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Title: The U.S. commitment to global health: Recommendations for the public and private sectors.
Author: Institute of Medicine. Committee on the U.S. Commitment to Global Health
Source: Washington, D.C., Institute of Medicine, 2009 May. 4 p. (Report Brief)
Abstract: In 2008, the Institute of Medicine convened the expert Committee on the U.S. Commitment to Global Health to investigate the U.S. commitment to global health and to articulate a vision for future U.S. investments in this arena. The committee concludes that the U.S. government and U.S.-based commercial entities, foundations, universities, and other nonprofit organizations have an opportunity to improve global health. The committee initially issued an interim report with recommendations aimed specifically at the U.S. government, such as prioritizing global health as a pillar of foreign policy. This subsequent report addresses other sectors as well as government. The committee identifies five areas for action by the interdisciplinary team: 1. Scale-up existing interventions to achieve significant health gains; 2. Generate and share knowledge to address problems prevalent in poor countries; 3. Invest in people, institutions, and capacity building with global partners; 4. Increase U.S. financial commitments to global health; 5. Set the example of engaging in respectful partnerships. (Excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | RECOMMENDATIONS | GOVERNMENT | ORGANIZATIONS | PRIVATE SECTOR | HEALTH | FOREIGN AID | CAPACITY BUILDING | KNOWLEDGE | LEADERSHIP | INTERNATIONAL COOPERATION | Developed Countries | North America | Americas | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors | Financial Activities | Program Sustainability | Programs | Organization and Administration
Document Number: 331419

Title: How to put an end to the practice of female genital mutilation (FGM)? Panel discussion report (6 February 2008).
Author: Inter-Parliamentary Union; International Organization for Migration [IOM]; Inter-African Committee on Traditional Practices Affecting the Health of Women and Children; Switzerland. Geneva. Departement des Institutions
Source: Geneva, Switzerland, Inter-Parliamentary Union, 2009. 32 p.
Abstract: Every 10 seconds, somewhere in the world, a little girl is a victim of genital mutilation. Three million girls are excised every year. To mark the International Day of Zero Tolerance to FGM on 6 February 2008, more than 100 representatives of international organizations, civil society, media, diplomatic missions and the local authorities in Geneva gathered at The House of Parliaments to discuss ways of putting an end to this harmful practice. The IPU, the Departement des Institutions de l?Etat de Geneve (Geneva Department of Institutions), the International Organization for Migration and the Inter-African Committee on Traditional Practices decided to join forces to put an end to this human tragedy. This publication contains the experts' contributions, extracts of the debates and conclusions of the seminar. (Excerpts)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | POLICYMAKERS | ADOLESCENTS, FEMALE | FEMALE GENITAL CUTTING | POLITICAL FACTORS | ADVOCACY | RELIGION | LEADERSHIP | SOCIAL POLICY | WOMEN'S RIGHTS | CULTURE | Economic Development | Economic Factors | Administrative Personnel | Organization and Administration | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Harmful Traditional Practices | Traditional Health Practices | Sociocultural Factors | Communication | Policy | Human Rights
Document Number: 331363

Title: Global action for health system strengthening: Policy recommendations to the G8 Task Force on Global Action for Health System Strengthening.
Author: Japan Center for International Exchange. Task Force on Global Action for Health System Strengthening
Source: Tokyo, Japan, Japan Center for International Exchange, 2009. 131 p.
Abstract: On January 16, 2009, a high-level working group on global health convened by the Japan Center for International Exchange (JCIE) released a report to the Japanese government outlining measures that the G8 countries should take to set them on a path toward fulfilling their existing commitments to contributing to an overall improvement in the health of individuals and communities around the world. The Working Group on Challenges in Global Health and Japan's Contributions (the "Takemi Working Group") is chaired by Japan's former Senior Vice Minister for Health, Labour and Welfare Keizo Takemi and directed by JCIE President Tadashi Yamamoto. The Japanese government will pass the report to the Italian government, encouraging them to put these recommendations on the agenda of the 2009 G8 Summit in Italy. The report includes chapters by an international team of researchers and advisors on three specific building blocks of health systems-health financing, health information, and the health workforce-that are generally acknowledged to be critical components of any strong health system. While each paper offers specific recommendations for improvements that can be made in each individual building block, they also come to several common conclusions: 1.) While there is still a dire need for more resources-financial, human, and knowledge resources-in the global health field, there is also a critical need to use existing resources more efficiently and more effectively. Recognizing that the current global financial environment will make it even more difficult to secure the resources needed to make health systems work better for everyone, the paper writers recommend complementing the quest for more resources with creative thinking on ways to achieve better health outcomes with the resources we already have. 2.) The human security concept, which has become a pillar of Japan's foreign policy, is identified as a promising approach that can be adopted globally for strengthening health systems. Human security's emphasis on the wellbeing of individuals and communities is very much in line with the ultimate goal of health system strengthening: improving people's health and making health services available to all so that they can be healthy, productive members of society. Human security also responds to the complexity of health system strengthening with its focus on integrating community empowerment with protection strategies and its recognition of the dynamic way in which health is interconnected with many other human security challenges. 3.) In all areas of health system strengthening, donor countries tend to tell their partners in developing countries how they should behave and make decisions. This can lead to confusion, with contradicting instructions often coming from multiple donors and even from single donors, and loss of motivation for stakeholders in partner countries to take ownership of processes to improve their own health sectors. Contributing to this challenge, capacity for making informed decisions on health is often weak, further discouraging domestic decision making in planning and management of health systems. The paper writers all recommend that donor countries invest in capacity building for health sector decision making at the national and local levels and, at the same time, encourage stakeholders in partner countries to drive their own planning and implementation processes. 4.) Finally, the paper writers all recommend that the G8 follow through on its commitment to accountability by establishing an annual review of its activities and accomplishments within each of these three building blocks. (excerpt)
Language: English
Keywords:
GLOBAL | DEVELOPING COUNTRIES | CONFERENCES AND CONGRESSES | RECOMMENDATIONS | SYSTEMS ANALYSIS | HEALTH PERSONNEL | LABOR FORCE | HEALTH POLICY | FOREIGN AID | CAPACITY BUILDING | GOVERNMENT FINANCING | INFORMATION SERVICES | PRIMARY HEALTH CARE | INTERNATIONAL COOPERATION | COORDINATION | Research Methodology | Delivery of Health Care | Health | Human Resources | Economic Factors | Policy | Political Factors | Sociocultural Factors | Financial Activities | Program Sustainability | Programs | Organization and Administration | Information | Health Services
Document Number: 328416

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

Title: Postpartum family planning for healthy pregnancy outcomes. A training manual.
Author: Pathfinder International. Extending Service Delivery Project
Source: Watertown, Massachusetts, Pathfinder, 2009 Feb. 124 p. (USAID Contract No. GPO-A-00-05-00027-00)
Abstract: This manual provides material to conduct a comprehensive two-day training for facility-based health workers (such as health supervisors, nurses and midwives) on providing community-based postpartum family planning education, counseling and referral that enables women and couples to use family planning methods for Healthy Timing and Spacing of Pregnancy (HTSP). The Manual addresses the following content areas: 1. The importance of the postpartum period; 2. HTSP for postpartum women; 3. Postpartum family planning for HTSP; 4. Postpartum family planning counseling and education; 5. Postpartum family planning for HIV positive women. Under each topic, key information for the trainer is provided, as well as a training activity to promote participant learning and skills development for improved community-based postpartum care that includes family planning and HTSP. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | MANUAL | RECOMMENDATIONS | EVALUATION | POSTPARTUM WOMEN | PREGNANCY OUTCOMES | FAMILY PLANNING EDUCATION | TRAINING OF TRAINERS | PREGNANCY INTERVALS | POSTPARTUM PROGRAMS | FAMILY PLANNING PROGRAMS | COUNSELING | MEN'S INVOLVEMENT | Puerperium | Reproduction | Pregnancy | Education | Training Programs | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration
Document Number: 325159

Title: Voluntary population planning activities -- supplemental requirements (January 2009) [letter]
Author: United States. Agency for International Development [USAID]. Bureau for Management. Office of Acquisition and Assistance
Source: Washington, D.C., USAID, Bureau for Management, Office of Acquisition and Assistance, 2009 Jan 26. [5] p.
Abstract: The purpose of this letter is to amend the Standard provisions of all grants and cooperative agreements involving any aspect of voluntary population planning activities and which contain the provision VOLUNTARY POPULATION PLANNING ACTIVITIES - SUPPLEMENTAL REQUIREMENTS (May 2006). This provision is deleted and replaced by the new provision VOLUNTARY POPULATION PLANNING ACTIVITIES - SUPPLEMENTAL REQUIREMENTS (January 2009) which removes the conditions relating to the Mexico City Policy that were set forth in the May 2006 version of the provision. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | GOVERNMENT PUBLICATION | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | USAID | STANDARDIZATION | GRANTS | POPULATION POLICY | FAMILY PLANNING PROGRAM EVALUATION | INCENTIVES | FAMILY PLANNING POLICY | CONTRACEPTIVE AGENTS | ABORTION LAW | STERILIZATION, SEXUAL | Administrative Personnel | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Data Adjustment | Research Methodology | Financial Activities | Economic Factors | Social Policy | Policy | Family Planning Programs | Family Planning | Contraception | Fertility Control, Postconception
Document Number: 331346 Notification

10.

Title: Assessment of family planning services in Kenya: Evidence from the 2004 Kenya Service Provision Assessment Survey.
Author: Agwanda A; Khasakhala A; Kimani M
Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [51] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 4) Based on further analysis of the 2004 Kenya Service Provision Assessment Survey.
Abstract: This study focused on factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to family planning clientele; the degree to which health care providers foster informed selection of an appropriate contraceptive method; and the extent to which clients perceive services to be of high quality. Data was obtained from the 2004 Kenya Service Provision Assessment. The composite indicators scores for facility readiness were generally low and many facilities lacked simple items like visual aids, guidelines, towels, speculum, etc. There were marked differences in facility readiness by region, facility type, and managing authority. Provider service provision scores were generally high but the only important difference was by region. Client satisfaction was dependent on the facility type, managing authority, sex of the provider, and the waiting time to receive services. Clients were more likely to be satisfied with female rather than male providers. Clients were less satisfied in Nyanza, although the facilities were more ready with high-performing providers. In contrast, North Eastern Province had less ready facilities, but high client satisfaction and high provider performance. Health centre, clinics, and dispensaries need to be revamped to appropriate standards so as to include all basic elements of family planning service provision. North Eastern Province, with motivated workers, highly satisfied clients but poor facilities, deserves proper attention. Facilities in Nairobi need improvements in staff supervision and retraining. There is need to educate the clientele on the availability of appropriate services within the government facilities.
Language: English
Keywords:
KENYA | RESEARCH REPORT | RECOMMENDATIONS | HEALTH SURVEYS | KAP SURVEYS | EVALUATION INDEXES | FAMILY PLANNING PERSONNEL CHARACTERISTICS | FAMILY PLANNING PERSONNEL EVALUATION | FAMILY PLANNING PROGRAM EVALUATION | PERCEPTION | HUMAN GEOGRAPHY | SATISFACTION | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Health | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Family Planning Personnel | Family Planning Programs | Family Planning | Psychological Factors | Behavior | Geography | Social Sciences | Science | Sociocultural Factors | Population Characteristics | Demographic Factors | Population
Document Number: 329890

11.

Peer Reviewed

Title: Pregnancy and optimal care of HIV-infected patients.
Author: Anderson BL; Cu-Uvin S
Source: Clinical Infectious Diseases. 2009 Feb 15;48(4):449-55.
Abstract: Human immunodeficiency virus (HIV) infection during pregnancy is a condition that requires multidisciplinary care. Care must be rendered that is appropriate for both the mother and the fetus. Prevention of mother-to-child transmission of HIV is of paramount concern. To prevent transmission, universal testing for HIV infection in pregnant women is ideal. In the United States and other developed countries, great strides have been made toward decreasing the risk of HIV transmission to infants to <2% with use of a combination of highly active antiretroviral therapy during the antepartum period and during labor and delivery, scheduled cesarean section when appropriate, avoidance of breast-feeding, and 6 weeks of zidovudine prophylaxis for infants. The continuation of antiretroviral therapy after delivery depends on the needs of the mother with regard to treatment of her own health. In resource-limited countries, where simplified and shortened courses of antiretroviral regimens have been used, reduction in mother-to-child transmission has also been shown, although not as effectively as that with highly active antiretroviral therapy. In these settings, exclusive breast-feeding for 6 months is recommended to reduce the risk of postnatal transmission.
Language: English
Keywords:
UNITED STATES OF AMERICA | DEVELOPING COUNTRIES | RECOMMENDATIONS | PREGNANT WOMEN | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV TESTING | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | DRUG RESISTANCE | ANTIRETROVIRAL THERAPY | RISK FACTORS | CESAREAN SECTION | BREASTFEEDING | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Disease Transmission Control | Prevention and Control | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Drugs | HIV | HIV Infections | Viral Diseases | Obstetrical Surgery | Surgery | Infant Nutrition | Nutrition
Document Number: 342644

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13.
Title: Approach in sexually transmitted diseases.
Author: Belda Junior W; Shiratsu R; Pinto V
Source: Anais Brasileiros de Dermatologia. 2009 Mar-Apr;84(2):151-9.
Abstract: Nowadays, sexually transmitted diseases are one of the most common public health issues. Among its consequences are the possibility of transmission from mother to baby - which may cause miscarriages and congenital disease, male and female infertility, and the increase of HIV infection risk. Therefore, the main goal of these guidelines is to contribute to the improvement of the treatment for sexually transmitted diseases patients by presenting to the medical community how today's science stands on the matter and also what the recommendation for diagnosing and treating a patient are.
Language: EnglishPortuguese
Keywords:
BRAZIL | RECOMMENDATIONS | SEXUALLY TRANSMITTED DISEASES | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | TREATMENT | CHANCROID | GONORRHEA | South America, Eastern | South America | Latin America | Americas | Developing Countries | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342656

14.
Peer Reviewed

Title: Provision of abortion by mid-level providers: international policy, practice and perspectives.
Author: Berer M
Source: Bulletin of the World Health Organization. 2009 Jan;87(1):58-63.
Abstract: Based on articles found on the PubMed and Popline databases on the provision of first-trimester abortion by mid-level providers, this article describes policies on type of abortion provider, comparative studies of different types of abortion provider, provider perspectives, and programmatic experience in Bangladesh, Cambodia, France, Mozambique, South Africa, Sweden, the United States of America and Viet Nam. It shows that it is safe and beneficial for suitably trained mid-level health-care providers, including nurses, midwives and other non-physician clinicians, to provide first-trimester vacuum aspiration and medical abortions. Moreover, it finds that projects in Kenya, Myanmar and Uganda have successfully trained nurse-midwives to provide post-abortion care for incomplete abortion with manual vacuum aspiration, and that studies in Ethiopia and India have recommended that providers such as auxiliary nurse-midwives should be trained in abortion service delivery to ensure that they provide safe abortions for low-income women. The paper recommends the authorization of all qualified mid-level health-care providers to carry out first-trimester abortions, and it also recommends the integration of training in providing first-trimester abortion care into basic education and clinical training for all mid-level providers and medical students interested in obstetrics and gynaecology. Finally, it calls for documentation of the role of mid-level providers in managing second-trimester medical abortions to further inform policy and practice.
Language: English
Keywords:
DEVELOPING COUNTRIES | DEVELOPED COUNTRIES | RECOMMENDATIONS | COMPARATIVE STUDIES | CLINICAL RESEARCH | HEALTH PERSONNEL | ABORTION | PREGNANCY, FIRST TRIMESTER | POSTABORTION CARE | TRAINING PROGRAMS | Studies | Research Methodology | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Health Services | Education
Document Number: 341127

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Peer Reviewed

Title: A global fund for the health MDGs?
Author: Cometto G; Ooms G; Starrs A; Zeitz P
Source: Lancet. 2009 May 2;373(9674):1500-2.
Abstract: The world is off track to achieve the health-related targets of the Millennium Development Goals (MDGs) by 2015. Maternal mortality has stagnated for two decades, child mortality is not declining fast enough, HIV/AIDS still infects people faster than the pace of antiretroviral treatment roll-out, and inequalities are widening within and across countries. Addressing these crises will require increased funding and more efficient spending. The next Board meetings of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance, scheduled for May and June, respectively, present an opportunity to tackle these issues. We propose that the exceptional approach created for the fight against AIDS should be expanded: the entire global health agenda must adopt a rights-based approach, which in some countries requires challenging the model of national financial autonomy. We therefore recommend that the Global Fund and the GAVI Alliance gradually move towards becoming a global fund for all the health MDGs, which will require substantially greater resources to address the broader mandate. As a first step the next Global Fund and GAVI Alliance board meetings should expand the review of their architecture to provide greater support to national health plans, including co-financing non-disease-specific human resources for health. A global fund for the health MDGs would eventually allow the delivery of prevention and treatment services for specific diseases through revamped general health services, reducing transaction costs and streamlining the global health architecture. Such radical, yet rational, action is our best chance of meeting-or at least making significant progress toward-the health-related MDG targets by 2015.
Language: English
Keywords:
DEVELOPING COUNTRIES | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | GOALS | DEVELOPMENT POLICY | HEALTH POLICY | FUNDS | FOREIGN AID | INTERNATIONAL COOPERATION | COORDINATION | WHO | Administrative Personnel | Organization and Administration | Planning | Policy | Political Factors | Sociocultural Factors | Financial Activities | Economic Factors | UN | International Agencies | Organizations
Document Number: 341099

19.
Title: Mainstreaming early and exclusive breastfeeding for improving child survival.
Author: Dadhich JP; Agarwal RK
Source: Indian Pediatrics. 2009 Jan;46(1):11-7.
Abstract: India is home to maximum number of under-five deaths and underweight children in the world. In 2006, for the first time, the number of children in the world dying before their fifth birthday fell below 10 million, to 9.7 million annually. South Asia's contribution to this figure was 3.1 million out of which 2.1 million deaths occurred in India i.e., 21 percent of the global burden of under five deaths. Most of these deaths occur during the neonatal period. A reduction in the number of deaths among the under-five children reflects the country's progress on the fourth Millennium Development Goal (MDG 4). About 55 million, or one-third of the world's underweight children under the age of five years, live in India. Malnutrition has been estimated to be an underlying cause of up to 50-60 percent of under five deaths. The number of young underweight children reflects the country's progress on the first Millennium Development Goal (MDG 1), which deals with eradication of extreme poverty and hunger. In India, the average annual rate of decline in malnutrition has been around 0.9% since 1990. Considerably accelerated progress is needed for India to meet its MDG target of halving the percentage of underweight children by 2015. Despite breastfeeding's numerous recognized advantages, early and exclusive breastfeeding rates in most states of the India are low. There are many gaps in policy and programs related to infant and young child feeding in India. The big challenge is how to mainstream IYCF counseling and support interventions to help women to succeed both in early and exclusive breastfeeding. The rationale for supporting a major program to protect, promote and support breastfeeding action, backed by a budgetary support, is compelling for our country. Child health and development policies should urgently address this major concern.
Language: English
Keywords:
INDIA | RECOMMENDATIONS | HEALTH SURVEYS | MOTHERS | INFANT | BREASTFEEDING, EXCLUSIVE | CHILD SURVIVAL | MALNUTRITION | BODY WEIGHT | TIME FACTORS | POSTPARTUM PROGRAMS | LONGTERM EFFECTS | INTELLIGENCE | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Asia, Southern | Asia | Developing Countries | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Infant Nutrition | Nutrition | Survivorship | Length of Life | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Physiology | Biology | Family Planning Programs | Family Planning | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Disease Transmission Control | Prevention and Control
Document Number: 331250

20.

Peer Reviewed

Title: Intensified case finding for tuberculosis in prevention of mother-to-child transmission programs: a simple and potentially vital addition for maternal and child health.
Author: Deluca A; Chaisson RE; Martinson NA
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Feb 1;50(2):196-9.
Abstract: The intersection of HIV and tuberculosis (TB) poses a serious threat to HIV-infected women and their children. The majority of patients with TB in sub-Saharan Africa are infected with HIV, and together the overlapping epidemics synergistically accelerate illness and death. Escalating case rates, increased mortality, and the recent emergence of extensively drug-resistant TB highlights how catastrophic a once preventable and curable disease has become among people with HIV/AIDS. The HIV epidemic requires new strategies to control TB in high-burden areas especially as women of reproductive age are disproportionately affected by the epidemic. Intensified case finding for TB has the potential to reduce morbidity and mortality for people living with HIV, especially pregnant women, their families, and infants. (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | LITERATURE REVIEW | RECOMMENDATIONS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | COMPLICATIONS | INTEGRATED PROGRAMS | PREVALENCE | INCIDENCE | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infections | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Measurement
Document Number: 330367

21.

Title: Advances and future directions in HIV surveillance in low- and middle-income countries.
Author: Diaz T; Garcia-Calleja JM; Ghys PD; Sabin K
Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):253-9.
Abstract: PURPOSE OF REVIEW: To present recent advances in HIV/AIDS surveillance methods in low- and middle-income countries. RECENT FINDINGS: From 2001 to 2008, 30 low- and middle-income countries implemented national population-based surveys with HIV testing. Antenatal clinic HIV sentinel surveillance sites in sub-Saharan Africa increased from just over 1000 in 2003-2004 to almost 2500 in 2005-2006, becoming more representative of rural areas. Between 2003 and 2007, at least 122 behavioral surveys in low- and middle-income countries used respondent-driven sampling for surveillance among high-risk populations, although many countries with concentrated epidemics continue to have major sentinel surveillance gaps. Improvements have been made in modeling estimates of number of persons HIV infected, and systems are now in place to measure HIV drug resistance. However, the reliable monitoring of trends and the measuring of HIV incidence, morbidity, and mortality is still a challenge. SUMMARY: In the past 5 years, there have been substantial improvements in the quantity and quality of HIV surveillance studies, especially in the countries with high prevalence. Further efforts should be made in countries that lack fully implemented surveillance systems to improve HIV incidence, morbidity, and mortality surveillance and to use data more effectively.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | RECOMMENDATIONS | HIV INFECTIONS | AIDS | EPIDEMICS | MONITORING | MORTALITY | PREVALENCE | HIV TESTING | DRUG RESISTANCE | INCIDENCE | Viral Diseases | Diseases | Evaluation | Population Dynamics | Demographic Factors | Population | Measurement | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment
Document Number: 342342

22.

Title: Thrombophilic conditions in the adolescent: the gynecologic impact.
Author: Dietrich JE; Yee DL
Source: Obstetrics and Gynecology Clinics of North America. 2009 Mar;36(1):163-75.
Abstract: As Virchow's triad suggests, a fine balance exists between the vascular wall, intravascular contents, and dynamic blood flow, such that a shift in this balance predisposes to thrombosis. Although thromboembolic events (TEs) are relatively infrequent in adolescents, the morbidity and mortality associated with TEs can be significant. Over the past 15 years, TEs and inherited and acquired thrombophilic conditions underlying them have become increasingly recognized in teens at risk, with combined hormonal contraception constituting one of the most significant of these risk factors. Therefore, managing gynecologic problems in teens who have thrombophilic conditions can be challenging. It is important to have a clear understanding about safe options available to help address adolescent gynecologic concerns in this setting and to manage situations collaboratively with a hematologist.
Language: English
Keywords:
UNITED STATES OF AMERICA | RECOMMENDATIONS | ADOLESCENTS, FEMALE | GYNECOLOGY | THROMBOSIS | RISK FACTORS | HEREDITARY DISEASES | CONTRACEPTIVE AGENTS, FEMALE | ORAL CONTRACEPTIVES, COMBINED | BLOOD COAGULATION EFFECTS | SCREENING | PROGESTERONE | CONTRACEPTIVE METHODS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Thromboembolism | Embolism | Vascular Diseases | Diseases | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Hematological Effects | Hemic System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Progestational Hormones | Hormones | Endocrine System
Document Number: 342856

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25.

Peer Reviewed

Title: Universal voluntary HIV testing and immediate antiretroviral therapy [letter]
Author: Epstein H
Source: Lancet. 2009 Mar 28;373(9669):1078-9; author reply 1080-1.
Abstract: Reuben Granich and colleagues explore a policy of universal voluntary HIV testing with immediate anti retroviral therapy as a strategy for elimination of HIV transmission. I wonder how relevant their findings are, given that the models used do not account for concurrency-i.e., overlapping, longterm partnerships-which are likely to account for a substantial amount of HIV transmission in South Africa. Granich and colleagues do state that their model "allows for a high level of concurrency and for a much higher infectiousness during the acute phase than during the chronic phase." However, the reference they use to support this statement does not model concurrency, but uses a basic risk-category, deterministic model combined with a factor for changes in viral load. This is not the same thing as modelling concurrency, which is a network effect enhanced by, but independent of, viral load fluctuations. For deterministic models to approximate the observed prevalence of HIV, they must make unreasonable assumptions about African sexual behaviour. The authors of the cited paper, and presumably Granich and colleagues, assume that 1% of people have on average 77 partners per year. Behavioural surveys from Africa have never found such high levels of "promiscuity". The authors' assumption is derived not from behavioural data, but from the demands of the model itself. The model would not predict actual prevalence otherwise. Network models do not require unrealistic assumptions, and are much better able to derive prevalence estimates on the basis of actual behavioural data. Thus, it would seem worth modelling the effect of testing and antiretroviral therapy with a network model that includes concurrent partnerships. At the very least, factoring in concurrency would increase the relative amount of transmission attributable to the "acute" phase-i.e., when infection is not even detectable on an HIV test- beyond that calculated by Abu-Raddad and Longini (and presumably Granich and colleagues). That would reduce the effect of testing and early treatment significantly, I suspect. (full-text)
Language: English
Keywords:
SOUTH AFRICA | CRITIQUE | RECOMMENDATIONS | THEORETICAL MODELS | TARGET POPULATION | VOLUNTARY COUNSELING AND TESTING | HIV TESTING | HIV PREVENTION | CAPACITY BUILDING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Program Design | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Program Sustainability
Document Number: 330978

26.

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

27.

Title: Guatemala: Using supply chain modeling and simulation to analyze the Ministry of Health supply chain.
Author: Gibney J; Sanchez A; Lamadrid C
Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009 Mar. 38 p. (USAID Contract No. GPO-I-01-06-00007-00)
Abstract: This activity analyzed the characteristics of the integrated logistics system in three departments in Guatemala: Solol�, Totonicap�n, and Jutiapa. This paper identifies some of the obstacles to achieving contraceptive availability for the underserved and vulnerable populations; it also offers options for improving equity in access for family planning commodities. The study identifies elements in the Ministry of Public Health and Social Welfare�s (MSPAS) logistics system that could impede the availability and accessibility of contraceptives. By using supply chain simulation and optimization modeling software, with geographic information system tools, the authors propose system-related solutions that could improve the performance of the overall MSPAS.
Language: English
Keywords:
GUATEMALA | RECOMMENDATIONS | GOVERNMENT AGENCIES | LOGISTICS | HEALTH SERVICES EVALUATION | CONTRACEPTIVE AVAILABILITY | OBSTACLES | NEEDS | CONTRACEPTIVE DISTRIBUTION | PERFORMANCE IMPROVEMENT | GEOGRAPHY | INFORMATION RETRIEVAL SYSTEMS | TRANSPORTATION | Central America | Latin America | Americas | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Program Evaluation | Programs | Contraception | Family Planning | Economic Factors | Distributional Activities | Program Activities | Social Sciences | Science | Data Storage and Retrieval | Information Processing | Information
Document Number: 331663

28.

Peer Reviewed

Title: The obstetric face and challenge of HIV/AIDS.
Author: Guidozzi F; Black V
Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):270-84.
Abstract: The human immunodeficiency virus (HIV) pandemic is one of the most serious health crises facing the world. Of the estimated 33.2 million people living with HIV worldwide, 22.5 million (68%) live in Sub-Saharan Africa, where women of childbearing age are most severely affected. Children primarily acquire HIV infection through mother-to-child transmission. Despite recent encouraging success, low-income countries have not been able to effectively curtail transmission of HIV to the infant during or after pregnancy, resulting in about 90% of the estimated 420,000 newly infected children per annum occurring in Sub-Saharan Africa.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | HIV INFECTIONS | AIDS | EPIDEMICS | OBSTETRICS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | BREASTFEEDING | HIV TESTING | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | DRUG RESISTANCE | Viral Diseases | Diseases | Medicine | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Infant Nutrition | Nutrition | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | HIV | Treatment | Drugs
Document Number: 342173

29.

30.

Peer Reviewed

Title: Scheduled and unscheduled bleeding patterns with two combined hormonal contraceptives: application of new recommendations for standardization.
Author: Hampton RM; Fisher AC; Pagano S; LaGuardia KD
Source: Fertility and Sterility. 2009 Aug;92(2):434-40.
Abstract: OBJECTIVE: To reassess and compare cycle control attained with two combined hormonal contraceptives, norgestimate (NGM)/ethinyl estradiol (EE) 25 microg and norethindrone acetate (NETA)/EE 20 microg, by new general criteria recommendations for all combined hormonal contraceptives. DESIGN: Analysis of bleeding data for cycles 1-6 from a randomized, multicenter trial. SETTING: 221 North American centers. PATIENT(S): Healthy, sexually active women (18-45 years old). INTERVENTION(S): NETA/EE: 1 mg NETA/20 microg EE, days 1-21 of each cycle and 75 mg of ferrous fumarate, days 22-28; NGM/EE: triphasic NGM in 7-day increments (days 1-7: 180 microg; days 8-14: 215 microg; days 15-21: 250 microg) and 25 microg EE, placebo on days 22-28. MAIN OUTCOME MEASURE(S): Cycle control evaluated from patients' daily diaries. RESULT(S): For cycles 1-6, there was a statistically significant lower incidence of unscheduled bleeding/spotting with NGM/EE 25 microg (range 21.0%-34.4%) than with NETA/EE 20 microg (range 33.0%-46.6%). Of the women who had unscheduled bleeding/spotting, the mean number of days per cycle of bleeding/spotting was comparable. A statistically significant higher incidence of scheduled bleeding was seen with NGM/EE 25 microg (95.2%-97.5%) than with NETA/EE 20 microg (78.5%-84.2%). CONCLUSION(S): The NGM/EE 25 microg has a lower incidence and comparable length of unscheduled bleeding and a higher incidence of scheduled bleeding than NETA/EE 20 microg in this post hoc analysis.
Language: English
Keywords:
NORTH AMERICA | RESEARCH REPORT | CLINICAL TRIALS | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | NORETHINDRONE ACETATE | BLEEDING | STANDARDS | EVALUATION | RECOMMENDATIONS | Developed Countries | Americas | Clinical Research | Research Methodology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Norethindrone | Contraceptive Agents, Progestin | Signs and Symptoms | Diseases
Document Number: 342585


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