1.  Title: Global action for health system strengthening: Policy recommendations to the G8 Task Force on Global Action for Health System Strengthening. Author: Japan Center for International Exchange. Task Force on Global Action for Health System Strengthening Source: Tokyo, Japan, Japan Center for International Exchange, 2009. 131 p. Abstract: On January 16, 2009, a high-level working group on global health convened by the Japan Center for International Exchange (JCIE) released a report to the Japanese government outlining measures that the G8 countries should take to set them on a path toward fulfilling their existing commitments to contributing to an overall improvement in the health of individuals and communities around the world. The Working Group on Challenges in Global Health and Japan's Contributions (the "Takemi Working Group") is chaired by Japan's former Senior Vice Minister for Health, Labour and Welfare Keizo Takemi and directed by JCIE President Tadashi Yamamoto. The Japanese government will pass the report to the Italian government, encouraging them to put these recommendations on the agenda of the 2009 G8 Summit in Italy. The report includes chapters by an international team of researchers and advisors on three specific building blocks of health systems-health financing, health information, and the health workforce-that are generally acknowledged to be critical components of any strong health system. While each paper offers specific recommendations for improvements that can be made in each individual building block, they also come to several common conclusions: 1.) While there is still a dire need for more resources-financial, human, and knowledge resources-in the global health field, there is also a critical need to use existing resources more efficiently and more effectively. Recognizing that the current global financial environment will make it even more difficult to secure the resources needed to make health systems work better for everyone, the paper writers recommend complementing the quest for more resources with creative thinking on ways to achieve better health outcomes with the resources we already have. 2.) The human security concept, which has become a pillar of Japan's foreign policy, is identified as a promising approach that can be adopted globally for strengthening health systems. Human security's emphasis on the wellbeing of individuals and communities is very much in line with the ultimate goal of health system strengthening: improving people's health and making health services available to all so that they can be healthy, productive members of society. Human security also responds to the complexity of health system strengthening with its focus on integrating community empowerment with protection strategies and its recognition of the dynamic way in which health is interconnected with many other human security challenges. 3.) In all areas of health system strengthening, donor countries tend to tell their partners in developing countries how they should behave and make decisions. This can lead to confusion, with contradicting instructions often coming from multiple donors and even from single donors, and loss of motivation for stakeholders in partner countries to take ownership of processes to improve their own health sectors. Contributing to this challenge, capacity for making informed decisions on health is often weak, further discouraging domestic decision making in planning and management of health systems. The paper writers all recommend that donor countries invest in capacity building for health sector decision making at the national and local levels and, at the same time, encourage stakeholders in partner countries to drive their own planning and implementation processes. 4.) Finally, the paper writers all recommend that the G8 follow through on its commitment to accountability by establishing an annual review of its activities and accomplishments within each of these three building blocks. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | CONFERENCES AND CONGRESSES | RECOMMENDATIONS | SYSTEMS ANALYSIS | HEALTH PERSONNEL | LABOR FORCE | HEALTH POLICY | FOREIGN AID | CAPACITY BUILDING | GOVERNMENT FINANCING | INFORMATION SERVICES | PRIMARY HEALTH CARE | INTERNATIONAL COOPERATION | COORDINATION | Research Methodology | Delivery of Health Care | Health | Human Resources | Economic Factors | Policy | Political Factors | Sociocultural Factors | Financial Activities | Program Sustainability | Programs | Organization and Administration | Information | Health Services Document Number: 328416 |
| 2. Title: mHealth for development: The opportunity of mobile technology for healthcare in the developing world. Author: Vital Wave Consulting Source: Washington, D.C., United Nations Foundation, 2009. 66 p. Abstract: Mounting interest in the field of mHealth -- the provision of health-related services via mobile communications -- can be traced to the evolution of several interrelated trends. In many parts of the world, epidemics and a shortage of healthcare workers continue to present grave challenges for governments and health providers. Yet in these same places, the explosive growth of mobile communications over the past decade offers a new hope for the promotion of quality healthcare. Among those who had previously been left behind by the 'digital divide,' billions now have access to reliable technology. There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services -- even in some of the most remote and resource-poor environments. This report examines issues at the heart of the rapidly evolving intersection of mobile phones and healthcare. It helps the reader to understand mHealth's scope and implementation across developing regions, the health needs to which mHealth can be applied, and the mHealth applications that promise the greatest impact on heath care initiatives. It also examines building blocks required to make mHealth more widely available through sustainable implementations. Finally, it calls for concerted action to help realize mHealth's full potential. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | PUBLIC HEALTH | TELECOMMUNICATIONS | INFORMATION DISTRIBUTION | EDUCATION | AWARENESS | DATA COLLECTION | PRIMARY HEALTH CARE | TRAINING ACTIVITIES | HEALTH PERSONNEL | DISEASE PREVENTION | TECHNOLOGY | TREATMENT | ADMINISTRATION AND DOSAGE | DRUGS | HIV TESTING | HIV PREVENTION | Health | Broadcast Media | Mass Media | Communication | Knowledge | Sociocultural Factors | Research Methodology | Health Services | Delivery of Health Care | Training Programs | Prevention and Control | Diseases | Economic Factors | Medical Procedures | Medicine | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | HIV Infections | Viral Diseases Document Number: 331450 |
| 3. Title: Promoting health and equity: Evidence, policy and action: Cases from the Western Pacific Region. Author: World Health Organization [WHO]. Regional Office for the Western Pacific Source: Manila, Philippines, WHO, Regional Office for the Western Pacific, 2009 Mar. [173] p. Abstract: Recent years have seen a growth in the evidence base on policies and actions to promote health equity. Despite efforts, however, the evidence shows that inequalities are increasing rather than decreasing in many countries. This may partly be due to faulty policy decisions. There is clearly need for a better evidence-based approach on health policies to achieve equity. At the same time, understanding is inadequate on how policy-makers can best make use of the growing evidence base on promoting equity in health. There is a need for stronger links between evidence and health policy-making and implementation. To respond in part to this need, the WHO Western Pacific Regional Office convened the High Level Meeting on Promoting Health Equity: Evidence, Policy and Action from 16-18 October 2007 in Phnom Penh, hosted by the Royal Government of Cambodia, to provide an opportunity to exchange experiences and identify ways to promote the more systematic use of equity research in health policy and action. Health ministers and other stake holders engaged in the evidence-to-policy process were invited to submit case studies that illustrate the process. This book compiles the nine cases presented at the meeting. An introductory chapter comprises a synthesis of the cases and the lessons learned from them. Language: English Keywords: CAMBODIA | CHINA | VIETNAM | NEW ZEALAND | MALAYSIA | MONGOLIA | SUMMARY REPORT | CASE STUDIES | DELIVERY OF HEALTH CARE | PRIMARY HEALTH CARE | TREATMENT | HEALTH POLICY | HEALTH SERVICES | TUBERCULOSIS | CAPACITY BUILDING | PREVENTION AND CONTROL | PROGRAM ACCESSIBILITY | Developing Countries | Asia, Southeastern | Asia | Asia, Eastern | Oceania | Developed Countries | Asia, Northern | Studies | Research Methodology | Health | Medical Procedures | Medicine | Policy | Political Factors | Sociocultural Factors | Infections | Diseases | Program Sustainability | Programs | Organization and Administration | Program Evaluation Document Number: 331453 |
| 4. Title: [Vulnerabilities in the use of contraceptive methods among youth: intersections between public policies and healthcare] Vulnerabilidades no uso de metodos contraceptivos entre adolescentes e jovens: Author: Alves CA; Brandao ER Source: Ciencia and Saude Coletiva. 2009 Mar-Apr;14(2):661-70. Abstract: This article discusses the moments of vulnerability in the utilization of contraceptive methods in the affective-sexual relations in adolescence and youth. The analyzed material consists of 17 semi-structured interviews with young people between 18 and 24 years (9 females and 8 males) of the middle-class of the city of Rio de Janeiro that had passed though at least one episode of pregnancy during adolescence. We also discuss the recent implementation of public policies focused on the sexuality and reproductive health of adolescents and the position of health professionals with respect to this subject within the scope of the Program of Integrated Healthcare for Women, Children and Adolescents (PAISMCA/SES-RJ). The results of the study show discontinuities in the use of contraceptive methods due to the strong gender hierarchy in the relationships between adolescents and the absence of appropriate sexual education in the family and school environments. There is little space for dealing with the sexual questions of the young in health services and schools. There are also cultural barriers that make it difficult for the society to approach the subject in a less prejudicial way, thus turning sexual initiation into a process full of silence and moral disapproval. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | INTERVIEWS | YOUTH | PRIMARY HEALTH CARE | HEALTH POLICY | CONTRACEPTIVE METHODS | ADOLESCENT PREGNANCY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Data Collection | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics Document Number: 330130 |
| 5. Peer Reviewed Title: [Opinions by physicians from the Family Health Program on four health care priorities proposed by the Agenda for Commitment to Comprehensive Child Health and Reduction of Infant Mortality] Perspectivas de medicos do Programa Saude da Familia acerca das linhas de cuidado Author: Alves e Silva AC; Villar MA; Wuillaume SM; Cardoso MH Source: Cadernos De Saude Publica. 2009 Feb;25(2):349-58. Abstract: The aim of this study was to understand how physicians from a team in the Brazilian Family Health Program perceive their work in child health, as compared to the program's principles outlined in the Agenda for Commitment to Comprehensive Child Health and Reduction of Infant Mortality, under the Ministry of Health. The backdrop was the strategy for implementation of primary care under the Unified National Health System (SUS). Semi-structured interviews were held, and the material was submitted to content analysis. According to the findings, in general the Agenda is being met. However, there are difficulties with referral and counter-referral; the measures proposed by the Family Health Program require medical and sociological competence and face problems inherent to biomedical training; the infrastructure and inputs are precarious; and the training provided does not prepare physicians sufficiently for a more comprehensive approach. In conclusion, the primary care model in Brazil requires adjustments to the country's reality, and partnerships that transcend the system are necessary. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | PHYSICIANS | CHILD HEALTH | SELF-PERCEPTION | INFANT MORTALITY | PRIMARY HEALTH CARE | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Health Personnel | Delivery of Health Care | Health | Perception | Psychological Factors | Behavior | Mortality | Population Dynamics | Demographic Factors | Population | Health Services | Programs | Organization and Administration Document Number: 342669 |
6.  Peer Reviewed Title: Impact of the Family Health Project on infant mortality in Brazilian municipalities. Author: Aquino R; de Oliveira NF; Barreto ML Source: American Journal of Public Health. 2009 Jan;99(1):87-93. Abstract: The authors evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. They collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. They performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. The authors observed a statistically significant negative association between FHP coverage and infant mortality rate. After controlling for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MATHEMATICAL MODEL | EVALUATION INDEXES | INFANT | URBAN POPULATION | INFANT MORTALITY | AGE SPECIFIC DEATH RATE | PRIMARY HEALTH CARE | HEALTH STATUS INDEXES | INEQUALITIES | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Theoretical Models | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Death Rate | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors Document Number: 328585 |
| 7. Title: Promoting and protecting the health of orphans and vulnerable children in Monkey Bay, Malawi. Author: Asibu W; Chingoni J; Majawa D; Jambo H; Kambewankako T Source: Harare, Zimbabwe, EQUINET, 2009. 32 p. Abstract: This report presents results from participatory action research (PRA) that focused on coordinating support from service providers and community organizations working to improve the sexual and reproductive health of orphans and vulnerable children in Monkey Bay, Malawi. Language: English Keywords: MALAWI | SUMMARY REPORT | ACTION RESEARCH | FOCUS GROUPS | ORPHANS AND VULNERABLE CHILDREN | CHILD HEALTH | AIDS | PRIMARY HEALTH CARE | QUALITY OF HEALTH CARE | PROGRAM ACTIVITIES | IMPACT | IMPLEMENTATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Collection | Family and Household | Sociocultural Factors | Health | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Communication Document Number: 342033 |
| 8. Title: Integrating syndromic case management of sexually transmitted diseases into primary healthcare services in Nigeria. Author: Banwat EB; Egah DZ; Peter J; Barau C; Majang Y; Mafuyai S; Imade GE; Bukbuk DN Source: Nigerian Journal of Medicine. 2009 Apr-Jun;18(2):215-8. Abstract: BACKGROUND: Sexually transmitted diseases (STDs) are a huge public health problem; both the aetiological and clinical approaches to management have limitations. WHO has therefore developed an alternative strategy--the syndromic case management approach. This paper reports a training of healthcare providers at the Primary Health Centers aimed at integrating STD care into other services in the PHCs to improve management at the community level. METHODS: Sixteen nurses, from eight PHCs were trained on this new strategy. The training included: identification of STDs, use of flow charts, patient education and counseling, clinic management issues and record keeping and reporting. RESULTS: Over a period of eight weeks post training, about 731 clients were attended to, 451 (61.7%) had signs and symptoms of various STDs (genital discharge, genital ulcer, genital warts and lower abdominal pains). They were treated using the syndromic case approach. About 18.6% (84/451) were males and 81.4% (367/451) were Females. Singles (never married) constituted 32.8% (148/451) while 28.6% were married. About 26.6% and 12.0% were divorced and separated respectively. Age group 20-35 years was at highest risk of infection CONCLUSION: Syndromic case management of STDs can be conveniently integrated into the primary health care delivery system in Nigeria. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | NURSES AND NURSING | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | TREATMENT | PRIMARY HEALTH CARE | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | EXAMINATIONS AND DIAGNOSES | COUNSELING | PRE-POST TESTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Health Personnel | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Programs | Organization and Administration | Training Programs | Education | Clinic Activities | Program Activities | Program Evaluation Document Number: 342684 |
| 9. Title: Task-shifting: exposing the cracks in public health systems [editorial] Author: Berer M Source: Reproductive Health Matters. 2009 May;17(33):4-8. Abstract: This editorial piece discusses the innovative efforts to increase access to skilled reproductive health care especially in resource-poor settings where physicians are in short supply or physicians are not necessary due to trained mid-level providers performing procedures. It also examines the lack of capacity or failure of developing countries to build and strengthen their health systems and develop a strong, well-trained public health workforce. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | PUBLIC HEALTH | PRIMARY HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | HUMAN RESOURCES | TRAINING ACTIVITIES | HEALTH POLICY | DELIVERY OF HEALTH CARE | ANTIRETROVIRAL THERAPY | FINANCIAL ACTIVITIES | QUALITY OF HEALTH CARE | Health | Health Services | Economic Factors | Training Programs | Education | Policy | Political Factors | Sociocultural Factors | HIV | HIV Infections | Viral Diseases | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 342010 |
| 10. Peer Reviewed Title: Towards a global fund for the health MDGs? [letter] Author: Bermejo A Source: Lancet. 2009 Jun 20;373(9681):2110. Abstract: Language: English Keywords: ITALY | CRITIQUE | MIGRANT WORKERS | PRIMARY HEALTH CARE | HUMAN RIGHTS | LEGISLATION | PROGRAM ACCESSIBILITY | Developed Countries | Europe, Southern | Europe | Labor Force | Human Resources | Economic Factors | Health Services | Delivery of Health Care | Health | Political Factors | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration Document Number: 342234 |
| 11. Peer Reviewed Title: Early results of integrated malaria control and implications for the management of fever in under-five children at a peripheral health facility: a case study of Chongwe rural health centre in Zambia. Author: Chanda P; Hamainza B; Mulenga S; Chalwe V; Msiska C; Chizema-Kawesha E Source: Malaria Journal. 2009;8:49. Abstract: BACKGROUND: Zambia has taken lead in implementing integrated malaria control so as to attain the National Health Strategic Plan goal of "reducing malaria incidence by 75% and under-five mortality due to malaria by 20% by the year 2010". The strategic interventions include the use of long-lasting insecticide-treated nets and indoor residual spraying, the use of artemisinin-based combination therapies (ACT) for the treatment of uncomplicated malaria, improving diagnostic capacity (both microscopy and rapid diagnostic tests), use of intermittent presumptive treatment for pregnant women, research, monitoring and evaluation, and behaviour change communication. Financial barriers to access have been removed by providing free malaria prevention and treatment services. METHODS: Data involving all under-five children reporting at the health facility in the first quarter of 2008 was evaluated prospectively. Malaria morbidity, causes of non-malaria fever, prescription patterns treatment patterns and referral cases were evaluated RESULTS: Malaria infection was found only in 0.7% (10/1378), 1.8% (251378) received anti-malarial treatment, no severe malaria cases and deaths occurred among the under-five children with fever during the three months of the study in the high malaria transmission season. 42.5% (586/1378) of the cases were acute respiratory infections (non-pneumonia), while 5.7% (79/1378) were pneumonia. Amoxicillin was the most prescribed antibiotic followed by septrin. CONCLUSION: Malaria related OPD visits have reduced at Chongwe rural health facility. The reduction in health facility malaria cases has led to an increase in diagnoses of respiratory infections. These findings have implications for the management of non-malaria fevers in children under the age of five years. Language: English Keywords: ZAMBIA | RESEARCH REPORT | CASE STUDIES | MANAGEMENT | RURAL POPULATION | CHILDREN | MALARIA PREVENTION | FEVER | PRIMARY HEALTH CARE | RESPIRATORY INFECTIONS | PREVENTION AND CONTROL | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Organization and Administration | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Malaria | Parasitic Diseases | Diseases | Body Temperature | Physiology | Biology | Health Services | Delivery of Health Care | Health | Infections Document Number: 341025 |
| 12. Peer Reviewed Title: Saving the lives of South Africa's mothers, babies, and children: can the health system deliver? Author: Chopra M; Daviaud E; Pattinson R; Fonn S; Lawn JE Source: Lancet. 2009 Sep 5;374(9692):835-46. Abstract: South Africa is one of only 12 countries in which mortality rates for children have increased since the baseline for the Millennium Development Goals (MDGs) in 1990. Continuing poverty and the HIV/AIDS epidemic are important factors. Additionally, suboptimum implementation of high-impact interventions limits programme effectiveness; between a quarter and half of maternal, neonatal, and child deaths in national audits have an avoidable health-system factor contributing to the death. Using the LiST model, we estimate that 11,500 infants' lives could be saved by effective implementation of basic neonatal care at 95% coverage. Similar coverage of dual-therapy prevention of mother-to-child transmission with appropriate feeding choices could save 37,200 children's lives in South Africa per year in 2015 compared with 2008. These interventions would also avert many maternal deaths and stillbirths. The total cost of such a target package is US$1.5 billion per year, 24% of the public-sector health expenditure; the incremental cost is $220 million per year. Such progress would put South Africa squarely on track to meet MDG 4 and probably also MDG 5. The costs are affordable and the key gap is leadership and effective implementation at every level of the health system, including national and local accountability for service provision. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | ESTIMATION TECHNIQUES | ECONOMIC MODEL | EXCESS MORTALITY | CAUSES OF DEATH | HIV INFECTIONS | INTERVENTIONS | IMPLEMENTATION | HEALTH POLICY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PRIMARY HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | PERFORMANCE IMPROVEMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Theoretical Models | Mortality | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Health Services | Delivery of Health Care | Health | Management Document Number: 342802 |
| 13. Peer Reviewed Title: Prevalence and risk factors for Hepatitis C and HIV-1 infections among pregnant women in Central Brazil. Author: Costa ZB; Machado GC; Avelino MM; Gomes Filho C; Macedo Filho JV; Minuzzi AL; Turchi MD; Stefani MM; de Souza WV; Martelli CM Source: BMC Infectious Diseases. 2009;9:116. Abstract: BACKGROUND: Hepatitis C (HCV) and human immunodeficiency virus (HIV) infections are a major burden to public health worldwide. Routine antenatal HIV-1 screening to prevent maternal-infant transmission is universally recommended. Our objectives were to evaluate the prevalence of and potential risk factors for HCV and HIV infection among pregnant women who attended prenatal care under the coverage of public health in Central Brazil. METHODS: Screening and counselling for HIV and HCV infections was offered free of charge to all pregnant women attending antenatal clinic (ANC) in the public health system, in Goiania city (~1.1 million inhabitants) during 2004-2005. Initial screening was performed on a dried blood spot collected onto standard filter paper; positive or indeterminate results were confirmed by a second blood sample. HCV infection was defined as a positive or indeterminate sample (EIA test) and confirmed HCV-RNA technique. HIV infection was defined according to standard criteria. Factors associated with HIV and HCV infections were identified with logistic regression. The number needed to screen (NNS) to prevent one case of infant HIV infection was calculated using the Monte Carlo simulation method. RESULTS: A total of 28,561 pregnant women were screened for HCV and HIV-1 in ANC. Mean maternal age was 23.9 years (SD = 5.6), with 45% of the women experiencing their first pregnancy. Prevalence of HCV infection was 0.15% (95% CI 0.11%-0.20%), and the risk increased with age (p < 0.01). The prevalence of anti-HIV infection was 0.09% (95% CI 0.06%-0.14%). Black women had a 4.9-fold (95% CI 1.42-16.95) greater risk of HIV-1 infection compared to non-black women. NNS to prevent one case of infant HIV infection ranged from 4,141 to 13,928. CONCLUSION: The prevalence of HIV and HCV infections were low among pregnant women, with high acceptability rates in the opt-in strategy in primary care. Older maternal age was a risk factor for HCV and antenatal HCV testing does not fulfill the requirements for screening recommendation. The finding of higher risk of HIV-1 infection among black women despite being in consonance with the HIV-1 ethnic pattern in some American regions cannot be ruled out to be a surrogate marker of socio-economic condition. Language: English Keywords: BRAZIL | RESEARCH REPORT | PREVALENCE | RISK FACTORS | PREGNANT WOMEN | BLACKS | ANTENATAL CARE | HIV TESTING | HIV INFECTIONS | SCREENING | COUNSELING | PRIMARY HEALTH CARE | AGE FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Health | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Maternal Health Services | Maternal-Child Health Services | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Viral Diseases | Diseases | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 342683 |
| 14. Peer Reviewed Title: Stuips, spuits and prophet ropes: the treatment of abantu childhood illnesses in urban South Africa. Author: Friend-du Preez N; Cameron N; Griffiths P Source: Social Science and Medicine. 2009 Jan;68(2):343-51. Abstract: With a paucity of data on health-seeking behaviour for childhood illnesses in urban South Africa, a mixed method approach was used to investigate the treatment of abantu childhood illnesses in Johannesburg and Soweto between March and June 2004. In-depth interviews were held with caregivers (n=5), providers of traditional (n=6) and Western (n=6) health care, as well as five focus groups with caregivers. A utilisation-based survey was conducted with 206 black African caregivers of children under 6 years of age from one public clinic in Soweto (n=50), two private clinics in Johannesburg (50 caregivers in total), two public hospitals from Johannesburg and Soweto (53 caregivers in total) and two traditional healers from Johannesburg and Orange Farm (53 caregivers in total), an informal settlement on the outskirts of Johannesburg. The symptoms of several childhood abantu health problems, their treatment with traditional, church and home remedies, and influences on such patterns of resort are described. Despite free primary health care for children under 6 years, the pluralistic nature of health-seeking in this urban environment highlights the need for community and household integrated management of childhood illnesses and a deeper understanding of how symptoms may be interpreted and treated in the context of the local belief system. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | URBAN POPULATION | TRADITIONAL MEDICINE | CHILD HEALTH | INFECTIONS | TREATMENT | BELIEFS | BEHAVIOR | PRIMARY HEALTH CARE | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Medical Procedures | Culture | Sociocultural Factors Document Number: 331180 |
| 15. Title: Challenges in providing HIV care to paediatric age group in India. Author: Haldar P; S Reddy DC Source: Indian Journal of Medical Research. 2009 Jan;129(1):7-10. Abstract: To ensure comprehensive paediatric HIV care in India, in addition to expansion of the availability of skilled paediatricians and laboratory infrastructure for diagnosis at specialist centres, the capacity building of health care workers at primary and secondary levels should be a priority. This would immensely improve access to treatment, care and co-trimoxazole (CTX) prophylaxis for children living with HIV/AIDS (CLHA) in India. Appropriate guidelines for management and referral at different levels need to be developed and distributed. An integrated approach with the ongoing scale up of Prevention of Parent to Child Transmission (PPTCT) in India would also be important to impart effective primary prevention for children since more than 95 per cent of children acquire HIV infection from mother by perinatal transmission. (excerpt) Language: English Keywords: INDIA | SUMMARY REPORT | DATA COLLECTION | CHILDREN | PERSONS LIVING WITH HIV/AIDS | PRIMARY HEALTH CARE | CHILD HEALTH | EXAMINATIONS AND DIAGNOSES | TREATMENT | HIV INFECTIONS | AGE FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine Document Number: 341546 |
| 16. Peer Reviewed Title: The vital signs of chronic disease management. Author: Harries AD; Zachariah R; Kapur A; Jahn A; Enarson DA Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):537-40. Abstract: The vital signs of pulse rate, blood pressure, temperature and respiratory rate are the 'nub' of individual patient management. At the programmatic level, vital signs could also be used to monitor the burden and treatment outcome of chronic disease. Case detection and treatment outcome constitute the vital signs of tuberculosis control within the WHO's 'DOTS' framework, and similar vital signs could be adapted and used for management of chronic diseases. The numbers of new patients started on therapy in each month or quarter (new incident cases) are sensitive indicators for programme performance and access to services. Using similar reporting cycles, treatment outcomes for all patients can be assessed, the vital signs being: alive and retained on therapy at the respective facility; died; stopped therapy; lost to follow-up; and transferred out to another facility. Retention on treatment constitutes the prevalent number of cases, the burden of disease, and this provides important strategic information for rational drug forecasting and logistic planning. If case numbers and outcomes of chronic diseases were measured reliably and consistently as part of an integrated programmatic approach, this would strengthen the ability of resource-poor countries to monitor and assess their response to these growing epidemics. Language: English Keywords: DEVELOPED COUNTRIES | RESEARCH REPORT | CLIENTS | MANAGEMENT | PREVENTIVE HEALTH CARE | TUBERCULOSIS | ANTIRETROVIRAL THERAPY | DISEASES | TREATMENT | PRIMARY HEALTH CARE | DIABETES | Program Activities | Programs | Organization and Administration | Health Services | Delivery of Health Care | Health | Infections | HIV | HIV Infections | Viral Diseases | Medical Procedures | Medicine Document Number: 342748 |
| 17. Title: Home truths: facing the facts on children, AIDS, and poverty. Final report of the Joint Learning Initiative on Children and HIV/AIDS. Author: Irwin A; Adams A; Winter A Source: Joint Learning Initiative on Children and HIV/AIDS, 2009. [84] p. Abstract: This report summarizes two years of research and analysis of AIDS- related policies, programs, and funding sources and their effectiveness in addressing the needs of children. It calls for greater emphasis on strengthening families and communities to enable them to give children the care and support they are uniquely suited to provide. The report also recommends new approaches to address the simultaneous impacts of HIV, poverty, food insecurity, and social inequality that many countries confront today. Language: English Keywords: AFRICA, SUB SAHARAN | SUMMARY REPORT | CHILDREN | PERSONS LIVING WITH HIV/AIDS | HUMAN CAPITAL | PRIMARY HEALTH CARE | HEALTH SERVICES | TREATMENT | COMMUNITY PARTICIPATION | FAMILY AND HOUSEHOLD | FAMILY LIFE | CARE AND SUPPORT | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Human Resources | Economic Factors | Delivery of Health Care | Health | Medical Procedures | Medicine | Organization and Administration | Sociocultural Factors Document Number: 330184 |
| 18. Peer Reviewed Title: Emergency obstetric care and referral: experience of two midwife-led health centres in rural Rajasthan, India. Author: Iyengar K; Iyengar SD Source: Reproductive Health Matters. 2009 May;17(33):9-20. Abstract: This paper documents the experience of two health centres in a primary health service located in interior rural areas of southern Rajasthan, northern India, where trained nurse-midwives are providing skilled maternal and newborn care round the clock daily. The nurse-midwives independently detect and manage complications and decide when to refer women to the nearest hospital for emergency care, in telephonic consultation with a doctor if required. From 2000-2008, 2,771 women in labour and 202 women with maternal emergencies who were not in labour were attended by nurse-midwives. Of women in labour, 21% had a life-threatening complication or its antecedent condition and 16% were advised referral, of which two-thirds complied. Compliance with referral was higher for maternal conditions than fetal conditions. Among the 202 women who came with complications antenatally, post-abortion or post-partum, referral was advised for 70%, of whom 72% complied. The referral system included counselling, arranging transport, accompanying women, facilitating admission and supporting inpatient care, and led to higher referral compliance rates. There was only one maternal death in nine years. We conclude that trained nurse-midwives can significantly improve access to skilled maternal and neonatal care in rural areas, and manage maternal complications with and without the need for referral. Protocols must acknowledge that some families might not comply with referral advice, and also that initial care by nurse-midwives can reverse progression of certain complications and thereby avert the need for referral. Spanish Abstract: Este artículo documenta la experiencia de dos centros de salud de primer nivel situados en zonas rurales del interior de Rajasthan meridional, en la India septentrional, donde enfermeras-parteras profesionales capacitadas brindan atención calificada a madres y recién nacidos las 24 horas del día. Independientemente, ellas detectan y manejan complicaciones y deciden cuándo remitir a las mujeres al hospital más cercano para que reciban atención de urgencia, en consulta telefónica con un médico si es necesario. Desde 2000 a 2008, 2,771 mujeres en trabajo de parto y 202 con urgencias maternas, que no estaban de parto, fueron atendidas por enfermeras-parteras profesionales. De las que estaban de parto, el 21% presentó una complicación que puso en riesgo su vida, o su afección antecedente, y el 16% fueron aconsejadas referencia y, de éstas, dos terceras partes accedieron. El cumplimiento de la referencia fue más alto para las afecciones maternas que para las fetales. Entre las 202 mujeres que llegaron con complicaciones antenatales, se aconsejó referencia postaborto o posparto al 70%, de las cuales el 72% accedieron. El sistema de referencia incluyó consejería, planes de transporte, acompañar a las mujeres, facilitar admisión y atención con apoyo a las pacientes internadas, por lo cual aumentaron las tasas de cumplimiento de referencias. En nueve años hubo una sola muerte materna. Concluimos que las enfermeras-parteras profesionales capacitadas pueden mejorar considerablemente el acceso a la atención materna y neonatal calificada en zonas rurales, y manejar las complicaciones maternas con o sin la necesidad de referencias. Los protocolos deben reconocer la posibilidad de que algunas familias no sigan el consejo de referencia, y que la atención inicial brindada por enfermeras-parteras profesionales puede detener la evolución de algunas complicaciones y evitar la necesidad de referencia. French Abstract: Dans deux centres de santé d’un service de soins de santé primaires situé dans des zones rurales de l’intérieur du Rajasthan méridional, en Inde septentrionale, des infirmières sages-femmes formées assurent des soins de la mère et du nouveau-né tous les jours, 24 heures sur 24. Les infirmières sages-femmes décèlent et prennent en charge indépendamment les complications et décident quand transférer les femmes à l’hôpital le plus proche pour des soins d’urgence, si nécessaire en consultation téléphonique avec un médecin. De 2000 à 2008, les infirmières sages-femmes se sont occupées de 2771 femmes en couches et de 202 femmes avec d’autres urgences maternelles. Sur les femmes en couches, 21% présentaient une complication pouvant entraîner la mort ou son stade précédent ; et 16% se sont vu conseiller un transfert et les trois quarts l’ont accepté. L’acceptation du transfert était plus élevée pour les problèmes maternels que fœtaux. Un transfert a été conseillé à 70% des 202 femmes présentant des complications prénatales, post-avortement ou post-partum, et 72% d’entre elles l’ont accepté. Le système de transfert comprenait des conseils, l’organisation du transport, l’accompagnement des patientes, l’aide à l’admission et aux soins hospitaliers ; il a accru les taux d’acceptation du transfert. Un seul décès maternel a été enregistré en neuf ans. Nous en concluons que, dans les zones rurales, les infirmières sages-femmes formées peuvent notablement élargir l’accès à des soins maternels et néonatals compétents, et prendre en charge les complications maternelles nécessitant ou non un transfert. Les protocoles doivent reconnaître qu’il arrive que des familles ne suivent pas les recommandations de transfert et aussi que les soins donnés initialement par des infirmières sages-femmes peuvent régler certaines complications et éviter la nécessité d’un transfert de la patiente. Language: English Keywords: INDIA | EVALUATION REPORT | NURSE-MIDWIVES | EMERGENCY SERVICES | OBSTETRICS | PRIMARY HEALTH CARE | REFERRAL AND CONSULTATION | RURAL HEALTH CENTERS | MATERNAL-CHILD HEALTH SERVICES | PROGRAM ACCESSIBILITY | PREGNANCY COMPLICATIONS | COUNSELING | Asia, Southern | Asia | Developing Countries | Evaluation | Health Personnel | Delivery of Health Care | Health | Health Services | Medicine | Program Activities | Programs | Organization and Administration | Health Facilities | Program Evaluation | Diseases | Clinic Activities Document Number: 342011 |
| 19. Peer Reviewed Title: Exploring health stakeholders' perceptions on moving towards comprehensive primary health care to address childhood malnutrition in Iran: a qualitative study. Author: Javanparast S; Coveney J; Saikia U Source: BMC Health Services Research. 2009;9:36. Abstract: BACKGROUND: Due to the multifaceted aspect of child malnutrition, a comprehensive approach, taking social factors into account, has been frequently recommended in health literature. The Alma-Ata declaration explicitly outlined comprehensive primary health care as an approach that addresses the social, economic and political causes of poor health and nutrition. Iran as a signatory country to the Alma Ata Declaration has established primary health care since 1979 with significant progress on many health indicators during the last three decades. However, the primary health care system is still challenged to reduce inequity in conditions such as child malnutrition which trace back to social factors. This study aimed to explore the perceptions of the Iranian health stakeholders with respect to the Iranian primary health care performance and actions to move towards a comprehensive approach in addressing childhood malnutrition. Health stakeholders are defined as those who affect or can be affected by health system, for example health policy-makers, health providers or health service recipients. METHODS: Stakeholder analysis approach was undertaken using a qualitative research method. Different levels of stakeholders, including health policy-makers, health providers and community members were interviewed as either individuals or focus groups. Qualitative content analysis was used to interpret and compare/contrast the viewpoints of the study participants. RESULTS: The results demonstrated that fundamental differences exist in the perceptions of different health stakeholders in the understanding of comprehensive notion and action. Health policy-makers mainly believed in the need for a secure health management environment and the necessity for a whole of the government approach to enhance collaborative action. Community health workers, on the other hand, indicated that staff motivation, advocacy and involvement are the main challenges need to be addressed. Turning to community stakeholders, greater emphasis has been placed on community capabilities, informal link with other social sectors based on trust and local initiatives. CONCLUSION: This research provided a picture of the differences in the perceptions and values of different stakeholders with respect to primary health care concepts. The study suggests that a top-down approach, which still exists among health policy-makers, is a key obstacle that delays, and possibly worse, undermines the implementation of the comprehensive strategy codified by the Alma-Ata Declaration. A need to revitalize primary health care to use its full potential and to combine top-down and bottom-up approaches by narrowing the gap between perceptions of policy makers and those who provide and receive health-related services is crucial. Language: English Keywords: IRAN | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CHILDREN | POLICYMAKERS | COMMUNITY | COMMUNITY WORKERS | HEALTH PERSONNEL | PRIMARY HEALTH CARE | CHILD NUTRITION | MALNUTRITION | PERCEPTION | HEALTH POLICY | COMMUNITY HEALTH SERVICES | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Delivery of Health Care | Health | Health Services | Nutrition | Nutrition Disorders | Diseases | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 331083 |
| 20. Peer Reviewed Title: Bypassing primary care facilities for childbirth: a population-based study in rural Tanzania. Author: Kruk ME; Mbaruku G; McCord CW; Moran M; Rockers PC; Galea S Source: Health Policy and Planning. 2009 Jul;24(4):279-88. Abstract: In an effort to reduce maternal mortality, developing countries have been investing in village-level primary care facilities to bring skilled delivery services closer to women. We explored the extent to which women in rural western Tanzania bypass their nearest primary care facilities to deliver at more distant health facilities, using a population-representative survey of households (N = 1204). Using a standardized instrument, we asked women who had a delivery within 5 years about the place of their most recent delivery. Information on all functioning health facilities in the area were obtained from the district health office. Women who delivered in a health facility that was not the nearest available facility were considered bypassers. Forty-four per cent (186/423) of women who delivered in a health facility bypassed their nearest facility. In adjusted analysis, women who bypassed were more likely than women who did not bypass to be 35 or older (OR 2.5, P Language: English Keywords: TANZANIA | RESEARCH REPORT | PRIMARY HEALTH CARE | HEALTH FACILITIES | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | OBSTETRICS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Health Services | Delivery of Health Care | Health | Maternal-Child Health Services | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Medicine Document Number: 342992 |
| 21. Peer Reviewed Title: The effect of interrupted 5-day training on Integrated Management of Neonatal and Childhood Illness on the knowledge and skills of primary health care workers. Author: Kumar D; Aggarwal AK; Kumar R Source: Health Policy and Planning. 2009 Mar;24(2):94-100. Abstract: The conventional 8-day Integrated Management of Neonatal and Childhood Illness (IMNCI) training package poses several operational constraints, particularly due to its long duration. A 5-day training package was developed and administered in an interrupted mode of 3 days and 2 days duration with a break of 4 days in-between, in a district of Haryana state in northern India. Improvement in the knowledge and skills of 50 primary health care workers following the interrupted 5-day training was compared with that of 35 primary health care workers after the conventional 8-day IMNCI training package. The average score increased significantly (P < 0.05) from 46.3 to 74.6 in 8-day training and from 40.0 to 73.2 in 5-day training. Knowledge score improved for all health conditions, like anaemia, diarrhoea, immunization, malnutrition, malaria, meningitis and possible severe bacterial infection, and for breastfeeding in 8-day as well as in 5-day training. Average skills score for respiratory problems increased from 38 to 57 in 8-day training and from 41 to 91 in 5-day training. Corresponding increases in skill scores for diarrhoea assessment were from 28 to 67 and 48 to 75, and for breastfeeding assessment from 33 to 84 and 42 to 86 in 8-day and 5-day training, respectively. Average counselling skill score also rose from 42 to 89 in 8-day and from 37 to 70 in 5-day training. A direct cost saving of US$813 for a batch of 25 trainees and an indirect cost saving of 3 days per trainee and resource person makes the interrupted 5-day IMNCI training more cost-effective. Language: English Keywords: INDIA | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | COST BENEFIT ANALYSIS | HEALTH PERSONNEL | TRAINING PROGRAMS | NEONATAL DISEASES AND ABNORMALITIES | CHILD HEALTH | INTEGRATED PROGRAMS | TIME FACTORS | PRIMARY HEALTH CARE | KNOWLEDGE | EXAMINATIONS AND DIAGNOSES | COST EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Delivery of Health Care | Health | Education | Diseases | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Health Services | Sociocultural Factors | Medical Procedures | Medicine | Evaluation Indexes Document Number: 331230 |
| 22. Title: Knowledge about breastfeeding among a group of primary care physicians and residents in Puerto Rico. Author: Leavitt G; Martinez S; Ortiz N; Garcia L Source: Journal of Community Health. 2009 Feb;34(1):1-5. Abstract: Physicians have an essential role in promoting, protecting, and supporting breastfeeding as the ideal method of infant feeding. They are in an important position to promote breastfeeding but report difficulty in advising mothers with lactation problems. The purpose of this study is to assess knowledge about breastfeeding among primary care physicians and residents and identify potential barriers to its promotion. One hundred seventy-seven residents and physicians answered an anonymous questionnaire. The participants recognized breastfeeding benefits but 26% did not encourage exclusive breastfeeding. Mastitis, breast abscess, and the use of medications by the mother were considered contraindications to breastfeeding. Temporary breastfeeding discontinuation and bilirubin levels measurement were the preferred recommendations for the jaundiced infant. Most physicians received training in breastfeeding benefits although they report fair knowledge in myths, techniques, and contraindications. Physicians demonstrated to recognize breastfeeding benefits, but formal education is needed to eliminate barriers to breastfeeding promotion and support. Language: English Keywords: PUERTO RICO | RESEARCH REPORT | PHYSICIANS | KNOWLEDGE | PRIMARY HEALTH CARE | HEALTH FACILITIES | BREASTFEEDING | HEALTH EDUCATION | MATERNAL HEALTH | Caribbean | Americas | Developed Countries | Health Personnel | Delivery of Health Care | Health | Sociocultural Factors | Health Services | Infant Nutrition | Nutrition | Education Document Number: 330862 |
| 23. Title: The role of nursing in the management of unintended pregnancy. Author: Levi AJ; Simmonds KE; Taylor D Source: Nursing Clinics of North America. 2009 Sep;44(3):301-14. Abstract: This article explores the role of nurses in the prevention, management, and treatment of unintended pregnancy. All nurses have a responsibility to understand the importance of reproductive health care in the primary care of women and their families, and to be prepared to respond to patients' needs for the prevention and management of unintended pregnancy. A public health framework provides an opportunity to identify the role of the nurse in primary, secondary, and tertiary prevention strategies that can contribute to the management of unintended pregnancy for the health of women and their families. Nursing education and the role of nurses in advocacy for reproductive health concerns are also addressed. Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | NURSES AND NURSING | PREGNANCY, UNPLANNED | REPRODUCTIVE HEALTH | PRIMARY HEALTH CARE | FAMILY PLANNING PROGRAMS | ABORTION | COUNSELING | PREGNANCY TESTS | HEALTH EDUCATION | ADVOCACY | Developed Countries | North America | Americas | Health Personnel | Delivery of Health Care | Health | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Health Services | Family Planning | Fertility Control, Postconception | Clinic Activities | Program Activities | Programs | Organization and Administration | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Education | Communication Document Number: 342606 Notification |
| 24. Title: First trimester procedural abortion in family medicine. Author: Lyus RJ; Gianutsos P; Gold M Source: Journal of the American Board of Family Medicine. 2009 Mar-Apr;22(2):169-74. Abstract: Unintended pregnancy is common, and in the United States almost half of all women will have at least one abortion during their lifetime. The majority of abortions are performed in the first trimester. Although advances have been made in the provision of medical abortion in the family medicine setting, procedural methods remain the cornerstone of abortion care. We present a step-wise review of first trimester procedural abortion using the manual vacuum aspirator to demonstrate the feasibility of incorporating this service into a primary care setting. Language: English Keywords: UNITED STATES OF AMERICA | RECOMMENDATIONS | PREGNANCY, FIRST TRIMESTER | ABORTION | MEDICAL PROCEDURES | COUNSELING | CERVICAL DILATATION | CURETTAGE | ANALGESIA | ANESTHESIA | FETAL MEMBRANES | PRIMARY HEALTH CARE | Developed Countries | North America | Americas | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Medicine | Health Services | Delivery of Health Care | Health | Clinic Activities | Program Activities | Programs | Organization and Administration | Treatment | Obstetrical Surgery | Surgery | Fetus Document Number: 342001 Notification |
| 25. Title: A text messaging trial in family planning clinics. Author: Mackenzie H Source: Studies In Health Technology and Informatics. 2009;146:154-9. Abstract: The New Zealand Family Planning Association (Family Planning) is a national not-for-profit organization providing sexual and reproductive primary care health services as well as health promotion, professional training and advocacy on issues of sexual and reproductive health. By 2006 Family Planning had become acutely aware of the increasing amount of staff time being used to make phone calls to clients, particularly about appointment reminders and laboratory results, and the associated escalation in telephone costs. Much of the increased cost related to the trend for the clients, who are predominantly under 25 year of age, to have only a mobile phone as their phone contact. This paper describes a project to identify and implement an alternative means of communication with these clients, with the outcome being the introduction of a text messaging program (txt2remind) integrated with the Practice Management System (Medtech 32) into clinics by June 2008. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | PRIMARY HEALTH CARE | FAMILY PLANNING | TELECOMMUNICATIONS | CONTACTING CLIENTS | Oceania | Developed Countries | Health Services | Delivery of Health Care | Health | Broadcast Media | Mass Media | Communication | Clients | Program Activities | Programs | Organization and Administration Document Number: 342050 |
| 26. Peer Reviewed Title: The burden of non-communicable diseases in South Africa. Author: Mayosi BM; Flisher AJ; Lalloo UG; Sitas F; Tollman SM; Bradshaw D Source: Lancet. 2009 Sep 12;374(9693):934-47. Abstract: 15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urban areas, most prominently in poor people living in urban settings, and are resulting in increasing pressure on acute and chronic health-care services. Major factors include demographic change leading to a rise in the proportion of people older than 60 years, despite the negative effect of HIV/AIDS on life expectancy. The burden of these diseases will probably increase as the roll-out of antiretroviral therapy takes effect and reduces mortality from HIV/AIDS. The scale of the challenge posed by the combined and growing burden of HIV/AIDS and non-communicable diseases demands an extraordinary response that South Africa is well able to provide. Concerted action is needed to strengthen the district-based primary health-care system, to integrate the care of chronic diseases and management of risk factors, to develop a national surveillance system, and to apply interventions of proven cost-effectiveness in the primary and secondary prevention of such diseases within populations and health services. We urge the launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | RURAL AREAS | RURAL POPULATION | LOW INCOME POPULATION | PRIMARY HEALTH CARE | DISEASES | HEALTH SERVICES | QUALITY OF HEALTH CARE | DEMOGRAPHIC TRANSITION | DEMOGRAPHIC AGING | HIV PREVENTION | AIDS PREVENTION | INTEGRATED PROGRAMS | GOVERNMENT PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Population Characteristics | Demographic Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Population Dynamics | HIV Infections | Viral Diseases | AIDS Document Number: 342869 |
| 27. Peer Reviewed Title: The impact of primary health care on malaria morbidity--defining access by disease burden. Author: O'Meara WP; Noor A; Gatakaa H; Tsofa B; McKenzie FE; Marsh K Source: Tropical Medicine and International Health. 2009 Jan;14(1):29-35. Abstract: OBJECTIVES: Primary care facilities are increasingly becoming the focal point for distribution of malaria intervention strategies, but physical access to these facilities may limit the extent to which communities can be reached. To investigate the impact of travel time to primary care on the incidence of hospitalized malaria episodes in a rural district in Kenya. METHODS: The incidence of hospitalized malaria in a population under continuous demographic surveillance was recorded over 3 years. The time to travel to the nearest primary health care facility was calculated for every child between birth and 5 years of age and trends in incidence of hospitalized malaria as a function of travel time were evaluated. RESULTS: The incidence of hospitalized malaria more than doubled as travel time to the nearest primary care facility increased from 10 min to 2 h. Good access to primary health facilities may reduce the burden of disease by as much as 66%. CONCLUSIONS: Our results highlight both the potential of the primary health care system in reaching those most at risk and reducing the disease burden. Insufficient access is an important risk factor, one that may be inequitably distributed to the poorest households. Language: English Keywords: KENYA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | RURAL POPULATION | CHILDREN | PREVALENCE | MALARIA PREVENTION | PRIMARY HEALTH CARE | PROGRAM ACCESSIBILITY | DISTANCE | HEALTH FACILITIES | UTILIZATION OF HEALTH CARE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Measurement | Malaria | Parasitic Diseases | Diseases | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Geographic Factors Document Number: 330249 |
| 28. Peer Reviewed Title: [Provision of voluntary surgical sterilization in the Campinas Metropolitan Area, Sao Paulo State, Brazil: perceptions of public health services managers and professionals] Atendimento a demanda pela esterilizacao cirurgica na Regiao Metropolitana de Author: Osis MJ; Carvalho LE; Cecatti JG; Bento SF; Padua KS Source: Cadernos De Saude Publica. 2009 Mar;25(3):625-34. Abstract: This study describes the perceptions of public health services managers and professionals concerning provision of voluntary surgical sterilization in the Campinas Metropolitan Area, Sao Paulo State, Brazil. The study adopted a qualitative approach in four municipalities (counties), where semi-structured interviews were conducted with 26 health professionals and health services managers involved in the provision of surgical sterilization. The interviewees identified difficulties in scheduling visits at Outpatient Family Clinics or Reference Centers (APF/CR), and the number of available surgeries in the accredited hospitals was insufficient. They emphasized the lack of physical infrastructure and human resources for conducting family planning activities in the primary health units as well as in the APF/CR.They also criticized the legal criteria for authorizing surgical sterilization, and mentioned adaptations to make them more appropriate to the each municipality's situation. According to the health services managers and professionals, despite the efforts, meeting the demand for surgical sterilization in the Campinas Metropolitan Area was jeopardized by its centralization in the APF/CR, which in practice had to cover the gap in family planning activities in each municipality's primary care units. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | QUALITATIVE RESEARCH | HEALTH PERSONNEL | PERCEPTION | PUBLIC HEALTH | HEALTH SERVICES | STERILIZATION, SEXUAL | PRIMARY HEALTH CARE | QUALITY OF HEALTH CARE | MANAGEMENT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Delivery of Health Care | Health | Psychological Factors | Behavior | Family Planning | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 342581 |
| 29. Title: Beyond douching: use of feminine hygiene products and STI risk among young women. Author: Ott MA; Ofner S; Fortenberry JD Source: Journal of Sexual Medicine. 2009 May;6(5):1335-40. Abstract: INTRODUCTION: Use of feminine hygiene products (feminine wipes, sprays, douches, and yeast creams) by adolescent women is common, yet understudied. AIM: We examine the association among these genital hygiene behaviors, condom use, and sexually transmitted infection (STI). MAIN OUTCOME MEASURES: Using the interview as our unit of analysis, we examined associations between genital hygiene behaviors (use of feminine wipes, feminine sprays, douches, or yeast creams), STI risk factors, and infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. METHODS: We recruited 295 adolescent women from primary care clinics as part of a larger longitudinal study of STI among high-risk adolescents. Participants completed face-to-face interviews every 3 months, and provided vaginal swabs for STI testing. Data were analyzed with repeated measures logistic models to control for multiple observations contributed by each participant. RESULTS: Participants reported douching in 25% of interviews, feminine sprays in 29%, feminine wipes in 27%, and yeast creams in 19% of interviews. We observed a co-occurrence of douching, spraying, and wiping. A past STI (6 months or more prior) was associated with increased likelihood of yeast cream use, and a recent STI (3 months prior) was associated with increased likelihood of feminine wipe use. Condom use was modestly associated with increased likelihood of douching. CONCLUSIONS: Young women frequently use feminine hygiene products, and it is important for clinicians to inquire about use as these products may mimic or mask STI. We found no associations between douching and STI, but instead modest associations between hygiene and STI prevention, suggesting motivation for self-care. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | INTERVIEWS | DATA ANALYSIS | WOMEN | ADOLESCENTS, FEMALE | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | POSTCOITAL DOUCHING | HEALTH SERVICES | PRIMARY HEALTH CARE | Developed Countries | North America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Risk Reduction Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases | Fertility Control, Postcoital | Family Planning | Delivery of Health Care | Health Document Number: 342721 |
| 30. Title: Demographic & clinical profile of HIV infected children accessing care at Tambaram, Chennai, India. Author: Rajasekaran S; Jeyaseelan L; Raja K; Ravichandran N Source: Indian Journal of Medical Research. 2009 Jan;129(1):42-9. Abstract: BACKGROUND & OBJECTIVE: Human immunodeficiency virus (HIV) is severely affecting the poorly educated and economically disadvantaged in Indian society. When children start developing clinical manifestations, needing treatment, they have to travel long distances for accessing care and support at tertiary institutions. This places an extra burden on patients, who are already struggling to cope with their illness. Sufficient data are needed for the government to evolve appropriate policy for providing care to the children affected with HIV. We undertook this study to present the socio-demographic characteristics, signs and symptoms, clinical profile, distance travelled and follow up pattern of HIV positive children who accessed care for the first time in a referral hospital at Chennai, India. METHODS: Electronic medical records from patients diagnosed with HIV between 2002 and 2004 at the Government Hospital for Thoracic Medicine (GHTM) in Tambaram (Chennai) in India were analyzed to understand care-seeking behaviours. Demographic variables such as age, sex, education and occupation, data on clinical manifestations were examined together with geographic information. RESULTS: At GHTM 1,768 new paediatric patients accessed care from 2002 to 2004. Children aged less than 5 yr were 49.9 per cent; 1115 children had (63%) tuberculosis. Significantly, 14.9 and 20.6 per cent children had extra-pulmonary TB and disseminated TB respectively. Lower respiratory infection (15.8%), Pneumocystis carinii pneumonia (15.20%), oral/oesophageal candidiasis (13.5%), wasting (6.1%) and diarrhoeal disorders (3.5%) were the common clinical manifestations. In all 47 per cent children traveled between 200-400 km from home and 14 per cent travelled over 400 km. INTERPRETATION & CONCLUSION: Our findings showed that tuberculosis should be regarded as the indicator disease for HIV infection in children, especially when they have clinical manifestations of progressive, non pulmonary and disseminated disease. The primary and secondary health care centres should have the trained capacity to diagnose and treat HIV disease and opportunistic infections so as the children to have much needed care and support nearer to their residence. Language: English Keywords: INDIA | RESEARCH REPORT | RECORDS | DATA COLLECTION | CHILDREN | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | TUBERCULOSIS | PRIMARY HEALTH CARE | CHILD HEALTH | TREATMENT | Asia, Southern | Asia | Developing Countries | Information Processing | Information | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Infections | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine Document Number: 341545 |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |