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1.
Title: [Of office hysteroscopy for the removal of intrauterine device. Literature review] Histeroscopia de consultorio para la extraccion de dispositivo intrauterino.
Author: Alanis Fuentes J; Amoroso Hernandez MA
Source: Ginecologia Y Obstetricia De Mexico. 2009 Apr;77(4):197-201.
Abstract: OBJECTIVE: To review the literature related to the hysteroscopic techniques such as outpatient diagnostic and therapeutic tools for the extraction of foreign bodies in patients with intrauterine device. METHOD: We searched the main electronic databases were searched for those words: hysteroscopy and intrauterine device in articles related to the removal of intrauterine devices by hysteroscopy. RESULTS: The loss or translocation of IUD is a common problem resulting from the large number of women who have applied. The importance of early diagnosis is to avoid, such as the inappropriate position of the device promotes an unwanted pregnancy, genital bleeding and injury to adjacent organs such as bowel and bladder. The assessment by ultrasound or X-rays, or both, allowing the device to locate and determine the desirability or otherwise of outpatient hysteroscopy (in practice) without anesthesia and with low morbidity for the patient or, well, resorting to other methods, and laparoscopy in the operating room. CONCLUSIONS: Hysteroscopy is an effective procedure for recovering intrauterine foreign bodies or hidden in properly selected patients.
Language: Spanish
Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | HYSTEROSCOPY | IUD | CONTRACEPTIVE REMOVAL | CONTRACEPTIVE USE-EFFECTIVENESS | PROGRAM EFFECTIVENESS | Demographic Factors | Population | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Treatment | Contraceptive Effectiveness | Program Evaluation | Programs | Organization and Administration
Document Number: 342313

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Title: Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis.
Author: Alderman H; Ndiaye B; Linnemayr S; Ka A; Rokx C; Dieng K; Mulder-Sibanda M
Source: Public Health Nutrition. 2009 May;12(5):667-73.
Abstract: There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.
Language: English
Keywords:
SENEGAL | RESEARCH REPORT | COHORT ANALYSIS | RURAL POPULATION | CHILD NUTRITION | INTERVENTIONS | NUTRITION PROGRAMS | PROGRAM EFFECTIVENESS | BODY WEIGHT | COMMUNITY HEALTH SERVICES | PROMOTION | BEHAVIOR CHANGE | GROWTH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Program Evaluation | Physiology | Biology | Marketing | Economic Factors | Behavior | Child Development
Document Number: 342116

Peer Reviewed

Title: Parent-adolescent communication about sex in Morelos, Mexico: does it impact sexual behaviour?
Author: Atienzo EE; Walker DM; Campero L; Lamadrid-Figueroa H; Gutierrez JP
Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):111-9.
Abstract: OBJECTIVES: Parent-adolescent communication about sexuality has been shown to influence adolescents' sexual behaviour. This study aims to describe communication about sex between Mexican parents and adolescents, and its relation to age at first intercourse and condom use. METHODS: Cross-sectional study with self-administered questionnaires of first year students at 23 high schools. Communication was divided into three themes: biological aspects, risks associated with sexual behaviour, and prevention. For sexually active adolescents, discussion timing was determined to have occurred prior to, or after sexual initiation. Analysis included logistic regression models stratifying by discussion timing. RESULTS: Overall 5,461 questionnaires were analysed. Among male respondents 24.3% and among females 10.6% stated that they were sexually active. As many as 83.1% reported having spoken with parents about sexual relations. Communication was more common with mothers. Discussions about risk and prevention prior to sexual initiation was associated with condom use at first intercourse (Odds ratio [OR] = 2.05); late discussion was associated with younger age (<15) at first intercourse (OR = 3.51). CONCLUSIONS: Communication before onset of sexual activity about risk and prevention is associated with safe sex practices. Improving parent-adolescent communication is a poorly studied strategy to influence adolescents' behaviour. Interventions should promote early parent-adolescent communication.
Language: English
Keywords:
MEXICO | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADOLESCENTS | YOUTH | PARENTAL INVOLVEMENT | INTERPERSONAL RELATIONS | COMMUNICATION | SEX BEHAVIOR | RISK BEHAVIOR | PROGRAM EFFECTIVENESS | North America | Americas | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 341614

Peer Reviewed

Title: Questioning gender norms with men to improve health outcomes: Evidence of impact.
Author: Barker G; Ricardo C; Nascimento M; Olukoya A; Santos C
Source: Global Public Health. 2009;:1-15.
Abstract: This article describes a review of 58 evaluation studies of programmes with men and boys in sexual and reproductive health (including HIV prevention, treatment, care and support); father involvement; gender-based violence; maternal, newborn and child health; and gender socialisation more broadly. While few of the programmes go beyond the pilot stage, or a relatively short-term timeframe, they offer compelling evidence that well-designed programmes with men and boys can lead to positive changes in their behaviours and attitudes related to sexual and reproductive health; maternal, newborn and child health; their interaction with their children; their use of violence against women; their questioning of violence with other men; and their health-seeking behaviour. The evidence indicates that programmes that incorporate a gender-transformative approach and promote gender-equitable relationships between men and women are more effective in producing behaviour change than narrowly focused interventions, as are programmes which reach beyond the individual level to the social context. (author's)
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | SOCIAL BEHAVIOR | REPRODUCTIVE HEALTH | MEN'S INVOLVEMENT | PROGRAM EFFECTIVENESS | ATTITUDES | SEX BEHAVIOR | HIV PREVENTION | MALE ROLE | VIOLENCE | BEHAVIOR CHANGE | Behavior | Health | Programs | Organization and Administration | Program Evaluation | Psychological Factors | HIV Infections | Viral Diseases | Diseases
Document Number: 342230

6.
Title: The President's Emergency Plan for AIDS Relief in Africa: an evaluation of outcomes.
Author: Bendavid E; Bhattacharya J
Source: Annals of Internal Medicine. 2009 May 19;150(10):688-95.
Abstract: BACKGROUND: Since 2003, the President's Emergency Plan for AIDS Relief (PEPFAR) has been the most ambitious initiative to address the global HIV epidemic. However, the effect of PEPFAR on HIV-related outcomes is unknown. OBJECTIVE: To assess the effect of PEPFAR on HIV-related deaths, the number of people living with HIV, and HIV prevalence in sub-Saharan Africa. DESIGN: Comparison of trends before and after the initiation of PEPFAR's activities. SETTING: 12 African focus countries and 29 control countries with a generalized HIV epidemic from 1997 to 2007 (451 country-year observations). INTERVENTION: A 5-year, $15 billion program for HIV treatment, prevention, and care that started in late 2003. MEASUREMENTS: HIV-related deaths, the number of people living with HIV, and HIV prevalence. RESULTS: Between 2004 and 2007, the difference in the annual change in the number of HIV-related deaths was 10.5% lower in the focus countries than in the control countries (P = 0.001). The difference in trends between the groups before 2003 was not significant. The annual growth in the number of people living with HIV was 3.7% slower in the focus countries than in the control countries from 1997 to 2002 (P = 0.05), but during PEPFAR's activities, the difference was no longer significant. The difference in the change in HIV prevalence did not significantly differ throughout the study period. These estimates were stable after sensitivity analysis. LIMITATION: The selection of the focus countries was not random, which limits the generalizability of the results. CONCLUSION: After 4 years of PEPFAR activity, HIV-related deaths decreased in sub-Saharan African focus countries compared with control countries, but trends in adult prevalence did not differ. Assessment of epidemiologic effectiveness should be part of PEPFAR's evaluation programs. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
Language: English
Keywords:
AFRICA | RESEARCH REPORT | COMPARATIVE STUDIES | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | CAUSES OF DEATH | HIV INFECTIONS | AIDS | PROGRAM EFFECTIVENESS | PROGRAM EVALUATION | Developing Countries | Studies | Research Methodology | Measurement | Viral Diseases | Diseases | Mortality | Population Dynamics | Demographic Factors | Population | Programs | Organization and Administration
Document Number: 341612

7.
Title: [Assessment of adherence to antiretroviral drugs in a municipality in southern Brazil] Avaliacao da adesao aos anti-retrovirais em um municipio no Sul do Brasil.
Author: Blatt CR; Citadin CB; Souza FG; Mello RS; Galato D
Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2009 Mar-Apr;42(2):131-6.
Abstract: The aim of this research is to assess predicting factors and adherence levels to antiretrovirals through self-report and the date of drug retrieval. It is a transversal study in which 67 patients were interviewed. Patients who used more than 90% of doses were considered to have complied with the treatment. Results of adherence were: self-reports (72.7%); calculated using dosage forgotten on the last day (70%); in three (76.1%) days; in seven (80.5%) days; and in fifteen (80.5%) days; calculated using the date of drug retrieval in a period of three (53.7%) months; and in six (47.8%) months. Variables significantly associated with adherence were: educational level, living with the family, refer good adherence, positive assessment of the antiretroviral therapy, a diagnosis of an opportunistic disease, NADIR greater than 200 cells/mm(3) and being in first-time treatment. To improve adherence rates individual and collective strategies should be elaborated taking into account factors which have been identified as negatively effecting adherence.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | INTERVIEWS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | TREATMENT | ADMINISTRATION AND DOSAGE | PROGRAM EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Behavior | Drugs | Program Evaluation
Document Number: 342167

Title: Effectiveness of an intervention to improve breastfeeding knowledge and attitudes among fifth-grade children in Brazil.
Author: Bottaro SM; Giugliani ER
Source: Journal of Human Lactation. 2009 Aug;25(3):325-32.
Abstract: This cluster-randomized trial evaluated the effectiveness and residual effect of an educational intervention to improve breastfeeding knowledge and attitudes among fifth grade children of both sexes in Brazil. Schools were considered clusters and analysis of variance was used to compare an intervention group (n = 298) and a control group (n = 253) regarding knowledge, perceptions, and beliefs about breastfeeding before and after the intervention, measured through a standardized 25-item, multiple-choice questionnaire. The scores in the intervention group improved significantly, with the effect lasting at least 3 months. The intervention had greater impact on girls and on students between 9 and 11 years of age when compared with boys and students between 12 and 17 years old and also between students from public schools. Results suggest that pro-breastfeeding interventions in schools improve breastfeeding knowledge and attitudes.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | INTERVENTIONS | CHILDREN | PRIMARY SCHOOLS | STUDENTS | BREASTFEEDING | KNOWLEDGE | ATTITUDES | PROGRAM EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Programs | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Schools | Education | Infant Nutrition | Nutrition | Health | Sociocultural Factors | Psychological Factors | Behavior | Program Evaluation
Document Number: 342903

Title: [Contraceptive use and incidence of pregnancy among women after HIV testing in Abidjan, Ivory Coast] Pratiques contraceptives et incidence des grossesses chez des femmes apres un
Author: Brou H; Viho I; Djohan G; Ekouevi DK; Zanou B; Leroy V; Desgrees-du-Lou A
Source: Revue d'Epidemiologie et de Sante Publique. 2009 Mar 20;
Abstract: BACKGROUND: Within the framework of programs for the prevention of mother-to-child HIV transmission, women who discover their HIV-infection during their pregnancy receive perinatal interventions in order to reduce the risk of HIV transmission to the child. They also receive family planning counselling and free contraceptives in order to avoid a new pregnancy. In this study, we compared contraceptive use and pregnancy incidence between HIV-positive and HIV-negative women who were offered HIV counselling and testing during a program of prevention of mother-to-child HIV transmission. METHODS: In the Ditrame Plus program in Abidjan, 546 HIV-positive and 393 HIV-negative women were HIV-tested prenatally and followed up 2years after delivery. At each post-partum visit, proportions of contraceptive use were noted, by method. The pregnancy incidence was calculated as the number of pregnancies for 100 women-years at risk. Factors related to the arrival of a new pregnancy were analyzed by Cox model. RESULTS: Between 6 and 24 months post-partum, proportions of women using modern contraception varied from 52 to 65% among HIV-positive women, and from 65 to 75% among HIV-negative women. Pregnancy incidence for 100 women-years at risk was 5.70 (95%CI: 4.17-7.23) and 4.37 (95%CI : 2.83-5.91) (p=0.237) and unwanted pregnancy incidence was 1.07 (95%CI: 0.41-1.73) and 2.39 (95%CI: 1.25-3.53) (p=0.023), respectively among HIV-positive and HIV-negative women. The end of post-partum abstinence, the death of the index child and the end of breastfeeding were positively linked to the arrival of a new pregnancy in the post-partum period. CONCLUSION: Among these women prenatally HIV-tested, family planning counselling and regular follow-up was accompanied by a high rate of contraceptive use after delivery, and consecutively to a low pregnancy incidence irrespective of serostatus. In particular, HIV-positive women had fewer unwanted pregnancies than HIV-negative women. Integration of adequate family planning services in the post-partum follow-up in prevention programs plays an important role in reducing the risk of mother-to-child transmission, by reducing pregnancies among HIV-positive women.
Language: French
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | INCIDENCE | PREGNANCY | WOMEN | HIV TESTING | CONTRACEPTIVE USAGE | CLINIC VISITS | VOLUNTARY COUNSELING AND TESTING | POSTPARTUM | FAMILY PLANNING | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Reproduction | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Service Statistics | Program Activities | Programs | Organization and Administration | Puerperium | Program Evaluation
Document Number: 330856

10.

Title: An assessment of the effectiveness of growth monitoring and promotion practices in the Lusaka district of Zambia.
Author: Charlton KE; Kawana BM; Hendricks MK
Source: Nutrition. 2009 Oct;25(10):1035-46.
Abstract: OBJECTIVE: We evaluated the effectiveness of the growth monitoring and promotion (GMP) program in Zambia. METHODS: A 3-mo prospective study of growth outcomes was undertaken at randomly selected health facilities and community posts within the Lusaka district. Children <2 y old (n=698) were purposively sampled from three health facilities (n=459) and four community posts (n=77) where health workers had undergone training in GMP and three health facilities where staff had not received training (n=162). Qualitative data on knowledge, attitudes, and practices of GMP were collected from health facility managers (n=6), health workers (n=35), and mothers whose children attended all follow-up visits (n=27). RESULTS: Anthropometric status of children in all groups deteriorated, with children at community posts having the worst outcomes (change in weight-for-age Z-score -0.8+/-0.7), followed by trained (-0.5+/-0.6) and untrained (-0.3+/-0.47; P<0.05) health facilities. A similar trend was seen for weight for length. The overall dropout rate was 74.1%. Weight-for-age Z-scores were higher at 1- and 2-mo follow-up visits for children who did not complete the study at trained health facilities and community posts compared with those who remained in the study. Mothers/caregivers identified GMP as important in attending the under-five clinic, associated their child's weight with overall health status, and expressed a willingness to comply with health workers' advice. However, health care providers were poorly motivated, inadequately supervised, and demonstrated poor practices. CONCLUSIONS: The GMP program in Lusaka is functioning suboptimally, even in facilities with trained staff.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | MONITORING | CHILDREN | GROWTH | CHILD DEVELOPMENT | BODY WEIGHT | ANTHROPOMETRY | PROMOTION | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Physiology | Measurement | Research Methodology | Marketing | Economic Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 342875

11.

Peer Reviewed

Title: A cluster randomized controlled trial of an adolescent HIV prevention program among Bahamian youth: effect at 12 months post-intervention.
Author: Chen X; Lunn S; Deveaux L; Li X; Brathwaite N; Cottrell L; Stanton B
Source: AIDS and Behavior. 2009 Jun;13(3):499-508.
Abstract: Behavioral interventions based on the Protection Motivation Theory (PMT) have been demonstrated to reduce HIV risk behavior among mid- and older adolescents in different settings across the globe but have not been evaluated among Caribbean nations and have received limited evaluation among pre-adolescents. To determine (1) the effectiveness among pre-adolescents in The Bahamas of a PMT-based HIV prevention program "Focus on Youth in the Caribbean" (FOYC) and (2) the role of the targeted PMT constructs in intervention effect. 1,360 sixth grade youth (10-11 years of age) from 15 urban schools in New Providence, The Bahamas were randomized by school to receive either FOYC or a control condition. Data collected at baseline, 6 and 12 months post intervention were analyzed. A five-step scheme was used to assess sexual behavior progression, ranging from "1" = "a virgin without intention to have sex" to "5" = "having sex without a condom". Group-based trajectory analysis was utilized in assessing the program effect. Two sexual behavior progression patterns were detected: slow progressors and quick progressors. Receiving FOYC reduced the likelihood for adolescents to become quick progressors (adjusted OR = 0.77, 95% CI: 0.64-1.00). The observed effectiveness was especially impacted by a subset of the targeted PMT constructs. FOYC effectively delays sexual risk among Bahamian pre-adolescents. The group-based trajectory analysis provides an analytical approach for assessing interventions among adolescents with low rates and diverse progression patterns of sexual activity.
Language: English
Keywords:
CARIBBEAN | RESEARCH REPORT | PRE-POST TESTS | ADOLESCENTS | YOUTH | HIV PREVENTION | AIDS PREVENTION | RISK BEHAVIOR | SEX BEHAVIOR | INTERVENTIONS | PROGRAM EFFECTIVENESS | Developing Countries | Americas | Program Evaluation | Programs | Organization and Administration | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | AIDS | Behavior
Document Number: 342104

12.

Peer Reviewed

Title: Trends in primary and secondary abstinence among Kenyan youth.
Author: Chiao C; Mishra V
Source: AIDS Care. 2009 Jul;Calverton, Maryland, Macro International, Demographic and Health Research Division, MEASURE DHS, 2007 Nov. 21(7):881-892. 15 p. (DHS Working Papers No. 36USAID Contract No. GPO-C-00-03-00002-00)
Abstract: The authors used data from Kenya Demographic and Health Surveys in 1993, 1998, and 2003 to examine 10-year trends in primary and secondary abstinence among never-married youth ages 15�24 and to explore the role of HIV prevention knowledge, schooling, and contextual factors in affecting their abstinence behaviors. Their analysis shows that both primary and secondary abstinence levels have risen in the past 10 years, with the abstinence levels higher among females than among males. Logistic regression models indicate that knowledge that abstinence can prevent HIV infection was positively associated with the likelihood of practicing abstinence. However, knowledge that condom use can prevent HIV infection was associated with lower abstinence practice. In-school youth were more likely to abstain from sex than those working. Effects of the contextual variables were only significant on the likelihood of primary abstinence among female youth.
Language: English
Keywords:
KENYA | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | DATA ANALYSIS | YOUTH | ADOLESCENTS | STUDENTS | PRIMARY SCHOOLS | SECONDARY SCHOOLS | ABSTINENCE | HIV INFECTIONS | TRANSMISSION | HIV PREVENTION | KNOWLEDGE | CONDOM USE | BEHAVIOR | SEX EDUCATION | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Research Methodology | Age Factors | Population Characteristics | Education | Schools | Family Planning, Behavioral Methods | Family Planning | Viral Diseases | Diseases | Infections | Sociocultural Factors | Risk Reduction Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 322987

13.

Peer Reviewed

Title: Integration of STI and HIV prevention, care, and treatment into family planning services: a review of the literature.
Author: Church K; Mayhew SH
Source: Studies in Family Planning. 2009 Sep;40(3):171-186.
Abstract: The last comprehensive literature review to examine the effectiveness of family planning (FP) services in delivering STI and HIV prevention and care was published in 2000. This review updates that report by examining evidence of the impact of integrating any components of STI or HIV prevention, care, and treatment into a family planning setting in developing countries. Forty-four reports were identified from a comprehensive search of published databases and �grey literature.� The weight of evidence demonstrates that integrated services can have a positive impact on client satisfaction, improve access to component services, and reduce clinic-based HIV-related stigma, and that they are cost-effective. Evidence of FP services reaching men and adolescents and of their impact on health outcomes is inconclusive. Several studies found that providers frequently miss opportunities to integrate care and that the capacity to maintain the quality of care is also influenced by many programmatic challenges. The range of experiences indicates that managers need to determine appropriate health-care service-delivery models based on a consideration of epidemiological, structural, and health-systems factors.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | EPIDEMIOLOGY | FAMILY PLANNING | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | PROGRAM EFFECTIVENESS | Public Health | Health | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration
Document Number: 339700

14.

Title: HIV in adolescents in sub-Saharan Africa.
Author: Cowan F; Pettifor A
Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):288-93.
Abstract: The authors summarize existing evidence on the effectiveness of different intervention approaches to HIV prevention in adolescents. They focus on studies that are either from or are relevant to sub-Saharan Africa. In addition, they include a brief review of other issues relevant to HIV prevention research in adolescents. Although numerous adolescent behavioral HIV prevention interventions have been evaluated, few have assessed their impact on HIV endpoints or been undertaken in Africa. In the three trials from Africa, which had HIV endpoints, none of the interventions had an impact on HIV, although all affected some knowledge and attitudes and reported behaviors. In one of these trials, there was a borderline effect on herpes simplex virus-2 incidence. Adolescents have typically been excluded from trials of biological interventions, although they are likely to benefit from these interventions if found to be effective. Despite the regulatory difficulties, they must be considered for inclusion in these trials as an important target population.
Language: English
Keywords:
AFRICA, SUB SAHARAN | LITERATURE REVIEW | ADOLESCENTS | HIV PREVENTION | INTERVENTIONS | PROGRAM EFFECTIVENESS | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | BEHAVIOR CHANGE | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Program Evaluation | Sociocultural Factors | Psychological Factors | Behavior
Document Number: 342339

15.
Peer Reviewed

Title: Prevention of mother-to-child transmission of HIV in Haiti.
Author: Deschamps MM; Noel F; Bonhomme J; Devieux JG; Saint-Jean G; Zhu Y; Wright P; Pape JW; Malow RM
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2009 Jan;25(1):24-30.
Abstract: OBJECTIVES: To describe the effectiveness of a program designed to reduce the rate of mother-to-child transmission (MTCT) of HIV at the primary HIV testing and treatment center in Haiti between 1999 and 2004. METHODS: All pregnant, HIV-positive women who attended the major HIV testing and treatment clinic in Port-au-Prince, Haiti, between March 1999 and December 2004 were asked to participate in an MTCT prevention program. Of the 650 women who participated, 73.3% received zidovudine (AZT), 2.9% received nevirapine (NVP), and 10.1% received triple-drug therapy when it became available in 2003 and if clinical/laboratory indications were met. Approximately 13.8% received no antiretroviral medication. All participants received cotrimoxazole prophylaxis and infant formula for their children. Kaplan-Meier survival analysis and the log rank test were used to evaluate program impact on child survival. RESULTS: Complete data were available for 348 mother-infant pairs who completed the program to prevent MTCT of HIV. The rate of MTCT in the study was 9.2% (95% CI: 6.14-12.24), in contrast to the historical mother-to-child transmission rate of 27% in Haiti. HIV-positive infants were less likely to survive than HIV-negative infants at 18 months of follow-up (chi(2) = 19.06, P < .001, log rank test). Infant survival improved with early pediatric diagnosis and antiretroviral treatment. CONCLUSIONS: The MTCT prevention program described proved to be feasible and effective in reducing vertical HIV transmission in Haiti. The authors emphasize the need to expand testing, extend services to rural areas, and implement early HIV diagnosis to reduce infant mortality.
Language: English
Keywords:
HAITI | RESEARCH REPORT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTENATAL CARE | HIV TRANSMISSION | HIV INFECTIONS | PROGRAM EFFECTIVENESS | Developing Countries | Caribbean | Americas | Disease Transmission Control | Prevention and Control | Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Viral Diseases | Program Evaluation | Programs | Organization and Administration
Document Number: 341542

16.

Title: A comparative analysis of select health facility survey methods applied in low and middle income countries.
Author: Edward A; Matsubiyashi T; Fapohunda B; Becker S
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2009 Jul. 47 p. (MEASURE Evaluation Working Paper Series WP-09-111USAID Cooperative Agreement No. GHA-A-00-08-00003-00)
Abstract: A majority of health systems in developing countries have severe limitations in the technical expertise and research capacity needed to perform independent assessments. Most are heavily reliant on donor support and engage other institutions and academia to undertake these surveys. Hence, it is important to examine the perspectives of the implementers to determine the management utility and plans for future sustainability. A key informant interview guide was developed for interviews with policy planners, implementing agencies, and health providers to examine their perspectives on the management utility of selected approaches. Key informants were interviewed, including policy planners, project directors, systems supervisors / coordinators, and enumerators, and the findings are presented later in this paper. A comparison of the approach to health facility assessment in the specific methods appears next. Based on the results of the review and key informant interviews, this paper discusses the comparative advantage and limitation of HF surveys and their management utility. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | TECHNICAL REPORT | COMPARATIVE STUDIES | SURVEY METHODOLOGY | HEALTH FACILITIES | HEALTH SERVICES EVALUATION | QUALITY OF HEALTH CARE | PROGRAM EFFECTIVENESS | INTERVIEWS | HEALTH SERVICES ADMINISTRATION | DECISION MAKING | Studies | Research Methodology | Surveys | Sampling Studies | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Data Collection | Management | Behavior
Document Number: 331840

17.

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

18.
Peer Reviewed

Title: Cohort comparison of two fertility awareness methods of family planning.
Author: Fehring RJ; Schneider M; Barron ML; Raviele K
Source: Journal of Reproductive Medicine. 2009 Mar;54(3):165-70.
Abstract: OBJECTIVE: To determine if an electronic hormonal fertility monitor aided method (EHFM) of family planning is more effective than a cervical mucus only method (CMM) in helping couples to avoid pregnancy. STUDY DESIGN: Six hundred twenty-eight women were taught how to avoid pregnancy with either the EHFM (n=313) or the CMM (n = 315). Both methods involved standardized group teaching and individual follow-up. All pregnancies were reviewed and classified by health professionals. Correct use and total unintended pregnancy rates over 12 months of use were determined by survival analysis. Comparisons of unintended pregnancies between the 2 methods were made by use of the Fisher exact test. RESULTS: There were a total of 28 unintended pregnancies with the EFHM and 41 with the CMM. The 12-month correct use pregnancy rate of the monitor-aided method was 2.0%, and the total pregnancy rate was 12.0%. In comparison, the 12-month correct use pregnancy rate of the CMM was 3.0%, and the total pregnancy rate was 23.0%. There was a significant difference in total pregnancies between the 2 groups (p<0.05). CONCLUSION: EFHM is more effective than CMM. Further research is needed to verify the results.
Language: English
Keywords:
DEVELOPING COUNTRIES | UNITED STATES OF AMERICA | RESEARCH REPORT | FAMILY PLANNING | FERTILITY | NATURAL FAMILY PLANNING | PREGNANCY, UNPLANNED | PREVENTION AND CONTROL | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | Population Dynamics | Demographic Factors | Population | Family Planning, Behavioral Methods | Reproductive Behavior | Diseases | Program Evaluation | Programs | Organization and Administration
Document Number: 331019

19.

Peer Reviewed

Title: Saving mother's lives: programs that work.
Author: Fortney JA; Leong M
Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):224-36.
Abstract: Maternal mortality is a complex problem requiring complex responses. Nevertheless, every intervention must operate through one of 3 pathways: preventing pregnancy, preventing complications, or preventing death when obstetric complications occur. We describe interventions following each pathway and assess their evidence base. In general, the more specific the intervention (such as procedures) the stronger the evidence. Broad interventions ("programs" for example) have a weaker evidence base although evidence is accumulating. The potential for robust evidence for effective programs is limited by epidemiologic design-the logistic difficulties of randomization, blinding, and single impact variables.
Language: English
Keywords:
GLOBAL | RECOMMENDATIONS | POLICYMAKERS | COMMUNITY | SAFE MOTHERHOOD | MATERNAL MORTALITY | INTERVENTIONS | PREGNANCY COMPLICATIONS | OBSTETRICS | EMERGENCY SERVICES | MATERNAL HEALTH SERVICES | PROGRAM EFFECTIVENESS | FAMILY PLANNING PROGRAMS | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Population | Maternal Health | Health | Mortality | Population Dynamics | Demographic Factors | Programs | Diseases | Medicine | Health Services | Delivery of Health Care | Maternal-Child Health Services | Primary Health Care | Program Evaluation | Family Planning
Document Number: 342175

20.

Title: HIV/AIDS knowledge and behaviour: have information campaigns reduced HIV infection? The case of Kenya.
Author: Frolich M; Vazquez-Alvarez R
Source: African Development Review. 2009 Apr;21(1):86-146.
Abstract: AIDS continues to have a devastating effect on developing countries, particularly in sub-Saharan Africa. The lack of a proven effective vaccine to stop HIV transmission has led to much of public policy putting an emphasis on information campaigns in order to reduce HIV-prevalence. In this paper we examine the impact of HIV/AIDS-knowledge from two sides. First, we examine to what extent the campaigns have been successful at inducing the expected behavioural change with regards to HIV-related attitudes. Second, we examine the impact of HIV/AIDS knowledge on HIV status. The basic policy issue can be expressed as follows: even if individuals have acquired sufficient and necessary information on the basic facts about AIDS, factors such as innate risk attitudes or cultural background could undermine the effects of the campaigns. Using the Kenya Demographic and Health Survey (2003) we elicit empirical evidence on the relation between declared HIV/AIDS-knowledge, behavioural attitudes related to HIV/AIDS situations and the relation between knowledge and observed HIV-status. Overall, our empirical findings suggest that information campaigns have been effective at equipping the adult population in Kenya with the required knowledge to avoid becoming HIV-positive. However, when HIV-status is measured objectively we find that the relation between correctly declared attitudes and actual behaviour is only statistically significant for females who have arrived into sexuality late enough to benefit from such campaigns: it is for these females that the impact of the information campaigns has been to statistically reduce the probability of becoming HIV positive, as intended. In the case of males we find that there is no statistical relation between either knowledge or timing of the information campaigns and a positive HIV status. Nevertheless, another important finding refers to the selection bias induced by males who are sampled randomly but decline to take the HIV test. The consequences of this bias are twofold; first, the estimated policy parameters for males should be interpreted with caution, but more importantly, estimating the population level HIV-prevalence for Kenyan males based on the DHS implies underestimating the true and unknown prevalence rate. Our analysis controls for individual characteristics, selection bias and endogeneity effects, thus allowing us to make inferences for the full population and with regards to policy implementation.
Language: English
Keywords:
KENYA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | HIV INFECTIONS | AIDS | PREVALENCE | KNOWLEDGE | ATTITUDES | INFORMATION | CAMPAIGNS | PROGRAM EFFECTIVENESS | BEHAVIOR | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Research Methodology | Sociocultural Factors | Psychological Factors | Communication Programs | Communication | Program Evaluation | Programs | Organization and Administration
Document Number: 341877

21.

Title: Effect of preventive supplementation on young children in Niger [letter]
Author: Ghosh D
Source: JAMA. 2009 Jun 3;301(21):2208-9; author reply 2209.
Abstract: Ms Isanaka and colleagues conducted a cluster randomized trial to evaluate the effect of ready-to-use therapeutic foods on various measures of nutritional status, morbidity, and mortality in children in Niger. The cluster randomized trial design is a very useful one for this setting because of logistical constraints. However, such a design leads to analytic complications. There are 2 levels of correlation in the study that need to be accounted for in the analysis. The first is that the children were clustered within households. This is shown in Figure 1 of the article, which indicates 1671 children from 647 households in the intervention group and 1862 children from 760 households in the control group. This leads to use of mixed effects models in which correlation is accounted for at the village, household, and individual levels. However, the survival analyses are more problematic in this setting. The authors employed a marginal modeling approach, in which the population-averaged effect of treatment on the time to event was modeled, adjusting for other covariates. For this approach, the correlation at multiple levels is not accounted for in the estimation of the adjusted hazard ratios. It is instead adjusted for in the estimates of the variance of the adjusted hazard ratios, which are reflected in the estimated 95% confidence intervals presented in Tables 2 and 3. However, validity of this estimation procedure requires that the number of truly statistically independent sampling units be large. In this study, the sampling units are the villages, of which there are 12. Such a small number calls into doubt the validity of the standard errors used in computing the 95% confidence intervals in the adjusted hazard ratios in Tables 2 and 3. The issue of how to properly model survival data in a group-randomized trial setting is still very much an open question, although some recent proposals have been made. (full-text)
Language: English
Keywords:
NIGER | CRITIQUE | CHILDREN | MALNUTRITION | FOOD SUPPLEMENTATION | PREVENTION AND CONTROL | IMPACT | PROGRAM EFFECTIVENESS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Communication | Program Evaluation | Programs | Organization and Administration
Document Number: 341624

22.

Peer Reviewed

Title: International family-planning budgets in the "new US" era.
Author: Gillespie D; Maguire ES; Neuse M; Sinding SW; Speidel JJ
Source: Lancet. 2009 May 2;373(9674):1505-7.
Abstract: Anticipating major shifts in the political complexion of Washington as a result of the 2008 Presidential election, we, as five former directors of the US Agency for International Development's (USAID) population and reproductive health programme, recently issued a report as part of an effort to increase USAID's stagnant family-planning budget. Our evidence-based report, Making the case for international family planning, recommends an increase from the present level of US$457 million to $1.2 billion in 2010, with modest further annual increases thereafter. With dramatic political shift in Washington, we are optimistic that our message will resonate well in the new policy environment. We have no illusions about the treacherous political terrain of reproductive health in the USA. However, we are much encouraged by President Obama's commitment to bring science back into the service of public policy, his efforts to find common ground in the national debate about abortion, and his and Secretary of State Hillary Clinton's determination to make international development cooperation and women's rights far more prominent features of US foreign policy. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | USAID | FAMILY PLANNING | FINANCIAL ACTIVITIES | POLITICAL FACTORS | HEALTH POLICY | REPRODUCTIVE HEALTH | SOCIAL SCIENCES | FAMILY PLANNING PROGRAMS | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | Government Agencies | Organizations | Sociocultural Factors | Economic Factors | Policy | Health | Science | Program Evaluation | Programs | Organization and Administration
Document Number: 341020

23.
Peer Reviewed

Title: Operational effectiveness of guidelines on complete breast-feeding cessation to reduce mother-to-child transmission of HIV: results from a prospective observational cohort study at routine prevention of mother-to-child transmission sites, South Africa.
Author: Goga AE; Van Wyk B; Doherty T; Colvin M; Jackson DJ; Chopra M
Author: Good Start Study Group
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Apr 15;50(5):521-8.
Abstract: OBJECTIVE: Until 2006, HIV-positive women who chose to exclusively breast-feed were advised to completely stop breast-feeding by 6 months. We investigated operational feasibility and predictors of complete breast-feeding cessation (CBC). DESIGN: A prospective observational cohort study at 3 routine prevention of mother-to-child transmission sites, South Africa. METHODS: Data on "complete breast-feeding cessation at 24 weeks" and "not breast-feeding (NBF) for 4 days before the last follow-up visit at or before 24 weeks" were gathered during home visits (3, 5, 7, 9, 12, 16, 20, and 24 weeks). The main subgroup of interest for this analysis was women practicing exclusive breast-feeding/predominant breast-feeding at 3 weeks. Univariate analysis, logistic regression, Kaplan-Meier Survival analysis, and Cox regression were performed. RESULTS: Eighty-eight women (43.6%) reported CBC. "Health staff suggesting formula use: [OR(a) 4.39 (1.76-10.97)] and "infant hospitalization" [OR(a) 3.27 (1.37-7.79)] were the only significant predictors of CBC. The probability of NBF at 5, 7, 9, 12, 16, 20, and 24 weeks was 2.8% [95% confidence interval (CI) 1.8% to 3.8%], 4.3% (3.0% to 5.6%), 5.9% (4.4% to 7.4%, 9.8% (7.9% to 11.7%), 16.1 (13.8% to 18.4%), 23.1% (20.5% to 25.7%), and 37.6% (34.6% to 40.6%), respectively. Infant HIV status [hazard ratio 5.5 95% CI 2.4 to 12.5] was the only predictor of infant death. NBF was not protective against 9-month infant HIV or death in univariate and multivariable analysis. CONCLUSIONS: At programmatic level, CBC by 24 weeks is uncommon, and success seems unrelated to predetermined social, economic, and environmental (acceptable, feasible, affordable, sustainable, and safe AFASS) criteria. Thus at this level, activities that encourage CBC (amongst women meeting AFASS criteria) need to be identified and tested.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | STANDARDS | MOTHERS | BREASTFEEDING | BREASTFEEDING, EXCLUSIVE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MOTHER-TO-CHILD TRANSMISSION | WEANING | HIV PREVENTION | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Disease Transmission Control | Prevention and Control | Diseases | Transmission | Infections | HIV Infections | Viral Diseases | Program Evaluation | Programs | Organization and Administration
Document Number: 341054

24.
Title: Evaluating the President's Emergency Plan for AIDS Relief: time to scale it up [editorial]
Author: Gross R; Bisson G
Source: Annals of Internal Medicine. 2009 May 19;150(10):727-8.
Abstract: This editorial examines the President's Emergency Plan for AIDS Relief (PEPFAR) and measures the effects of the program by comparing trends in AIDS-related death rates and HIV prevalence rates. It also discusses PEPFAR's achievement of some of its goals but will have to meet a higher standard and document impact by gathering credible evidence in the future and note which aspects of the program are working and which are not.
Language: English
Keywords:
UNITED STATES OF AMERICA | DEVELOPING COUNTRIES | SUMMARY REPORT | EVALUATION | AIDS PREVENTION | HIV PREVENTION | LIFE EXPECTANCY | GOVERNMENT PROGRAMS | PROGRAM EVALUATION | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | AIDS | HIV Infections | Viral Diseases | Diseases | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Programs | Organization and Administration
Document Number: 341603

25.

Peer Reviewed

Title: Enhancing HIV prevention requires addressing the complex relationship between prevention and treatment.
Author: Henderson K; Worth H; Aggleton P; Kippax S
Source: Global Public Health. 2009;4(2):117-30.
Abstract: Globally each year, HIV continues to infect millions of people, and the number of people living with HIV and AIDS grows. While there has been an increase in funding for HIV and AIDS, there is a growing gap between the funds available and the funds needed for both prevention and treatment. Yet, one of the means of closing that gap - preventing new infections - has slipped down the agenda. In arguing for a significant intensification of the HIV prevention response, and the relevance of a strong social stance within this response, this paper addresses the need to manage finding a balance between prevention and treatment and care. Not only is there not enough being spent on HIV prevention, but also in some instances, the prevention agenda has been hijacked by those who favour morally conservative, but ineffective, HIV prevention strategies. We argue that effective prevention needs to be firmly located within the everyday realities affecting communities and societies, and needs to focus on what is known to work. In particular, we need to move beyond a public health underpinned by neo-liberal notions of agency and individual responsibility to a public health that recognises the collective nature of epidemics, and works with communities and networks to transform social relations. This latter, more 'social' public health, is concerned with the social, political and economic factors that produce HIV risk and responses to it. Contrary to what some might suggest, HIV prevention has not failed, rather, governments and donors have failed HIV prevention.
Language: English
Keywords:
GLOBAL | CRITIQUE | AIDS PREVENTION | HIV PREVENTION | EPIDEMICS | FUNDS | PROGRAM EFFECTIVENESS | PUBLIC HEALTH | ANTIRETROVIRAL THERAPY | AIDS | HIV Infections | Viral Diseases | Diseases | Financial Activities | Economic Factors | Program Evaluation | Programs | Organization and Administration | Health | HIV
Document Number: 341398

26.

Peer Reviewed

Title: In vitro testing of rationally designed spermicides for selectively targeting human sperm in vagina to ensure safe contraception.
Author: Jain RK; Jain A; Maikhuri JP; Sharma VL; Dwivedi AK; Kumar ST; Mitra K; Bajpai VK; Gupta G
Source: Human Reproduction. 2009 Mar;24(3):590-601.
Abstract: BACKGROUND: Rational synthesis of novel structures resulted in two unique molecules (DSE-36 and DSE-37, disulphide esters of carbothioic acid) that killed sperm 25 times more strongly and with a precisely targeted action than nonoxynol-9 (N-9). We examine the effects of DSE-36 and DSE-37 on human spermatozoa versus HeLa cells to establish specificity and safety compared with N-9. METHODS AND RESULTS: At spermicidal EC(100) (20 microg/ml) DSE-36 and DSE-37 killed 100% sperm in <30 s (Sander-Cramer assay) and at EC(50) induced apoptosis in sperm (Annexin-V-fluorescein isothiocyanate and JC-1 labelling and Flow Cytometry) in 3 h. However, at EC(100) these molecules had no effect on HeLa cells by 24 h or on cell viability [3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay], surface ultrastructure (scanning electron microscopy), Annexin-V and JC-1 labelling pattern and reactive oxygen species (ROS) generation. N-9, with a spermicidal EC(100) of 500 microg/ml, decreased HeLa cell viability at 20 microg/ml in 24 h (P < 0.001), accompanied by acute damage to cell surface ultrastructural topography, induction of apoptosis and ROS generation. Unlike DSE-36 and DSE-37, N-9 also significantly induced mRNA levels (RT-PCR) of pro-inflammatory biomarkers (interleukin (IL)-1 alpha, IL-6, IL-8, RANTES) in HeLa cells and increased IL-6 and IL-8 secretion (P < 0.001, enzyme-linked immunosorbent assay). Furthermore, DSE-36 and DSE-37 did not inhibit Lactobacillus growth at EC(100) and exhibited mild microbicidal activity against Trichomonas vaginalis, while N-9 inhibited Lactobacillus and Trichomonas growth but had a lower prophylactic index. CONCLUSIONS: The ability of these novel spermicides to kill sperm almost instantaneously at innocuously low concentration indicates their worth as improved active ingredients for vaginal contraceptive preparations compared with N-9.
Language: English
Keywords:
INDIA | RESEARCH REPORT | WOMEN | SPERMICIDAL CONTRACEPTIVE AGENTS | CONTRACEPTION | NONOXYNOL | CONTRACEPTIVE SAFETY | VAGINAL APPROACH | PROGRAM EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Agents | Family Planning | Alcohols | Organic Chemicals | Ingredients and Chemicals | Safety | Public Health | Health | Female Sterilization | Sterilization, Sexual | Program Evaluation | Programs | Organization and Administration
Document Number: 342583

27.

28.
Peer Reviewed

Title: Directing diarrhoeal disease research towards disease-burden reduction.
Author: Kosek M; Lanata CF; Black RE; Walker DG; Snyder JD; Salam MA; Mahalanabis D; Fontaine O; Bhutta ZA; Bhatnagar S; Rudan I
Source: Journal of Health, Population, and Nutrition. 2009 Jun;27(3):319-31.
Abstract: Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research questions; the efficacy and effectiveness of the intervention resulting from the research; the maximal potential for disease-burden reduction of the interventions derived from the research; the affordability, deliverability, and sustainability of the intervention supported by the research; and the overall effect of the research-derived intervention on equity. Experts scored each research option independently to delineate the best investments for diarrhoeal disease control in the developing world to reduce the burden of disease by 2015. Priority scores obtained for health policy and systems research obtained eight of the top 10 rankings in overall scores, indicating that current investments in health research are significantly different from those estimated to be the most effective in reducing the global burden of diarrhoeal disease by 2015.
Language: English
Keywords:
DEVELOPING COUNTRIES | EVALUATION REPORT | RESEARCH ACTIVITIES | DIARRHEA | PREVENTION AND CONTROL | INTERVENTIONS | PROGRAM EFFECTIVENESS | PROGRAM SUSTAINABILITY | CHILD HEALTH | GOALS | DELIVERY OF HEALTH CARE | COST EFFECTIVENESS | Evaluation | Research Methodology | Diseases | Programs | Organization and Administration | Program Evaluation | Health | Planning | Evaluation Indexes | Quantitative Evaluation
Document Number: 341924

29.

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

30.

Peer Reviewed

Title: Integrating quality postnatal care into PMTCT in Swaziland.
Author: Mazia G; Narayanan I; Warren C; Mahdi M; Chibuye P; Walligo A; Mabuza P; Shongwe R; Hainsworth M
Source: Global Public Health. 2009;4(3):253-70.
Abstract: Swaziland's prevention of mother-to-child transmission (PMTCT) programme is linked to maternal and newborn health (MNH) services, but is mainly focussed on HIV/AIDS. Existing MNH services are inadequate, especially postnatal care (PNC) of mothers and babies, with delayed postnatal visits occurring at 4-6 weeks after delivery. Fifty-seven percent of staff in seven Swazi health facilities were trained in promoting and providing early PNC. A final evaluation showed a 20-fold increase in the number of visits coming for an early postnatal visit (within the first three days after birth). A direct observation of the client-provider interaction showed a significant increase in the competence of the health workers related to postnatal examinations, and care of mothers and babies (p<0.05- < 0.01). The percentage of women breastfeeding within one hour of delivery increased by 41% in HIV-positive mothers and 52% in HIV-negative mothers. Cotrimoxazole prophylaxis for HIV-exposed infants increased by 24%. Although, health workers were observed providing counselling, maternal recall of messages was deficient, suggesting the need for additional strategies for promoting healthy behaviours. High-quality integrated PMTCT programmes and MNH postnatal services are feasible and acceptable, and can result in promoting early postnatal visits and improved care of both HIV-positive and HIV-negative mothers and their babies.
Language: English
Keywords:
SWAZILAND | RESEARCH REPORT | PILOT PROJECTS | PROVIDERS WITH CLIENTS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MATERNAL-CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | PROGRAM EFFECTIVENESS | TRAINING ACTIVITIES | KNOWLEDGE | CLINIC VISITS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Diseases | Primary Health Care | Programs | Organization and Administration | Program Evaluation | Training Programs | Education | Sociocultural Factors | Service Statistics | Program Activities
Document Number: 341394


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