | INTEGRATED PROGRAMS | IMPLEMENTATION | INEQUALITIES | PROGRAM ACCESSIBILITY | PROGRAM EVALUATION | HEALTH POLICY | UNHCR | Developing Countries | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Delivery of Health Care | Health | Programs | Organization and Administration | Socioeconomic Factors | Economic Factors | Policy | Political Factors | Sociocultural Factors | UN | International Agencies | Organizations
Document Number: 340217

26.

Peer Reviewed

Title: Integration of immunization services with other health interventions in the developing world: what works and why? Systematic literature review.
Author: Wallace A; Dietz V; Cairns KL
Source: Tropical Medicine and International Health. 2009 Jan;14(1):11-9.
Abstract: OBJECTIVE: To assess benefits, challenges and characteristics of integrating child and maternal health services with immunization programmes. METHODS: Literature review using journal databases and grey literature. Papers meeting the inclusion criteria were rated for the quality of methodology and relevant information was systematically abstracted. RESULTS: Integrated services were vitamin A supplementation, bednet distribution, deworming tablet distribution, Intermittent Preventive Therapy for infants and referrals for family planning services. Two key characteristics of success were compatibility between interventions and presence of a strong immunization service prior to integration. Overburdened staff, unequal resource allocation and logistical difficulties were mentioned as risks of integration, whereas rapid uptake of the linked intervention and less competition for resources were listed as two key benefits of integration. CONCLUSION: The theoretical strengths of integrating other health services with immunization services remain to be rigorously proved in practice. When additional interventions are carefully selected for compatibility and when they receive adequate support, coverage of these interventions may improve, provided immunization coverage is already high. Evidence for the effectiveness of integration in increasing efficiency of resource use was insufficient and most benefits and challenges were not statistically quantified. More substantive information about the costs of integrated vs. vertical programmes and full documentation of the impacts of integration on immunization services should be published.
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CHILDREN | INTEGRATED PROGRAMS | IMMUNIZATION | MATERNAL-CHILD HEALTH SERVICES | VITAMIN A | FOOD SUPPLEMENTATION | BED NETS | DISTRIBUTIONAL ACTIVITIES | PARASITE CONTROL | PREVENTIVE HEALTH CARE | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Public Health | Program Activities
Document Number: 330264

27.
Peer Reviewed

Title: Why first-level health workers fail to follow guidelines for managing severe disease in children in the Coast Region, the United Republic of Tanzania.
Author: Walter ND; Lyimo T; Skarbinski J; Metta E; Kahigwa E; Flannery B; Dowell SF; Abdulla S; Kachur SP
Source: Bulletin of the World Health Organization. 2009 Feb;87(2):99-107.
Abstract: OBJECTIVE: To determine why health workers fail to follow integrated management of childhood illness (IMCI) guidelines for severely ill children at first-level outpatient health facilities in rural areas of the United Republic of Tanzania. METHODS: Retrospective and prospective case reviews of severely ill children aged < 5 years were conducted at health facilities in four districts. We ascertained treatment and examined the characteristics associated with referral, conducted follow-up interviews with parents of severely ill children, and gave health workers questionnaires and interviews. FINDINGS: In total, 502 cases were reviewed at 62 facilities. Treatment with antimalarials and antibiotics was consistent with the diagnosis given by health workers. However, of 240 children classified as having 'very severe febrile disease', none received all IMCI-recommended therapies, and only 25% of severely ill children were referred. Lethargy and anaemia diagnoses were independently associated with referral. Most (91%) health workers indicated that certain severe conditions can be managed without referral. CONCLUSION: The health workers surveyed rarely adhered to IMCI treatment and referral guidelines for children with severe illness. They administered therapy based on narrow diagnoses rather than IMCI classifications, disagreed with referral guidelines and often considered referral unnecessary. To improve implementation of IMCI, attention should focus on the reasons for health worker non-adherence.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | PROVIDERS WITH CLIENTS | CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | TREATMENT | REFERRAL AND CONSULTATION | SIGNS AND SYMPTOMS | EXAMINATIONS AND DIAGNOSES | QUALITY OF HEALTH CARE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Health Services | Delivery of Health Care | Health | Maternal-Child Health Services | Primary Health Care | Programs | Organization and Administration | Medical Procedures | Medicine | Program Activities | Diseases | Health Services Evaluation | Program Evaluation
Document Number: 341789

28.

Title: Child health services in Kenya. January 2009. Based on further analysis of the 2004 Kenya Service Provision Assessment Survey.
Author: Wamae A; Kichamu G; Kundu F; Muhunzu I
Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [38] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 2)
Abstract: Given the worrying trends in infant and child mortality rates, there is a clear need to assess current practices in the management of childhood illnesses and to identify opportunities for intervention. The 2004 Kenya Service Provision Assessment Survey (KSPA) findings indicate that most health care providers are not taking care of sick children holistically, but rather are treating children only for the presenting illness. Using data obtained from the 2004 KSPA, this study aims to establish the factors that are associated with the promotion of child health using a holistic approach, such as the Integrated Management of Childhood Illness (IMCI) strategy to manage a sick child. The IMCI strategy aims to reduce morbidity and infant and child mortality by implementing three main components: improving health workers' skills in case management; improving the health systems; and improving family and community childcare practices. Three composite dependent variables representing the holistic approach to child health care were created to measure the following: full assessment of sick child; proper counseling of the child's caretaker; and facility support services for holistic care of sick children. The independent variables used in the analysis include facility type, facility managing authority, region, qualifications of the provider, and sex of the provider. Almost all health providers surveyed missed critical opportunities to conduct a full assessment of the sick children who presented to them for care. According to the survey, enrolled nurses and doctors were doing better in full assessment and counseling of sick children compared to registered nurses and clinical officers. This difference can be attributed to the fact that doctors and enrolled nurses were likely to have received IMCI training in the previous year compared to registered nurses. Notably, about twice as many female health providers as male health providers assessed major signs and thrice as many female health workers assessed for all three danger signs. Female providers were also more likely than male providers to properly monitor child growth. Counseling caretakers on children's illnesses was generally poor, with only one in every five caretakers being counseled in clinics and one in every ten caretakers being counseled in health centres. Male providers were more likely to counsel caretakers than their female counterparts. Providers in private facilities were twice as likely to counsel caretakers as providers in public facilities. The full range of essential equipment was lacking in almost all facilities. Hospitals were more likely to be stocked with all essential equipment, followed by dispensaries and maternities with health centers and clinics the least likely. The results reveal that the quality of care provided to sick children at the first level of health facilities should be improved. Also, help is needed to determine the areas that should be emphasized during the training and supervision of IMCI and other child survival strategies. The KSPA results also suggest the need to improve the skills of more health workers managing children younger than five years and to mobilize more resources for child health.
Language: English
Keywords:
KENYA | RESEARCH REPORT | HEALTH SURVEYS | CHILDREN | HEALTH PERSONNEL | CHILD HEALTH SERVICES | HEALTH SERVICES EVALUATION | QUALITY OF HEALTH CARE | INTEGRATED PROGRAMS | HEALTH SERVICES ADMINISTRATION | COMMUNITY HEALTH SERVICES | COUNSELING | SEX FACTORS | EXAMINATIONS AND DIAGNOSES | PRIVATE SECTOR | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Maternal-Child Health Services | Primary Health Care | Health Services | Program Evaluation | Programs | Organization and Administration | Management | Clinic Activities | Program Activities | Medical Procedures | Medicine | Macroeconomic Factors | Economic Factors
Document Number: 329887

29.

Title: Should issues of sexuality and HIV and AIDS be a rehabilitation concern? The voices of young South Africans with physical disabilities.
Author: Wazakili M; Mpofu R; Devlieger P
Source: Disability and Rehabilitation. 2009;31(1):32-41.
Abstract: PURPOSE: Although rehabilitation is an integral part of the lives of many young people with physical disabilities, sexuality education and HIV and AIDS prevention services are not. The purpose of this study was to record the voices of disabled young people regarding their experiences of sexuality and HIV and AIDS and to determine the role of rehabilitation professionals in this regard. METHODS: Sixteen young people with physical disabilities, aged 15-24 years participated in the study. Individual in-depth interviews were conducted with each participant, followed by focus group discussions comprising four to six participants. Responses were audiotaped and transcribed verbatim. Textual and contextual features of the Atlas.ti computer programme were used to support the thematic analysis of the data. RESULTS: The results indicated that most participants had received some form of rehabilitation for their physical impairment, yet sexuality and HIV and AIDS matters were not part of the rehabilitation process. Although the majority were aware of sexuality and HIV and AIDS issues, their limited factual knowledge did not persuade them to change their sexual behaviour or take preventive measures against contracting HIV infection. CONCLUSION: Rehabilitation professionals need to widen their scope of practice to include the promotion of good sexual and reproductive health for disabled young people.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | YOUTH | DISABLED PERSONS AND DISABILITIES | HIV INFECTIONS | AIDS | SEXUALITY | COMPUTER PROGRAMS AND PROGRAMMING | TREATMENT | INTEGRATED PROGRAMS | KNOWLEDGE | SEX BEHAVIOR | RISK BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Information Processing | Information | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Sociocultural Factors
Document Number: 331087

30.

Title: The art of coalition building: A population, health, and environment consortium in Ethiopia.
Author: Zuehlke E; Bremner J
Source: Washington, D.C., Population Reference Bureau [PRB], 2009 Apr. [1] p.
Abstract: For more than a decade, PRB has nurtured national and international coalitions that address population, maternal and child health, global health priorities, and the environment. Sharing the successes and challenges of coalitions in similar contexts can motivate and instigate new coalitions. This article captures the experiences from a newly formed but rapidly advancing coalition focused on population, health, and environment issues in Ethiopia, with the hope that their experience will be valuable to similar nascent groups in sub-Saharan Africa and beyond. (Excerpt).
Language: English
Keywords:
ETHIOPIA | SUMMARY REPORT | POPULATION GROWTH | PUBLIC HEALTH | REPRODUCTIVE HEALTH | ENVIRONMENTAL PROTECTION | CAPACITY BUILDING | SOCIAL DEVELOPMENT | INTEGRATED PROGRAMS | COMMUNICATION STRATEGY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Population Dynamics | Demographic Factors | Population | Health | Natural Resources | Environment | Program Sustainability | Programs | Organization and Administration | Economic Factors | Communication
Document Number: 331348


	Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy