1.  Peer Reviewed Title: The "seeded" focus group: a strategy to recruit HIV+ community members into treatment research. Author: Busza J; Zaba B; Urassa M Source: Sexually Transmitted Infections. 2009 Jun;85(3):212-5. Abstract: OBJECTIVE(S): We piloted an innovative community-based recruitment approach to contact known HIV+ individuals for referral to treatment without endangering their confidentiality. METHODS: Nested within an HIV cohort study, operations research to monitor and improve rural uptake of antiretroviral therapy (ART) was conducted alongside the introduction of Tanzania's national treatment programme. We confronted the challenge of recruiting participants without inadvertently disclosing their HIV status to family or other community members. During post-test counselling, nurses compiled a list of HIV+ persons who expressed interest in being contacted when ART became available. Study numbers, but not names, of 12 "seeds" were added to a randomly generated list of residents, matched by age group and sex, and all were invited to participate in focus-group discussions on community perceptions of treatment. After the discussion, the original counsellors met each participant in private, inviting the "seed" for ART referral and offering VCT to others. RESULTS: Ten "seeds" were successfully located and attended the local focus-group discussion; all subsequently volunteered to undergo clinical tests in advance of receiving antiretroviral therapy. They also agreed to participate in a study of barriers to ART access. The other focus-group members contributed useful information on levels of understanding and support for treatment, and several came forward for HIV testing. CONCLUSIONS: The "seeded" focus group is a very straightforward and easily arranged method of recruiting HIV+ people for research or service delivery within a wider context of engaging with local community perceptions. Language: English Keywords: TANZANIA | RESEARCH REPORT | PILOT PROJECTS | COHORT ANALYSIS | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RECRUITMENT ACTIVITIES | ANTIRETROVIRAL THERAPY | PERCEPTION | COMMUNITY-BASED DISTRIBUTION | HIV TESTING | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Program Activities | HIV | Psychological Factors | Behavior | Nonclinical Distribution | Distributional Activities | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342673 |
| 2. Peer Reviewed Title: Successful integration of tuberculosis and HIV treatment in rural South Africa: the Sizonq'oba study. Author: Gandhi NR; Moll AP; Lalloo U; Pawinski R; Zeller K; Moodley P; Meyer E; Friedland G Author: Tugela Ferry Care and Research (TFCaRes) Collaboration Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Jan 1;50(1):37-43. Abstract: BACKGROUND: Tuberculosis (TB) is the leading cause of death among HIV-infected patients worldwide. In KwaZulu-Natal, South Africa, 80% of TB patients are HIV coinfected, with high treatment default and mortality rates. Integrating TB and HIV care may be an effective strategy for improving outcomes for both diseases. METHODS: Prospective operational research study treating TB/HIV-coinfected patients in rural KwaZulu-Natal with once-daily antiretroviral (ARV) therapy concurrently with TB therapy by home-based, modified directly observed therapy. Patients were followed for 12 months after ARV initiation. RESULTS: Of 119 TB/HIV-coinfected patients enrolled, 67 (56%) were female, mean age was 34.0 years, and median CD4 count was 78.5 cells per cubic millimeter. After 12 months on ARVs, mean CD4 count increase was 211 cells per cubic millimeter, and 88% had an undetectable viral load; 84% completed TB treatment. Thirteen patients (11%) died; 10 (77%) with multidrug-resistant or extensively drug-resistant TB. There were few severe adverse events or immune reconstitution events. Adherence was high with 93% of study visits attended and 99% of ARV doses taken. CONCLUSIONS: Integration of TB and HIV treatment in a rural setting using concurrent home-based therapy resulted in excellent adherence and TB and HIV outcomes. This model may result in successful management of both diseases in other rural resource-poor settings. Language: English Keywords: SOUTH AFRICA | EVALUATION REPORT | PROSPECTIVE STUDIES | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RURAL POPULATION | INTEGRATED PROGRAMS | TUBERCULOSIS | AIDS PREVENTION | TREATMENT | RURAL HEALTH SERVICES | COMPLICATIONS | ANTIRETROVIRAL THERAPY | HOME VISITS | DRUG RESISTANCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Infections | AIDS | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Communication Document Number: 330981 |
| 3. Title: Interaction of malaria and HIV in Africa. Author: Reithinger R; Kamya MR; Whitty CJ; Dorsey G; Vermund SH Source: BMJ. 2009;338:b2141. Abstract: Language: English Keywords: AFRICA | CRITIQUE | OPERATIONS RESEARCH | HIV INFECTIONS | MALARIA | COORDINATION | EXAMINATIONS AND DIAGNOSES | PREVENTION AND CONTROL | BED NETS | ANTIMALARIAL DRUGS | ANTIRETROVIRAL DRUGS | DRUG INTERACTIONS | Developing Countries | Research Methodology | Program Evaluation | Programs | Organization and Administration | Viral Diseases | Diseases | Parasitic Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Parasite Control | Public Health | Treatment | Drugs Document Number: 341925 |
| 4. Title: A peer-led HIV counselling and testing programme for the deaf in Kenya. Author: Taegtmeyer M; Hightower A; Opiyo W; Mwachiro L; Henderson K; Angala P; Ngare C; Marum E Source: Disability and Rehabilitation. 2009;31(6):508-14. Abstract: PURPOSE: To describe and evaluate the establishment of the first VCT services for the Deaf in Africa. METHOD: Operational research methods were used to document programme establishment. The demographics of deaf VCT clients were compared with hearing clients at the same sites as well as where clients had learned of the service, HIV risks, and HIV test results. Univariate and multivariate analyses were used. RESULTS: During the two year period (January 2004 to December 2005) 1709 Deaf and 1649 hearing clients were seen at three Deaf VCT sites. The majority of Deaf clients in this sample learned of the services through the peer education programme. Data indicate that Deaf VCT clients are as much at risk of HIV from sexual transmission as their hearing counterparts and that Deaf persons seeking VCT services have an HIV prevalence of 7%, similar to the national rate of 6.7%. CONCLUSIONS: The Deaf in Kenya are at risk of HIV and there is an urgent need for Deaf-friendly HIV services, supplemented by peer education programmes. This is the first published report describing HIV services run by the Deaf for the Deaf in the developing world. Language: English Keywords: KENYA | RESEARCH REPORT | OPERATIONS RESEARCH | DEAFNESS | COUNSELING | HIV | HIV TESTING | PROGRAM ACTIVITIES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Evaluation | Programs | Organization and Administration | Sensory Effects | Physiology | Biology | Clinic Activities | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341560 |
| 5. Peer Reviewed Title: Nurse auxiliaries as providers of intrauterine devices for contraception in Guatemala and Honduras. Author: Vernon R Source: Reproductive Health Matters. 2009 May;17(33):51-60. Abstract: Nurse auxiliaries staff the majority of primary health service delivery outlets in low-income countries, particularly in rural areas with high unmet need for contraception. Yet often service delivery guidelines prohibit them from providing contraceptive methods such as the intrauterine device (IUD). Operations research in Guatemala and Honduras in 1997-2005, described in this paper, have shown that nurse auxiliaries can provide IUDs in a safe and clinically appropriate fashion, which can help improve women's choice of methods and decrease costs in health centres with physicians and professional nurses, and health posts. Empowering these health workers requires commitment at the health system and policy levels to a long-term strategy in which small pilot studies are first conducted, followed by phased scaling-up of the strategies, which can require several years. Training can be conducted both in high volume clinics or on-site in health posts. Simple measures such as mentioning the method during counselling and to users of different services and providing women and communities with printed materials have been effective in increasing requests for IUDs. These studies also showed that nurse auxiliaries can take on other reproductive health services, such as contraceptive injections. Language: English Keywords: GUATEMALA | HONDURAS | CRITIQUE | OPERATIONS RESEARCH | PARAMEDICAL PERSONNEL | IUD | INJECTABLES | TRAINING PROGRAMS | NEEDS | COST EFFECTIVENESS | Central America | Latin America | Americas | Developing Countries | Research Methodology | Program Evaluation | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Education | Economic Factors | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 341668 |
6.  Title: Analysis of the operational policy barriers to financing and procuring contraceptives in Malawi. Author: Constella Futures. Health Policy Initiative; John Snow [JSI]. DELIVER Source: Washington, D.C., Health Policy Initiative, Constella Futures, 2008 Jun. :viii, 23 p.. viii, 23 p. (USAID Contract No. GPO-I-01-05-00040-00USAID Contract No. GPO-I-01-06-00007-00) Abstract: Contraceptive security exists when every person can choose, obtain, and use high-quality contraceptives whenever they need them. Two of the most important factors in achieving contraceptive security are adequate financing and efficient contraceptive procurement mechanisms. The USAID | Health Policy Initiative and USAID | DELIVER Project are working together to develop a methodology for identifying operational policy barriers in the financing and procurement of family planning (FP) products. The goal is to help national governments, donors, and other key stakeholders improve the policy environment for contraceptive security. This report presents the findings from a pilot study the two projects conducted in Malawi to test this methodology. Language: English Keywords: MALAWI | METHODOLOGICAL STUDIES | OPERATIONS RESEARCH | PILOT PROJECTS | DEMOGRAPHIC AND HEALTH SURVEYS | PRIVATE SECTOR | USAID | GOVERNMENT FINANCING | FINANCIAL ACTIVITIES | CONTRACEPTIVE AVAILABILITY | EQUIPMENT AND SUPPLIES | LOGISTICS | CONTRACEPTIVE PREVALENCE | DECENTRALIZATION | CAPACITY BUILDING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Program Evaluation | Programs | Organization and Administration | Research Methodology | Studies | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Macroeconomic Factors | Economic Factors | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Management | Contraceptive Usage | Program Sustainability Document Number: 308944 |
| 7. Title: Reproductive health knowledge and practices in northern Nigeria: challenging misconceptions. Author: Pathfinder International. Reproductive Health / Family Planning Service Delivery Project in Northern Nigeria Source: Abuja, Nigeria, Pathfinder International, [2008]. [31] p. Abstract: Pathfinder International's Reproductive Health/Family Planning Service Delivery Project, funded by the David and Lucile Packard Foundation, aims to improve the Reproductive Health (RH) status of adults and adolescents in northern Nigeria, and to increase the utilization of services through a network of public- and private-sector facilities and community-based providers. In the third phase, the project sought to respond more positively to its target communities by conducting a community survey to inform implementation of its future interventions in six states of northern Nigeria (Borno, Kaduna, Kano, Katsina, Niger, and Sokoto) and the Federal Capital Territory. Pathfinder is implementing the project in northern Nigeria to address the region's depressed socioeconomic conditions and low demand for and use of services, as compared to the southern region. The community survey used qualitative methods (including focus group discussions, key informant interviews, and in-depth interviews) to elicit information from 511 respondents on their knowledge, practices, and beliefs about RH and Family Planning (FP). It also served to establish the stakeholders' level of awareness of the project in target communities. (excerpt) Language: English Keywords: NIGERIA | RESEARCH REPORT | OPERATIONS RESEARCH | BASELINE SURVEYS | KAP SURVEYS | COMMUNITY SURVEYS | REPRODUCTIVE HEALTH | FAMILY PLANNING | KNOWLEDGE | ATTITUDES | AWARENESS | PROGRAM ACCEPTABILITY | PROGRAM SUSTAINABILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Program Evaluation | Programs | Organization and Administration | Research Methodology | Surveys | Sampling Studies | Studies | Health | Sociocultural Factors | Psychological Factors | Behavior Document Number: 325036 |
| 8. Title: Helping Egyptian women achieve optimal birth spacing intervals through fostering linkages between family planning and maternal / child health services. Author: Abdel-Tawab N; Loza S; Zaki A Source: [Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2008 Sep. [45] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: Population Council's USAID-funded Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Egyptian Ministry of Health and Population (MOHP) and the NGO 'Social Planning, Analysis and Administration Consultants'; (SPAAC), conducted an operations research study to measure the acceptability and effectiveness of two birth spacing message models. For Model I (health services model), birth spacing messages were communicated through services by health workers to women during prenatal and postpartum periods. Model II (community awareness model), provided this service plus an awareness raising component that targeted men through training community influentials to communicate messages. Both models proved effective in changing women's knowledge and attitudes towards birth spacing and in enhancing use of contraception at 10-11 months postpartum, by 48 percent among Model I mothers and 43 percent among Model II mothers, compared with 31 percent among control group mothers. Over the postpartum period, women in the two intervention groups used contraception more consistently than women in the control group (median duration of protection against pregnancy was 6.8 months for Model I mothers, 4.5 months for Model II mothers and 2.9 months for control group mothers). Both intervention models were associated with an increased utilization of services, especially family planning services, by women who only had one child (36 percent increase in Model I clinics, 47 percent increase in Model II clinics and 3.2 percent in control clinics). However, a fear of contraceptive side-effects continues to be a major concern among women and men in all groups and is an obstacle in achieving healthy birth intervals. (Excerpts) Language: English Keywords: EGYPT | SUMMARY REPORT | OPERATIONS RESEARCH | WOMEN | BIRTH SPACING | FAMILY PLANNING | MATERNAL-CHILD HEALTH SERVICES | KNOWLEDGE | ATTITUDES | POSTPARTUM | CONTRACEPTIVE USAGE | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | Developing Countries | Africa, North | Africa | Research Methodology | Program Evaluation | Programs | Organization and Administration | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Sociocultural Factors | Psychological Factors | Behavior | Puerperium | Reproduction | Contraception Document Number: 331442 |
| 9. Peer Reviewed Title: Strengthening functional community-provider linkages: lessons from the Indore urban health programme. Author: Agarwal S; Satyavada A; Patra P; Kumar R Source: Global Public Health. 2008 Jul;3(3):308-325. Abstract: Weak linkages between health providers and slum communities hinder the improvement of health services for India's urban poor. To address this issue, an urban health programme is implementing two approaches in Indore city, Madhya Pradesh, the demand-supply linkage approach and ward coordination approach. The former is based on the premise that building social capital, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services for the urban poor. The latter focuses on encouraging local stakeholders to function in a coordinated manner to ensure better health service coverage in underserved slum areas. Findings suggest that the programme has enhanced utilization of services among Indore's slum communities and helped improve immunization coverage and other maternal and child health indicators. (author's) Language: English Keywords: INDIA | EVALUATION REPORT | OPERATIONS RESEARCH | SLUMS | HEALTH PERSONNEL | INTERPERSONAL COMMUNICATION | PHYSICIAN-PATIENT RELATIONS | COMMUNICATION STRATEGY | COORDINATION | HUMAN CAPITAL | SOCIAL MOBILIZATION | COMMUNITY PARTICIPATION | UTILIZATION OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Evaluation | Program Evaluation | Programs | Organization and Administration | Research Methodology | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Delivery of Health Care | Health | Communication | Interpersonal Relations | Behavior | Human Resources | Economic Factors | Social Change | Sociocultural Factors | Health Services Document Number: 327758 |
| 10. Peer Reviewed Title: The Onchocerciasis Control Programme in West Africa (OCP). Author: Boatin B Source: Annals of Tropical Medicine and Parasitology. 2008 Sep;102 Suppl 1:13-7. Abstract: The Onchocerciasis Control Programme in West Africa (OCP) started operations in 1975. Its main objectives were to eliminate human onchocerciasis, as a disease of public-health importance and an obstacle to socio-economic development, from the Programme area. By the end of 2002, the OCP covered 11 West African countries, and had introduced large-scale Mectizan (ivermectin) distribution to about 10 million people, through the communitydirected treatment approach, with treatment coverages ranging from 51%-81%. Research on large-scale Mectizan use illustrated the importance of evidence-based results, the power of multicountry studies, the need for social science in community-driven endeavours and operations research, and the value of empowering communities as allies in disease control. The generous donation of Mectizan by Merck & Co., Inc., has increased general interest in health-related public-private partnerships and generated the momentum for other donations to tackle other diseases. The vector control on which the OCP was initially based successfully interrupted the transmission of the parasite causing human onchocerciasis, Onchocerca volvulus, in many areas. The introduction of Mectizan led to the decline in anterior-segment lesions in the eye and the arrest of posterior-segment lesions. The drug continues to be highly effective in morbidity control, although recently there have been reports of sub-optimal responses in some adult O. volvulus, albeit in a few, very small and isolated foci. Language: English Keywords: AFRICA, SUB SAHARAN | PROGRESS REPORT | OPERATIONS RESEARCH | INTERDISCIPLINARY STUDIES | COMMUNITY | ONCHOCERCIASIS | PARASITE CONTROL | COMMUNITY HEALTH SERVICES | COMMUNITY-BASED DISTRIBUTION | SOCIAL SCIENCES | FOREIGN AID | VECTOR CONTROL | Africa | Developing Countries | Program Evaluation | Programs | Organization and Administration | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Parasitic Diseases | Diseases | Public Health | Health | Primary Health Care | Health Services | Delivery of Health Care | Nonclinical Distribution | Distributional Activities | Program Activities | Science | Sociocultural Factors | Financial Activities | Economic Factors | Disease Transmission Control | Prevention and Control Document Number: 329160 |
| 11. Title: Family Health International's partnership on the FRONTIERS Program, 1998 - 2008. Author: Bratt JH; Adamchak S; Homan R; Janowitz B; Williamson N Source: [Arlington, Virginia], Family Health International [FHI], 2008 Sep. 10 p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: The Population Council (PC) and Family Health International (FHI) have a long history of collaboration to advance the goal of improving reproductive health in the developing world. In operations research, the two institutions began working together informally in the late 1980s through the regional OR projects managed by the Population Council. FHI contributed its expertise in health economics and collaborated with Council staff to test many innovations and techniques to control costs and increase income, mainly in Latin America and Africa. When USAID combined the regional OR projects into a global procurement in 1998, the Population Council and FHI (along with Tulane University) bid as partners. FHI took responsibility for two main areas: overall direction of the Global Agenda for Operations Research and economic evaluation across the entire FRONTIERS program. FHI contributed a full-time staff position to provide leadership and coordination for the global research agenda and approximately two full-time equivalent staff positions for the economic evaluation activities. The purpose of this report is to describe, in broad strokes, the activities carried out and the products produced by FHI in the course of this ten-year partnership. (Excerpt) Language: English Keywords: KENYA | BANGLADESH | MEXICO | SENEGAL | SUMMARY REPORT | OPERATIONS RESEARCH | YOUTH | REPRODUCTIVE HEALTH | ANTENATAL CARE | FAMILY PLANNING | POSTPARTUM | PARTICIPATION | MEN'S INVOLVEMENT | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Asia, Southern | Asia | North America | Americas | Africa, Western | Research Methodology | Program Evaluation | Programs | Organization and Administration | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Puerperium | Reproduction | Social Behavior | Behavior Document Number: 331440 |
| 12. Title: Medical practices for prevention of perinatal infections in Puerto Rico. Author: Dayan GH; Caquías CR; García Y; Malik T; Copeland J Source: Paediatric and Perinatal Epidemiology. 2008 Jan;22(1):31-39. Abstract: Recommendations for screening for maternal infections and interventions to prevent disease in the fetus or newborn have been in place in Puerto Rico for more than 10 years. However, compliance with these recommendations has not been widely documented. We evaluated compliance with rubella/hepatitis B prenatal screening and vaccination recommendations, assessed hospital screening practices for syphilis and HIV, and determined risk factors for suboptimal prenatal care. Records of a random, stratified sample of 2003 pregnant women delivering in eight maternity hospitals in Puerto Rico in 2002 were reviewed. Obstetric prenatal and postnatal records were also reviewed when rubella/hepatitis B surface antigen (HBsAg) screening was not available at the hospital, and to document rubella postpartum vaccination (PPV). Prenatal screening rates were 98.4% for rubella and 98.8% for HBsAg. Overall, 5.4% [95% CI 4.4, 6.5] of women were susceptible to rubella. No eligible women received rubella PPV at the hospitaland only 1.5% had documented rubella vaccine prescription at the obstetric records. Only one woman was found to be HBsAg positive and her newborn was adequately treated. However, only 0.9% newborns born to mothers with unknown HBsAg status received hepatitis B vaccine. Screening was documented in 85.7% of the hospital records for HIV and 87.9% for syphilis. Suboptimal prenatal care was more likely among teenagers, low-educated women, and women with greater than 3 previous pregnancies. Screening rates for rubella and hepatitis B were high; however, implementation of recommendations for prevention of rubella and hepatitis B needs to be improved. (author's) Language: English Keywords: PUERTO RICO | RECOMMENDATIONS | RESEARCH REPORT | OPERATIONS RESEARCH | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | FETUS | HOSPITAL PERSONNEL | SCREENING | BEST PRACTICES | SYPHILIS | HIV TESTING | RISK FACTORS | ANTENATAL CARE | HOSPITALS | Caribbean | Americas | Developed Countries | Program Evaluation | Programs | Organization and Administration | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Pregnancy | Reproduction | Health Personnel | Delivery of Health Care | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Laboratory Examinations and Diagnoses | Biology | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Facilities Document Number: 323205 |
| 13. Title: Enhancing utilization of the findings from the Youth Reproductive Health Project in Senegal. Author: Diop NJ; Diagne AF Source: [Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2008 Mar. [35] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: In 1999, FRONTIERS began a three-year collaboration with the World Health Organization (WHO), the Senegalese ministries of Education (MOE), of Youth (MOY), and Family and Social Affairs (MOFSA), the Center for Research and Training (CEFOREP) and the Population Training Group (GEEP) to test the feasibility, effectiveness and cost of school-, clinic-, and community-based interventions to improve the reproductive health of youth aged 10-19 years. The Operations Research (OR) study focused on providing information appropriate to the cultural context of Senegalese adolescents on a variety of reproductive health issues including: knowledge of the human body; puberty; sexuality; gender roles; different cultural, familial, and peer values regarding sexual and reproductive behavior; contraception; responsible parenthood; STIs and AIDS; and sources of help and services. The study tested different ways of providing information. At the community through outreach, an 'edutainment' format was adopted; this comprised interactive participation of beneficiaries involving both education and entertainment. In schools, extra curricular activities and events such as music festivals were used as the forum. In clinics, a combination of edutainment and standard approaches of providing information were used. The study was undertaken in three urban communities in northern Senegal. It had an overall positive result on young people's reproductive health knowledge, enhanced community understanding of youth reproductive health needs, and showed that a multisectoral approach is vital to supporting young people's healthy growth. This success prompted a follow-on effort, beginning in 2004, to institutionalize youth reproductive health in the study districts, create a favorable policy and funding environment for adolescent reproductive health at the national level, and scale up the intervention in Senegal and to other Francophone African countries (Mauritania, Guinea, Burkina Faso, Mali). This summary describes the essential process elements of this institutionalization effort. (Excerpt) Language: English Keywords: SENEGAL | RESEARCH REPORT | OPERATIONS RESEARCH | YOUTH | ADOLESCENTS | ADOLESCENT HEALTH | REPRODUCTIVE HEALTH | PARTICIPATION | CAPACITY BUILDING | IMPLEMENTATION | PROGRAM ACTIVITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Program Evaluation | Programs | Organization and Administration | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Social Behavior | Behavior | Program Sustainability Document Number: 331598 |
| 14. Title: Improving communication between parents and adolescents on reproductive health and HIV / AIDS. Executive summary. Author: Diop NJ; Diagne A Source: In: Improving communication between parents and adolescents on reproductive health and HIV / AIDS, by Nafissatou J. Diop, Alioune Diagne. [Washington, D.C,], Population Council, Frontiers in Reproductive Health, 2008 Mar. :i-viii. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) English summary of French report. Abstract: In 2005 the Population Council's FRONTIERS in Reproductive Health Program, in collaboration with the Centre for Development and Population Activities (CEDPA), the Ministry of Health and the Ministry of Youth in Senegal, conducted an operations research project aimed at improving parent-child (specifically parent-adolescent) communication about reproductive health and HIV/AIDS. The study was designed to focus on parents/guardians of adolescents (10-14 years and 15-19 years) and adolescent youth living in urban and rural Senegal. The overall objective was to gain a better understanding of interventions designed specifically to reduce risks to Adolescent Reproductive Health. The specific goal of the project was to develop a model of intervention and assess its effectiveness and functionality in increasing adult-youth communication around issues of adolescent well-being, sexuality and reproductive health in terms of changes in the areas of: parents' and youth's knowledge and attitudes about issues concerning adolescents, particularly reproductive health; community support for adolescent needs, particularly in communication on adolescents' reproductive health issues; the frequency, quality, and topics discussed during parent-child (parent-adolescent) communication; the protective and regulatory mechanisms used by parents to address adolescents' reproductive health. (excerpt) Language: English Keywords: SENEGAL | RESEARCH REPORT | OPERATIONS RESEARCH | PARENTS | ADOLESCENTS | PARENTAL INVOLVEMENT | INTERPERSONAL COMMUNICATION | INTERVENTIONS | REPRODUCTIVE HEALTH | ADOLESCENT HEALTH | PROGRAM DESIGN | PRE-POST TESTS | KNOWLEDGE | ATTITUDES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Program Evaluation | Programs | Organization and Administration | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior | Communication | Health | Psychological Factors Document Number: 326885 |
| 15. Title: Technical assistance to the Interagency Coordination Group seeking to reduce Female Genital Mutilation / Cutting. Author: Diop NJ Source: [Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2008 Apr. [11] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: Because of this range of experiences in different socio-cultural settings, USAID's Special Initiative has provided support to FRONTIERS to enable it to offer technical assistance to the Interagency Coordination Group on FGM / C. FRONTIERS was invited to join this group of multilateral organizations to provide technical assistance in achieving the following objectives: 1. Establish a collaborative network to support work within countries; 2. Develop a comprehensive program of interventions against FGM / C and other harmful traditional practices; 3. Share experiences and disseminate successful strategies, tools and information; 4. Provide technical assistance to countries to document and disseminate experiences; 5. Contribute to raising human and financial resources needed for the implementation of country interventions; 6. Support civil society organizations to better address the issue of FGM / C; 7. Build the capacity of organizations, including monitoring and evaluation; 8. Advocate for more awareness and visibility of FGM / C issues at national, regional and international levels. In summary, FRONTIERS did manage to support the first year of activities of the Interagency Coordination Group. In particular, staff assisted the group in networking, learning to talk to each other, setting up an operational way of functioning, and influencing key international policy and programmatic documents. In addition, lessons learned through OR on FGM / C were disseminated widely through the group's activities and FRONTIERS technical assistance influenced several plans of action and implementation programs. Beyond some effort in better networking for presenting a common regional vision during the development of policy and programmatic international documents, there is room for improving the collaboration between agencies. There is a need for more coordination and information sharing within each agency, particularly between headquarters and regional offices. (Excerpts) Language: English Keywords: MAURITANIA | SUMMARY REPORT | OPERATIONS RESEARCH | WOMEN | FEMALE GENITAL CUTTING | BEHAVIOR CHANGE | COMMUNICATION STRATEGY | INTERVENTIONS | CAPACITY BUILDING | MONITORING | EVALUATION | Developing Countries | Africa, North | Africa | Research Methodology | Program Evaluation | Programs | Organization and Administration | Demographic Factors | Population | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors | Behavior | Communication | Program Sustainability Document Number: 331591 |
| 16. Title: Early lessons from the integration of tuberculosis and HIV services in primary care centers in Lusaka, Zambia. Author: Harris JB; Hatwiinda SM; Randels KM; Chi BH; Kancheya NG; Jham MA; Samungole KV; Tambatamba BC; Cantrell RA; Levy JW; Kimerling ME; Reid SE Source: International Journal of Tuberculosis and Lung Disease. 2008 Jul;12(7):773-9. Abstract: BACKGROUND: Zambia faces overlapping tuberculosis (TB) and human immunodeficiency virus (HIV) epidemics; however, care for co-infected patients often occurs through separate, vertical programs. OBJECTIVE: To establish a program to integrate TB and HIV services in Lusaka primary care centers. METHODS: In collaboration with the Zambian Ministry of Health, TB-HIV integration activities began in December 2005 and were expanded to seven health centers by March 2007. Principal activities included developing staff capacity to manage co-infected patients, implementing HIV testing within TB departments and establishing referral systems between departments. RESULTS: Using a provider-initiated approach, 2053 TB patients were offered HIV testing. Seventy-seven per cent agreed to be tested; 69% of those tested were HIV-infected. Of these, 59% were enrolled in HIV care. The proportion of antiretroviral treatment (ART) program enrollees who were TB-HIV co-infected increased by 38% after program implementation. The median CD4 count among co-infected patients was 161 cells/microl, with 88% eligible for ART. CONCLUSION: Integration of HIV testing and referral services into urban primary care centers identified many co-infected patients and significantly increased the proportion of TB patients among people accessing HIV care. Ongoing challenges include maximizing the number of patients accepting HIV testing and overcoming barriers to enrollment into HIV care. Language: English Keywords: ZAMBIA | EVALUATION REPORT | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | INTEGRATED PROGRAMS | TUBERCULOSIS | HIV INFECTIONS | COMPLICATIONS | PRIMARY HEALTH CARE | CAPACITY BUILDING | HIV TESTING | TREATMENT | REFERRAL AND CONSULTATION | ANTIRETROVIRAL THERAPY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Program Evaluation | Programs | Organization and Administration | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Infections | Health Services | Delivery of Health Care | Health | Program Sustainability | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Program Activities | HIV Document Number: 329260 |
| 17. Peer Reviewed Title: Motorcycle ambulances for referral of obstetric emergencies in rural Malawi: Do they reduce delay and what do they cost? Averting maternal death and disability. Author: Hofman JJ; Dzimadzi C; Lungu K; Ratsma EY; Hussein J Source: International Journal of Gynecology and Obstetrics. 2008 Aug;102(2):191-197. Abstract: The objectives of this study were to assess whether motorcycle ambulances placed at rural health centers are a more effective method of reducing referral delay for obstetric emergencies than a car ambulance at the district hospital, and to compare investment and operating costs with those of a 4 wheel drive car ambulance at the district hospital. Motorcycle ambulances were placed at 3 remote rural health centers in Malawi. Data were collected over a 1-year period, from October 2001 to September 2002, using logbooks, cashbooks, referral forms, and maternity registers. Depending on the site, median referral delay was reduced by 2-4.5 hours (35%-76%). Purchase price of a motorcycle ambulance was 19 times cheaper than for a car ambulance. Annual operating costs were US $508, which was almost 24 times cheaper than for a car ambulance. In resource-poor countries motorcycle ambulances at rural health centers are a useful means of referral for emergency obstetric care and a relatively cheap option for thehealth sector. (author's) Language: English Keywords: RESEARCH REPORT | OPERATIONS RESEARCH | RURAL HEALTH CENTERS | EMERGENCY SERVICES | TRANSPORTATION | MATERNAL MORTALITY | SAFE MOTHERHOOD | COST EFFECTIVENESS | COST BENEFIT ANALYSIS | QUANTITATIVE RESEARCH | Program Evaluation | Programs | Organization and Administration | Research Methodology | Health Facilities | Delivery of Health Care | Health | Health Services | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Population | Maternal Health | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 327687 |
| 18. Title: Development of a quality assurance procedure for reproductive health services for district public health systems: Implementation and scale-up in the State of Gujarat. Author: Khan ME; Mishra A; Sharma V; Varkey LC Source: [New Delhi, India], Population Council, Frontiers in Reproductive Health, 2008 Apr. [30] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: This project, entitled was carried out in two districts each in Gujarat and Maharashtra states. It confirmed that Quality Assurance (QA) checklists and an implementation manual, developed by the USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council in collaboration with UNFPA/India, are useful and effective tools that the Ministry of Health and Social Welfare (MOHFW) can use to monitor the quality of services provided by health facilities. It also demonstrated that this QA mechanism can be easily institutionalized at the district level management. The QA procedure involves a series of visits to health facilities by a team of three district level health officials, called the Quality Assurance Group (QAG). This team uses the QA checklists to review the readiness of the facility to offer services and the measures the quality of services provided. Before the QAG team leaves the facility, any gaps in readiness or quality identified by the team members are communicated to the Medical Officer in-charge (MO I/C) and actions are suggested for improvement. Further visits are made to the facility every four months, during which progress in addressing the gaps identified previously is assessed. The QA checklists provide easy procedures to provide an aggregated score for each individual facility with respect to input (readiness), process (how the service is delivered) and outcome (performance). (excerpt) Language: English Keywords: INDIA | ADMINISTRATIVE DISTRICTS | EVALUATION REPORT | MANUAL | OPERATIONS RESEARCH | PILOT PROJECTS | ADMINISTRATIVE PERSONNEL | QUALITY CONTROL | REPRODUCTIVE HEALTH | CAPACITY BUILDING | USAID | PROGRAM EVALUATION | PERFORMANCE IMPROVEMENT | INSTITUTION BUILDING | TRAINING PROGRAMS | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Evaluation | Programs | Organization and Administration | Research Methodology | Studies | Health | Program Sustainability | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Management | Education Document Number: 326783 |
| 19. Title: Implementing a quality improvement programme in a family planning centre in Monastir, Tunisia. Author: Letaief M; Hmida AB; Mouloud B; Essabbeh B; Aissa RB Source: Eastern Mediterranean Health Journal. 2008 May-Jun;14(3):615-627. Abstract: We aimed to improve the quality of family planning and reproductive health services in a family planning centre though implementation of a quality improvement programme. Clients were surveyed to identify quality-related problems. Health care teams then analysed the causes of the problems, developed solutions for 3 selected ones and established a quality assurance framework. The selected issues were: long waiting time at the centre; insufficient integration of family planning and reproductive health services; and lack of a holistic approach. The final phase was aimed at testing and implementing corrective measures. (author's) Language: English Keywords: TUNISIA | RESEARCH REPORT | OPERATIONS RESEARCH | FAMILY PLANNING CENTERS | FAMILY PLANNING PROGRAMS | REPRODUCTIVE HEALTH | HEALTH SERVICES | QUALITY CONTROL | QUALITY OF HEALTH CARE | PROGRAM EFFECTIVENESS | FAMILY PLANNING PROGRAM EVALUATION | Africa, North | Africa | Developing Countries | Program Evaluation | Programs | Organization and Administration | Research Methodology | Health Facilities | Delivery of Health Care | Health | Family Planning | Health Services Evaluation Document Number: 326993 |
| 20. Title: Creating the conditions for scaling up the integration of reproductive health services for men in health and family welfare centers in Bangladesh. Author: Mannan MA; Hakim JA; Waris ST; Ali A; Hakim AK Source: [Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2008 Apr. [33] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: An operations research (OR) study, supported by the Population Council's Frontiers in Reproductive Health (FRONTIERS) Program, had showed that reproductive health services for men could be feasibly and acceptably integrated within the Health and Family Welfare Centres (HFWC) in Bangladesh, which have been primarily women-centered health facilities (NIPORT et al. 2004). Given these findings, this follow-on study was implemented to create the conditions for scaling up the model through identifying and piloting the operational details to consider when taking the intervention to scale. The Directorate General of Family Planning (DGFP), in collaboration with the Institute of Child and Mother Health (ICMH), scaled up the intervention in 40 HFWCs selected from four districts of Dhaka division. Exit interviews with clients and observations of client-provider interactions revealed a satisfactory quality of services overall, measured in terms of providers' focusing on the clients' needs, asking the right questions about their problems and service needs, including appropriate questions for RTI / STI clients, and correctly following syndromic management protocols. Most of the clients interviewed were satisfied with the services they had received. (Excerpts) Language: English Keywords: BANGLADESH | RESEARCH REPORT | OPERATIONS RESEARCH | HEALTH PERSONNEL | MEN | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | REPRODUCTIVE HEALTH | HEALTH SERVICES | EXAMINATIONS AND DIAGNOSES | TREATMENT | TRAINING ACTIVITIES | INTEGRATED PROGRAMS | PROGRAM ACTIVITIES | PROGRAM EVALUATION | Developing Countries | Asia, Southern | Asia | Research Methodology | Programs | Organization and Administration | Delivery of Health Care | Health | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Medical Procedures | Medicine | Training Programs | Education Document Number: 331587 |
| 21. Title: Can research accelerate progress toward millennium development goal 5 (maternal health) in Jamaica? Author: McCaw-Binns A Source: West Indian Medical Journal. 2008 Dec;57(6):549-54. Abstract: The Ministry of Health and the University of the West Indies have collaborated over 25 years to develop the evidence base to improve maternal health. The experience is reviewed as a model to accelerate Jamaica's progress toward achieving the Millennium Development Goals (MDGs). The process included measuring the disease burden due to maternal morbidity and mortality; developing and field testing interventions to manage the leading problems, national scale-up, monitoring and evaluation. This began with developing clinical guidelines to manage the hypertensive disorders of pregnancy while establishing high risk (referral) antenatal clinics, expansion and upgrading of referral facilities, and audits to identify barriers to quality healthcare, including establishing maternal mortality surveillance. As we succeed, research funds have become scarce, limiting support to postgraduate students, a reliable, cost effective resource pool capable of undertaking the research needed to provide the evidence base to influence public policy more widely. A locally financed resource pool is needed to support fellowships for graduate students to accelerate their training and availability to contribute to national development. The model from Thailand is put forward for consideration. The operations research model for maternal health can be transferred to other MDG objectives. As Jamaica pursues its goal of developed nation status, and international grant financing shrinks, local civil society will need to fill the vacancy and invest in the most abundant natural resource, young people. Language: English Keywords: JAMAICA | THAILAND | RESEARCH REPORT | OPERATIONS RESEARCH | GOALS | YOUTH | MATERNAL HEALTH | ANTENATAL CARE | HYPERTENSION | TRAINING ACTIVITIES | TESTING | INTERVENTIONS | RESEARCH AND DEVELOPMENT | Caribbean | Americas | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Program Evaluation | Programs | Organization and Administration | Planning | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Vascular Diseases | Diseases | Training Programs | Education | Measurement | Technology | Economic Factors Document Number: 342425 |
| 22. Peer Reviewed Title: The evolving impact of HIV/AIDS on outpatient health services in KwaZulu-Natal, South Africa. Author: Parikh A; Veenstra N Source: South African Medical Journal. 2008 Jun;98(6):468-472. Abstract: Background and objective. The high HIV prevalence in KwaZulu-Natal (KZN) places immense pressure on the health system. The burden of HIV/AIDS on health services is evolving as the epidemic progresses and as antiretroviral treatment becomes more widely available. For health policy makers and managers, timely and appropriate information is needed to facilitate adaptive management of health services. Through longitudinal research covering outpatient health services in KZN we examined the dynamics of the evolving HIV/AIDS burden and the resource implications of this burden, necessary for resource allocation decisions. Methods. Data were collected between 2004 and 2005 in outpatient services across six health facilities in the province. The burden of HIV/AIDS was measured by assessing the proportion of outpatients presenting as HIV positive, determined by a clinical diagnosis (and test result where available). The burden was also measured by looking at the types of diseases presenting at outpatient facilities. Moreover, the study assessed the burden experienced by health care workers and financial implications for health facilities. Results and conclusions. The study demonstrates that the burden on outpatient services is significant but has not been increasing over time, suggesting that people are not accessing care if and when they need it. However, in terms of resources, this burden has been increasing and shifting from tertiary services to more primary services. In order to accommodate the demands of HIV/AIDS, our focus therefore needs to turn towards outpatient services, in particular at the primary care level. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | LONGITUDINAL STUDIES | OPERATIONS RESEARCH | EPIDEMIOLOGIC METHODS | POLICYMAKERS | HIV INFECTIONS | HOSPITALS | IMPACT | HEALTH SERVICES EVALUATION | ANTIRETROVIRAL THERAPY | TIME FACTORS | REFERRAL AND CONSULTATION | PREVALENCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | Administrative Personnel | Viral Diseases | Diseases | Health Facilities | Delivery of Health Care | Health | Communication | HIV | Population Dynamics | Demographic Factors | Population | Program Activities | Measurement Document Number: 330699 |
| 23. Title: Regional Workshop to Use the Findings from Operations Research to Increase the Access, Quality and Integration of Contraceptive Services in Latin America and the Caribbean. Author: Rivero-Fuentes ME; Martin A Source: [Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2008 Apr. 21 p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: In October 2007, the Frontiers in Reproductive Health Program (FRONTIERS) held a three-day regional workshop in La Antigua, Guatemala, to disseminate results of its operations research projects. The workshop was attended by 60 participants from 11 countries: Bolivia, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Peru and the United States. Participants included health providers, program managers, non-governmental organization (NGO) directors, bilateral-agreements country representatives, and directors of professional organizations, the list of participants was composed of delegates from Ministries of Health (MOH), Social Security Institutes (SSI), USAID missions, international agencies, and non-governmental organizations (NGOs). During the workshop, participants received contraceptive technology updates, and learned about effective strategies tested by FRONTIERS to increase access to the IUD and vasectomy, integration of family planning with postpartum, postabortion and PMTCT. Featured were the Balanced Counseling Strategy (BCS), and Systematic Screening. Researchers discussed study results; program managers explained how they were used, and practitioners talked about implementing the interventions. This combination of perspectives successfully transmitted the message that the interventions were not difficult to apply, could have a great impact, and, as one participant wrote on the evaluation form, that "small changes could lead to great results". (Excerpt) Language: English Keywords: LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | OPERATIONS RESEARCH | WORKSHOPS | WOMEN | POSTPARTUM | FAMILY PLANNING | REPRODUCTIVE HEALTH | POSTABORTION CARE | HEALTH SERVICES | CONTRACEPTION | SCREENING | COUNSELING | NEEDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PROGRAM EVALUATION | Americas | Developing Countries | Research Methodology | Programs | Organization and Administration | Education | Demographic Factors | Population | Puerperium | Reproduction | Health | Delivery of Health Care | Examinations and Diagnoses | Medical Procedures | Medicine | Clinic Activities | Program Activities | Economic Factors | Disease Transmission Control | Prevention and Control | Diseases Document Number: 331596 |
| 24. Peer Reviewed Title: Drug-prescribing patterns during pregnancy in the tertiary care hospitals of Pakistan: a cross sectional study. Author: Rohra DK; Das N; Azam SI; Solangi NA; Memon Z Source: BMC Pregnancy and Childbirth. 2008 Jul 15;8(24):[21] p. Abstract: The rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child is also at stake. Information on the use of drugs during pregnancy is not available in Pakistan. The aim of this study was to evaluate the patterns of drug prescriptions to pregnant women in tertiary care hospitals of Pakistan. METHODS: This was a cross-sectional study conducted at five tertiary care hospitals of Pakistan. Copies of outpatient medicinal prescriptions given to pregnant patients attending the antenatal clinics were collected. The drugs were classified according to the pharmacological class and their teratogenic potential. RESULTS: All the pregnant women attending the antenatal clinics received a prescription containing at least one drug. A total of 3769 distinct prescriptions given to different women were collected. Majority of the women who received the prescriptions belonged to third trimester (55.4%) followed by second (33.6%) and first trimester (11.0%). On an average, each prescription contained 1.66 +/- 0.14 drugs. The obstetricians at Civil Hospital, Karachi and Chandka Medical College Hospital, Larkana showed a tendency of prescribing lesser number of drugs compared to those in other hospitals. Anti-anemic drugs including iron preparations and vitamin and mineral supplements (79.4%) were the most frequently prescribed drugs followed by analgesics (6.2%) and anti-bacterials (2.2%). 739 women (19.6%) received prescriptions containing drugs other than vitamin or mineral supplements. Only 1275 (21.6%) of all the prescribed drugs (n = 6100) were outside this vitamin/mineral supplement class. Out of these 1275 drugs, 29 (2.3%) drugs were prescribed which are considered to be teratogenic. Misoprostol was the most frequently prescribed (n = 6) among the teratogenic drugs followed by carbimazole (n = 5) and methotrexate (n = 5). Twenty nine pregnant women (0.8% of all the women studied) were prescribed these teratogenic drugs. CONCLUSION: Less than one percent of the pregnant women attending tertiary care hospitals in Pakistan are prescribed teratogenic drugs. The prescribing practices of Pakistani physicians are similar to those in western countries. Language: English Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | OPERATIONS RESEARCH | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | HOSPITAL PERSONNEL | PHYSICIANS | HOSPITALS | PRESCRIPTIONS | ANTENATAL CARE | GESTATIONAL AGE | OBSTETRICS | Developing Countries | Asia, Southern | Asia | Research Methodology | Program Evaluation | Programs | Organization and Administration | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Health Facilities | Distributional Activities | Program Activities | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Fetus | Pregnancy | Reproduction | Medicine Document Number: 327749 |
| 25. Title: Government--NGO collaboration and sustainability of orphans and vulnerable children projects in southern Africa. Author: Rosenberg A; Hartwig K; Merson M Source: Evaluation and Program Planning. 2008 Feb;31(1):51-60. Abstract: Given current donor attention to orphans and children made vulnerable by HIV/AIDS, and the need for a new framework that recognizes the complementary roles of nations and non-governmental organizations (NGOs), this analysis reviews NGO-operated community-based orphans and vulnerable children (OVC) projects in Botswana, Lesotho, Namibia, South Africa, and Swaziland. There has been a lack of attention within the field of evaluation to inter-organizational relationships, specifically those with government agencies, as a factor in sustainability. We analyzed evaluations of nine OVC projects funded by the Bristol-Myers Squibb Foundation for the influence of government-NGO collaboration on project sustainability. For eight of the nine projects, evaluations provided evidence of the importance of the government partnership for sustainability. Government collaboration was important in projects designed to help families access government grants, initiate community-based solutions, and advocate for OVC rights through legislation. Government partnerships were also critical to the sustainability of two projects involved in placing children in foster care, but these showed signs of tension with government partners. In addition to the more common factors associated with sustainability, such as organizational characteristics, donors and NGOs should concentrate on developing strong partnerships with local and national government agencies for the sustainability of their projects. (author's) Language: English Keywords: AFRICA, SOUTHERN | RESEARCH REPORT | INTERDISCIPLINARY STUDIES | OPERATIONS RESEARCH | NONGOVERNMENTAL ORGANIZATIONS | GOVERNMENT | ORPHANS AND VULNERABLE CHILDREN | PROGRAM SUSTAINABILITY | COORDINATION | AIDS | COMMUNITY HEALTH SERVICES | ADVOCACY | GRANTS | LEGISLATION | FOSTERING | Africa, Sub Saharan | Africa | Developing Countries | Program Evaluation | Programs | Organization and Administration | Research Methodology | Organizations | Political Factors | Sociocultural Factors | Family and Household | HIV Infections | Viral Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Communication | Financial Activities | Economic Factors | Child Rearing | Behavior Document Number: 325210 |
| 26. Peer Reviewed Title: Antiretroviral therapy in Zambia: colours, 'spoiling', 'talk' and the meaning of antiretrovirals. Author: Schumaker LL; Bond VA Source: Social Science and Medicine. 2008 Dec;67(12):2126-34. Abstract: We examine responses to the roll-out of antiretroviral drugs (ARVs) in Zambia in 2004, focusing on material features of the drugs (colour, shape, size, origin), 'spoiling' (concern about toxicity, side effects of the drugs) and rumours ('talk' about the drugs). Data consists of interviews with 10 people living with HIV and 21 healthcare practitioners. We found that the colour symbolism of 'traditional medicine' has some influence on ideas about ARVs, suggesting possible 'meaning responses' that could affect treatment outcomes. Respondents also become concerned when colours, shapes and side effects differ from expectations. 'Talk' about ARVs concerns risks of medication, sustainability of treatment programmes and people's feelings of vulnerability within larger socio-economic contexts in which countries like Zambia are disadvantaged. Understanding the associations that pharmaceuticals evoke can improve treatment programmes by elucidating public and patient concerns and sensitising healthcare professionals to the historical and political circumstances that condition the 'meaning' of ARVs. Language: English Keywords: ZAMBIA | RESEARCH REPORT | OPERATIONS RESEARCH | KAP SURVEYS | ADMINISTRATIVE PERSONNEL | AIDS PREVENTION | ANTIRETROVIRAL THERAPY | TOXICITY | SIDE EFFECTS | BELIEFS | TRADITIONAL HEALTH PRACTICES | PERCEPTION | PROGRAM SUSTAINABILITY | ECONOMIC DEVELOPMENT | PUBLIC OPINION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Program Evaluation | Programs | Organization and Administration | Surveys | Sampling Studies | Studies | AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Culture | Sociocultural Factors | Psychological Factors | Behavior | Economic Factors | Attitudes Document Number: 331064 |
| 27. Title: The cost effectiveness of Standard Days Method refresher trainings using the Knowledge Improvement Tool in Guatemala. Author: Suchi T; Karim F; Marcus J; Naik S Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [19] p. (http://www.phishare.org/files/6074_KIT_in_Guatemala.pdf) Abstract: Ensuring that family planning service providers have the necessary support to offer quality services is a challenge for program managers. Most programs do not have adequate resources to provide refresher training, follow-up and supervision to their service providers, which can result in poor quality of care. As the Institute for Reproductive Health at Georgetown University has worked with NGOs and ministries of health around the world to scale up the Standard Days Method® (SDM), a consistent challenge has been obtaining follow-up support for providers. To address this issue, the Institute developed an instrument called the Knowledge Improvement Tool (KIT), which allows supervisors to quickly identify gaps in knowledge of SDM providers, allowing them to provide targeted, effective support during routine supervisory visits. Operations research has demonstrated the effectiveness of the KIT in improving and maintaining SDM providers' knowledge. However, in practice the KIT has been applied in different ways: individually, in group settings, and provider to provider. The objective of this study was to assess the cost effectiveness of these different approaches and compare it to taking no action at all. The study showed that follow-up is necessary and that the most cost-effective approach is the group KIT refresher training. Programs which already actively supervise service providers through an individualized approach should consider a similar strategy for SDM providers using the KIT, as this strategy yielded superior results in terms of provider competence. (author's) Language: English Keywords: GUATEMALA | RESEARCH REPORT | OPERATIONS RESEARCH | COMPARATIVE STUDIES | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | FAMILY PLANNING PERSONNEL | KNOWLEDGE | FAMILY PLANNING TRAINING | TRAINING PROGRAMS | NEEDS ASSESSMENT | COST EFFECTIVENESS | Central America | Latin America | Americas | Developing Countries | Program Evaluation | Programs | Organization and Administration | Research Methodology | Studies | Family Planning | Family Planning Programs | Sociocultural Factors | Education | Evaluation | Evaluation Indexes | Quantitative Evaluation Document Number: 327614 |
| 28. Peer Reviewed Title: Working with risk: Occupational safety issues among healthcare workers in Kenya. Author: Taegtmeyer M; Suckling RM; Nguku PM; Meredith C; Kibaru J Source: AIDS Care. 2008 Mar;20(3):304-310. Abstract: The objective of this study was to explore knowledge of, attitudes towards and practice of post-exposure prophylaxis (PEP) among healthcare workers (HCWs) in the Thika district, Kenya. We used site and population-based surveys, qualitative interviews and operational research with 650 staff at risk of needlestick injuries (NSIs). Research was conducted over a 5-year period in five phases: (1) a bio-safety assessment; (2) a staff survey: serum drawn for anonymous HIV testing; (3) interventions: biosafety measures, antiretrovirals for PEP and hepatitis B vaccine; (4) a repeat survey to assess uptake and acceptability of interventions; in-depth group and individual interviews were conducted; and (5) health system monitoring outside a research setting. The main outcome measures were bio-safety standards in clinical areas, knowledge, attitudes and practice as regards to PEP, HIV-sero-prevalence in healthcare workers, uptake of interventions, reasons for poor uptake elucidated and sustainability indicators. Results showed that HCWs had the same HIV sero-prevalence as the general population but were at risk from poor bio-safety. The incidence of NSIs was 0.97 per healthcare worker per year. Twenty-one percent had had an HIV test in the last year. After one year there was a significant drop in the number of NSIs (OR: 0.4; CI: 0.3-0.6; p less than 0.001) and a significant increase in the number of HCWs accessing HIV testing (OR: 1.55; CI: 1.2-2.1; p = 0.003). In comparison to uptake of hepatitis B vaccination (88% of those requiring vaccine) the uptake of PEP was low (4% of those who had NSIs). In-depth interviews revealed this was due to HCWs fear of HIV testing and their perception of NSIs as low risk. We concluded that Bio-safety remains the most significant intervention through reducing the number of NSIs. Post-exposure prophylaxis can be made readily available in a Kenyan district. However, where HIV testing remains stigmatised uptake will be limited*particularly in the initial phases of a programme. (author's) Language: English Keywords: KENYA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | KAP SURVEYS | EPIDEMIOLOGIC METHODS | OPERATIONS RESEARCH | FOCUS GROUPS | HEALTH PERSONNEL | OCCUPATIONAL HEALTH | SAFETY | NEEDLE PIERCING | ACCIDENTS AND INJURIES | HIV TESTING | HIV TRANSMISSION | PREVALENCE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Surveys | Sampling Studies | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | Data Collection | Delivery of Health Care | Health | Public Health | Risk Behavior | Behavior | |