1.  Peer Reviewed Title: Neonatal near miss: a measure of the quality of obstetric care. Author: Avenant T Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Jun;23(3):369-374. Abstract: Thirty-seven percent of under-five deaths occur in the neonatal period. Identifying and correcting factors that contribute to neonatal and maternal care are of the utmost importance. Evaluation of severe acute maternal morbidity, also known as “near miss”, is used to improve obstetric practice. Neonatal near miss in conjunction with neonatal mortality can be used in a similar fashion to identify deficiencies in care. No accepted definition of neonatal near miss currently exists. None of the neonatal morbidity scoring systems is applicable or appropriate for this purpose. Organ system based criteria are objective and allow for identifying severe morbidities and identifying primary causes. This system can be of use in a variety of settings to identify health system problems and to institute remedial action where necessary. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | PREGNANCY | MATERNAL MORTALITY | PERINATAL MORTALITY | MORBIDITY | QUALITY OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | MEASUREMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Reproduction | Mortality | Population Dynamics | Demographic Factors | Population | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Research Methodology Document Number: 341303 |
| 2. Title: Reliability of reported breastfeeding duration among reproductive-aged women from Mexico. Author: Cupul-Uicab LA; Gladen BC; Hernandez-Avila M; Longnecker MP Source: Maternal and Child Nutrition. 2009 Apr;5(2):125-37. Abstract: Breastfed children have lower risk of infectious diseases, post-neonatal mortality and chronic diseases later in life. Because epidemiologic studies usually rely on reported history of previous breastfeeding, data on the accuracy and precision of recalled histories allow improved interpretation of the epidemiologic findings. We evaluated the reliability of two reported breastfeeding durations in 567 reproductive-aged women from Mexico using information obtained from nearly identical sets of questions applied at different times after weaning. We compared differences between reports, and examined the intraclass correlation coefficient (ICC) for any and for exclusive breastfeeding (EBF). Logistic regression was used to evaluate the determinants of poor recall (difference between reports of >20%). The reliability of duration of any breastfeeding was high (ICC 0.94). Overall, differences between reports of duration were usually <1 month, and for 385/567, the difference was < or =0.5 months. Predictors of poorer recall were having > or =4 children, and time between reports of >2 months. The only predictor of better recall was greater age of the baby at weaning. The reliability of EBF duration was lower (ICC 0.49). In this population with a relatively long duration of breastfeeding, reliability of any breastfeeding duration was high. Age, education and previous breastfeeding were not important predictors of recall, in contrast to findings in earlier studies. Consistent with previous reports, however, parity and length of recall were associated with poorer recall of duration of any breastfeeding. Future studies that use reported breastfeeding duration may want to consider the effect of these variables on recall. Language: English Keywords: MEXICO | RESEARCH REPORT | SAMPLING STUDIES | MEASUREMENT | MOTHERS | BREASTFEEDING | BREASTFEEDING, EXCLUSIVE | TIME FACTORS | RELIABILITY | SOCIOECONOMIC STATUS | North America | Americas | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Population Dynamics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors Document Number: 341786 |
3.  Title: Haiti: Going to scale with a performance incentive model. Author: Eichler R; Auxila P; Antoine U; Desmangles B 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. :165-188. Abstract: Rewarding NGOs for increasing access to a package of basic services and paying them for achieving population-based performance targets can result in significant increases in essential services such as immunizations and assisted deliveries. Paying NGOs for results strengthens institutional capacity to deliver services from the bottom up. Changes in the design throughout the six years offer lessons for other contexts. Language: English Keywords: HAITI | RESEARCH REPORT | PILOT PROJECTS | MATERNAL HEALTH | CHILD HEALTH | REPRODUCTIVE HEALTH | FAMILY PLANNING | MEASUREMENT | PERFORMANCE IMPROVEMENT | PROGRAM ACTIVITIES | NONGOVERNMENTAL ORGANIZATIONS | ORGANIZATION AND ADMINISTRATION | PROGRAM EVALUATION | MONITORING | Developing Countries | Caribbean | Americas | Studies | Research Methodology | Health | Management | Programs | Organizations | Political Factors | Sociocultural Factors | Evaluation Document Number: 331456 |
| 4. Title: Audit for maternal and newborn health services in resource-poor countries. Author: Kongnyuy EJ; van den Broek N Source: BJOG. 2009 Jan;116(1):7-10. Abstract: Each year more than 536 000 women worldwide die from complications of pregnancy and childbirth. Many more survive but will suffer ill health and disability as a result of these complications. In addition, an estimated 4 million neonatal deaths occur each year, accounting for almost 40% of all deaths in children younger than 5 years. The key strategies that have been identified to reduce this global burden are the presence of skilled birth attendants, the availability of essential (or emergency) obstetric care4 and newborn care. To have major effects on maternal outcomes, it is crucial that these elements are not just available but also of high quality. And assessment of quality requires effective clinical audit. However, anyone who has undertaken a clinical audit will realise that the practice is not as simple as the theory, and 'closing the loop' (to achieve the desired endpoint of improvements in clinical care) is often difficult. So the process of clinical audit itself must be critically evaluated. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | INFANT | INFANT HEALTH | QUALITY OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | NEEDS ASSESSMENT | PERFORMANCE IMPROVEMENT | COST EFFECTIVENESS | MEASUREMENT | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Health | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Evaluation | Management | Evaluation Indexes | Quantitative Evaluation | Research Methodology Document Number: 330471 |
| 5. Title: Food insecurity among volunteer AIDS caregivers in Addis Ababa, Ethiopia was highly prevalent but buffered from the 2008 food crisis. Author: Maes KC; Hadley C; Tesfaye F; Shifferaw S; Tesfaye YA Source: Journal of Nutrition. 2009 Sep;139(9):1758-64. Abstract: Our objective in this study was to assess the validity and dependability of the Household Food Insecurity Access Scale (HFIAS), which was developed for international use, among community health volunteers in Addis Ababa, Ethiopia. The HFIAS was translated into Amharic and subsequently tested for content and face validity. This was followed by a quantitative validation study based on a representative sample (n = 99) of female community volunteers (HIV/AIDS home-based caregivers), with whom the HFIAS was administered at 3 time points over the course of 2008, in the context of the local and global "food crisis." By pooling observations across data collection rounds and accounting for intra-individual correlation in repeated measures, we found that the HFIAS performed well according to standards in the field. We also observed slight amelioration in reported food insecurity (FI) status over time, which seems paradoxical given the increasing inaccessibility of food over the same time period due to inflating prices and disappearing food aid. We attempted to resolve this paradox by appealing to self-report-related phenomena that arise in the context of longitudinal study designs: 1) observation bias, in which respondents change their reports according to changing expectations of the observer-respondent relationship or change their behavior in ways that ameliorate FI after baseline self-reports; and 2) "response shift," in which respondents change their reports according to reassessment of internal standards of FI. Our results are important for the validation of FI tools and for the sustainability of community health programs reliant on volunteerism in sub-Saharan Africa. Language: English Keywords: ETHIOPIA | RESEARCH REPORT | MEASUREMENT | SAMPLING STUDIES | COMMUNITY WORKERS | VOLUNTEERS AND VOLUNTARISM | FOOD SECURITY | VALIDITY | AIDS | HOME CARE | HOUSEHOLD CONSUMPTION | DIET | INCOME | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Health Personnel | Delivery of Health Care | Health | Organization and Administration | Food Supply | Natural Resources | Environment | HIV Infections | Viral Diseases | Diseases | Care and Support | Health Services | Microeconomic Factors | Economic Factors | Nutrition | Socioeconomic Factors Document Number: 342809 |
| 6. Title: Incidence of induced abortions in Peru [letter] Author: Puccetti R Source: CMAJ. 2009 May 26;180(11):1133; author reply 1133-4. Abstract: Antonio Bernabé-Ortiz and colleagues misleadingly assert that, although access to induced abortion services is legally restricted in Peru, the incidence of induced abortion is "as high as, or higher than, the estimated incidence in many countries where induced abortion is legal and safe." The abortion rate (the number of abortions per 1000 women of reproductive age) is greatly influenced by a number of factors, namely contraceptive behaviour and fertility rates, and thus it is not a good measure to use to evaluate the impact of the legal status of abortion on the incidence of abortions in a particular jurisdiction. The estimated total fertility rate is 2.86 in Peru; in comparison, it is 2.04 in the United States and 1.66 in the United Kingdom. Therefore, it is not surprising that the abortion rate in Peru may be similar to the rates in the United States and United Kingdom. The legal status of abortion may strongly affect postconceptional attitudes concerning pregnancy termination; this effect is much better described by the abortion ratio (the number of abortions per 1000 live births). Of the approximately 8660 pregnancies reported by participants in the study by Bernabé-Ortiz and colleagues, 1127 ended in induced abortions and 996 in spontaneous abortions. This means that there were approximately 6538 live births and the abortion ratio was 172.3. The authors referred to a study with US data from 2001, in which there were 6.4 million pregnancies, 1.1 million spontaneous abortions and 1.3 million induced abortions. The corresponding abortion ratio was 325. More recent US data indicate that there were 1 206 200 abortions and 4 138 349 births in 2005. The corresponding abortion ratio was 291.5. In England and Wales, 193 737 induced abortions and 669 601 live births were registered in 2006, with a corresponding abortion ratio of 289.3. These data show that there is a lower incidence of abortion in Peru than in other countries where abortion is legal. (full-text) Language: English Keywords: PERU | CRITIQUE | COMPARATIVE STUDIES | MEASUREMENT | ABORTION LAW | ABORTION RATE | REPRODUCTIVE BEHAVIOR | TOTAL FERTILITY RATE | Developing Countries | South America, Western | South America | Latin America | Americas | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Fertility | Population Dynamics | Demographic Factors | Population | Fertility Rate | Birth Rate | Fertility Measurements Document Number: 341641 |
| 7. Peer Reviewed Title: Severe acute maternal morbidity in low-income countries. Author: Ronsmans C Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Jun;23(3):305-316. Abstract: Although obstetric complications are sometimes presented as a relatively easy alternative to maternal deaths, difficulties remain in their definition and identification, and there is limited experience with the use of severe obstetric complications as a starting point for audits or case reviews or as an indicator for monitoring the success of safe motherhood programmes in low-income countries. In this paper we review published studies reporting on the measurement of severe acute maternal morbidity in low-income countries. We found 37 studies from 24 countries. We describe the definition and ascertainment of cases of severe acute maternal morbidity and we give examples of how information on severe acute maternal morbidity has been used to inform safe motherhood programmes in low-income countries. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | LOW INCOME POPULATION | MORBIDITY | SAFE MOTHERHOOD | MATERNAL HEALTH | MEASUREMENT | MATERNAL MORTALITY | OBSTETRICS | SURGERY | REPRODUCTIVE HEALTH | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Diseases | Health | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Treatment | Medical Procedures Document Number: 330188 |
| 8. Title: Forensic considerations of pregnancy-related maternal deaths: an overview. Author: Sharma BR; Gupta N Source: Journal of Forensic and Legal Medicine. 2009 Jul;16(5):233-8. Abstract: During the 20th century, risks to women associated with childbirth in developed countries have been dramatically reduced on account of many factors that include technological advancements in obstetrical care, greater access to health services and fewer births occurring at the extremes of women's reproductive age span. However, pregnancy-related maternal deaths continue to be a major health concern in developing countries. In the year 2005, an estimated 536,000 women died of maternal causes worldwide of which 86% occurred in sub-Saharan Africa and South Asia and less than 1% in more developed countries. The large regional differences in maternal deaths demonstrate that most of these deaths are preventable. It is nevertheless important to monitor patterns of pregnancy-related mortality and serious morbidity and to be sensitive to what observed patterns or changes may tell us in order to continue to safeguard women during this critical period and the monitoring process must begin with ascertainment of the accuracy of routine reporting of deaths associated with pregnancy and childbirth. We examine the pregnancy-related maternal deaths with a forensic view point. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | MEASUREMENT | MATERNAL MORTALITY | DEATH RATE | CAUSES OF DEATH | RISK FACTORS | PREGNANCY COMPLICATIONS | VITAL STATISTICS | MONITORING | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Health | Diseases | Population Statistics | Evaluation Document Number: 342792 |
| 9. Peer Reviewed Title: Social desirability bias in family planning studies: a neglected problem. Author: Stuart GS; Grimes DA Source: Contraception. 2009 Aug;80(2):108-12. Abstract: Studies on family planning methods traditionally have relied on self-reports of unknown validity and reproducibility. Social desirability bias, a type of information bias, occurs when study participants respond inaccurately - but in ways that will be viewed favorably by others. Several lines of evidence reveal that this bias can be powerful in sexual matters, including reports of coitus, use of contraceptives and induced abortion. For example, studies using vaginal prostate-specific antigen testing reveal underreporting of unprotected coitus and overreporting of barrier contraceptive use. Medication Event Monitoring System studies, which electronically record the time of pill dispensing from a bottle or pack, indicate widespread exaggeration of adherence to pill-taking regimens, including oral contraceptives. Comparisons of provider data and self-reports of induced abortions reveal extensive underreporting of induced abortion. Reliance on self-reported data underestimates contraceptive efficacy. Although techniques to minimize this bias exist, they are infrequently used in family planning studies. Greater skepticism about self-reports and more objective means of documenting coitus and contraceptive use are needed if contraceptive efficacy is to be accurately measured. Language: English Keywords: GLOBAL | CRITIQUE | MEASUREMENT | DATA QUALITY | DATA REPORTING | BIAS | ABORTION | CONDOM USE | CONTRACEPTIVE EFFECTIVENESS | ORAL CONTRACEPTIVES | USER COMPLIANCE | Research Methodology | Data Analysis | Data Collection | Error Sources | Fertility Control, Postconception | Family Planning | Risk Reduction Behavior | Behavior | Contraception | Contraceptive Methods Document Number: 342309 Notification |
| 10. Peer Reviewed Title: The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N). Author: Uys LR; Holzemer WL; Chirwa ML; Dlamini PS; Greeff M; Kohi TW; Makoae LN; Stewart AL; Mullan J; Phetlhu RD; Wantland DJ; Durrheim KL; Cuca YP; Naidoo JR Source: AIDS Care. 2009 Feb;21(2):150-9. Abstract: Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n=251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n=244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions. Language: English Keywords: LESOTHO | SWAZILAND | TANZANIA | SOUTH AFRICA | MALAWI | RESEARCH REPORT | QUALITATIVE RESEARCH | MEASUREMENT | NURSES AND NURSING | HIV INFECTIONS | AIDS | STIGMA | SATISFACTION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Eastern | Research Methodology | Health Personnel | Delivery of Health Care | Health | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Psychological Factors | Behavior Document Number: 330810 |
| 11. Peer Reviewed Title: The lifetime risk of maternal mortality: concept and measurement. Author: Wilmoth J Source: Bulletin of the World Health Organization. 2009 Feb 13;87:256-262. Abstract: Objective The lifetime risk of maternal mortality, which describes the cumulative loss of life due to maternal deaths over the female life course, is an important summary measure of population health. However, despite its interpretive appeal, the lifetime risk of dying from maternal causes can be defined and calculated in various ways. A clear and concise discussion of both its underlying concept and methods of measurement is badly needed. Methods I define and compare a variety of procedures for calculating the lifetime risk of maternal mortality. I use detailed survey data from Bangladesh in 2001 to illustrate these calculations and compare the properties of the various risk measures. Using official UN estimates of maternal mortality for 2005, I document the differences in lifetime risk derived with the various measures. Findings Taking sub-Saharan Africa as an example, the range of estimates for the 2005 lifetime risk extends from 3.41% to 5.76%, or from 1 in 29 to 1 in 17. The highest value resulted from the method used for producing official UN estimates for the year 2000. The measure recommended here has an intermediate value of 4.47%, or 1 in 22. Conclusion There are strong reasons to consider the calculation method proposed here more accurate and appropriate than earlier procedures. Accordingly, it was adopted for use in producing the 2005 UN estimates of the lifetime risk of maternal mortality. By comparison, the method used for the 2000 UN estimates appears to overestimate this important measure of population health by around 20%. Language: English Keywords: BANGLADESH | RESEARCH REPORT | DATA ANALYSIS | MATERNAL MORTALITY | CAUSES OF DEATH | RISK FACTORS | MEASUREMENT | Developing Countries | Asia, Southern | Asia | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Health Document Number: 340205 |
| 12. Title: Indonesia Young Adult Reproductive Health Survey 2007. Preliminary report. Author: Indonesia. Statistics Indonesia; Indonesia. National Family Planning Coordinating Board [BKKBN]; Indonesia. Ministry of Health; Macro International. MEASURE DHS Source: Jakarta, Indonesia, Statistics Indonesia, 2008 Jul. 25 p. Abstract: The primary objective of the 2007 Indonesia Young Adult Reproductive Health Survey (IYARHS) is to provide policymakers and program managers with national-level and provincial-level data on knowledge, attitudes, and practices of young adults regarding human reproduction, relationships, HIV/AIDS, and sexuality. Specifically, the 2007 IYARHS was designed to: measure the level of knowledge of young adults about reproductive health issues, examine the attitudes of young adults on various issues in reproductive health, measure the level of tobacco use, alcohol consumption, and drug use, measure the level of sexual activity among young adults, explore young adults' awareness of HIV / AIDS and other sexually transmitted infections. The survey findings are expected to provide updated indicators on adolescent reproductive health covered in the 2002-2003 IYARHS. Language: English Keywords: INDONESIA | SUMMARY REPORT | SURVEYS | MEASUREMENT | YOUTH | REPRODUCTIVE HEALTH | KNOWLEDGE | SEX BEHAVIOR | ATTITUDES | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | SEXUALLY TRANSMITTED DISEASES | AIDS | EVALUATION | Developing Countries | Asia, Southeastern | Asia | Sampling Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Sociocultural Factors | Behavior | Psychological Factors | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases Document Number: 331579 |
| 13. Peer Reviewed Title: Measure of HIV/STD risk-reduction: strategies for enhancing the utility of behavioral and biological outcome measures for African American couples. Author: NIMH Multisite HIV/STD Prevention Trial for African American Couples Group Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49 Suppl 1:S35-41. Abstract: OBJECTIVE: Numerous studies have discussed the value of including biological outcome measures as a complement to behavioral outcome measures to assess the efficacy of HIV risk-reduction interventions. This article highlights strategies used to minimize the limitations of including both self-reported sexual behaviors and biologically confirmed sexually transmitted diseases as primary outcome measures in an HIV/sexually transmitted disease (STD) prevention program for African American serodiscordant couples (Eban). DESIGN: Couples receiving an HIV intervention condition (Eban) were compared with couples receiving a time-equivalent General Health Promotion condition on behavioral and biological outcomes. Both behavioral and biological data were collected at baseline, immediately postintervention, and at 6 and 12 months postintervention. METHODS: Literature reviews, consulting other researchers who conducted couples studies, our investigative team's experience in previous HIV interventions, and formative work were used to develop procedures to minimize potential limitations associated with the inclusion of behavioral and biological outcome measures for Eban. RESULTS: Given the strengths of including behavioral and biological outcome measures, the Eban study chose to have both measures serve as primary outcomes. The primary behavioral outcome for the trial is the proportion of protected vaginal and anal intercourse episodes that occurred within the index couple in 90 days before each follow-up assessment and over the 12-month postintervention follow-up period. The primary biological outcome is the proportion of participants (male or female study partners) with an incident STD (Chlamydia, gonorrhea, or trichomoniasis) over the 12-month postintervention follow-up period. CONCLUSIONS: Employing procedures to minimize limitations of using self-reported sexual behaviors and STDs as complementary primary outcomes enhances their utility as measures of the efficacy of HIV/STD prevention interventions. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | MEASUREMENT | COUPLES | BLACKS | HETEROSEXUALS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK REDUCTION BEHAVIOR | INTERVENTIONS | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Reproductive Tract Infections | Infections | Diseases | Programs | Organization and Administration | Program Evaluation Document Number: 328591 |
| 14. Title: Measurement of HIV prevention indicators: A comparison of the PLACE Method and a Demographic Health Survey in Rwanda. Author: Rwanda. Commission Nationale de Lutte contre le SIDA; University of North Carolina at Chapel Hill. Carolina Population Center. MEASURE Evaluation Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2008 Jun. 28 p. (MEASURE Evaluation Working Paper Series WP-08-105USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: The 2005 Rwandan Demographic Health Survey (DHS) found that nearly 90 percent of the general population knew about HIV and prevention methods; however, it also found that condom use was very low (only 20 percent of people used a condom with a non-cohabiting partner). To respond better to the large gap between knowledge and safe sexual behavior, and to coordinate local efforts better in the fight against AIDS, the Commission Nationale de Lutte contre le SIDA (CNLS), with technical assistance from MEASURE Evaluation, implemented the Priorities for Local AIDS Control Efforts (PLACE) protocol in 12 provinces. The 2005 PLACE and Rwandan DHS results are useful tools for program managers wishing to focus scarce resources in effective HIV prevention. The DHS results provide information concerning the general population and provide a global picture of people?s HIV knowledge, attitudes, and behaviors. The PLACE results provide information about populations that exhibit riskier sexual behavior than the general population. Together, the survey results from PLACE and DHS can provide program managers and other stakeholders working in HIV/AIDS comprehensive information on knowledge, attitudes, and practices in both the general population and specific subgroups. The aim of this report is to compare results between the two surveys and illustrate how both surveys can be used together, giving HIV/AIDS program managers and policymakers a better picture of certain determinates of the generalized epidemic in Rwanda. (author's) Language: English Keywords: RWANDA | RESEARCH REPORT | EVALUATION RESEARCH | COMPARATIVE STUDIES | SURVEYS | HIV PREVENTION | KNOWLEDGE | BEHAVIOR | BEHAVIOR CHANGE | EVALUATION | MEASUREMENT | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Evaluation Methodology | Studies | Research Methodology | Sampling Studies | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors Document Number: 328118 |
| 15. Peer Reviewed Title: No HIV stage is dominant in driving the HIV epidemic in sub-Saharan Africa. Author: Abu-Raddad LJ; Longini IM Jr Source: AIDS. 2008;22(9):1055-1061. Abstract: The objective was to estimate the role of each of the HIV progression stages in fueling HIV transmission in sub-Saharan Africa by using the recent measurements of HIV transmission probability per coital per HIV stage in the Rakai study. A mathematical model, parameterized by empirical data from the Rakai, Masaka, and Four-City studies, was used to estimate the proportion of infections due to each of the HIV stages in two representative epidemics in sub-Saharan Africa. The first setting represents a hyperendemic HIV epidemic (Kisumu, Kenya) whereas the second setting represents a generalized but not hyperendemic HIV epidemic (Yaounde´, Cameroon). We estimate that 17, 51, and 32% of HIV transmissions in Kisumu were due to index cases in their acute, latent, and late stages, respectively. In Yaounde´, the fractions were 25, 44, and 31%. We found that the relative contribution of each stage varied with the epidemic evolution with the acute stage prevailing early on when the infection is concentrated in the high-risk groups with the late stage playing a major role as the epidemic matured and stabilized. The latent stage contribution remained largely stable throughout the epidemic and contributed about half of all transmissions. No HIV stage dominated the epidemical though the latent stage provided the largest contribution. The role of each stage depends on the phase of the epidemic and on the prevailing levels of sexual risk behavior in the populations in which HIV is spreading. These findings may influence the design and implementation of different HIV interventions. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | MATHEMATICAL MODEL | MEASUREMENT | HIV | HIV TRANSMISSION | TIME FACTORS | INFECTIONS | Developing Countries | Africa | Theoretical Models | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Dynamics | Demographic Factors | Population Document Number: 327153 |
| 16. Title: Caring for children: a model of healthcare service quality in Bangladesh. Author: Andaleeb S Source: International Journal for Quality in Health Care. 2008 Oct;20(5):339-45. Abstract: OBJECTIVE: This study assesses the links between service quality and patient satisfaction in the context of health services delivered to children in a developing country. With the growing importance of patients' voice in the healthcare environment, it is important to assess the factors that are best able to explain patient satisfaction to influence the art and science of patient care and health service delivery. DESIGN: A field survey was conducted using a household survey to assess the quality of services provided to children who had been to a hospital in the past 12 months. PARTICIPANTS: Caregivers who had accompanied an afflicted child to a hospital in Dhaka City. MAIN OUTCOME MEASURES: Patient satisfaction was the main outcome/dependent variable as reflected in surrogate measures obtained from the children's accompanying caregivers. RESULTS: A regression model was tested. The independent variables were nurse composite, doctor composite, tangibles, health inputs and facilitation payments. The model explained 67.4% of the variation in the dependent variable (R(2)). The behavior of nurses had the greatest impact on satisfaction (P < 0.001) as reflected in the standardized betas, followed by the behavior of doctors (P < 0.001). Facilitation payments had a negative effect on satisfaction (P < 0.01). CONCLUSIONS: Bringing about attitude change among doctors, nurses and support staff is vital for improving children's satisfaction with hospital care. Installing proper recruitment procedures, training, supervision, and reward systems are most likely to facilitate this change. But similar changes are also needed elsewhere: in the Ministry of Health and Family Welfare, other facilitating ministries, as well as the development partners to achieve enduring and positive effects. Language: English Keywords: BANGLADESH | RESEARCH REPORT | CLIENTS | CHILDREN | HEALTH SERVICES | CHILD HEALTH | SATISFACTION | QUALITY OF HEALTH CARE | MEASUREMENT | MANAGEMENT | Developing Countries | Asia, Southern | Asia | Program Activities | Programs | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Psychological Factors | Behavior | Health Services Evaluation | Program Evaluation | Research Methodology Document Number: 330026 |
| 17. Title: Comparison of the two-dimensional and multiplanar methods and establishment of a new constant for the measurement of fetal lung volume. Author: Araujo Junior E; Nardozza LM; Pires RC; Guimaraes Filho HA; Moron AF Source: Journal of Maternal-Fetal and Neonatal Medicine. 2008 Jan;21(1):81-88. Abstract: The objectives were to compare the two-dimensional (2D) and multiplanar methods in the measurement of lung volume in normal fetuses, to obtain a new constant to be incorporated into the 2D equation, and to apply the new equation in fetuses with pulmonary hypoplasia (PH) confirmed postnatally. A cross-sectional study was performed on 51 pregnant women at between 20 and 35 weeks of gestation. The ellipsoid formula (x x y x z x 0.52) was used to calculate lung volume by the 2D method. A sequence of multiple planes with 2.0-mm intervals was used with the multiplanar method. In order to compare the techniques, the intra-class correlation coefficient (ICC) and the Student's t-test (p) were used. First-order linear regressions were used to establish a new constant, with three-dimensional (3D) lung volume as dependent variable and gestational age and 2D volume as independent variables. In order to validate it, the new equation was applied to 11 fetuses with confirmed lethal PH. The mean volumes obtained by the 2D method were overestimated when compared to the multiplanar method (right lung: 23.87 vs. 18.26 mL, respectively, p < 0.001 and left lung: 16.18 vs. 14.33 mL, respectively, p = 0.008). Using a first-order polynomial regression, new constants were obtained for the right lung (0.152) and for the left lung (0.167). When compared to the traditional formula, the new equation presented higher sensitivity (18.1%) in predicting lethal PH. The recalculated 2D equation can be a promising alternative to 3D ultrasonography in the prediction of PH. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | MEASUREMENT | COMPARATIVE STUDIES | FETUS | PULMONARY EFFECTS | OBSTETRICS | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Pregnancy | Reproduction | Physiology | Biology | Medicine | Health Services | Delivery of Health Care | Health | Medical Procedures Document Number: 323406 |
| 18. Peer Reviewed Title: A prospective key informant surveillance system to measure maternal mortality -- findings from indigenous populations in Jharkhand and Orissa, India. Author: Barnett S; Nair N; Tripathy P; Borghi J; Rath S Source: BMC Pregnancy and Childbirth. 2008 Feb 28;8(6):[22] p. Abstract: In places with poor vital registration, measurement of maternal mortality and monitoring the impact of interventions on maternal mortality is difficult and seldom undertaken. Mortality ratios are often estimated and policy decisions made without robust evidence. This paper presents a prospective key informant system to measure maternal mortality and the initial findings from the system. In a population of 228 186, key informants identified all births and deaths to women of reproductive age, prospectively, over a period of 110 weeks. After birth verification, interviewers visited households six to eight weeks after delivery to collect information on the ante-partum, intra-partum and post-partum periods, as well as birth outcomes. For all deaths to women of reproductive age they ascertained whether they could be classified as maternal, pregnancy related or late maternal and if so, verbal autopsies were conducted. 13 602 births were identified, with a crude birth rate of 28.2 per 1000 population (C.I. 27.7-28.6) and a maternal mortality ratio of 722 per 100 000 live births (C.I. 591-882) recorded. Maternal deaths comprised 29% of all deaths to women aged 15-49. Approximately a quarter of maternal deaths occurred ante-partum, a half intra-partum and a quarter post-partum. Haemorrhage was the commonest cause of all maternal deaths (25%), but causation varied between the ante-partum, intra-partum and postpartum periods. The cost of operating the surveillance system was US$386 a month, or US$0.02 per capita per year. This low cost key informant surveillance system produced high, but plausible birth and death rates in this remote population in India. This method could be used to monitor trends in maternal mortality and to test the impact of interventions in large populations with poor vital registration and thus assist policy makers in making evidence-based decisions. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | METHODOLOGICAL STUDIES | MATERNAL MORTALITY | CAUSES OF DEATH | MEASUREMENT | DATA COLLECTION | VITAL STATISTICS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Population Statistics Document Number: 324224 |
| 19. Peer Reviewed Title: Can response of a pruritic papular eruption to antiretroviral therapy be used as a clinical parameter to monitor virological outcome? Author: Castelnuovo B; Byakwaga H; Menten J; Schaefer P; Kamya M Source: AIDS. 2008 Jan 11;22(2):269-273. Abstract: A pruritic papular eruption (PPE) is a common skin manifestation observed in 12-46% of persons with HIV infection living in tropical countries. The objective was to determine whether PPE responds to HAART and whether monitoring PPE severity could be used as a clinical marker to predict virological outcome in resource-limited settings where viral load testing is not available. The study enrolled 53 patients with PPE for at least 1 month before starting a first-line HAART regimen as part of a prospective study. CD4 cell count and viral load were measured at enrolment and every 3 months. A scoring system was developed to evaluate the PPE severity by asking two questions. Over the last month how itchy has your skin been? Over the last month how has itching interfered with your sleep? Median CD4 cell count was 15 cells/ml and median viral load 268 663 copies/ ml. All patients initiated a regimen containing a nonnucleoside reverse transcriptase inhibitor. Mean PPE score declined from 3.9 at enrolment to0.1 at 24 months. In 37 (86%) of the 43 patients with at least 6 months of follow-up data, the PPE disappeared and never returned. Patients with viral load > 400 copies/ml at months 9 and/or 12 had significantly higher PPE scores at months 9 to 12 than the patients with < 400 copies/ml. In most patients, PPE disappears during HAART and PPE severity scores were higher in patients whose first-line HAART failed to control plasma viral load. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | ADULTS | ANTIRETROVIRAL THERAPY | DERMATOLOGICAL EFFECTS | MONITORING | IMMUNITY, CELLULAR | LABORATORY PROCEDURES | MEASUREMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | Physiology | Biology | Evaluation | Immunity | Immune System | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 323106 |
| 20. Peer Reviewed Title: Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: Systematic review and meta-analysis. Author: Cnossen JS; Vollebregt KC; de Vrieze N; ter Riet G; Mol BW Source: BMJ. British Medical Journal. 2008;336(7653):1117-1120. Abstract: The objective was to determine the accuracy of using systolic and diastolic blood pressure, mean arterial pressure, and increase of blood pressure to predict pre-eclampsia. The design used was a systematic review with meta-analysis of data on test accuracy. The data sources used were Medline, Embase, Cochrane Library, Medion, checking reference lists of included articles and reviews, contact with authors. Without language restrictions, two reviewers independently selected the articles in which the accuracy of blood pressure measurement during pregnancy was evaluated to predict pre-eclampsia. Data were extracted on study characteristics, quality, and results to construct 2×2 tables. Summary receiver operating characteristic curves and likelihood ratios were generated for the various levels and their thresholds. 34 studies, testing 60 599 women (3341 cases of pre-eclampsia), were included. In women at low risk for pre-eclampsia, the areas under the summary receiver operating characteristic curves for blood pressure measurement in the second trimester were 0.68 (95% confidence interval 0.64 to 0.72) for systolic blood pressure, 0.66 (0.59 to 0.72) for diastolic blood pressure, and 0.76 (0.70 to 0.82) for mean arterial pressure. Findings for the first trimester showed a similar pattern. Second trimester mean arterial pressure of 90 mm Hg or more showed a positive likelihood ratio of 3.5 (95% confidence interval 2.0 to 5.0) and a negative likelihood ratio of 0.46 (0.16 to 0.75). In women deemed to be at high risk, a diastolic blood pressure of 75 mm Hg or more at 13 to 20 weeks' gestation best predicted pre-eclampsia: positive likelihood ratio 2.8 (1.8 to 3.6), negative likelihood ratio 0.39 (0.18 to 0.71). Additional subgroup analyses did not show improved predictive accuracy. When blood pressure is measured in the first or second trimester of pregnancy, the mean arterial pressure is a better predictor for pre-eclampsia than systolic blood pressure, diastolic blood pressure, or an increase of blood pressure. (author's) Language: English Keywords: NETHERLANDS | LITERATURE REVIEW | PREGNANT WOMEN | TESTING | PREGNANCY, FIRST TRIMESTER | PREGNANCY, SECOND TRIMESTER | PREECLAMPSIA | BLOOD PRESSURE | MEASUREMENT | RELIABILITY | Developed Countries | Europe, Western | Europe | Population Characteristics | Demographic Factors | Population | Research Methodology | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Hemic System | Physiology | Biology Document Number: 326845 |
| 21. Title: Validity and reliability of a self-efficacy expectancy scale for adherence to antiretroviral therapy for parents and carers of children and adolescents with HIV / AIDS. Author: Costa LS; Latorre MD; da Silva MH; Bertolini DV; Machado DM Source: Jornal de Pediatria. 2008 Jan-Feb;84(1):41-46. Abstract: The objective was to validate and evaluate the reproducibility of a self-efficacy (SE) scale for adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/guardians. The study was carried out at the Hospital-Dia, Centro de Referencia e Treinamento em DST/AIDS (CRT/ SP), in Sao Paulo, Brazil. The parents/guardians of 54 children and adolescents aged 6 months to 20 years were interviewed during routine consultations at our service. Data on SE were collected using the Self-Efficacy for Following Anti-Retroviral Prescription Scale, and SE scores were calculated in two different ways: factor analysis and a predefined formula. The scale's internal consistency was verified using Cronbach's a coefficient. Validity was tested by comparing the mean scores of a group of patients who did adhere to antiretroviral treatment with those of a group that did not (Mann-Whitney test) and by calculating the Spearman correlation coefficient for agreement between scores and clinical parameters. Reproducibility was verified using the Wilcoxon test, intraclass correlation coefficients (ricc) and Bland-Altman plots. The SE scale demonstrated good internal consistency (alpha = 0.87) and good reproducibility (r/icc=0.69 and r/icc = 0.75). In terms of validity, the SE scale was capable of differentiating adherent patients from those who did not adhere to their antiretroviral treatment (p = 0.002) and exhibited a significant correlation with CD4 counts (r = 0.28; p = 0.04). The SE scale can be used to assess adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/carers. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | METHODOLOGICAL STUDIES | CHILDREN | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | DATA COLLECTION | MEASUREMENT | VALIDITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Research Methodology Document Number: 325038 |
| 22. Title: Measuring tuberculosis burden, trends, and the impact of control programmes. Author: Dye C; Basslli A; Bierrenbach AL; Broekmans JF; Chadha VK Source: Lancet Infectious Diseases. 2008 Apr;8(4):233-243. Abstract: The targets for tuberculosis control, framed within the United Nations' Millennium Development Goals, are to ensure that the incidence per head of tuberculosis is falling by 2015, and that the 1990 prevalence and mortality per head are halved by 2015. In monitoring progress in tuberculosis control, the ultimate aim for all countries is to count tuberculosis cases (incidence) accurately through routine surveillance. Disease prevalence surveys are costly and laborious, but give unbiased measures of tuberculosis burden and trends, and are justified in high-burden countries where many cases and deaths are missed by surveillance systems. Most countries in which tuberculosis is highly endemic do not yet have reliable death registration systems. Verbal autopsy, used in cause-of-death surveys, is an alternative, interim method of assessing tuberculosis mortality, but needs further validation. Although several new assays for Mycobacterium tuberculosis infection have recently been devised, the tuberculin skin test remains the only practical method of measuring infection in populations. However, this test typically has low specificity and is therefore best used comparatively to assess geographical and temporal variation in risk of infection. By 2015, every country should be able to assess progress in tuberculosis control by estimating the time trend in incidence, and the magnitude of reductions in either prevalence or deaths. (author's) Language: English Keywords: GLOBAL | SUMMARY REPORT | MEASUREMENT | INCIDENCE | PREVALENCE | TUBERCULOSIS | MORTALITY | DEATH RATE | SCREENING | VITAL STATISTICS | TRANSMISSION | MONITORING | Research Methodology | Infections | Diseases | Population Dynamics | Demographic Factors | Population | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Statistics | Evaluation Document Number: 325523 |
| 23. Peer Reviewed Title: p24 as a predictor of mortality in a cohort of HIV-1-infected adults in rural Africa. Author: Erikstrup C; Kallestrup P; Zinyama-Gutsire RB; Gomo E; Luneborg-Nielsen M Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Jul;48(3):345-349. Abstract: Implementation of antiretroviral treatment in sub-Saharan Africa requires efficient tools to monitor HIV patients. p24 measurements have been proposed as an alternative to HIV-RNA because of the low cost of reagents and equipment needed. Here, we evaluate p24 as a prognostic marker in a cohort of HIV-1-infected individuals in Zimbabwe. Treatment-naive HIV-1-infected individuals (n = 198) from the Mupfure Schistosomiasis and HIV Cohort were followed until death or censoring (3-4.3 years). At baseline, p24, HIV-RNA, CD4 cell counts, and clinical staging (Centers for Disease Control and Prevention classification) were assessed. p24 correlated with HIV-RNA (P < 0.0001, R2: 0.44). Ten percent of p24 but only 1% of HIV-RNA measurements was undetectable. p24 predicted Centers for Disease Control and Prevention category (P < 0.001) stronger than CD4 count (P = 0.34) in multivariate logistic regression. p24 predicted mortality in univariate Cox analysis (P < 0.0001) and in multivariate analysis, but it wasinferior to HIV-RNA and CD4 count. This is the first study to evaluate the prognostic strength of p24 in an area with a predominance of HIV subtype C infections. p24 correlated with HIV-RNA and predicted clinical stage better than CD4 count. It predicted mortality in both univariate and multivariate analysis, but in multivariate analysis, it was inferior to HIV-RNA and CD4 count. (author's) Language: English Keywords: ZIMBABWE | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | MORTALITY DETERMINANTS | MEASUREMENT | ANTIGENS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Viral Diseases | Diseases | HIV | Mortality | Population Dynamics | Demographic Factors | Population | Immunologic Factors | Immunity | Immune System | Physiology | Biology Document Number: 327522 |
| 24. Title: Population survey sampling methods in a rural African setting: Measuring mortality. Author: Fottrell E; Byass P Source: Population Health Metrics. 2008 May 20;6:2. Abstract: Population-based sample surveys and sentinel surveillance methods are commonly used as substitutes for more widespread health and demographic monitoring and intervention studies in resource-poor settings. Such methods have been criticised as only being worthwhile if the results can be extrapolated to the surrounding 100-fold population. With an emphasis on measuring mortality, this study explores the extent to which choice of sampling method affects the representativeness of 1% sample data in relation to various demographic and health parameters in a rural, developing-country setting. Data from a large community based census and health survey conducted in rural Burkina Faso were used as a basis for modelling. Twenty 1% samples incorporating a range of health and demographic parameters were drawn at random from the overall dataset for each of seven different sampling procedures at two different levels of local administrative units. Each sample was compared with the overall "gold standard" survey results, thus enabling comparisons between the different sampling procedures. All sampling methods and parameters tested performed reasonably well in representing the overall population. Nevertheless, a degree of variation could be observed both between sampling approaches and between different parameters, relating to their overall distribution in the total population. Sample surveys are able to provide useful demographic and health profiles of local populations. However, various parameters being measured and their distribution within the sampling unit of interest may not all be best represented by a particular sampling method. It is likely therefore that compromises may have to be made in choosing a sampling strategy, with costs, logistics the intended use of the data being important considerations. (author's) Language: English Keywords: BURKINA FASO | RESEARCH REPORT | METHODOLOGICAL STUDIES | SURVEYS | SAMPLING STUDIES | RURAL POPULATION | POPULATION STATISTICS | MORTALITY | DATA COLLECTION | ESTIMATION TECHNIQUES | MEASUREMENT | VALIDITY | RELIABILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Population Dynamics Document Number: 326904 |
| 25. Peer Reviewed Title: Stakeholders' opinions and expectations of the Global Fund and their potential economic implications. Author: Galarraga O; Bertozzi SM Source: AIDS. 2008 Jul;22 Suppl 1:S7-S15. Abstract: OBJECTIVES: To analyse stakeholder opinions and expectations of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and to discuss their potential economic and financial implications. DESIGN: The Global Fund commissioned an independent study, the '360 degrees Stakeholder Survey', to canvas feedback on the organization's reputation and performance with an on-line survey of 909 respondents representing major stakeholders worldwide. We created a proxy for expectations based on categorical responses for specific Global Fund attributes' importance to the stakeholders and current perceived performance. METHODS: Using multivariate regression, we analysed 23 unfulfilled expectations related to: resource mobilization; impact measurement; harmonization and inclusion; effectiveness of the Global Fund partner environment; and portfolio characteristics. The independent variables are personal and regional-level characteristics that affect expectations. RESULTS: The largest unfulfilled expectations relate to: mobilization of private sector resources; efficiency in disbursing funds; and assurance that people affected by the three diseases are reached. Stakeholders involved with the fund through the country coordinating mechanisms, those working in multilateral organizations and persons living with HIV are more likely to have unfulfilled expectations. In contrast, higher levels of involvement with the fund correlate with fulfilled expectations. Stakeholders living in sub-Saharan Africa were less likely to have their expectations met. CONCLUSIONS: Stakeholders' unfulfilled expectations result largely from factors external to them, but also from factors over which they have influence. In particular, attributes related to partnership score poorly even though stakeholders have influence in that area. Joint efforts to address perceived performance gaps may improve future performance and positively influence investment levels and economic viability. Language: English Keywords: GLOBAL | RESEARCH REPORT | SURVEYS | PERSONS LIVING WITH HIV/AIDS | INTERNATIONAL COOPERATION | INTERNATIONAL AGENCIES | PRIVATE SECTOR | SOCIAL MOBILIZATION | MEASUREMENT | RESOURCE ALLOCATION | FUNDS | INVESTMENTS | ECONOMIC FACTORS | PSYCHOLOGICAL FACTORS | Sampling Studies | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Political Factors | Sociocultural Factors | Organizations | Macroeconomic Factors | Social Change | Financial Activities | Behavior Document Number: 328452 |
| 26. Peer Reviewed Title: Assessing HIV / AIDS stigma and discrimination in developing countries. Author: Genberg BL; Kawichai S; Chingono A; Sendah M; Chariyalertsak S Source: AIDS and Behavior. 2008 Sep;12(5):772-780. Abstract: HIV/AIDS-related stigma and discrimination are barriers to HIV prevention effectiveness, voluntary counseling and testing uptake, and accessing care in many international settings. Most published stigma scales are not comprehensive and have been primarily tested in developed countries. We sought to draw on existing literature to develop a scale with strong psychometric properties that could easily be used in developing countries. From 82 compiled questions, we tested a 50-item scale which yielded 3 dimensions with 22 items in pilot testing in rural northern Thailand (n = 200) and urban and peri-urban Zimbabwe (n = 221). The three factors (shame, blame and social isolation; perceived discrimination; equity) had high internal consistency reliability and good divergent validity in both research settings. Systematic and significant differences in stigmatizing attitudes were found across countries, with few differences by age or sex noted within sites. This short, comprehensive and standardized measurecan be easily incorporated into questionnaires in international research settings. (author's) Language: English Keywords: THAILAND | ZIMBABWE | DEVELOPING COUNTRIES | RESEARCH REPORT | METHODOLOGICAL STUDIES | HIV | AIDS | STIGMA | SOCIAL DISCRIMINATION | SOCIOMETRICS | MEASUREMENT | RELIABILITY | Asia, Southeastern | Asia | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Research Methodology Document Number: 327998 |
| 27. Peer Reviewed Title: The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Author: Gipson JD; Koenig MA; Hindin MJ Source: Studies in Family Planning. 2008 Mar;39(1):18-38. Abstract: This article provides a critical review of studies assessing the effects of unintended pregnancy on the health of infants, children, and parents in developed and developing countries. A framework for determining and measuring the pathways between unintended pregnancy and future health outcomes is outlined. The review highlights persistent gaps in the literature, indicating a need for more studies in developing countries and for further research to assess the impact of unintended pregnancy on parental health and long-term health outcomes for children and families. The challenges in measuring and assessing these health impacts are also discussed, highlighting avenues in which further research efforts could substantially bolster existing knowledge. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | PREGNANCY, UNPLANNED | PREGNANCY, UNWANTED | LONGTERM EFFECTS | INFANT HEALTH | CHILD HEALTH | MATERNAL HEALTH | FERTILITY PREFERENCES | MEASUREMENT | TIME FACTORS | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Health | Research Methodology Document Number: 324221 |
| 28. Peer Reviewed Title: Simple adherence assessments to predict virologic failure among HIV-infected adults with discordant immunologic and clinical responses to antiretroviral therapy. Author: Goldman JD; Cantrell RA; Mulenga LB; Tambatamba BC; Reid SE; Levy JW; Limbada M; Taylor A; Saag MS; Vermund SH; Stringer JS; Chi BH Source: AIDS Research and Human Retroviruses. 2008 Aug;24(8):1031-5. Abstract: We evaluated the association between two antiretroviral therapy (ART) adherence measurements--the medication possession ratio (MPR) and patient self-report--and detectable HIV viremia in the setting of rapid service scale-up in Lusaka, Zambia. Drug adherence and outcomes were assessed in a subset of patients suspected of treatment failure based on discordant clinical and immunologic responses to ART. A total of 913 patients were included in this analysis, with a median time of 744 days (Q1, Q3: 511, 919 days) from ART initiation to viral load (VL) measurement. On aggregate over the period of follow-up, 531 (58%) had optimal adherence (MPR > or =95%), 306 (34%) had suboptimal adherence (MPR 80-94%), and 76 (8%) had poor adherence (MPR <80%). Of the 913 patients, 238 (26%) had VL > or =400 copies/ml when tested. When compared to individuals with optimal adherence, there was increasing risk for virologic failure in those with suboptimal adherence [adjusted relative risk (ARR): 1.3; 95% confidence interval (CI): 1.0, 1.6] and those with poor adherence (ARR: 1.7; 95% CI: 1.3, 2.4) based on MPR. During the antiretroviral treatment course, 676 patients (74%) reported no missed doses. The proportion of patients with virologic failure did not differ significantly among those reporting any missed dose from those reporting perfect adherence (26% vs. 26%, p = 0.97). Among patients with suspected treatment failure, a lower MPR was associated with higher rates of detectable viremia. However, the suboptimal sensitivity and specificity of MPR limit its utility as a sole predictor of virologic failure. Language: English Keywords: ZAMBIA | RESEARCH REPORT | MEASUREMENT | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | USER COMPLIANCE | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Behavior Document Number: 328930 |
| 29. Peer Reviewed Title: Measuring maternal mortality: An overview of opportunities and options for developing countries. Author: Graham WJ; Ahmed S; Stanton C; Abou-Zahr; Campbell OM Source: BMC Medicine. 2008 May 26;6:12. Abstract: There is currently an unprecedented expressed need and demand for estimates of maternal mortality in developing countries. This has been stimulated in part by the creation of a Millennium Development Goal that will be judged partly on the basis of reductions in maternal mortality by 2015. Since the launch of the Safe Motherhood Initiative in 1987, new opportunities for data capture have arisen and new methods have been developed, tested and used. This paper provides a pragmatic overview of these methods and the optimal measurement strategies for different developing country contexts. There are significant recent advances in the measurement of maternal mortality, yet also room for further improvement, particularly in assessing the magnitude and direction of biases and their implications for different data uses. Some of the innovations in measurement provide efficient mechanisms for gathering the requisite primary data at a reasonably low cost. No method, however, has zero costs. Investment is needed in measurement strategies for maternal mortality suited to the needs and resources of a country, and which also strengthen the technical capacity to generate and use credible estimates. Ownership of information is necessary for it to be acted upon: what you count is what you do. Difficulties with measurement must not be allowed to discourage efforts to reduce maternal mortality. Countries must be encouraged and enabled to count maternal deaths and act. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | RESEARCH REPORT | METHODOLOGICAL STUDIES | MATERNAL MORTALITY | VITAL STATISTICS | DATA COLLECTION | MEASUREMENT | ESTIMATION TECHNIQUES | COST EFFECTIVENESS | BIAS | RELIABILITY | Mortality | Population Dynamics | Demographic Factors | Population | Population Statistics | Research Methodology | Evaluation Indexes | Quantitative Evaluation | Evaluation | Error Sources Document Number: 326901 |
| 30. Peer Reviewed Title: Measuring progress in reducing maternal mortality. Author: Graham WJ; Foster LB; Davidson L; Hauke E; Campbell OM Source: Best Practice and Research Clinical Obstetrics and Gynaecology. 2008;22(3):425-445. Abstract: The need to monitor progress in reducing maternal mortality has a long history, which can be traced back to the 1700s in some parts of the Western world. Today, however, this need is felt most acutely in developing countries, where the priority is to stimulate, evaluate and sustain action to prevent these essentially avoidable deaths. Over the last two decades, considerable efforts have been made to understand and overcome the measurement challenges of maternal mortality in the context of weak information systems, and new and enhanced methods and tools have emerged. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | MATERNAL MORTALITY | MORTALITY DETERMINANTS | CAUSES OF DEATH | MEASUREMENT | Mortality | Population Dynamics | Demographic Factors | Population | Research Methodology Document Number: 326413 |
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