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Title: mHealth for development: The opportunity of mobile technology for healthcare in the developing world.
Author: Vital Wave Consulting
Source: Washington, D.C., United Nations Foundation, 2009. 66 p.
Abstract: Mounting interest in the field of mHealth -- the provision of health-related services via mobile communications -- can be traced to the evolution of several interrelated trends. In many parts of the world, epidemics and a shortage of healthcare workers continue to present grave challenges for governments and health providers. Yet in these same places, the explosive growth of mobile communications over the past decade offers a new hope for the promotion of quality healthcare. Among those who had previously been left behind by the 'digital divide,' billions now have access to reliable technology. There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services -- even in some of the most remote and resource-poor environments. This report examines issues at the heart of the rapidly evolving intersection of mobile phones and healthcare. It helps the reader to understand mHealth's scope and implementation across developing regions, the health needs to which mHealth can be applied, and the mHealth applications that promise the greatest impact on heath care initiatives. It also examines building blocks required to make mHealth more widely available through sustainable implementations. Finally, it calls for concerted action to help realize mHealth's full potential. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | PUBLIC HEALTH | TELECOMMUNICATIONS | INFORMATION DISTRIBUTION | EDUCATION | AWARENESS | DATA COLLECTION | PRIMARY HEALTH CARE | TRAINING ACTIVITIES | HEALTH PERSONNEL | DISEASE PREVENTION | TECHNOLOGY | TREATMENT | ADMINISTRATION AND DOSAGE | DRUGS | HIV TESTING | HIV PREVENTION | Health | Broadcast Media | Mass Media | Communication | Knowledge | Sociocultural Factors | Research Methodology | Health Services | Delivery of Health Care | Training Programs | Prevention and Control | Diseases | Economic Factors | Medical Procedures | Medicine | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | HIV Infections | Viral Diseases
Document Number: 331450

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Peer Reviewed

Title: Improved sanitation and income are associated with decreased rates of hospitalization for diarrhoea in Brazilian infants.
Author: Andrade IG; Queiroz JW; Cabral AP; Lieberman JA; Jeronimo SM
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 May;103(5):506-11.
Abstract: Diarrhoeal diseases remain a major cause of morbidity and mortality in Brazilian children. However, from 1992 to 2001 there was a significant decline in hospitalizations for acute diarrhoea in children below 1 year of age in Brazil. A significant improvement in child health was also observed in the state of Rio Grande do Norte (RN), with a decrease in child mortality from 70 to 40 deaths per 1000. Using distributed lag analysis we analysed a number of factors possibly connected with decreased hospitalization in RN and found that hospitalization was correlated up to lag 3 with poverty (P<0.001) and inflation (P<0.001). Improvements in public health infrastructure such as better waste collection, presence of city water supply and increased sanitation, socio-economic variables such as education and literacy, and increased investment in health services were all important in reducing severe early childhood diarrhoeas and thus directly associated with the decrease in hospitalization. We also observed a positive seasonal correlation between rainfall and hospitalizations with an increased in rainfall impacting positively on hospitalization in all lags. The data suggests that increased buying power and reductions in poverty played a crucial role in reducing hospitalizations for acute diarrhoea in infants in RN.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | INFANT | DIARRHEA, INFANTILE | POVERTY | INFANT MORTALITY | SANITATION | HOSPITALS | PUBLIC HEALTH | SOCIOECONOMIC FACTORS | PREVENTION AND CONTROL | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diarrhea | Diseases | Economic Factors | Mortality | Population Dynamics | Health | Health Facilities | Delivery of Health Care
Document Number: 342512

Peer Reviewed

Title: Rapid scale-up of antiretroviral treatment in Ethiopia: successes and system-wide effects.
Author: Assefa Y; Jerene D; Lulseged S; Ooms G; Van Damme W
Source: PLoS Medicine. 2009 Apr 28;6(4):e1000056.
Abstract: There has been substantial expansion of access to ART and HIV counseling and testing in Ethiopia, whilst maintaining the performance of other health programs such as tuberculosis and maternal and child health services. Task shifting to the health officers, nurses, and health extension workers is thought to be responsible for these successes. However, HIV prevention interventions and management of chronic care patients are lagging behind. This may be due to lack of attention to these health care areas and to physicians leaving the public sector for NGOs, including AIDS-related NGOs. Prevention of HIV infection, retention of patients in chronic care, and retention of physicians in the public sector need urgent attention for effective and sustainable HIV/AIDS and health systems responses in the long term.
Language: English
Keywords:
ETHIOPIA | EVALUATION REPORT | ANTIRETROVIRAL THERAPY | PUBLIC HEALTH | PROGRAM ACCESSIBILITY | DECENTRALIZATION | HIV TESTING | HIV PREVENTION | AIDS PREVENTION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | HIV | HIV Infections | Viral Diseases | Diseases | Health | Program Evaluation | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | AIDS
Document Number: 341678

Peer Reviewed

Title: Universal voluntary HIV testing and immediate antiretroviral therapy [letter]
Author: Assefa Y; Lera M
Source: Lancet. 2009 Mar 28;373(9669):1080; author reply 1080-1.
Abstract: Reuben Granich and colleagues use mathematical models to show that annual screening of most adults for HIV, with immediate commencement of antiretroviral therapy for all infected, would strikingly reduce HIV incidence. The findings are very interesting. We would like to share our lessons from Ethiopia. Ethiopia had a millennium AIDS campaign with the objective of increasing the number of people tested for HIV through universal voluntary counselling and testing and providing antiretroviral treatment for eligible patients. We were able to increase the number of people tested in 1 year from 560 000 in 2005/06 to 4.6 million in 2007/08. The number of patients started on antiretroviral therapy per month increased from 3500 to more than 5700. Even though we accomplished a lot in terms of HIV testing and antiretroviral therapy provision, we had challenges during the rapid scale-up of these services. We learnt that mass testing is very resource-intensive and needs a strong health system, including adequate human resources and a continuous supply of commodities. As a result, our current guiding principle is "high yield" and "high impact" through targeted testing of most-at-risk populations: patients with tuberculosis or sexually transmitted diseases, and pregnant women. Universal voluntary HIV testing and antiretroviral therapy provision might be effective in reducing HIV transmission, but with the current health system constraints in many sub-Saharan African countries such as Ethiopia, it is really not feasible to practise it. We recommend "high yield" and "high impact" HIV testing with early initiation of antiretroviral therapy, and improved adherence and retention of patients in care and treatment. (full-text)
Language: English
Keywords:
DEVELOPING COUNTRIES | THEORETICAL STUDIES | RESEARCH PROPOSAL | THEORETICAL MODELS | COST BENEFIT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | BEST PRACTICES | HIV PREVENTION | PUBLIC HEALTH | TIME FACTORS | COST EFFECTIVENESS | ETHICS | NOTIFICATION | Studies | Research Methodology | Quantitative Evaluation | Evaluation | HIV Infections | Viral Diseases | Diseases | HIV | Programs | Organization and Administration | Health | Population Dynamics | Demographic Factors | Population | Evaluation Indexes | Sociocultural Factors | Political Factors
Document Number: 330977

Title: Emergency contraception, efficacy and public health impact.
Author: Broekhuizen FF
Source: Current Opinion In Obstetrics and Gynecology. 2009 May 30;
Abstract: PURPOSE OF REVIEW: Emergency contraception in the past two decades had been proven to be effective and well tolerated. Counseling and advance provision and prescription of emergency contraception have been embraced by professional organizations in practice guidelines for its potential to reduce the number of unintended pregnancies and abortions. Has emergency contraception lived up to that promise? RECENT FINDINGS: Mifepristone (not available in the USA) is the agent of choice. Emergency contraception has not reduced the number of unintended pregnancies. Acceptance by healthcare providers and the public has not been optimal, and multiple financial and healthcare system barriers to use emergency contraception continue to exist. The public health impact of emergency contraception has been disappointing. SUMMARY: Although emergency contraception may continue to be an important component of contraceptive practice, only increased access to more effective methods of contraception will change unintended pregnancy rates. The use of mifepristone for emergency contraception in the USA must be considered.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | EMERGENCY CONTRACEPTION | PREGNANCY, UNPLANNED | RU-486 | PUBLIC HEALTH | Developed Countries | North America | Americas | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Health
Document Number: 341569

Peer Reviewed

Title: The national response to the HIV/AIDS epidemic in Peru: accomplishments and gaps--a review.
Author: Caceres CF; Mendoza W
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S60-6.
Abstract: In Peru, after the first case of AIDS was reported in 1983, nearly 20,000 AIDS cases have been notified to date and between 20,000 and 79,000 persons are estimated to be living with HIV. Despite a relatively low HIV prevalence in the general population, the epidemic has importantly mobilized social actors and economic resources and has helped articulate a very active field within the Peruvian health sector. In recent years, the country has become the largest recipient of HIV funding from the Global Fund for AIDS, Tuberculosis, and Malaria in Latin America, for which a substantial national counterpart has been committed. Peru's predictable selection as one of the 12 focal countries for the 5-year impact evaluation of the Global Fund suggested that an analysis of the response to the HIV epidemic in Peru may provide significant lessons on the possibilities of international aid in the AIDS field, particularly in the Latin American context. This article presents an analysis of the impact of the HIV/AIDS epidemic and the nature of the response articulated by the State and civil society in Peru, based on the Universal Access Principles proposed by World Health Organization, UNAIDS, and others. Relying on a number of recent secondary sources, we focus not only on the impact of the epidemic on morbidity and death but also on the changes in society as a whole, particularly in social movements and their dynamic relationship with the State. We start with an epidemiological overview and move to describe the role of social actors in response to the epidemic and then propose a framework for the analysis of the scope and limitations of the national response and elaborate on potential courses of action that may lead to strengthen accomplishments and resolve remaining gaps.
Language: English
Keywords:
PERU | RESEARCH REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | MORBIDITY | DEATH RATE | HEALTH POLICY | PUBLIC HEALTH | EPIDEMIOLOGY | EVALUATION | Developing Countries | South America, Western | South America | Latin America | Americas | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases | Mortality | Population Dynamics | Demographic Factors | Population | Policy | Political Factors | Sociocultural Factors | Health
Document Number: 341319

Peer Reviewed

Title: The health and health system of South Africa: historical roots of current public health challenges.
Author: Coovadia H; Jewkes R; Barron P; Sanders D; McIntyre D
Source: Lancet. 2009 Sep 5;374(9692):817-34.
Abstract: The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.
Language: English
Keywords:
SOUTH AFRICA | HISTORICAL REVIEW | PUBLIC HEALTH | COLONIALISM | POLITICAL FACTORS | ECONOMIC FACTORS | SOCIAL DISCRIMINATION | SEX DISCRIMINATION | INEQUALITIES | FAMILY LIFE | VIOLENCE | HEALTH SERVICES | HUMAN RESOURCES | POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Health | Political Systems | Sociocultural Factors | Social Problems | Socioeconomic Factors | Family and Household | Behavior | Delivery of Health Care
Document Number: 342803

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Peer Reviewed

Title: Ethical Considerations in HIV/AIDS Biobehavioral Surveys That Use Respondent-Driven Sampling: Illustrations From Lebanon.
Author: Dejong J; Mahfoud Z; Khoury D; Barbir F; Afifi RA
Source: American Journal of Public Health. 2009 Jul 16;
Abstract: Respondent-driven sampling is especially useful for reaching hidden populations and is increasingly used internationally in public health research, particularly on HIV. Respondent-driven sampling involves peer recruitment and has a dual-incentive structure: both recruiters and their peer recruits are paid. Recent literature focusing on the ethical dimensions of this method in the US context has identified integral safeguards that protect against ethical violations. We analyzed a study of 3 groups in Lebanon who are at risk for HIV (injection drug users, men who have sex with men, female sex workers) and the ethical issues that arose. More explicit attention should be given to ethical issues involved in research implementing respondent-driven sampling of at-risk populations in developing countries, where ethical review mechanisms may be weak.
Language: English
Keywords:
LEBANON | SUMMARY REPORT | RECRUITMENT ACTIVITIES | RESPONDENTS | IV DRUG USERS | MEN HAVING SEX WITH MEN | SEX WORKERS | PUBLIC HEALTH | HIV INFECTIONS | AIDS | ETHICS | INFORMED CONSENT | Middle East | Developing Countries | Program Activities | Programs | Organization and Administration | Surveys | Sampling Studies | Studies | Research Methodology | Drug Use and Abuse | Behavior | Sex Behavior | Health | Viral Diseases | Diseases | Sociocultural Factors | Health Services | Delivery of Health Care
Document Number: 342038

12.

Title: Women's rights and women's health during HIV/AIDS epidemics: the experience of women in sub-Saharan Africa.
Author: Dugassa BF
Source: Health Care For Women International. 2009 Aug;30(8):690-706.
Abstract: Twenty-five years have passed since HIV/AIDS was recognized as a major public health problem. Although billions of dollars are spent in research and development, we still have no medical cure or vaccination. In the early days of the epidemic, public health slogans suggested that HIV/AIDS does not discriminate. Now it is becoming clear that HIV/AIDS spreads most rapidly among poor, marginalized, women, colonized, and disempowered groups of people more than others. The HIV/AIDS epidemic is exacerbated by the social, economic, political, and cultural conditions of societies such as gender, racial, class, and other forms of inequalities. Sub-Saharan African countries are severely hit by HIV/AIDS. For these countries the pandemic of HIV/AIDS demands the need to travel extra miles. My objective in this article is to promote the need to go beyond the biomedical model of "technical fixes" and the traditional public health education tools, and come up with innovative ideas and strategic thinking to contain the epidemic. In this article, I argue that containing the HIV/AIDS epidemic and improving family and community health requires giving appropriate attention to the social illnesses that are responsible for exacerbating biological disorders.
Language: English
Keywords:
AFRICA, SUB SAHARAN | CRITIQUE | HIV INFECTIONS | AIDS | EPIDEMICS | WOMEN'S HEALTH | WOMEN'S RIGHTS | PUBLIC HEALTH | SOCIOECONOMIC FACTORS | HIV TRANSMISSION | MALNUTRITION | SOCIOCULTURAL FACTORS | Africa | Developing Countries | Viral Diseases | Diseases | Health | Human Rights | Political Factors | Economic Factors | Nutrition Disorders
Document Number: 342818

13.

Peer Reviewed

Title: Pill scare: communication conundrum.
Author: Edouard L
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):121-2.
Abstract: Adverse publicity for combined oral contraceptives (COCs) has led to pill scares on numerous occasions such as reproductive cancers in 1983 and venous thromboembolism (VTE) in 1995. Misinformation should be avoided, especially through the correct interpretation of relative risk to avoid confusion and decrease unnecessary anxiety. Reassurance is usually important, as the absolute risk is infinitely small. The popular media are very effective for the prompt dissemination of information, and authoritative statements are useful for improving communications with providers, patients and public.
Language: English
Keywords:
ALGERIA | HISTORICAL REVIEW | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | MISINFORMATION | FEAR | RISK ASSESSMENT | CANCER | THROMBOEMBOLISM | INFORMATION DISTRIBUTION | PUBLIC HEALTH | Africa, North | Africa | Developing Countries | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Health | Communication | Emotions | Psychological Factors | Behavior | Evaluation | Neoplasms | Diseases | Embolism | Vascular Diseases
Document Number: 341650

14.

Title: Infodemiology and infoveillance: Framework for an emerging set of public health informatics methods to analyze search, communication and publication behavior on the Internet [editorial]
Author: Eysenbach G
Source: Journal of Medical Internet Research. 2009;11(1):e11.
Abstract: Infodemiology can be defined as the science of distribution and determinants of information in an electronic medium, specifically the Internet, or in a population, with the ultimate aim to inform public health and public policy. Infodemiology data can be collected and analyzed in near real time. Examples for infodemiology applications include: the analysis of queries from Internet search engines to predict disease outbreaks (eg. influenza); monitoring peoples' status updates on microblogs such as Twitter for syndromic surveillance; detecting and quantifying disparities in health information availability; identifying and monitoring of public health relevant publications on the Internet (eg. anti-vaccination sites, but also news articles or expert-curated outbreak reports); automated tools to measure information diffusion and knowledge translation, and tracking the effectiveness of health marketing campaigns. Moreover, analyzing how people search and navigate the Internet for health-related information, as well as how they communicate and share this information, can provide valuable insights into health-related behavior of populations. Seven years after the infodemiology concept was first introduced, this paper revisits the emerging fields of infodemiology and infoveillance and proposes an expanded framework, introducing some basic metrics such as information prevalence, concept occurrence ratios, and information incidence. The framework distinguishes supply-based applications (analyzing what is being published on the Internet, eg. on Web sites, newsgroups, blogs, microblogs and social media) from demand-based methods (search and navigation behavior), and further distinguishes passive from active infoveillance methods. Infodemiology metrics follow population health relevant events or predict them. Thus, these metrics and methods are potentially useful for public health practice and research, and should be further developed and standardized. (Author's abstract)
Language: English
Keywords:
CANADA | CRITIQUE | EPIDEMIOLOGY | INFORMATION DISTRIBUTION | INFORMATION RETRIEVAL SYSTEMS | INTERNET | INFLUENZA | MONITORING | COMMUNICATION | PUBLIC HEALTH | Developed Countries | North America, Northern | Americas | Health | Data Storage and Retrieval | Information Processing | Information | Information Networks | Viral Diseases | Diseases | Evaluation
Document Number: 331416

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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

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Peer Reviewed

Title: The public health approach to identify antiretroviral therapy failure: high-level nucleoside reverse transcriptase inhibitor resistance among Malawians failing first-line antiretroviral therapy.
Author: Hosseinipour MC; van Oosterhout JJ; Weigel R; Phiri S; Kamwendo D; Parkin N; Fiscus SA; Nelson JA; Eron JJ; Kumwenda J
Source: AIDS. 2009 Jun 1;23(9):1127-34.
Abstract: BACKGROUND: Over 150,000 Malawians have started antiretroviral therapy (ART), in which first-line therapy is stavudine/lamivudine/nevirapine. We evaluated drug resistance patterns among patients failing first-line ART on the basis of clinical or immunological criteria in Lilongwe and Blantyre, Malawi. METHODS: Patients meeting the definition of ART failure (new or progressive stage 4 condition, CD4 cell count decline more than 30%, CD4 cell count less than that before treatment) from January 2006 to July 2007 were evaluated. Among those with HIV RNA of more than 1000 copies/ml, genotyping was performed. For complex genotype patterns, phenotyping was performed. RESULTS: Ninety-six confirmed ART failure patients were identified. Median (interquartile range) CD4 cell count, log10 HIV-1 RNA, and duration on ART were 68 cells/microl (23-174), 4.72 copies/ml (4.26-5.16), and 36.5 months (26.6-49.8), respectively. Ninety-three percent of samples had nonnucleoside reverse transcriptase inhibitor mutations, and 81% had the M184V mutation. The most frequent pattern included M184V and nonnucleoside reverse transcriptase inhibitor mutations along with at least one thymidine analog mutation (56%). Twenty-three percent of patients acquired the K70E or K65R mutations associated with tenofovir resistance; 17% of the patients had pan-nucleoside resistance that corresponded to K65R or K70E and additional resistance mutations, most commonly the 151 complex. Emergence of the K65R and K70E mutations was associated with CD4 cell count of less than 100 cells/microl (odds ratio 6.1) and inversely with the use of zidovudine (odds ratio 0.18). Phenotypic susceptibility data indicated that the nucleoside reverse transcriptase inhibitor backbone with the highest activity for subsequent therapy was zidovudine/lamivudine/tenofovir, followed by lamivudine/tenofovir, and then abacavir/didanosine. CONCLUSION: When clinical and CD4 cell count criteria are used to monitor first-line ART failure, extensive nucleoside reverse transcriptase inhibitor and nonnucleoside reverse transcriptase inhibitor resistance emerges, with most patients having resistance profiles that markedly compromise the activity of second-line ART.
Language: English
Keywords:
MALAWI | RESEARCH REPORT | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | CLIENTS | PUBLIC HEALTH | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | DRUG RESISTANCE | IMMUNOLOGICAL EFFECTS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Health | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Drugs | Immunity | Immune System | Physiology | Biology
Document Number: 342447

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Peer Reviewed

Title: Adding the female condom to the public health agenda on prevention of HIV and other sexually transmitted infections among men and women during anal intercourse.
Author: Kelvin EA; Smith RA; Mantell JE; Stein ZA
Source: American Journal of Public Health. 2009 Jun;99(6):985-7.
Abstract: Legal barriers to conducting public health research on methods of protection for anal intercourse were lifted in the United States in 2003 when the US Supreme Court invalidated all state antisodomy laws. Although research funding has been available for the development of rectal microbicides, the female condom, which has already been approved for vaginal use, has not been evaluated for anal use. Although there is no evidence that the female condom is safe for anal intercourse, it has already been taken up for off-label use by some men who have sex with men. This demonstrates the urgent need for more protection options for anal intercourse and, more immediately, the need to evaluate the safety and efficacy of the female condom for anal intercourse.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | PUBLIC HEALTH | COURT DECISION | ANAL SEX | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | FEMALE CONDOMS | SAFETY | MICROBICIDES | Developed Countries | North America | Americas | Health | Litigation | Political Factors | Sociocultural Factors | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341644

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Peer Reviewed

Title: The impact of an urban sewerage system on childhood diarrhoea in Tehran, Iran: a concurrent control field trial.
Author: Kolahi AA; Rastegarpour A; Sohrabi MR
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 May;103(5):500-5.
Abstract: The stepwise implementation of the Tehran Sewerage Project provided a convenient setting for which health impacts of an urban sewerage system could be examined with appropriate controls. In 2001, Tehran municipal districts 17 and 18 had no sewerage system connections, but areas within these districts had been planned to be connected by 2006. These areas were chosen as an intervention group. Neighbouring areas, with a similar socio-economic status, that had not been planned to connect to the sewerage system by 2006, were chosen as controls. Homes within designated areas were randomized and surveyed twice to determine diarrhoea incidences for children aged 6-60 months, once in 2001, before connection to the sewerage system, and once again in 2006, after the intervention. By 2006, 76% of the homes in the intervention zones were connected to the sewerage system. In the first stage of the study, diarrhoea incidences for intervention and control groups were 18.6 and 16.6%, respectively. In the second stage, incidences decreased to 10.1 and 10.5%, respectively. Data collected from 4179 children demonstrated that the diarrhoea incidence had decreased by 46% in the intervention group, whereas it had decreased by 37% in the controls.
Language: English
Keywords:
IRAN | RESEARCH REPORT | INCIDENCE | URBAN POPULATION | SANITATION | PUBLIC HEALTH | DIARRHEA | WASTE MANAGEMENT | HYGIENE | Middle East | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Health | Diseases | Environment
Document Number: 342515

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Peer Reviewed

Title: Health economics of contraception.
Author: Mavranezouli I
Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):187-198.
Abstract: Unintended pregnancies constitute a global problem associated with substantial costs to health and social services, and emotional distress to women, their families and society as a whole. Provision of contraception has been demonstrated to be a particularly cost-effective healthcare intervention as, besides preventing a significant number of unintended pregnancies, it also results in great cost-savings to society. Male and female sterilization and long-acting reversible methods (such as the copper-T intra-uterine device and the subdermal implant) constitute the most cost-effective contraceptive options, followed by other hormonal methods (such as oral contraceptives); barrier and behavioural methods (such as the male condom and withdrawal, respectively) are least cost-effective compared with other contraceptive options. Nevertheless, when compared with no method, they still prevent a large number of unintended pregnancies, thus leading to important cost-savings. Improvements in compliance and continuation rates are expected to further enhance the contraceptive benefits and cost-savings associated with contraceptive use.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | COST BENEFIT ANALYSIS | ECONOMICS | FEES | CONTRACEPTION | PUBLIC HEALTH | Developed Countries | Europe, Western | Europe | Quantitative Evaluation | Evaluation | Social Sciences | Science | Sociocultural Factors | Financial Activities | Economic Factors | Family Planning | Health
Document Number: 329667

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Peer Reviewed

Title: Community engagement in health research: two decades of experience from a research project on HIV in rural Uganda.
Author: Nakibinge S; Maher D; Katende J; Kamali A; Grosskurth H; Seeley J
Source: Tropical Medicine and International Health. 2009 Feb;14(2):190-5.
Abstract: OBJECTIVES: To describe how a research project on HIV epidemiology in rural Uganda has engaged the community over the past two decades, describing activities, opportunities and challenges that have arisen. METHOD: The review draws on the experience of the authors as investigators involved in the project at various times since its inception in 1989, and on project documents and peer-reviewed publications. RESULTS: The project attracts community interest, participation and support mostly through community groups. The three main areas of activity are: health care and promotion, HIV/AIDS prevention and care, and community development aimed at poverty reduction. Key opportunities arise from the long-term joint commitment of the project and the community over nearly 20 years, and the potential to accommodate research beyond HIV. Challenges arise from participation fatigue, countered by innovations for the community and investment in capacity development for staff, and from the need to balance community development expectations and the project focus on HIV research. CONCLUSIONS: Judged by criteria of longevity, acceptance, and scientific output, community engagement in this HIV research project in rural Uganda has been successful. The experience from this project contributes to the collective documentation and analysis of case studies from various research projects in developing countries which identify good practices from multiple stakeholder perspectives.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | EPIDEMIOLOGY | RURAL POPULATION | HIV | PUBLIC HEALTH | RESEARCH AND DEVELOPMENT | PROGRAM ACCEPTABILITY | COMMUNITY PARTICIPATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Technology | Economic Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 341030

22.

Peer Reviewed

Title: Obstetric fistulae in West Africa: patient perspectives.
Author: Nathan LM; Rochat CH; Grigorescu B; Banks E
Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):e40-2.
Abstract: OBJECTIVE: The objective of this study is to gain insight into the nature of obstetric fistulae in Africa through patient perspectives. STUDY DESIGN: At l'Hopital Saint Jean de Dieu in Tanguieta, Benin, 37 fistula patients underwent structured interviews about fistula cause, obstacles to medical care, prevention, and reintegration by 2 physicians via interpreters. RESULTS: The majority of participants (43%) thought their fistulae were a result of trauma from the operative delivery. Lack of financial resources (49%) was the most commonly reported obstacle to care, and prenatal care (38%) was most frequently reported as an intervention that may prevent obstetric fistulae. The majority (49%) of the participants requested no further reintegration assistance aside from surgery. CONCLUSION: Accessible emergency obstetric care is necessary to decrease the burden of obstetric fistulae in Africa. This may be accomplished through increased and improved health care facilities and education of providers and patients.
Language: English
Keywords:
AFRICA, WESTERN | RESEARCH REPORT | WOMEN | CLIENTS | FISTULA | MORBIDITY | PUBLIC HEALTH | PREGNANCY COMPLICATIONS | Developing Countries | Africa, Sub Saharan | Africa | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Diseases | Health
Document Number: 341240

23.
Peer Reviewed

Title: [Provision of voluntary surgical sterilization in the Campinas Metropolitan Area, Sao Paulo State, Brazil: perceptions of public health services managers and professionals] Atendimento a demanda pela esterilizacao cirurgica na Regiao Metropolitana de
Author: Osis MJ; Carvalho LE; Cecatti JG; Bento SF; Padua KS
Source: Cadernos De Saude Publica. 2009 Mar;25(3):625-34.
Abstract: This study describes the perceptions of public health services managers and professionals concerning provision of voluntary surgical sterilization in the Campinas Metropolitan Area, Sao Paulo State, Brazil. The study adopted a qualitative approach in four municipalities (counties), where semi-structured interviews were conducted with 26 health professionals and health services managers involved in the provision of surgical sterilization. The interviewees identified difficulties in scheduling visits at Outpatient Family Clinics or Reference Centers (APF/CR), and the number of available surgeries in the accredited hospitals was insufficient. They emphasized the lack of physical infrastructure and human resources for conducting family planning activities in the primary health units as well as in the APF/CR.They also criticized the legal criteria for authorizing surgical sterilization, and mentioned adaptations to make them more appropriate to the each municipality's situation. According to the health services managers and professionals, despite the efforts, meeting the demand for surgical sterilization in the Campinas Metropolitan Area was jeopardized by its centralization in the APF/CR, which in practice had to cover the gap in family planning activities in each municipality's primary care units.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | QUALITATIVE RESEARCH | HEALTH PERSONNEL | PERCEPTION | PUBLIC HEALTH | HEALTH SERVICES | STERILIZATION, SEXUAL | PRIMARY HEALTH CARE | QUALITY OF HEALTH CARE | MANAGEMENT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Delivery of Health Care | Health | Psychological Factors | Behavior | Family Planning | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 342581

24.
Title: Leveraging the role of public health nursing in managing HIV/AIDS in Thailand: a journey of international collaboration.
Author: Potempa K; Phancharoenworakul K; Glass N; Chasombat S; Cody BJ
Source: Collegian. 2009;16(2):49-53.
Abstract: Thailand is one of the first countries to have achieved significant advances in control over the HIV/AIDS epidemic occurring within its borders. Despite this impressive accomplishment, the disease continues to be a Leading cause of death in Thailand and is migrating into Thai populations heretofore relatively free of it, such as married women. In 2003, a unique Thai, American, academic, and government collaboration formed to address the on-going challenges of HIV/AIDS in Thailand and its emerging characteristics. The objective of this collaboration was to increase the capacity of Thailand's public health infrastructure to address the challenges of HIV/AIDS by utilizing a Larger and more empowered role for nurses within the country's existing health care system. This collaboration consisted of the Deans' Consortium of Nursing Educational Institutions, the Thai Ministry of Public Health, the Faculty of Nursing at Mahidol University, and United States university nursing educators. This paper describes the process that brought this collaboration into being. It also describes the outcomes achieved by this collaboration; a collaboration that realized a national strategy to Leverage and expand the role of public health nurses and the initiation of a nurse practitioners' role in the prevention and treatment of HIV/AIDS. This collaboration and strategy increased the capacity of the health care system in Thailand to more effectively meet the challenges posed by all infectious diseases in Thailand and, in particular, HIV/AIDS.
Language: English
Keywords:
THAILAND | SUMMARY REPORT | NURSES AND NURSING | PUBLIC HEALTH | HIV INFECTIONS | EPIDEMICS | PREVENTION AND CONTROL | INTERNATIONAL COOPERATION | CAPACITY BUILDING | CURRICULUM | IMPLEMENTATION | Developing Countries | Asia, Southeastern | Asia | Health Personnel | Delivery of Health Care | Health | Viral Diseases | Diseases | Political Factors | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | Education
Document Number: 342653

25.

Peer Reviewed

Title: Conducting unlinked anonymous HIV surveillance in developing countries: ethical, epidemiological, and public health concerns.
Author: Rennie S; Turner AN; Mupenda B; Behets F
Source: PLoS Medicine. 2009 Jan 20;6(1):e4.
Abstract: Data collected from HIV surveillance are crucial to guide public health interventions, planning, and prevention efforts. The practice of UAT, an important form of HIV surveillance, raises ethical, epidemiological, and public health challenges in low-income countries. Some ways of conducting UAT in the field violate the spirit and/or the letter of international ethical guidelines. Vulnerable populations, such as sex workers, may be subject to unjust treatment by local health authorities during HIV surveillance initiatives. Conducting UAT in ethically and epidemiologically sound ways in low-income countries requires a multifaceted approach including local capacity building, community engagement, and increased access to HIV and STI testing. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EPIDEMIOLOGIC METHODS | DATA COLLECTION | TARGET POPULATION | ETHICS | EPIDEMIOLOGY | PUBLIC HEALTH | HIV TESTING | CAPACITY BUILDING | PROGRAM ACCESSIBILITY | Research Methodology | Program Design | Programs | Organization and Administration | Sociocultural Factors | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Program Sustainability | Program Evaluation
Document Number: 330707

27.

Title: Life expectancy and welfare in Latin America and the Caribbean.
Author: Soares RR
Source: Health Economics. 2009 Apr;18 Suppl 1:S37-54.
Abstract: This paper analyses the recent evolution of life expectancy in Latin American and Caribbean countries, and evaluates how much it has contributed to the overall improvements in welfare. We argue that increases in life expectancy between 1960 and 2000, which were largely independent of income, represented gains in welfare comparable to the ones derived from income growth. For countries in the region, estimates of welfare improvements accounting for health increase the numbers obtained from income alone by 40% on average. The available evidence suggests that improvements in public health infrastructure - such as provision of treated water and sewerage services - and large-scale immunization programs may have been the key factors behind the mortality reductions observed in the period.
Language: English
Keywords:
CARIBBEAN | LATIN AMERICA | CRITIQUE | LIFE EXPECTANCY | SOCIAL WELFARE | PUBLIC HEALTH | IMMUNIZATION | WATER QUALITY | SANITATION | INCOME | INEQUALITIES | MORTALITY DECLINE | Developing Countries | Americas | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Economic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Water | Natural Resources | Environment | Socioeconomic Factors
Document Number: 341985

28.

Peer Reviewed

Title: International health policy and stagnating maternal mortality: is there a causal link?
Author: Unger JP; Van Dessel P; Sen K; De Paepe P
Source: Reproductive Health Matters. 2009 May;17(33):91-104.
Abstract: This paper examines why progress towards Millennium Development Goal 5 on maternal health appears to have stagnated in much of the global south. We contend that besides the widely recognised existence of weak health systems, including weak services, low staffing levels, managerial weaknesses, and lack of infrastructure and information, this stagnation relates to the inability of most countries to meet two essential conditions: to develop access to publicly funded, comprehensive health care, and to provide the not-for-profit sector with needed political, technical and financial support. This paper offers a critical perspective on the past 15 years of international health policies as a possible cofactor of high maternal mortality, because of their emphasis on disease control in public health services at the expense of access to comprehensive health care, and failures of contracting out and public�private partnerships in health care. Health care delivery cannot be an issue both of trade and of right. Without policies to make health systems in the global south more publicly-oriented and accountable, the current standards of maternal and child health care are likely to remain poor, and maternal deaths will continue to affect women and their families at an intolerably high level.
Spanish Abstract: En este art�culo se examinan las razones por las que los avances hacia el Objetivo 5 de Desarrollo del Milenio respecto a la salud materna parecen haberse estancado en gran parte del sur global. Arg�imos que adem�s de la existencia, ampliamente conocida de sistemas de salud d�biles, con servicios deficientes, n�mero reducido de personal, debilidades administrativas y falta de infraestructura e informaci�n, este estancamiento est� relacionado con la incapacidad de la mayor�a de los pa�ses para satisfacer dos condiciones esenciales: crear acceso a servicios de atenci�n integral de la salud financiados por el sector p�blico y brindar al sector sin fines de lucro el apoyo pol�tico, t�cnico y financiero que necesita. Este art�culo ofrece un punto de vista cr�tico sobre los �ltimos 15 a�os de pol�ticas internacionales de salud como un posible cofactor de las altas tasas de mortalidad materna, debido a su �nfasis en el control de enfermedades en servicios de salud p�blica a expensas del acceso a la atenci�n integral de la salud, as� como a los fracasos de subcontrataci�n y alianzas entre los sectores p�blico y privado de salud. La prestaci�n de atenci�n de salud no puede ser un asunto tanto de comercio como de derecho. Sin pol�ticas para lograr que los sistemas de salud del sur est�n m�s orientados hacia el p�blico y sean m�s responsables, los niveles actuales de atenci�n materno-infantil probablemente continuar�n siendo deficientes, y las muertes maternas continuar�n afectando intolerablemente a las mujeres y sus familias.
French Abstract: Pourquoi les progr�s vers l'OMD 5 relatif � la sant� maternelle semblent-ils stagner dans la plupart des pays du Sud ? Les auteurs de l'article avancent qu'en plus des faiblesses largement reconnues des syst�mes de sant�, notamment les d�ficiences des services, l'insuffisante dotation en personnel, les lacunes de la gestion, ainsi que le manque d'infrastructure et d'information, cette stagnation est due � l'incapacit� de la plupart des pays � rencontrer deux conditions essentielles : �largir l'acc�s � des soins de sant� globaux et financ�s par l'�tat, et doter le secteur non lucratif d'un soutien politique, technique et financier cruellement n�cessaire. L'article propose une perspective critique sur les politiques sanitaires internationales des 15 derni�res ann�es comme corr�lat possible de la mortalit� maternelle �lev�e, en raison de l'accent que ces politiques placent sur la lutte contre les maladies dans les services de sant� publique, aux d�pens de l'acc�s � des soins de sant� globaux, et le manque de recours aux services ext�rieurs et aux partenariats public-priv� dans la sant�. Les soins de sant� ne peuvent relever � la fois du commerce et du droit � la sant�. Sans politiques qui orienteront les syst�mes de sant� du Sud vers une logique sociale et les rendront plus comptables de leurs activit�s, les normes actuelles des soins de sant� maternelle et infantile risquent de rester m�diocres, et les d�c�s maternels continueront de toucher les femmes et leurs familles � un niveau intol�rable.
Language: English
Keywords:
GLOBAL | PHILOSOPHICAL OVERVIEW | INTERNATIONAL AGENCIES | HEALTH POLICY | GOALS | MATERNAL MORTALITY | PUBLIC HEALTH | MATERNAL-CHILD HEALTH SERVICES | DELIVERY OF HEALTH CARE | POLITICAL FACTORS | FINANCIAL ACTIVITIES | PRIVATE SECTOR | Organizations | Sociocultural Factors | Policy | Planning | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Health | Primary Health Care | Health Services | Economic Factors | Macroeconomic Factors
Document Number: 342018

29.

Title: The art of coalition building: A population, health, and environment consortium in Ethiopia.
Author: Zuehlke E; Bremner J
Source: Washington, D.C., Population Reference Bureau [PRB], 2009 Apr. [1] p.
Abstract: For more than a decade, PRB has nurtured national and international coalitions that address population, maternal and child health, global health priorities, and the environment. Sharing the successes and challenges of coalitions in similar contexts can motivate and instigate new coalitions. This article captures the experiences from a newly formed but rapidly advancing coalition focused on population, health, and environment issues in Ethiopia, with the hope that their experience will be valuable to similar nascent groups in sub-Saharan Africa and beyond. (Excerpt).
Language: English
Keywords:
ETHIOPIA | SUMMARY REPORT | POPULATION GROWTH | PUBLIC HEALTH | REPRODUCTIVE HEALTH | ENVIRONMENTAL PROTECTION | CAPACITY BUILDING | SOCIAL DEVELOPMENT | INTEGRATED PROGRAMS | COMMUNICATION STRATEGY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Population Dynamics | Demographic Factors | Population | Health | Natural Resources | Environment | Program Sustainability | Programs | Organization and Administration | Economic Factors | Communication
Document Number: 331348

30.
Peer Reviewed

Title: Report of the Intergovernmental Conference of Far-Eastern Countries on Rural Hygiene.
Source: American Journal of Public Health. 2008 Jan;98(1):40-42.
Abstract: While it is obvious that attention to the problem of rural populations has been an important consideration of Governments for many years, it is evident that, since the Great War. the people of many countries and their Governments realize more strongly than ever that that part of the population living on the land and producing the essential foodstuffs for all has been too often neglected. Governments are realizing more and more their obligations in this matter, and programs working toward the bettering of the social, economic, health and cultural conditions of the country-dwellers are becoming more general and more comprehensive. This present Conference had brought together Governmental representatives from the important countries of the East. The group includes: medical men concerned with curative and preventive medical services, educators, agronomists, specialists in rural reconstruction, sanitary engineers, experts in nutrition, and investigators who are devoting their attention to specific diseases. Statesmen and members of the legal profession who are concerned primarily with administrative duties are also to be found in the group. The development of rural programs reveals, in many instances, that the best results are to be obtained when the different welfare activities are planned and executed simultaneously by a trained staff. The interrelations of the work of the various groups have become more patent, and success in its broad lines rests on a realization of the interdependence of the work of all concerned. (excerpt)
Language: English
Keywords:
ASIA | SUMMARY REPORT | RECOMMENDATIONS | POPULATION | RURAL AREAS | GOVERNMENT | HEALTH SERVICES | EDUCATION | MALARIA PREVENTION | PUBLIC HEALTH | NUTRITION | HYGIENE | Developing Countries | Geographic Factors | Political Factors | Sociocultural Factors | Delivery of Health Care | Health | Malaria | Parasitic Diseases | Diseases
Document Number: 323107


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