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Title: Creating healthy families in Nepal: sustaining family planning practices among marginalized groups.
Author: CORE Group
Source: CORE Group, Washington, D.C., 2009 Mar.
Abstract: This case study documents the sustainable activities and interventions of a USAID Flexible Fund Program, Valued Behavior for Healthy Families-A Model for Social Inclusion, that was implemented by the Johns Hopkins Bloomberg School of Public Health, Center for Communications Programs through Save the Children/US in Nepal. Sustainable activities are defined here as those activities or practices that have been continued or improved after the project ended. The Valued Behavior project aimed to help women and couples from disadvantaged groups in Nepal realize their reproductive intentions through: a) increased knowledge and interest in family planning services through NGO involvement; b) improved quality of family planning (FP) services delivered by providers in selected facilities and the community; c) increased community access to FP services; and d) improved social and policy environment for FP and reproductive health services and behavior.
Language: English
Keywords:
NEPAL | SUMMARY REPORT | KNOWLEDGE | FAMILY PLANNING | SOCIAL DEVELOPMENT | POLICY | PROGRAM ACCESSIBILITY | PROGRAM ACTIVITIES | Developing Countries | Asia, Southern | Asia | Sociocultural Factors | Economic Factors | Political Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 328782

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

Title: Development of Assays to Estimate HIV Incidence. Meeting proceedings, Chapel Hill, North Carolina, May 13-14, 2009.
Author: Meeting on the Development of Assays to Estimate HIV Incidence (2009: Chapel Hill)
Source: [Research Triangle Park], North Carolina, Family Health International [FHI], 2009. [70] p.
Abstract: Family Health International (FHI) convened a meeting on the Development of Assays to Estimate HIV Incidence on May 13-14, 2009 at the Carolina Inn in Chapel Hill, North Carolina. The purpose of this meeting was to assess how new and existing technologies and research could be applied to advance the development of assays to estimate HIV incidence. Nearly fifty leading experts including immunologists, epidemiologists, HIV transmission experts, assay developers, virologists, industry representatives, and potential users of assays participated in the meeting. The meeting was primarily supported by the Bill & Melinda Gates Foundation and in conjunction with and the support of the World Health Organization (WHO), the HIV Prevention Trials Network (HPTN), and the Center for HIV / AIDS Vaccine Immunology (CHAVI). (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | RESEARCH METHODOLOGY | VALIDITY | ESTIMATION TECHNIQUES | INCIDENCE | EPIDEMIOLOGY | STUDY DESIGN | HIV INFECTIONS | AWARENESS | TREATMENT | PROGRAM ACTIVITIES | PROGRAM EVALUATION | Measurement | Public Health | Health | Viral Diseases | Diseases | Knowledge | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Programs | Organization and Administration
Document Number: 331753

Title: Building support for orphans and vulnerable children.
Author: Population Council
Source: Momentum. 2009 Jun;:[1] p.
Abstract: We provide solid scientific evidence about programs targeting orphans and vulnerable children to help governments and communities provide better care for these children in need. The Council�s studies apply innovative research techniques to address complex issues about providing care and services to children affected by HIV. The Council�s evaluation of the RAPIDS intervention has highlighted the effectiveness of program activities and valuable lessons for program managers and providers. A mid-term evaluation in 2007 showed important progress, such as more help with school books, uniform fees, and transportation and improvements in school attendance among vulnerable children. Results from the 2009 data collection promise to provide further guidance to program managers on how to ensure the greatest impact with available resources. (Excerpts)
Language: English
Keywords:
ZAMBIA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | PERSONS LIVING WITH HIV/AIDS | PROGRAM ACTIVITIES | MANAGEMENT | INFORMATION | FINANCIAL ACTIVITIES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Economic Factors
Document Number: 331493

Title: A strategic approach: HIV & AIDS and education.
Author: UNAIDS. Inter-Agency Task Team on Education
Source: Paris, France, UNESCO, 2009 May. 53 p. Also available: http://unesdoc.unesco.org/images/0016/001627/162723f.pdf (French) and http://unesdoc.unesco.org/images/0016/001627/162723s.pdf (Spanish).
Abstract: This publication provides a strategic vision of the role that education must play in addressing HIV and AIDS. It targets decision-makers and practitioners in the education sector, as well as colleagues who work on HIV and AIDS responses in other sectors. It can be used as an advocacy tool to build commitment to the role of education in the HIV and AIDS response and to generate multisectoral partnerships for implementation.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | PERSONS LIVING WITH HIV/AIDS | EDUCATION | AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | SCHOOLS | HIV PREVENTION | AIDS PREVENTION | TREATMENT | HIV TESTING | HEALTH EDUCATION | HEALTH SERVICES | PROGRAM ACCESSIBILITY | PROGRAM ACTIVITIES | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Medical Procedures | Medicine | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Program Evaluation | Programs | Organization and Administration
Document Number: 342035

Title: PRISM tools for assessing, monitoring, and evaluating RHIS performance.
Author: Aqil A; Lippeveld T
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. [32] p. (MS-09-34USAID Cooperative Agreement No. GPO-A-00-03-00003-00)
Abstract: PRISM Framework and its tools applications have expanded since 2004. Now it has been applied in Pakistan, Uganda, South Africa, Mexico, Paraguay, Honduras, Haiti, China and Cote d'Ivore for assessment and evaluation. It has been applied in diverse countries of Africa, Asia, Latin America and Carribean continents. While these applications showed the strengths and appropriateness of PRISM Framework and its tools in identifying strengths and weaknesses of the routine information systems, they brought some challenges to attention. First, to make a distinction between RHIS performance indicators -accuracy, timeliness and completeness, from their counterpart processes. Second, to keep minimum variables in various tools for triangulation of information to avoid respondent's burden of filling the details. Third, better measurement of use of information. Thus, there was a need to revise the PRISM tools. Uganda PRISM evaluation in 2007 for testing its reliability and validity also helped to make the revisions. PRISM tools version 3.0 meets old and new challenges in assessing, monitoring and evaluation of RHIS.
Language: English
Keywords:
PAKISTAN | MEXICO | HONDURAS | HAITI | CHINA | PARAGUAY | SOUTH AFRICA | UGANDA | SUMMARY REPORT | EVALUATION | INFORMATION PROCESSING | DATA COLLECTION | MANAGEMENT | PROGRAM ACTIVITIES | Developing Countries | Asia, Southern | Asia | North America | Americas | Central America | Latin America | Caribbean | Asia, Eastern | South America, Central | South America | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Information | Research Methodology | Organization and Administration | Programs
Document Number: 339994

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Title: Global health and the Bill & Melinda Gates Foundation [letter]
Author: Dabade G; Puliyel J
Source: Lancet. 2009 Jun 27;373(9682):2195-6.
Abstract: David McCoy and colleagues note that half of all Gates Foundation funding goes towards vaccination. US$1.5 billion provided by the Gates Foundation and some donor countries go to fund the GAVI Alliance's "advance marketing commitments" to purchase vaccines and provide them at subsidised costs in developing countries. The advance marketing commitments for pneumococcal vaccine illustrate the problem with this policy quite lucidly. Madhi and colleagues have calculated that 1000 children have to be vaccinated to prevent approximately four cases of pneumonia. Given that the vaccine costs $250 per child, $250 000 will be spent to prevent these four cases of pneumonia. Treatment of four children with pneumonia with oral cotrimoxazole, in accordance with the WHO protocol, will cost $1 in India. The hope that GAVI's funding of vaccines would push down their prices has been belied. One review found that prices actually went up after GAVI funding, meaning that the higher costs are borne by poor nations when GAVI funding is withdrawn. Entering into advance commitments to market this vaccine in developing countries allows GAVI to divert Gates Foundation money to vaccine manufacturers, without providing commensurate benefits to the children it is supposed to help. We agree with McCoy and colleagues that, given the substantial public subsidies that the foundation receives in the form of tax exemptions, its programmes must be subjected to public scrutiny. (full-text)
Language: English
Keywords:
GLOBAL | CRITIQUE | FUNDS | DECISION MAKING | HEALTH POLICY | DISEASE PREVENTION | VACCINES | PROGRAM ACTIVITIES | RESEARCH AND DEVELOPMENT | INTERNATIONAL COOPERATION | Financial Activities | Economic Factors | Behavior | Policy | Political Factors | Sociocultural Factors | Prevention and Control | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Technology
Document Number: 342052

12.

Peer Reviewed

Title: Gendered empowerment and HIV prevention: policy and programmatic pathways to success in the MENA region.
Author: Dworkin SL; Kambou SD; Sutherland C; Moalla K; Kapoor A
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51 Suppl 3:S111-8.
Abstract: Although HIV in the Middle East and North Africa is currently characterized as a low seroprevalence epidemic, there are numerous factors that are present in the region that could prevent-or exacerbate-the epidemic. The time to invest substantially in prevention-and gender-specific prevention in particular-is now. Given that most policy makers do not make gender-specific plans as epidemics progress, our research team-which draws upon expertise from both within and outside the region-worked together to make programmatic and policy suggestions in the Middle East and North Africa region in 5 key areas: (1) gender-specific and gender transformative HIV prevention interventions; (2) access to quality education and improvements in life skills and sex education; (3) economic empowerment; (4) property rights; and (5) antiviolence. In short, this work builds upon many ongoing efforts in the region and elucidates some of the links between gendered empowerment and health outcomes around the world, particularly HIV and AIDS.
Language: English
Keywords:
MIDDLE EAST | AFRICA, NORTH | RESEARCH REPORT | GENDER RELATIONS | HIV PREVENTION | INTERVENTIONS | HEALTH POLICY | WOMEN'S EMPOWERMENT | PROGRAM ACTIVITIES | Africa | Developing Countries | Gender Issues | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Policy | Political Factors | Women's Status | Socioeconomic Factors | Economic Factors
Document Number: 342681

13.

Title: Haiti: Going to scale with a performance incentive model.
Author: Eichler R; Auxila P; Antoine U; Desmangles B
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :165-188.
Abstract: Rewarding NGOs for increasing access to a package of basic services and paying them for achieving population-based performance targets can result in significant increases in essential services such as immunizations and assisted deliveries. Paying NGOs for results strengthens institutional capacity to deliver services from the bottom up. Changes in the design throughout the six years offer lessons for other contexts.
Language: English
Keywords:
HAITI | RESEARCH REPORT | PILOT PROJECTS | MATERNAL HEALTH | CHILD HEALTH | REPRODUCTIVE HEALTH | FAMILY PLANNING | MEASUREMENT | PERFORMANCE IMPROVEMENT | PROGRAM ACTIVITIES | NONGOVERNMENTAL ORGANIZATIONS | ORGANIZATION AND ADMINISTRATION | PROGRAM EVALUATION | MONITORING | Developing Countries | Caribbean | Americas | Studies | Research Methodology | Health | Management | Programs | Organizations | Political Factors | Sociocultural Factors | Evaluation
Document Number: 331456

14.

Title: Money into health.
Author: Eichler R; Levine R
Source: In: Performance incentives for global health: potential and pitfalls, [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :3-9.
Abstract: This book addresses one set of approaches to using money and other material goods to affect the actions of those who are delivering and receiving health services. More specifically, it is about how to use particular types of incentives -- those that reward or penalize specific types of results -- to motivate health-related behaviors. Performance incentives are defined as the transfer of money or material goods conditional on taking a measurable action or achieving a predetermined performance target. In the conceptualization we use, performance incentives include those that operate at the level of the health facilities (or networks of facilities), the individual provider, the household decisionmakers, and the patients. In other words, we look at incentives on both the demand and the supply sides, at both individual and collective levels. In our framework, we do not include the conditional payments that donor agencies offer to national governments, such as additional grant monies if and when particularpolicy decisions are made. We look solely at the interface between provider and patient. (Excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | DEVELOPING COUNTRIES | LITERATURE REVIEW | MALARIA PREVENTION | AIDS PREVENTION | HIV PREVENTION | FINANCIAL ACTIVITIES | FUNDS | HEALTH SERVICES | DELIVERY OF HEALTH CARE | QUALITY OF HEALTH CARE | PROGRAM ACTIVITIES | Developed Countries | North America | Americas | Malaria | Parasitic Diseases | Diseases | AIDS | HIV Infections | Viral Diseases | Economic Factors | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 331460

15.

Title: Using performance incentives.
Author: Eichler R; Levine R
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :23-50.
Abstract: When the goal is to reduce needless death and disease, and part of what is getting in the way is a misalignment between health goals and the real-world behaviors of individual patients, health workers, and those who influence them, it may be time to consider performance incentives. These can complement other interventions, such as providing training, revamping infrastructure, and improving the supply of drugs and other inputs. Here we look at how performance incentives can contribute to better health results, increased use of services, enhanced quality, and improved efficiency. To identify the experiences to highlight in this book, we searched the published literature, consulted experts, and included regional and national cases with substantial documented evidence. The evidence discussed here and in the case summaries in part 2 relies on both evaluations conducted with varying degrees of rigor and other sources of information. It comes from qualitative surveys, baseline and endline statistics, contrasts between intervention and comparison groups, and routine program monitoring. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | PERFORMANCE IMPROVEMENT | HEALTH SERVICES | INCENTIVES | DELIVERY OF HEALTH CARE | DISEASE PREVENTION | PROGRAM ACTIVITIES | INTERVENTIONS | PREVENTION AND CONTROL | HEALTH SERVICES ADMINISTRATION | EQUIPMENT AND SUPPLIES | Management | Organization and Administration | Health | Policy | Political Factors | Sociocultural Factors | Diseases | Programs | Medical Procedures | Medicine
Document Number: 331462

16.

Title: Communicating with youth: Using the Internet and mobile phones in reproductive health programs. The Internet and mobile phones hold promise as tools for reaching youth, but more evaluation is needed.
Author: Fazekas K; Moffett J
Source: Research Triangle Park, North Carolina, Family Health International [FHI], Interagency Youth Working Group, 2009 May. [4] p. (YouthLens on Reproductive Health and HIV / AIDS No. 28)
Abstract: A growing number of programs are turning to the Internet and mobile phones to communicate with young people about reproductive health and HIV / AIDS prevention. The surge in availability and popularity of these technologies among youth offers new opportunities but also raises important questions. How can the Internet and mobile phones best be used in reproductive health interventions for youth? What are the advantages and challenges of using these technologies? Is there evidence to demonstrate that interventions using the Internet or mobile phone are effective? (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | YOUTH | ADOLESCENTS | COMMUNICATION | TELECOMMUNICATIONS | REPRODUCTIVE HEALTH | INTERNET | PROGRAM ACCESSIBILITY | PROGRAM ACTIVITIES | INTERVENTIONS | PROGRAM EFFECTIVENESS | Age Factors | Population Characteristics | Demographic Factors | Population | Broadcast Media | Mass Media | Health | Information Networks | Program Evaluation | Programs | Organization and Administration
Document Number: 331497

17.

Title: Funding cuts threaten women's access to contraception. UN warns that global economic crisis may hit reproductive health services around the world.
Author: Ford L
Source: Guardian. 2009 Apr 8;:[2] p. Posting to Katine Chronicles blog.
Abstract: The article highlights the fears that the current financial crisis will lead to a shortfall in development financing available for family planning and in turn adversely affect the ability of developing nations to meet their Millenium Development Goals to improve women's wealth.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | NEEDS ASSESSMENT | REPRODUCTIVE HEALTH | FAMILY PLANNING | FUNDS | PROGRAM ACTIVITIES | Evaluation | Health | Financial Activities | Economic Factors | Programs | Organization and Administration
Document Number: 331361

18.

Peer Reviewed

Title: Needle exchange and sexual risk behaviors among a cohort of injection drug users in Chicago, Illinois.
Author: Huo D; Ouellet LJ
Source: Sexually Transmitted Diseases. 2009 Jan;36(1):35-40.
Abstract: OBJECTIVE: To examine the impact of a needle exchange program (NEP) on sexual risk behaviors of injecting drug users (IDUs). METHODS:: Between 1997 and 2000, 889 IDUs in Chicago were recruited from NEPs and an area with no NEP into a cohort study. They were interviewed and tested for HIV at baseline and 3 annual follow-up visits. Random-effect logistic models were used to compare NEP users and nonusers regarding the number of sex partners, number of unprotected sex acts, and frequency of condom use. RESULTS: Compared to NEP nonusers, NEP users had a similar number of sex partners over time, but had 49% higher odds of using condoms with their main partners (P = 0.047). At baseline, there was no difference between NEP users and nonusers in episodes of vaginal intercourse, but over time the odds of having a higher number of unprotected instances of vaginal intercourse were reduced by 26% per year for NEP users but only 10% per year for nonusers (P = 0.02). CONCLUSION: This study suggests that NEP participation may help reduce the absolute risk of HIV sexual transmission.
Language: English
Keywords:
UNITED STATES OF AMERICA | ILLINOIS | RESEARCH REPORT | COHORT ANALYSIS | IV DRUG USERS | NEEDLE CLEANING | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | PROGRAM ACTIVITIES | Developed Countries | North America | Americas | Research Methodology | Drug Use and Abuse | Behavior | Hygiene | Public Health | Health | Programs | Organization and Administration
Document Number: 329738

19.

Title: Abuse of HIV/AIDS-relief funds in Mozambique.
Author: Johnson P
Source: Lancet Infectious Diseases. 2009 Sep;9(9):523-4.
Abstract: This letter discusses the increase in corruption in Mozambique with the millions of dollars in funds from US President's Emergency Plan for AIDS Relief. It explains that the corruption results in identity theft of HIV-positive people for their benefits, prevention programme funds being pocketed, as well as an inaccurate picture of progress in HIV/AIDS prevention results.
Language: English
Keywords:
MOZAMBIQUE | CRITIQUE | HIV PREVENTION | FINANCIAL ACTIVITIES | PROGRAM ACTIVITIES | MONITORING | EVALUATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Economic Factors | Programs | Organization and Administration
Document Number: 342724

20.

Peer Reviewed

Title: Outputs and cost of HIV prevention programmes for truck drivers in Andhra Pradesh, India.
Author: Kumar SG; Dandona R; Schneider JA; Ramesh YK; Dandona L
Source: BMC Health Services Research. 2009;9:82.
Abstract: BACKGROUND: HIV prevention programmes for truck drivers form part of the HIV control efforts, but systematic data on the outputs and cost of providing such services in India are not readily available for further planning and use of resources. METHODS: Detailed cost and output data were collected from written records and interviews for 2005-2006 fiscal year using standardized methods at six sampled HIV prevention programmes for truck drivers in the Indian state of Andhra Pradesh. The total economic cost for these programmes was computed and the relation of unit cost of services per truck driver with programme scale was assessed using regression analysis. RESULTS: A total of 120,436 truck drivers were provided services by the six programmes of which 55.9% were long distance truck drivers. The annual economic cost of providing services to a truck driver varied between programmes from US$ 1.52 to 4.56 (mean US$ 2.49). There was an inverse relation between unit economic cost of serving a truck driver and scale of the programme (R2 = 0.63; p = 0.061). The variation between programmes in the average number of contacts made by the programme staff with truck drivers was 1.3 times versus 5.8 times for contacts by peer educators. Only 1.7% of the truck drivers were referred by the programmes for counseling and HIV testing. CONCLUSION: These data provide information for further planning of HIV prevention programmes for truck drivers and estimating the resources needed for such programmes. The findings suggest the need to strengthen the role of peer educators and increase referral of truck drivers for HIV testing.
Language: English
Keywords:
INDIA | RESEARCH REPORT | INTERVIEWS | TRUCK DRIVERS | HIV PREVENTION | PROGRAM ACTIVITIES | PEER EDUCATORS | HEALTH EDUCATION | PROGRAM EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Labor Force | Human Resources | Economic Factors | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Education | Program Evaluation
Document Number: 342438

21.

Peer Reviewed

Title: The costs and effectiveness of four HIV counseling and testing strategies in Uganda.
Author: Menzies N; Abang B; Wanyenze R; Nuwaha F; Mugisha B; Coutinho A; Bunnell R; Mermin J; Blandford JM
Source: AIDS. 2009 Jan 28;23(3):395-401.
Abstract: OBJECTIVE: HIV counseling and testing (HCT) is a key intervention for HIV/AIDS control, and new strategies have been developed for expanding coverage in developing countries. We compared costs and outcomes of four HCT strategies in Uganda. DESIGN: A retrospective cohort of 84 323 individuals received HCT at one of four Ugandan HCT programs between June 2003 and September 2005. HCT strategies assessed were stand-alone HCT; hospital-based HCT; household-member HCT; and door-to-door HCT. METHODS: We collected data on client volume, demographics, prior testing and HIV diagnosis from project monitoring systems, and cost data from project accounts and personnel interviews. Strategies were compared in terms of costs and effectiveness at reaching key population groups. RESULTS: Household-member and door-to-door HCT strategies reached the largest proportion of previously untested individuals (>90% of all clients). Hospital-based HCT diagnosed the greatest proportion of HIV-infected individuals (27% prevalence), followed by stand-alone HCT (19%). Household-member HCT identified the highest percentage of discordant couples; however, this was a small fraction of total clients (<4%). Costs per client (2007 USD) were $19.26 for stand-alone HCT, $11.68 for hospital-based HCT, $13.85 for household-member HCT, and $8.29 for door-to-door-HCT. CONCLUSION: All testing strategies had relatively low per client costs. Hospital-based HCT most readily identified HIV-infected individuals eligible for treatment, whereas home-based strategies more efficiently reached populations with low rates of prior testing and HIV-infected people with higher CD4 cell counts. Multiple HCT strategies with different costs and efficiencies can be used to meet the UNAIDS/WHO call for universal HCT access by 2010.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | CLIENTS | VOLUNTARY COUNSELING AND TESTING | HIV TESTING | HIV INFECTIONS | PROGRAM ACTIVITIES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases
Document Number: 330877

22.

Peer Reviewed

Title: Male homosexual identities, relationships, and practices among young men who have sex with men in Vietnam: implications for HIV prevention.
Author: Ngo DA; Ross MW; Phan H; Ratliff EA; Trinh T; Sherburne L
Source: AIDS Education and Prevention. 2009 Jun;21(3):251-65.
Abstract: This qualitative study examines local identities, relationships, and sexual practices among young men who have sex with men (MSM) aged 15-24 in the cities of Hanoi and Ho Chi Minh City. The analyses were based on 26 in-depth interviews and 10 focus group discussions with young MSM recruited through public place intercepts and cruising areas. Data document the linguistic classification, sexual relationships and behaviors, identity and process of homosexual identification, and the potential linkage between sexual identity and sexual behaviors of MSM in Vietnam.
Language: English
Keywords:
VIETNAM | RESEARCH REPORT | QUALITATIVE RESEARCH | MEN | MEN HAVING SEX WITH MEN | YOUTH | TARGET POPULATION | HIV PREVENTION | SEX BEHAVIOR | RISK BEHAVIOR | PROGRAM ACTIVITIES | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Behavior | Age Factors | Population Characteristics | Program Design | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases
Document Number: 342060

23.

Title: Community-based psychosocial intervention for HIV-affected children and their caregivers: evaluation of the Salvation Army's Mama Mkubwa Program in Tanzania.
Author: Nyangara F; Obiero W; Kalungwa Z; Thurman TR
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. 29 p. (SR-09-50USAID Cooperative Agreement No. GPO-A-00-03-00003-00)
Abstract: This report presents the post-test findings from an outcome evaluation of the Mama Mkubwa community-centered psychosocial support program implemented by the Salvation Army, Tanzania Command, that provides assistance to OVC and their families and communities. In addition, the paper discusses the programmatic implications of the findings for program implementers and policy-makers to help them make informed decisions on how to meet OVC needs and reduce their vulnerabilities.
Language: English
Keywords:
TANZANIA | SUMMARY REPORT | YOUTH | ORPHANS AND VULNERABLE CHILDREN | PSYCHOSOCIAL FACTORS | SUPPORT GROUPS | PROGRAM DESIGN | PROGRAM ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Behavior | Social Networks | Friends and Relatives | Programs | Organization and Administration
Document Number: 339997

24.
Title: [Actions of education health for child and adolescents in the city of Vitoria] As acoes de educacao em saude para criancas e adolescentes nas unidades basicas
Author: Oliveira CB; Frechiani JM; Silva FM; Maciel EL
Source: Ciencia and Saude Coletiva. 2009 Mar-Apr;14(2):635-44.
Abstract: This was a cross-sectional study carried in six Family Health Units, for direct observation of educative activities. The objective was to evaluate the actions of Education Health carried through in the informative sessions that approached the following subjects: family planning, breast feeding, families registered in Nutrition Programmes and children in nutritional risk. For the study proposed we establish that al action developed out side the individual approach to resolved heath problems will be considerer as health education. The unprepared of some professionals for the full functioning of the activities can still be observed. The findings of this study disclose the little participation of these Units in the accomplishment of educative activities on family planning come back toward the adolescents. Concerning the activities developed for the families registered in Nutrition Programmes, excellent subjects as the importance to appear the educative activities of the unit had been boarded in the most part of the lectures. The social activities for children in nutritional risk are carried out together with the families of the Nutrition Programmes. Although we observed several activities we still need to improved the multidisciplinary work to implement the heath promotion.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CHILDREN | ADOLESCENTS | FAMILY PLANNING | BREASTFEEDING | CHILD NUTRITION | HEALTH EDUCATION | PROMOTION | NEEDS | PROGRAM ACTIVITIES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Education | Marketing | Economic Factors | Programs | Organization and Administration
Document Number: 342096

25.

Title: Nicaragua: Combining demand- and supply-side incentives.
Author: Regalia F; Castro L
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :215-235.
Abstract: A conditional cash transfer program should incorporate both demand-side and supply-side performance incentives. Significant improvements are seen in immunizations, growth monitoring, and reductions in stunting. Two-phase impact evaluation does not disentangle the individual impacts of demand-side and supply-side incentives, but its results suggest that a well-targeted strategy of supply-side performance incentives could, on its own, be enough to achieve and maintain high levels of health care service use among poor rural populations.
Language: English
Keywords:
NICARAGUA | RESEARCH REPORT | LOW INCOME POPULATION | IMMUNIZATION | DELIVERY OF HEALTH CARE | HEALTH SERVICES | INCENTIVES | POVERTY | PROGRAM ACTIVITIES | MONITORING | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Primary Health Care | Health | Policy | Political Factors | Sociocultural Factors | Programs | Organization and Administration | Evaluation
Document Number: 331458

26.

Peer Reviewed

Title: The Validity of Teens' and Young Adults' Self-reported Condom Use.
Author: Rose E; Diclemente RJ; Wingood GM; Sales JM; Latham TP; Crosby RA; Zenilman J; Melendez J; Hardin J
Source: Archives of Pediatrics and Adolescent Medicine. 2009 Jan;163(1):61-4.
Abstract: OBJECTIVE: To examine the concordance between teens' and young adults' self-reported condom use, assessed by audio-computer-assisted self-interviewing, and Y-chromosome polymerase chain reaction (Yc-PCR) assay, a nondisease marker for detecting the presence of sperm in vaginal fluid for 14 days after unprotected vaginal sex. DESIGN: Randomized trial of a human immunodeficiency virus prevention program. Only data from baseline (before randomization) were used for this analysis. SETTING: A clinic-based sample in Atlanta, Georgia. PARTICIPANTS: Eligible teens and young adults were African American female teens and young adults 15 to 21 years old who had reported sexual activity in the previous 60 days. Of 1558 teens and young adults screened from March 1, 2002, through August 31, 2004, 847 were eligible and 715 (84.4%) participated at baseline. MAIN OUTCOME MEASURES: Self-reported consistent condom use in the 14 days before baseline and Yc-PCR results. RESULTS: Of participants who reported vaginal sex in the past 14 days, 186 reported consistent condom use, defined as 100% condom use. Of these, 63 had a positive Yc-PCR result, indicating detection of the Y chromosome in the vaginal fluid. Participants who reported consistent condom use with a self-reported history of sexually transmitted diseases were 2.4 times more likely to have a positive Yc-PCR result (adjusted odds ratio, 2.4; 95% confidence interval, 1.2-4.8; P = .01). CONCLUSIONS: A significant degree of discordance between self-reports of consistent condom use and Yc-PCR positivity was observed. Several rival explanations for the observed discordance exist, including (1) teens and young adults inaccurately reported condom use; (2) teens and young adults used condoms consistently but used them incorrectly, resulting in user error; and (3) teens and young adults responded with socially desirable answers. Using an objective biological measure may provide one strategy for validating teens' and young adults' self-reported condom use.
Language: English
Keywords:
UNITED STATES OF AMERICA | GEORGIA | RESEARCH REPORT | VALIDITY | YOUTH | CONDOM USE | HIV PREVENTION | LABORATORY PROCEDURES | PROGRAM ACTIVITIES | Developed Countries | North America | Americas | Developing Countries | Asia, Southwestern | Asia | Measurement | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration
Document Number: 329639

27.

Title: Rwanda: Performance-based financing in the public sector.
Author: Rusa L; Schneidman M; Fritsche G; Musango L
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :189-214.
Abstract: Countrywide implementation demonstrates that a national performance-based financing approach with both the public and private nonprofit health facilities is feasible in low-income countries. Incentives reward both quantity and quality of curative, maternal and child health, and HIV / AIDS services. Donor-funded pilots provided the evidence for the government of Rwanda to implement performance incentives as well as a menu of options that informed the design of a unified national model.
Language: English
Keywords:
RWANDA | RESEARCH REPORT | PILOT PROJECTS | HEALTH SERVICES | MALNUTRITION | FERTILITY | CHILD MORTALITY | MATERNAL MORTALITY | HIV INFECTIONS | INTERVENTIONS | PROGRAM ACTIVITIES | EVALUATION | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Delivery of Health Care | Health | Nutrition Disorders | Diseases | Population Dynamics | Demographic Factors | Population | Mortality | Viral Diseases | Programs | Organization and Administration
Document Number: 331457

28.

Peer Reviewed

Title: Twenty-five years of HIV: lessons for low prevalence scenarios.
Author: Sawires S; Birnbaum N; Abu-Raddad L; Szekeres G; Gayle J
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51 Suppl 3:S75-82.
Abstract: During the initial quarter century since the discovery of HIV, international response has focused on high prevalence scenarios and concentrated epidemics. Until recently, the theoretical underpinnings of HIV prevention were largely based on these responses-the assumption that inadequate responses to concentrated epidemics within low prevalence populations could rapidly lead to generalized epidemics. The limits of these assumptions for HIV prevention in low prevalence scenarios have become evident. While examples of rapid HIV diffusion in once low prevalence scenarios exist, emergence of generalized epidemics are less likely for much of the world. This paper reviews several key issues and advances in biomedical and behavioural HIV prevention to date and highlights relevance to low prevalence scenarios.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | PREVALENCE | HIV INFECTIONS | HIV | HEALTH POLICY | GENDER RELATIONS | HIV PREVENTION | PROGRAM ACTIVITIES | Developed Countries | North America | Americas | Measurement | Research Methodology | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors | Gender Issues | Programs | Organization and Administration
Document Number: 342679

29.

Title: South African national HIV prevalence, incidence, behaviour and communication survey 2008: a turning tide among teenagers?
Author: Shisana O; Rehle T; Simbayi LC; Zuma K; Jooste S
Source: Cape Town, South Africa, HSRC Press, 2009. [116] p.
Abstract: This report is the third in a series of population-based HIV seroprevalence surveys that started in 2002 and were repeated in 2005 and again in 2008. The survey found that South Africa's HIV epidemic has leveled off at a prevalence of 10.9 percent for people aged two years and older, with 5.2 million people estimated to be living with HIV in 2008. HIV prevalence has also declined among children aged 2-14, from 5.6 percent in 2002 to 2.5 percent in 2008, and a decline in new infections has also been noted among teenagers aged 15-19. But the survey warns that the overall situation remains "dire" since South Africa has the world's largest HIV-positive population.
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | RESEARCH METHODOLOGY | INCIDENCE | ADOLESCENTS | SEX BEHAVIOR | RISK BEHAVIOR | HIV TESTING | ANTIRETROVIRAL DRUGS | TREATMENT | ETHICS | INFORMED CONSENT | LABORATORY PROCEDURES | PROGRAM ACTIVITIES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sociocultural Factors | Programs | Organization and Administration
Document Number: 342037

30.

Title: Afghanistan: Paying NGOs for performance in a postconflict setting.
Author: Sondorp E; Palmer N; Strong L; Wali A
Source: In: Performance incentives for global health: potential and pitfalls, [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :139-164.
Abstract: Large-scale contracting of nongovernmental organizations can deliver essential services to the population, even in a postconflict setting with weak service delivery capacity. Government stewardship of the health sector can be enhanced with services delivered by contracted nongovernmental organizations. Results suggest that nongovernmental organizations that are paid based partly on results perform better than those that are paid for expenditures on inputs, although this evidence is far from conclusive.
Language: English
Keywords:
AFGHANISTAN | RESEARCH REPORT | NONGOVERNMENTAL ORGANIZATIONS | HEALTH SERVICES | EXPENDITURES | FINANCIAL ACTIVITIES | PROGRAM ACTIVITIES | PROGRAM EVALUATION | MONITORING | Asia, Southern | Asia | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Delivery of Health Care | Health | Economic Factors | Programs | Organization and Administration | Evaluation
Document Number: 331455


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