1. ![]() Title: Evidence-based interventions for youth. Author: Family Health International [FHI] Source: Family Health Research. 2009 Feb;3(1):1-8. Abstract: This newsletter explores how research results can be used to prevent unintended pregnancies and HIV infection among youth. It discusses existing evidence on successful programs and interventions, curriculum-based programs that reduce sexual risk-taking, and ways that community can bolster behavioral interventions. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | YOUTH | ADOLESCENT PREGNANCY | PREGNANCY, UNPLANNED | HIV PREVENTION | REPRODUCTIVE HEALTH | INTERVENTIONS | HEALTH SERVICES | QUALITY OF HEALTH CARE | COUNSELING | HIV TESTING | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | HIV Infections | Viral Diseases | Diseases | Health | Programs | Organization and Administration | Delivery of Health Care | Health Services Evaluation | Program Evaluation | Clinic Activities | Program Activities | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 341209   |
2. ![]() Title: Celebrating life: The U.S. President's Emergency Plan for AIDS Relief. 2009 Annual Report to Congress. Author: United States. Office of the United States Global AIDS Coordinator Source: Washington, D.C., Office of the United States Global AIDS Coordinator, 2009. 64 p. Abstract: The fifth Annual Report celebrates life. In countless communities around the world, through partnerships with the American people, courageous individuals in nations devastated by HIV/AIDS are choosing life, saving the lives of their fellow countrymen and women, and creating hope for a future free of HIV/AIDS. Through the power of these partnerships, the American people and the dedicated men and women in nations devastated by HIV/ AIDS have proven that the seemingly impossible is possible. Language: English Keywords: DEVELOPING COUNTRIES | ANNUAL REPORT | EVALUATION | POLICYMAKERS | PROGRAM EVALUATION | AIDS PREVENTION | HIV PREVENTION | ANTIRETROVIRAL THERAPY | FOREIGN AID | INTERNATIONAL COOPERATION | TREATMENT | GOVERNMENT FINANCING | INTERVENTIONS | Administrative Personnel | Organization and Administration | Programs | AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Financial Activities | Economic Factors | Political Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 328418   |
3. ![]() Title: Sexual and reproductive health and HIV linkages: evidence review and recommendations. Author: World Health Organization [WHO]; United Nations Population Fund [UNFPA]; International Planned Parenthood Federation [IPPF]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; University of California, San Francisco. Global Health Sciences Source: Geneva, Switzerland, WHO, 2009 Apr. [8] p. Abstract: The importance of linking sexual and reproductive health (SRH) and HIV is widely recognized. The international community agrees that the Millennium Development Goals will not be achieved without ensuring universal access to SRH and HIV prevention, treatment, care and support. In order to gain a clearer understanding of the effectiveness, optimal circumstances, and best practices for strengthening SRH and HIV linkages, a systematic review of the literature was conducted. The findings corroborate the many benefits gained from linking SRH and HIV policies, systems and services. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | CLIENTS | HIV TESTING | COUNSELING | HIV PREVENTION | FAMILY PLANNING | MATERNAL HEALTH | SEXUALLY TRANSMITTED DISEASE PREVENTION | CHILD HEALTH | MANAGEMENT | KNOWLEDGE | ATTITUDES | STIGMA | BEHAVIOR | FEES | HIV/FP INTEGRATION | INTERVENTIONS | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinic Activities | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors | Psychological Factors | Social Problems | Financial Activities | Economic Factors Document Number: 331466   |
4. ![]() Title: WHO / USAID / FHI Technical Consultation: Expanding Access to Injectable Contraception, 15-17 June 2009, Room M405, WHO, Geneva. Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI] Source: [Unpublished] 2009. 5 p. Abstract: The agenda for the consultation is presented. The objectives of the consultation were: To review systematically the evidence and programmatic experience on interventions designed to expand access to / provision of contraceptive injectables, focusing on non clinic-based services and programs; To reach conclusions on issues: (a) for which evidence is consistent and strong; (b) for which evidence is mixed; and (c) for which evidence is marginal or entirely lacking and, thus requires additional research; To document discussions and conclusions of the Consultation, including policy and program implications, and to disseminate these widely. Language: English Keywords: GLOBAL | TABLES AND CHARTS | CONFERENCES AND CONGRESSES | WHO | USAID | INJECTABLES | CONTRACEPTIVE AVAILABILITY | INTERVENTIONS | NEEDS | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION CONTINUATION | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Government Agencies | Contraceptive Methods | Contraception | Family Planning | Programs | Organization and Administration | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Contraceptive Usage Document Number: 331853   |
5. Peer Reviewed Title: Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria--Niger Delta and Sahel Savannah. Author: Afolabi BM; Sofola OT; Fatunmbi BS; Komakech W; Okoh F; Saliu O; Otsemobor P; Oresanya OB; Amajoh CN; Fasiku D; Jalingo I Source: Malaria Journal. 2009;8:30. Abstract: BACKGROUND: Current use of treated mosquito nets for the prevention of malaria falls short of what is expected in sub-Saharan Africa (SSA), though research within the continent has indicated that the use of these commodities can reduce malaria morbidity by 50% and malaria mortality by 20%. Governments in sub-Sahara Africa are investing substantially in scaling-up treated mosquito net coverage for impact. However, certain significant factors still prevent the use of the treated mosquito nets, even among those who possess them. This survey examines household ownership as well as use and non-use of treated mosquito nets in Sahel Savannah and Niger Delta regions of Nigeria. METHODOLOGY: This survey employed cross-sectional survey to collect data from households on coverage and use of mosquito nets, whether treated or not. Fever episodes in previous two weeks among children under the age of five were also recorded. The study took place in August 1 - 14 2007, just five months after the March distribution of treated mosquito nets, coinciding with the second raining period of the year and a time of high malaria transmission during the wet season. EPI INFO version 2003 was used in data analysis. RESULTS: The survey covered 439 households with 2,521 persons including 739 under-fives, 585 women in reproductive age and 78 pregnant women in Niger Delta Region and Sahel Savannah Region. Of the 439 HHs, 232 had any mosquito nets. Significantly higher proportion of households in the Niger Delta Region had any treated or untreated mosquito nets than those in the Sahel Savannah Region. In the Niger Delta Region, the proportion of under-fives that had slept under treated nets the night before the survey exceeded those that slept under treated nets in the Sahel Savannah Region. Children under the age of five years in the Niger Delta Region were four times more likely to sleep under treated nets than those in the Sahel Savannah Region. CONCLUSION: This study found that despite the fact that treated nets were distributed widely across Nigeria, the use of this commodity was still very low in the Sahel Savannah region. Future campaigns should include more purposeful social and health education on the importance and advantages of the use of treated nets to save lives in the Sahel Savannah region of Nigeria. Language: English Keywords: NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | MALARIA PREVENTION | BED NETS | HEALTH EDUCATION | INTERVENTIONS | IMPACT | SEASONAL VARIATION | GEOGRAPHIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Education | Programs | Organization and Administration | Communication | Population Dynamics Document Number: 330812   |
6. Peer Reviewed Title: Effects of school health nursing education interventions on HIV/AIDS-related attitudes of students in Akwa Ibom State, Nigeria. Author: Akpabio II; Asuzu MC; Fajemilehin BR; Ofi AB Source: Journal of Adolescent Health. 2009 Feb;44(2):118-123. Abstract: Purpose: One of the greatest challenges facing school nurses is that of identifying and using appropriate strategies to meet the health education needs of adolescents in regard to prevention of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study examined the effects of HIV/AIDS preventive health education with parental involvement on students' attitude toward HIV/AIDS prevention in Akwa Ibom State, Nigeria. Methods: The study population comprised students from three of nine secondary schools in the study area. The three schools were randomly assigned as Intervention Group 1 (IG1), involving nurses only; Intervention Group 2 (IG2), involving both nurses and parents (IG2); and a control group. A pretest/ post-test intervention design was used. A 29-item, validated questionnaire was the instrument for data collection. Sampling involved multistage and stratified random technique to select 120 subjects from each of the three selected schools, with a total of 360 subjects representing 8.3% of the study population. From this number, 339 (94.2%) provided sufficient data for analysis. Data analysis involved analysis of covariance and the Scheffé post hoc test determined at the .05 significance level. Results: Results show significant effect of intervention on students attitudes toward preventive measures (F<234.27, p .001*). The intervention that involved nurses only was found to be a more potent strategy in providing favorable attitudes toward HIV/AIDS prevention (IG1 mean, 20.59; IG2 mean, 19.20; control mean, 12.34). Attitudes were influenced by older age but not by gender. Conclusion: Health education efforts aimed at improving HIV/AIDS-related attitudes should not only focus on children but also on parents so that they in turn could assist to improve on health workers' efforts in educating the children. Language: English Keywords: NIGERIA | RESEARCH REPORT | INTERVENTIONS | STUDENTS | NURSES AND NURSING | HEALTH EDUCATION | ATTITUDES | HIV INFECTIONS | AIDS | PARENTAL INVOLVEMENT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Programs | Organization and Administration | Education | Health Personnel | Delivery of Health Care | Health | Psychological Factors | Behavior | Viral Diseases | Diseases | Child Rearing Document Number: 330164   |
7. Title: Prevention of low birthweight. Author: Alam DS Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:209-21; discussion 221-5, 259-68. Abstract: Globally an estimated 20 million infants are born with low birthweight (LBW), of those over 18 million are born in developing countries. These LBW infants are at a disproportionately higher risk of mortality, morbidity, poor growth, impaired psychomotor and cognitive development as immediate outcomes, and are also disadvantaged as adults due to their greater susceptibility to type 2 diabetes, hypertension and coronary heart disease. Maternal malnutrition prior to and during pregnancy manifested by low bodyweight, short stature, inadequate energy intake during pregnancy and coexisting micronutrient deficiency are considered major determinants in developing countries where the burden is too high. LBW is a multifactorial outcome and its prevention requires a lifecycle approach and interventions must be continued for several generations. So far, most interventions are targeted during pregnancy primarily due to the increased nutritional demand and aggravations of already existing inadequacy in most women. Several individually successful interventions during pregnancy include balanced protein energy supplementation, several single micro-nutrients or more recently a mix of multiple micronutrients. Nutrition education has been successful in increasing the dietary intake of pregnant women but has had no effect on LBW. The challenge is to identify a community-specific intervention package. Current evidence supports intervention during pregnancy with increased dietary intakes including promotions of foods rich in micronutrients and micronutrient supplementation, preferably with a multiple micronutrient mix. Simultaneously a culturally appropriate educational component is required to address misconceptions about diet during pregnancy and childbirth including support for healthy pregnancy with promotion of antenatal and perinatal care services. While further research is needed to identify more efficacious interventions, an urgent public health priority would be to select and implement an optimal mix of interventions to avert the immediate adverse consequences of LBW and to prevent the impending epidemic of type 2 diabetes, hypertension and coronary heart disease which are negatively associated with LBW. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW BIRTH WEIGHT | PREVALENCE | INTERVENTIONS | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | VITAMINS AND MINERALS | DIET | Birth Weight | Body Weight | Physiology | Biology | Measurement | Research Methodology | Programs | Organization and Administration | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care Document Number: 341347   |
8. Title: Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis. Author: Alderman H; Ndiaye B; Linnemayr S; Ka A; Rokx C; Dieng K; Mulder-Sibanda M Source: Public Health Nutrition. 2009 May;12(5):667-73. Abstract: There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control. Language: English Keywords: SENEGAL | RESEARCH REPORT | COHORT ANALYSIS | RURAL POPULATION | CHILD NUTRITION | INTERVENTIONS | NUTRITION PROGRAMS | PROGRAM EFFECTIVENESS | BODY WEIGHT | COMMUNITY HEALTH SERVICES | PROMOTION | BEHAVIOR CHANGE | GROWTH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Program Evaluation | Physiology | Biology | Marketing | Economic Factors | Behavior | Child Development Document Number: 342116   |
9. Peer Reviewed Title: Structural barriers and human rights related to HIV prevention and treatment in Zimbabwe. Author: Amon JJ; Kasambala T Source: Global Public Health. 2009 Mar 26;:1-17. Abstract: There has long been recognition that individual risk factors can only partially explain vulnerability to HIV infection, and that a broader range of socioeconomic, cultural and political factors must be taken into account. More recently this understanding has been applied to addressing obstacles to accessing HIV treatment. Yet, while structural interventions aimed at contextual factors related to HIV prevention and treatment have been shown to be effective, they have not been widely implemented. Using the situation of Zimbabwe as an example, we will present an illustration of how contextual barriers can be understood in human rights terms, and how using a human rights analysis can specifically help define 'structural-rights' interventions and compel their implementation. Language: English Keywords: ZIMBABWE | CRITIQUE | EVALUATION | PERSONS LIVING WITH HIV/AIDS | POLICYMAKERS | HUMAN RIGHTS | HIV PREVENTION | AIDS PREVENTION | SOCIOECONOMIC FACTORS | CULTURE | POLITICAL FACTORS | INTERVENTIONS | SOCIAL PROBLEMS | HEALTH POLICY | SOCIAL POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Administrative Personnel | Organization and Administration | Sociocultural Factors | AIDS | Economic Factors | Programs | Policy Document Number: 341476   |
| 10. Peer Reviewed Title: Changes in sexual behavior following a sex education program in Brazilian public schools. Author: Andrade HH; Mello MB; Sousa MH; Makuch MY; Bertoni N; Faundes A Source: Cadernos De Saude Publica. 2009 May;25(5):1168-76. Abstract: This paper describes an evaluation of possible changes in sexual behavior in adolescents who participated in a school-based sex education program in selected public schools in four municipalities in the state of Minas Gerais, Brazil. The program is inserted within the context of reproductive rights, deals with risks involved in unsafe sexual practices and focuses on the positive aspects of sexuality. A quasi-experimental design with pre and post-tests and a non-equivalent control group was used to evaluate the intervention. A total of 4,795 questionnaires were included in this analysis. The program succeeded in more than doubling consistent condom use with casual partners and in increasing the use of modern contraceptives during last intercourse by 68%. The intervention had no effect on age at first intercourse or on adolescents' engagement in sexual activities. The sex education program was effective in generating positive changes in the sexual behavior of adolescents, while not stimulating participation in sexual activities. Language: English Keywords: BRAZIL | RESEARCH REPORT | ADOLESCENTS | SEX BEHAVIOR | SEX EDUCATION | SCHOOLS | REPRODUCTIVE RIGHTS | RISK BEHAVIOR | INTERVENTIONS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Education | Human Rights | Political Factors | Sociocultural Factors | Programs | Organization and Administration Document Number: 342612   |
11. Peer Reviewed Title: Effects of a rapid peer-based HIV/AIDS educational intervention on knowledge and attitudes of high school students in a high-income Arab country. Author: Barss P; Grivna M; Ganczak M; Bernsen R; Al-Maskari F Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):86-98. Abstract: INTRODUCTION: In response to low knowledge about HIV and intolerant attitudes toward persons living with HIV among Arab university students, a peer-based educational intervention was developed and impact evaluated on knowledge and attitudes of high school students in 2 of 4 main cities of United Arab Emirates. METHODS: Four small teams of final year medical students, 3 female and 1 male, were trained. Multistage random sampling selected 14 female and 5 male Arab schools, then 56 female and 14 male grade 12 classes in Al Ain and Abu Dhabi. The 90-minute intervention included a factual presentation and 3 attitude workshops. Baseline and postintervention knowledge and attitudes were assessed. Significance was tested by McNemar, Wilcoxon signed rank, and multilevel regression tests. RESULTS: Response was 99.6%, 1398 females and 505 males. Misconceptions about modes of transmission and intolerant attitudes were evident. Mean knowledge score improved from 65% to 82% and attitude 51% to 64%, that is, relative increase 26% (P < 0.0005). Females had slightly lower baseline knowledge than males but showed greater improvement in knowledge and attitudes (P < 0.0005) CONCLUSIONS: Grade 12 students' knowledge about HIV/AIDS was inadequate and attitudes stigmatizing. Peer-based knowledge workshops were effective, especially among females. Concise integrated teaching and workshops designed to address key knowledge and attitudinal deficiencies can be highly effective. Language: English Keywords: MIDDLE EAST | RESEARCH REPORT | STUDENTS | SECONDARY SCHOOLS | HIGH INCOME POPULATION | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | SEX EDUCATION | HIV INFECTIONS | AIDS | INTERVENTIONS | STIGMA | ADOLESCENT HEALTH | PROMOTION | AIDS PREVENTION | HIV PREVENTION | EPIDEMIOLOGY | Education | Schools | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Psychological Factors | Behavior | Viral Diseases | Diseases | Programs | Organization and Administration | Social Problems | Health | Marketing | Public Health Document Number: 342885   |
12. Title: On what diseases and health conditions should new economic research on health and development focus? Author: Behrman JR; Behrman JA; Perez NM Source: Health Economics. 2009 Apr;18 Suppl 1:S109-28. Abstract: Given the public goods nature of research, economic research on health in developing countries is likely to have the highest returns by focusing, inter alia, on diseases and health conditions that are relatively widespread and costly and that are relatively rapidly growing. This article first summarizes the time patterns in economic research on diseases and health in developing countries for 1990-2005. It then compares those time patterns with the distribution of disability-adjusted life years (DALYs) for diseases and health conditions in developing countries estimated for 2005 and for 2030. These comparisons suggest relatively overemphasis on HIV/AIDS and underemphasis on noncommunicable diseases (NCDs). This opens the possibility for individuals or organizations initiating, re-evaluating, or increasing their economic research on health and development to make a significant contribution by focusing particularly on the analysis of behaviour and policy choices related to NCDs. Careful consideration must, of course, be given to other demands, but on the basis of these two criteria, potential contributions are likely to be greatest from research with such a focus. Language: English Keywords: GLOBAL | CRITIQUE | LITERATURE REVIEW | RESEARCH ACTIVITIES | ECONOMICS | ECONOMIC DEVELOPMENT | HEALTH | HIV INFECTIONS | DISEASES | INTERVENTIONS | COST BENEFIT ANALYSIS | LENGTH OF LIFE | Research Methodology | Social Sciences | Science | Sociocultural Factors | Economic Factors | Viral Diseases | Programs | Organization and Administration | Quantitative Evaluation | Evaluation | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 341823   |
13. Peer Reviewed Title: Independent association between rate of clearance of infection and clinical outcome of HIV-associated cryptococcal meningitis: analysis of a combined cohort of 262 patients. Author: Bicanic T; Muzoora C; Brouwer AE; Meintjes G; Longley N; Taseera K; Rebe K; Loyse A; Jarvis J; Bekker LG; Wood R; Limmathurotsakul D; Chierakul W; Stepniewska K; White NJ; Jaffar S; Harrison TS Source: Clinical Infectious Diseases. 2009 Sep 1;49(5):702-9. Abstract: BACKGROUND: Progress in therapy for cryptococcal meningitis has been slow because of the lack of a suitable marker of treatment response. Previously, we demonstrated the statistical power of a novel endpoint, the rate of clearance of infection, based on serial quantitative cultures of cerebrospinal fluid, to differentiate the fungicidal activity of alternative antifungal drug regimens. We hypothesized that the rate of clearance of infection should also be a clinically meaningful endpoint. METHODS: We combined data from cohorts of patients with human immunodeficiency virus-associated cryptococcal meningitis from Thailand, South Africa, and Uganda, for whom the rate of clearance of infection was determined, and clinical and laboratory data prospectively collected, and explored the association between the rate of clearance of infection and mortality by Cox survival analyses. RESULTS: The combined cohort comprised 262 subjects. Altered mental status at presentation, a high baseline organism load, and a slow rate of clearance of infection were independently associated with increased mortality at 2 and 10 weeks. Rate of clearance of infection was associated with antifungal drug regimen and baseline cerebrospinal fluid interferon-gamma levels. CONCLUSIONS: The results support the use of the rate of clearance of infection or early fungicidal activity as a means to explore antifungal drug dosages and combinations in phase II studies. An increased understanding of how the factors determining outcome interrelate may help clarify opportunities for intervention. Language: English Keywords: SOUTH AFRICA | THAILAND | UGANDA | RESEARCH REPORT | CLIENTS | MENINGITIS | HIV INFECTIONS | DRUGS | INTERVENTIONS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Asia, Southeastern | Asia | Africa, Eastern | Program Activities | Programs | Organization and Administration | Central Nervous System Effects | Central Nervous System | Physiology | Biology | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342967   |
14. Peer Reviewed Title: Can sex workers regulate police? Learning from an HIV prevention project for sex workers in southern India. Author: Biradavolu MR; Burris S; George A; Jena A; Blankenship KM Source: Social Science and Medicine. 2009 Apr;68(8):1541-7. Abstract: There is an argument that policing practices exacerbate HIV risk, particularly for female sex workers. Interventions that mobilize sex workers to seek changes in laws and law enforcement practices have been prominent in India and have received considerable scholarly attention. Yet, there are few studies on the strategies sex worker advocates use to modify police behavior or the struggles they face in challenging state institutions. This paper draws upon contemporary theories of governance and non-state regulation to analyze the evolving strategies of an HIV prevention non-governmental organization (NGO) and female sex worker community-based organizations (CBOs) to reform police practices in southern India. Using detailed ethnographic observations of NGO and CBO activities over a two year period, and key informant interviews with various actors in the sex trade, this paper shows how a powerless group of marginalized and stigmatized women were able to leverage the combined forces of community empowerment, collective action and network-based governance to regulate a powerful state actor, and considers the impact of the advocacy strategies on sex worker well-being. Language: English Keywords: INDIA | RESEARCH REPORT | NONGOVERNMENTAL ORGANIZATIONS | POLICE | SEX WORKERS | HIV PREVENTION | INTERVENTIONS | ADVOCACY | POWER | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Corrections Officers | Government | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Communication | Data Collection | Research Methodology Document Number: 341691   |
15. Title: Effectiveness of an intervention to improve breastfeeding knowledge and attitudes among fifth-grade children in Brazil. Author: Bottaro SM; Giugliani ER Source: Journal of Human Lactation. 2009 Aug;25(3):325-32. Abstract: This cluster-randomized trial evaluated the effectiveness and residual effect of an educational intervention to improve breastfeeding knowledge and attitudes among fifth grade children of both sexes in Brazil. Schools were considered clusters and analysis of variance was used to compare an intervention group (n = 298) and a control group (n = 253) regarding knowledge, perceptions, and beliefs about breastfeeding before and after the intervention, measured through a standardized 25-item, multiple-choice questionnaire. The scores in the intervention group improved significantly, with the effect lasting at least 3 months. The intervention had greater impact on girls and on students between 9 and 11 years of age when compared with boys and students between 12 and 17 years old and also between students from public schools. Results suggest that pro-breastfeeding interventions in schools improve breastfeeding knowledge and attitudes. Language: English Keywords: BRAZIL | RESEARCH REPORT | INTERVENTIONS | CHILDREN | PRIMARY SCHOOLS | STUDENTS | BREASTFEEDING | KNOWLEDGE | ATTITUDES | PROGRAM EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Programs | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Schools | Education | Infant Nutrition | Nutrition | Health | Sociocultural Factors | Psychological Factors | Behavior | Program Evaluation Document Number: 342903   |
| 16. Title: Unhygienic male circumcision procedures and HIV transmission [letter] Author: Brewer DD; Potterat JJ; Roberts JM Jr; Brody S Source: South African Medical Journal. 2009 Jan;99(1):11-2. Abstract: This first letter to the editor discusses the tendency to emphasize either cost or effectiveness in the evaluation of medicines rather than a systematic analysis that incorporates both considerations. The second disputes the association between circumcision and HIV infection prevalence rates in South Africans and hypothesizes that often unhygienic circumcision procedures among black South Africans may facilitate HIV transmission. The third letter argues in favor of male circumcision and discusses the findings from the study from Orange Farm. Language: English Keywords: SOUTH AFRICA | CRITIQUE | PREVALENCE | YOUTH | HIV TRANSMISSION | HIV INFECTIONS | ETHICS | MALE CIRCUMCISION | RISK FACTORS | SURGERY | INTERVENTIONS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Programs | Organization and Administration Document Number: 341056   |
17. Title: Maternal mortality in low-income countries: what interventions have been evaluated and how should the evidence base be developed further? Author: Burchett HE; Mayhew SH Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):78-81. Abstract: OBJECTIVE: This article reviews the evidence for the effectiveness of non-clinical interventions to reduce maternal mortality in low-income settings and identifies the gaps in the evidence base. METHODS: A systematic search was conducted to identify reviews and evaluations of non-clinical interventions to reduce maternal mortality in lower-income countries with high maternal mortality published between 1997 and 2008. Studies were reviewed to identify the topic focus, study design, and outcomes measured. RESULTS: There were 109 intervention evaluations and 30 reviews identified. Studies had been conducted in less than half of the countries and were generally poor quality. More studies focused on tertiary prevention (i.e., preventing death) rather than secondary prevention (i.e., preventing complications). More interventions sought to address quality of care than delays in seeking or accessing care. CONCLUSIONS: While evidence partly reflects difficulties in evaluating complex public health interventions, more robust study designs are possible to evaluate interventions to reduce maternal mortality. In addition, better standardized outcome measures are needed. This overview identifies topic areas neglected by intervention research. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | INTERVENTIONS | LOW INCOME POPULATION | MATERNAL MORTALITY | EVALUATION | RESEARCH METHODOLOGY | Developed Countries | Europe, Western | Europe | Programs | Organization and Administration | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 341377   |
18. Peer Reviewed Title: Political feasibility of scaling-up five evidence-informed HIV interventions in Pakistan: a policy analysis. Author: Buse K; Lalji N; Mayhew SH; Imran M; Hawkes SJ Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 2):ii37-ii42. Abstract: Background: Drawing on policy theories, an assessment was made of the perceived political feasibility of scaling-up five evidence-based interventions to curb Pakistan's HIV epidemic: needle and syringe exchange programmes; targeted behaviour change communication; sexual health care for male and transgender sex workers; sexual and reproductive health care for female sex workers; and promoting and protecting the rights of those at greatest risk. Method: A questionnaire was emailed to 40 stakeholders and completed by 22. They expressed their level of agreement with 15 statements for each intervention (related to variables associated with policy success). Semi-structured interviews were conducted with 12 respondents. Results: The interventions represent considerable change from the status quo, but are perceived to respond to widely acknowledged problems. These perceptions, held by the HIV policy elite, need to be set in the context of the prevailing view that the AIDS response is not warranted given the small and concentrated nature of the epidemic and that the interventions do not resonate closely with values held by society. The interventions were perceived to be evidence-based, supported by at least one donor and subject to little resistance from frontline staff as they will be implemented by contracted non-government organisations. The results were mixed in terms of other factors determining political feasibility, including the extent to which interventions are easy to explain, exhibit simple technical features, require few additional funds, are supported and not opposed by powerful stakeholders. Conclusion: The interventions stand a good chance of being implemented although they depend on donor support. The prospects for scaling them would be improved by ongoing policy analysis and strengthening of domestic constituencies among the target groups. Language: English Keywords: PAKISTAN | RESEARCH REPORT | THEORETICAL MODELS | KAP SURVEYS | POLICYMAKERS | IV DRUG USERS | SEX WORKERS | HIV PREVENTION | BEHAVIOR CHANGE COMMUNICATION | POLICY DEVELOPMENT | HEALTH POLICY | INTERVENTIONS | CAPACITY BUILDING | SEXUALLY TRANSMITTED DISEASE PREVENTION | SYRINGE | NEEDLE SHARING | SOCIAL POLICY | Developing Countries | Asia, Southern | Asia | Research Methodology | Surveys | Sampling Studies | Studies | Administrative Personnel | Organization and Administration | Drug Use and Abuse | Behavior | Sex Behavior | HIV Infections | Viral Diseases | Diseases | Communication Programs | Communication | Behavior Change | Planning | Policy | Political Factors | Sociocultural Factors | Programs | Program Sustainability | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Behavior Document Number: 340114   |
19. Peer Reviewed Title: Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania. Author: Castro MC; Tsuruta A; Kanamori S; Kannady K; Mkude S Source: Malaria Journal. 2009;8:57. Abstract: BACKGROUND: Historically, environmental management has brought important achievements in malaria control and overall improvements of health conditions. Currently, however, implementation is often considered not to be cost-effective. A community-based environmental management for malaria control was conducted in Dar es Salaam between 2005 and 2007. After community sensitization, two drains were cleaned followed by maintenance. This paper assessed the impact of the intervention on community awareness, prevalence of malaria infection, and Anopheles larval presence in drains. METHODS: A survey was conducted in neighbourhoods adjacent to cleaned drains; for comparison, neighbourhoods adjacent to two drains treated with larvicides and two drains under no intervention were also surveyed. Data routinely collected by the Urban Malaria Control Programme were also used. Diverse impacts were evaluated through comparison of means, odds ratios (OR), logistic regression, and time trends calculated by moving averages. RESULTS: Individual awareness of health risks and intervention goals were significantly higher among sensitized neighbourhoods. A reduction in the odds of malaria infection during the post-cleaning period in intervention neighbourhoods was observed when compared to the pre-cleaning period (OR = 0.12, 95% CI 0.05-0.3, p < 0.001). During the post-cleaning period, a higher risk of infection (OR = 1.7, 95% CI 1.1-2.4, p = 0.0069) was observed in neighbourhoods under no intervention compared to intervention ones. Eighteen months after the initial cleaning, one of the drains was still clean due to continued maintenance efforts (it contained no waste materials and the water was flowing at normal velocity). A three-month moving average of the percentage of water habitats in that drain containing pupae and/or Anopheles larvae indicated a decline in larval density. In the other drain, lack of proper resources and local commitment limited success. CONCLUSION: Although environmental management was historically coordinated by authoritarian/colonial regimes or by industries/corporations, its successful implementation as part of an integrated vector management framework for malaria control under democratic governments can be possible if four conditions are observed: political will and commitment, community sensitization and participation, provision of financial resources for initial cleaning and structural repairs, and inter-sectoral collaboration. Such effort not only is expected to reduce malaria transmission, but has the potential to empower communities, improve health and environmental conditions, and ultimately contribute to poverty alleviation and sustainable development. Language: English Keywords: TANZANIA | URBAN AREAS | RESEARCH REPORT | MALARIA PREVENTION | VECTOR CONTROL | INTERVENTIONS | SANITATION | MALARIA | PREVALENCE | COMMUNITY PARTICIPATION | POLITICAL FACTORS | FINANCIAL ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Parasitic Diseases | Diseases | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Public Health | Health | Measurement | Research Methodology | Sociocultural Factors | Economic Factors Document Number: 341983   |
20. ![]() Title: Evaluating the impact of community-based interventions on schooling outcomes among orphans and vulnerable children in Lusaka, Zambia. Author: Chatterji M; Hutchinson P; Murray N; Buek K; Mulenga Y Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Apr. 34 p. (MEASURE Evaluation Working Paper Series WP-09-110USAID Cooperative Agreement No. GPO-A-00-03-00003-00USAID Task Order GHS-I-00-07-00002-00) Abstract: This paper evaluates the impact of a community-based program implemented by a Zambian nongovernmental agency (NGO) on educational outcomes among orphans and vulnerable children (OVC) in Lusaka, Zambia. These outcomes included school enrollment and being at the correct age-for-grade. The study design included two rounds of post-intervention data collection, in 2003 and 2006. There were 2,302 children, ages 6-19, interviewed in 2003; and 3,105 children or young adults, ages 8-22, interviewed in 2006. A sub-sample of 2,922 orphans and vulnerable children, ages 8-19, was used. The effectiveness of Bwafwano Community Home-Based Care Organization, an NGO working in Lusaka, was evaluated, first using the individual cross-sectional samples and then using a differences-in-differences model on the pooled sample. Both cross-sectional analyses found positive and statistically significant effects of the intervention on school enrollment, with marginal effects of 0.104 and 0.168 respectively. The differences-in-differences estimates for school enrollment were positive, but small and not statistically significant. For the estimations of the effects of Bwafwano on the outcome of appropriate age-for-grade, only the difference-in-difference models showed positive program effect, with participation in the program being associated with a 15.7 percentage point increase in appropriate age-for-grade for intervention children, relative to control children. This study suggests that the Bwafwano program is a promising approach to improving educational outcomes among orphans and vulnerable children in urban Zambia. Language: English Keywords: ZAMBIA | RESEARCH REPORT | ORPHANS AND VULNERABLE CHILDREN | EDUCATIONAL STATUS | PRIMARY SCHOOLS | INTERVENTIONS | HIV PREVENTION | HOME CARE | PROGRAM EVALUATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Schools | Education | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Care and Support | Health Services | Delivery of Health Care | Health Document Number: 339995   |
21. Peer Reviewed Title: A cluster randomized controlled trial of an adolescent HIV prevention program among Bahamian youth: effect at 12 months post-intervention. Author: Chen X; Lunn S; Deveaux L; Li X; Brathwaite N; Cottrell L; Stanton B Source: AIDS and Behavior. 2009 Jun;13(3):499-508. Abstract: Behavioral interventions based on the Protection Motivation Theory (PMT) have been demonstrated to reduce HIV risk behavior among mid- and older adolescents in different settings across the globe but have not been evaluated among Caribbean nations and have received limited evaluation among pre-adolescents. To determine (1) the effectiveness among pre-adolescents in The Bahamas of a PMT-based HIV prevention program "Focus on Youth in the Caribbean" (FOYC) and (2) the role of the targeted PMT constructs in intervention effect. 1,360 sixth grade youth (10-11 years of age) from 15 urban schools in New Providence, The Bahamas were randomized by school to receive either FOYC or a control condition. Data collected at baseline, 6 and 12 months post intervention were analyzed. A five-step scheme was used to assess sexual behavior progression, ranging from "1" = "a virgin without intention to have sex" to "5" = "having sex without a condom". Group-based trajectory analysis was utilized in assessing the program effect. Two sexual behavior progression patterns were detected: slow progressors and quick progressors. Receiving FOYC reduced the likelihood for adolescents to become quick progressors (adjusted OR = 0.77, 95% CI: 0.64-1.00). The observed effectiveness was especially impacted by a subset of the targeted PMT constructs. FOYC effectively delays sexual risk among Bahamian pre-adolescents. The group-based trajectory analysis provides an analytical approach for assessing interventions among adolescents with low rates and diverse progression patterns of sexual activity. Language: English Keywords: CARIBBEAN | RESEARCH REPORT | PRE-POST TESTS | ADOLESCENTS | YOUTH | HIV PREVENTION | AIDS PREVENTION | RISK BEHAVIOR | SEX BEHAVIOR | INTERVENTIONS | PROGRAM EFFECTIVENESS | Developing Countries | Americas | Program Evaluation | Programs | Organization and Administration | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | AIDS | Behavior Document Number: 342104   |
22. 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   |
23. Peer Reviewed Title: Saving the lives of South Africa's mothers, babies, and children: can the health system deliver? Author: Chopra M; Daviaud E; Pattinson R; Fonn S; Lawn JE Source: Lancet. 2009 Sep 5;374(9692):835-46. Abstract: South Africa is one of only 12 countries in which mortality rates for children have increased since the baseline for the Millennium Development Goals (MDGs) in 1990. Continuing poverty and the HIV/AIDS epidemic are important factors. Additionally, suboptimum implementation of high-impact interventions limits programme effectiveness; between a quarter and half of maternal, neonatal, and child deaths in national audits have an avoidable health-system factor contributing to the death. Using the LiST model, we estimate that 11,500 infants' lives could be saved by effective implementation of basic neonatal care at 95% coverage. Similar coverage of dual-therapy prevention of mother-to-child transmission with appropriate feeding choices could save 37,200 children's lives in South Africa per year in 2015 compared with 2008. These interventions would also avert many maternal deaths and stillbirths. The total cost of such a target package is US$1.5 billion per year, 24% of the public-sector health expenditure; the incremental cost is $220 million per year. Such progress would put South Africa squarely on track to meet MDG 4 and probably also MDG 5. The costs are affordable and the key gap is leadership and effective implementation at every level of the health system, including national and local accountability for service provision. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | ESTIMATION TECHNIQUES | ECONOMIC MODEL | EXCESS MORTALITY | CAUSES OF DEATH | HIV INFECTIONS | INTERVENTIONS | IMPLEMENTATION | HEALTH POLICY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PRIMARY HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | PERFORMANCE IMPROVEMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Theoretical Models | Mortality | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Health Services | Delivery of Health Care | Health | Management Document Number: 342802   |
24. Title: Prenatal origins of undernutrition. Author: Christian P Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:59-73; discussion 74-7, 259-68. Abstract: Undernutrition continues to be high in many regions of the developing world. Birthweight, a common proxy measure of intrauterine growth, is influenced by nutritional, environmental and lifestyle factors during pregnancy and, in turn, affects immediate survival and function, and is a determinant of later life risk of chronic diseases. Maternal pre-pregnancy weight and height are independently associated with birthweight and also modify the effects of pregnancy weight gain and interventions during pregnancy on birthweight and perinatal mortality. Other prenatal factors commonly known to impact birthweight include maternal age, parity, sex, and birth interval, whereas lifestyle factors such as physical activity and maternal stress, as well as environmental toxicants have variable influences. Tobacco and other substance use and infections, specifically ascending reproductive tract infections, malaria, and HIV, can cause intrauterine growth restriction (IUGR). Few studies have examined the contribution of prenatal factors including low birthweight to childhood wasting and stunting. Studies that have examined this, with adequate adjustment for confounders, have generally found odds ratios associated with low birthweight ranging between 2 and 5. Even fewer studies have examined birth length or maternal nutritional status as risk factors. More research is needed to determine the proportion of childhood under-nutrition attributable to IUGR so that interventions can be targeted to the appropriate life stages. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS, FEMALE | YOUTH | WOMEN | ETHNIC GROUPS | PARITY | REPRODUCTIVE AGE | MALNUTRITION | HEALTH STATUS INDEXES | INTRAUTERINE GROWTH RETARDATION | REPRODUCTIVE TRACT INFECTIONS | MALARIA | HIV INFECTIONS | INTERVENTIONS | Developed Countries | North America | Americas | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Fertility Measurements | Fertility | Population Dynamics | Reproduction | Nutrition Disorders | Diseases | Health | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Infections | Parasitic Diseases | Viral Diseases | Programs | Organization and Administration Document Number: 341348   |
25. ![]() Title: Combating cross-generational sex in Uganda. Author: Clifton D Source: Washington, D.C., Population Reference Bureau [PRB], 2009 Feb. [3] p. Abstract: Cross-generational sex -- or Sugar Daddy syndrome -- is a pattern of sexual behavior between young women and much older men that brings increased health risks and consequences for young women. In most cases of cross-generational sex, the women are ages 15 to 19 and unmarried; their male partners are at least 10 years older. Although most cross-generational sex is based on the exchange of favors or material goods, it is different from commercial sex or prostitution. Sadly, few large-scale interventions have been undertaken to combat this risky behavior and even fewer have been evaluated to show how well they actually work. However, in Uganda, an important collaboration between the government, local organizations, and USAID may be leading the way. The association of cross-generational sex with unsafe behaviors and HIV risk makes the practice a priority for attention in Africa. While there is much work to be done, this program has successfully involved the community in its efforts. In one year, audiences sent in more than 900 letters with questions and comments about the radio dramas and related materials. Y.E.A.H. has obviously struck a resonant chord in Uganda -- one that could possibly be replicated in other countries in sub-Saharan Africa. (Excerpts) Language: English Keywords: UGANDA | SUMMARY REPORT | YOUTH | WOMEN | SUGAR DADDIES | TRANSACTIONAL SEX | RISK BEHAVIOR | SEX BEHAVIOR | INTERVENTIONS | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Programs | Organization and Administration Document Number: 331482   |
26. Title: HIV in adolescents in sub-Saharan Africa. Author: Cowan F; Pettifor A Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):288-93. Abstract: The authors summarize existing evidence on the effectiveness of different intervention approaches to HIV prevention in adolescents. They focus on studies that are either from or are relevant to sub-Saharan Africa. In addition, they include a brief review of other issues relevant to HIV prevention research in adolescents. Although numerous adolescent behavioral HIV prevention interventions have been evaluated, few have assessed their impact on HIV endpoints or been undertaken in Africa. In the three trials from Africa, which had HIV endpoints, none of the interventions had an impact on HIV, although all affected some knowledge and attitudes and reported behaviors. In one of these trials, there was a borderline effect on herpes simplex virus-2 incidence. Adolescents have typically been excluded from trials of biological interventions, although they are likely to benefit from these interventions if found to be effective. Despite the regulatory difficulties, they must be considered for inclusion in these trials as an important target population. Language: English Keywords: AFRICA, SUB SAHARAN | LITERATURE REVIEW | ADOLESCENTS | HIV PREVENTION | INTERVENTIONS | PROGRAM EFFECTIVENESS | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | BEHAVIOR CHANGE | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Program Evaluation | Sociocultural Factors | Psychological Factors | Behavior Document Number: 342339   |
| 27. Peer Reviewed Title: Economic analysis of HIV prevention interventions in Andhra Pradesh state of India to inform resource allocation. Author: Dandona L; Kumar SG; Kumar GA; Dandona R Source: AIDS. 2009 Jan 14;23(2):233-42. Abstract: OBJECTIVE: To conduct composite economic analysis of HIV prevention interventions to inform efficient utilization of resources in India. METHODS: We obtained output and economic cost data for the 2005-2006 fiscal year from a representative sample of 128 public-funded HIV prevention programmes of 14 types in Andhra Pradesh state of India. Using data from various sources, we developed a model to estimate the number of HIV infections averted. We estimated the additional HIV infections that could be averted if each intervention reached optimal coverage and the associated cost. RESULTS: In a year, 9688 HIV infections were averted by public-funded HIV prevention interventions in Andhra Pradesh. Scaling-up interventions to the optimal level would require US$38.8 million annually, 2.8 times the US$13.8 million economic cost in 2005-2006. This could increase the number of HIV infections averted by 2.4-fold, if with higher resources there were many-fold increases in the proportional allocation for programmes for migrant labourers, men who have sex with men and voluntary counselling and testing, and reduction of the high proportion for mass media campaigns to one-third of the 2005-2006 proportion of resource utilization. If the proportions of resource allocation for interventions remained similar to 2005-2006, the higher resources would avert 54% of the additional avertable HIV infections. CONCLUSION: The recent four-fold increase in public funding for HIV/AIDS control in India should be adequate to scale-up HIV prevention interventions to an optimal level in Andhra Pradesh, but the prevention would be suboptimal if additional investments were not preferentially directed to some particular interventions. Language: English Keywords: INDIA | RESEARCH REPORT | INTERVENTIONS | HIV INFECTIONS | COST BENEFIT ANALYSIS | ECONOMIC FACTORS | RESOURCE ALLOCATION | FUNDS | FINANCIAL ACTIVITIES | Developing Countries | Asia, Southern | Asia | Programs | Organization and Administration | Viral Diseases | Diseases | Quantitative Evaluation | Evaluation Document Number: 330502   |
28. Peer Reviewed Title: Gendered empowerment and HIV prevention: policy and programmatic pathways to success in the MENA region. Author: Dworkin SL; Kambou SD; Sutherland C; Moalla K; Kapoor A Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51 Suppl 3:S111-8. Abstract: Although HIV in the Middle East and North Africa is currently characterized as a low seroprevalence epidemic, there are numerous factors that are present in the region that could prevent-or exacerbate-the epidemic. The time to invest substantially in prevention-and gender-specific prevention in particular-is now. Given that most policy makers do not make gender-specific plans as epidemics progress, our research team-which draws upon expertise from both within and outside the region-worked together to make programmatic and policy suggestions in the Middle East and North Africa region in 5 key areas: (1) gender-specific and gender transformative HIV prevention interventions; (2) access to quality education and improvements in life skills and sex education; (3) economic empowerment; (4) property rights; and (5) antiviolence. In short, this work builds upon many ongoing efforts in the region and elucidates some of the links between gendered empowerment and health outcomes around the world, particularly HIV and AIDS. Language: English Keywords: MIDDLE EAST | AFRICA, NORTH | RESEARCH REPORT | GENDER RELATIONS | HIV PREVENTION | INTERVENTIONS | HEALTH POLICY | WOMEN'S EMPOWERMENT | PROGRAM ACTIVITIES | Africa | Developing Countries | Gender Issues | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Policy | Political Factors | Women's Status | Socioeconomic Factors | Economic Factors Document Number: 342681   |
29. ![]() Title: Using performance incentives. 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. :23-50. Abstract: When the goal is to reduce needless death and disease, and part of what is getting in the way is a misalignment between health goals and the real-world behaviors of individual patients, health workers, and those who influence them, it may be time to consider performance incentives. These can complement other interventions, such as providing training, revamping infrastructure, and improving the supply of drugs and other inputs. Here we look at how performance incentives can contribute to better health results, increased use of services, enhanced quality, and improved efficiency. To identify the experiences to highlight in this book, we searched the published literature, consulted experts, and included regional and national cases with substantial documented evidence. The evidence discussed here and in the case summaries in part 2 relies on both evaluations conducted with varying degrees of rigor and other sources of information. It comes from qualitative surveys, baseline and endline statistics, contrasts between intervention and comparison groups, and routine program monitoring. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | PERFORMANCE IMPROVEMENT | HEALTH SERVICES | INCENTIVES | DELIVERY OF HEALTH CARE | DISEASE PREVENTION | PROGRAM ACTIVITIES | INTERVENTIONS | PREVENTION AND CONTROL | HEALTH SERVICES ADMINISTRATION | EQUIPMENT AND SUPPLIES | Management | Organization and Administration | Health | Policy | Political Factors | Sociocultural Factors | Diseases | Programs | Medical Procedures | Medicine Document Number: 331462   |
| 30. Peer Reviewed Title: Potential role of traditional birth attendants in neonatal healthcare in rural southern Nepal. Author: Falle TY; Mullany LC; Thatte N; Khatry SK; LeClerq SC; Darmstadt GL; Katz J; Tielsch JM Source: Journal of Health, Population, and Nutrition. 2009 Feb;27(1):53-61. Abstract: The potential for traditional birth attendants (TBAs) to improve neonatal health outcomes has largely been overlooked during the current debate regarding the role of TBAs in improving maternal health. Randomly-selected TBAs (n=93) were interviewed to gain a more thorough understanding of their knowledge, attitudes, and practices regarding maternal and newborn care. Practices, such as using a clean cord-cutting instrument (89%) and hand-washing before delivery (74%), were common. Other beneficial practices, such as thermal care, were low. Trained TBAs were more likely to wash hands with soap before delivery, use a clean delivery-kit, and advise feeding colostrum. Although mustard oil massage was a universal practice, 52% of the TBAs indicated their willingness to consider alternative oils. Low-cost, evidence-based interventions for improving neonatal outcomes might be implemented by TBAs in this setting where most births take place in the home and neonatal mortality risk is high. Continuing efforts to define the role of TBAs may benefit from an emphasis on their potential as active promoters of essential newborn care. Language: English Keywords: NEPAL | RESEARCH REPORT | RURAL AREAS | TRADITIONAL BIRTH ATTENDANTS | COMMUNITY WORKERS | KNOWLEDGE | ATTITUDES | NEONATAL MORTALITY | PERCEPTION | CHILDBIRTH | INTERVENTIONS | DELIVERY OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Health Personnel | Health | Sociocultural Factors | Psychological Factors | Behavior | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Programs | Organization and Administration Document Number: 331129   |
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