1.  Title: Guinea. Village health committees drive family planning uptake: communities play lead role in increased acceptability, availability. Author: Diakite O; Keita DR; Mwebesa W Source: Washington, D.C., Core Group, [2009]. 8 p. Abstract: This document highlights the Village Health Committee (VHC), a vital player in the child survival project and the integration of family planning work within Save the Children's portfolio in Guinea. The document briefly describes the committee's purpose, membership, and tasks. It focuses on a handful of the people and activities that exemplified the VHCs' unique role in ensuring that family planning was not only accessible but acceptable to the villagers they served. The document concludes with some outcomes of Save the Children's family planning component in Mandiana and Kouroussa. In effect, the VHCs' stellar success in building demand for contraception (when coupled with modest investments in existing health workers' ability to supply modern methods) resulted in a sustained increase in the use of contraception in the project zone. Language: English Keywords: GUINEA | PROGRESS REPORT | EVALUATION | COMMUNITY | RURAL POPULATION | USAID | COMMUNITY HEALTH SERVICES | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | PERFORMANCE IMPROVEMENT | RURAL HEALTH SERVICES | FAMILY PLANNING | HEALTH SERVICES EVALUATION | PROGRAM ACCEPTABILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Primary Health Care | Health Services | Health | Program Evaluation | Programs | Organization and Administration | Management Document Number: 325193 |
2.  Peer Reviewed Title: Successful integration of tuberculosis and HIV treatment in rural South Africa: the Sizonq'oba study. Author: Gandhi NR; Moll AP; Lalloo U; Pawinski R; Zeller K; Moodley P; Meyer E; Friedland G Author: Tugela Ferry Care and Research (TFCaRes) Collaboration Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Jan 1;50(1):37-43. Abstract: BACKGROUND: Tuberculosis (TB) is the leading cause of death among HIV-infected patients worldwide. In KwaZulu-Natal, South Africa, 80% of TB patients are HIV coinfected, with high treatment default and mortality rates. Integrating TB and HIV care may be an effective strategy for improving outcomes for both diseases. METHODS: Prospective operational research study treating TB/HIV-coinfected patients in rural KwaZulu-Natal with once-daily antiretroviral (ARV) therapy concurrently with TB therapy by home-based, modified directly observed therapy. Patients were followed for 12 months after ARV initiation. RESULTS: Of 119 TB/HIV-coinfected patients enrolled, 67 (56%) were female, mean age was 34.0 years, and median CD4 count was 78.5 cells per cubic millimeter. After 12 months on ARVs, mean CD4 count increase was 211 cells per cubic millimeter, and 88% had an undetectable viral load; 84% completed TB treatment. Thirteen patients (11%) died; 10 (77%) with multidrug-resistant or extensively drug-resistant TB. There were few severe adverse events or immune reconstitution events. Adherence was high with 93% of study visits attended and 99% of ARV doses taken. CONCLUSIONS: Integration of TB and HIV treatment in a rural setting using concurrent home-based therapy resulted in excellent adherence and TB and HIV outcomes. This model may result in successful management of both diseases in other rural resource-poor settings. Language: English Keywords: SOUTH AFRICA | EVALUATION REPORT | PROSPECTIVE STUDIES | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RURAL POPULATION | INTEGRATED PROGRAMS | TUBERCULOSIS | AIDS PREVENTION | TREATMENT | RURAL HEALTH SERVICES | COMPLICATIONS | ANTIRETROVIRAL THERAPY | HOME VISITS | DRUG RESISTANCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Infections | AIDS | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Communication Document Number: 330981 |
| 3. Peer Reviewed Title: Pregnancy-related deaths in rural Rajasthan, India: exploring causes, context, and care-seeking through verbal autopsy. Author: Iyengar K; Iyengar SD; Suhalka V; Dashora K Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):293-302. Abstract: In 2002-2003, all deaths (n=156) of women aged 15-49 years in a block of southern Rajasthan were investigated to determine the cause of death and care-seeking behaviour. Family members of 156 (98%) of 160 deceased women were interviewed following the comprehensive listing of all deaths among women of reproductive age. Of the 156 deaths, 31 (20%) were pregnancy-related; 77% of these women died during the postpartum period, and 74% of the deaths occurred in the home. Direct and indirect obstetric causes were responsible for 58% and 29% of the deaths respectively; 12% were injury-related deaths. Medical care was sought for 65% of the women, and 29% were hospitalized. Family perception of not being able to afford treatment at distant hospitals was a major barrier to seeking care, and 60% of those who sought care had to borrow money for treatment. Lack of skilled attendance and immediate postpartum care were major factors contributing to deaths. Improved access to emergency obstetric care facilities in rural areas and steps to eliminate costs at public hospitals would be crucial to prevent pregnancy-related deaths. Language: English Keywords: INDIA | RURAL AREAS | RESEARCH REPORT | CASE HISTORIES | LOW LITERATES | MATERNAL MORTALITY | PREGNANCY COMPLICATIONS | AUTOPSY | CAUSES OF DEATH | RURAL HEALTH SERVICES | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | OBSTACLES | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Data Collection | Research Methodology | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Maternal-Child Health Services | Primary Health Care | Organization and Administration Document Number: 341928 |
| 4. Peer Reviewed Title: Evaluating completeness of maternal mortality reporting in a rural health and social affairs unit in Vellore, India, 2004. Author: Kim SY; Rochat R; Rajaratnam A; Digirolamo A Source: Journal of Biosocial Science. 2009 Mar;41(2):195-205. Abstract: Health systems in developing countries infrequently implement and evaluate maternal death surveillance. This study identified under-reported and misclassified maternal deaths among women of reproductive age between 1999 and 2004 in a rural service unit in Vellore, India. In-depth interviews, semi-structured interviews and structured questionnaires were used to identify maternal deaths known to health care providers and community leaders who regularly come in contact with pregnant women. Eighteen under-reported and misclassified cases--or 50% of maternal deaths--were reported. These included 29% of abortion-related and 7% of domestic violence-related deaths. Based on this study's fieldwork, the existing death surveillance system detected 100% of the maternal deaths reported by hospital staff; however, it missed most maternal deaths reported by community workers. The latter are more likely than deaths reported by hospital workers to result from abortion and family violence. The existing surveillance system should be augmented with a community-based death surveillance system. This comprehensive approach identified twice as many maternal deaths than previously recorded and could be applied in other settings. Appropriate public health interventions should be initiated to prevent maternal deaths in this community. Language: English Keywords: INDIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CLASSIFICATION | KAP SURVEYS | LONGITUDINAL STUDIES | RURAL POPULATION | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | DEATH RATE | MATERNAL MORTALITY | RURAL HEALTH SERVICES | CAUSES OF DEATH | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Surveys | Sampling Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Mortality | Population Dynamics | Health Services | Delivery of Health Care | Health Document Number: 331112 |
| 5. Peer Reviewed Title: Early assessment of the implementation of a national programme for the prevention of mother-to-child transmission of HIV in Cameroon and the effects of staff training: a survey in 70 rural health care facilities. Author: Labhardt ND; Manga E; Ndam M; Balo JR; Bischoff A; Stoll B Source: Tropical Medicine and International Health. 2009 Mar;14(3):288-93. Abstract: OBJECTIVES: To assess the availability of equipment and the staff's knowledge to prevent Mother-To-Child Transmission (PMTCT) in rural healthcare facilities recently covered by the national PMTCT programme in Cameroon. METHODS: In eight districts inventories of antiviral drugs and HIV test kits were made on site, using a standardised check-list. Knowledge of HIV and PMTCT was evaluated with a multiple-choice (MC) questionnaire based on typical clinical PMTCT cases. Staff participated subsequently in a 2-day training on HIV/AIDS and the Cameroon PMTCT guidelines. Immediately after training and after 7 months, retention of knowledge was tested with the same questions but in different order and layout. RESULTS: Sixty two peripheral nurse-led clinics and the eight district hospitals were assessed. Whereas all district hospitals presented complete equipment, only six of the peripheral clinics (10%) were equipped with both complete testing materials and a full set of drugs to provide PMTCT. Thirty six peripheral facilities (58%) possessed full equipment for HIV-testing and 8 (13%) stocked all PMTCT drugs. Of 137 nurses, 102 (74%) agreed to the two knowledge tests. Fewer than 66% knew that HIV-diagnosis requires positive results in two different types of rapid tests and only 19% chose the right recommendation on infant-feeding for HIV-positive mothers. Correct answers on drug regimens in different PMTCT settings varied from 25% to 56%. All percentages of correct answers improved greatly with training (P < 0.001) and retention remained high 7 months after training (P < 0.001). CONCLUSIONS: Prevent Mother-To-Child Transmission programmes in settings such as rural Cameroon need to be adapted to the special needs of peripheral nurse-led clinics. Appropriate short training may considerably improve nurses' competence in PMTCT. Other important components are regular supervision and measures to guarantee supply of equipment in rural areas. Language: English Keywords: CAMEROON | EVALUATION REPORT | KAP SURVEYS | HEALTH PERSONNEL | INFANT | GOVERNMENT PROGRAMS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | TRAINING PROGRAMS | RURAL HEALTH SERVICES | KNOWLEDGE | HIV TESTING | ANTIRETROVIRAL DRUGS | EQUIPMENT AND SUPPLIES | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | HIV Infections | Viral Diseases | Education | Health Services | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Treatment Document Number: 330960 |
| 6. Title: Child survival: India and China's challenges [editorial] Source: Lancet. 2008 Aug 16;372(9638):508. Abstract: Last week, UNICEF published The State of Asia-Pacific's Children 2008-its first annual report on maternal, newborn, and child survival in the region. The report has a particular focus on the challenges for India and China, since, with their huge populations, achievements in these countries can make a substantial difference to child survival in the region and worldwide. China has made good investments in health (10% of gross domestic product) and is on track to reach Millennium Development Goal (MDG) 4 on child survival. However, UNICEF notes that the country's progress has slowed down in the past 10 years and the coverage of essential interventions remains low in rural areas. The report singles out India. It states that the global attainment of the health-related MDGs will largely depend on the country's progress in improving health and addressing the social determinants of health. A fifth of all deaths (2.1 million) in children younger than 5 years occurred in India in 2006. Huge disparities in infant mortality rates exist-within cities and between urban and rural areas, and between the sexes, socioeconomic groups, and different castes. The privatisation of health care in India and China is set to widen the gaps between rich and poor people. Without progress on reducing disparities, efforts to provide primary health care to women and children could founder, says UNICEF. But there are reasons for optimism in India. The government launched the National Rural Health Mission in 2005 to tackle deepening disparities in the country, with the reduction of the infant mortality rate as a primary goal. Interventions, such as cash transfers for expectant mothers living below the poverty line, neonatal services, and the Integrated Management of Neonatal and Childhood Illness, are gradually being rolled out. Such initiatives show there is political will in India to address child survival. But this commitment is not backed-up by serious financial investment. The Indian Government spends less on health (3% of gross domestic product) than several other countries in the Asia-Pacific region, despite a gross domestic product growth rate of 9% in 2007. India can, and must, spend more on health if its mothers and children are to prosper. (full text) Language: English Keywords: CHINA | INDIA | CRITIQUE | CHILD HEALTH SERVICES | CHILD MORTALITY | CHILD | INFANT | INFANT MORTALITY | POVERTY | RURAL HEALTH SERVICES | UNICEF | Asia, Eastern | Asia | Developing Countries | Asia, Southern | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Socioeconomic Factors | Economic Factors | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 328434 |
| 7. Title: Clients' satisfaction with services for prevention of mother-to-child transmission of HIV in Dodoma Rural district. Author: Lyatuu MB; Msamanga GI; Kalinga AK Source: East African Journal of Public Health. 2008 Dec;5(3):174-9. Abstract: OBJECTIVE: The study was conducted to assess clients' satisfaction with PMTCT services on privacy, waiting time and counselling in PMTCT of HIV /AIDS in Dodoma Rural district. METHODS: A cross sectional study was conducted to 208 women assessing Reproductive Child Health (RCH) and PMTCT of HIV services. Data collection method involved both client exit interviews and focus group discussions (FGD) with women attending RCH services. Systematic random sampling technique was used to obtain the required sample of 208 clients for the exit interviews. A total of five FGDs were conducted each with eight to ten people. The data obtained were analysed using Epi Info. SETTINGS: Dodoma Rural district, central Tanzania RESULTS: Of 113 clients' who accessed PMTCT services, 75.2% were satisfied with the counselling provided. A significant difference (P = 0.02) was observed between clients with no formal education as compared to those with primary level of education and above. Nearly a quarter of the clients who accessed PMTCT of HIV services were not satisfied with the privacy in the settings providing the service. It was also found that 71.7% of clients accessing PMTCT of HIV service was satisfied with the waiting time spent for the service; however a difference was observed (P = 0.001) between clients who accessed services at health centre (77.6%) and hospital (33.3%). CONCLUSION: A quarter of the clients were not satisfied either with the counselling they received on PMTCT of HIV, privacy or waiting time they spent while accessing services. Some of the reasons contributing to dissatisfaction included inadequacy in individual counselling, inadequate on site test supplies and equipment and cost incurred when travelling to seek for PMTCT service from a referral or satellite health facility. Language: English Keywords: TANZANIA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | FOCUS GROUPS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | RURAL POPULATION | SATISFACTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | EDUCATIONAL STATUS | WAITING AREAS AND QUEUES | TIME FACTORS | HOSPITALS | RURAL HEALTH SERVICES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Disease Transmission Control | Prevention and Control | Diseases | Socioeconomic Status | Socioeconomic Factors | Workplace | Employment | Macroeconomic Factors | Population Dynamics | Health Facilities | Delivery of Health Care | Health | Health Services Document Number: 331265 |
| 8. Peer Reviewed Title: Midwifery provision in two districts in Indonesia: How well are rural areas served? Author: Makowiecka K; Achadi E; Izati Y; Ronsmans C Source: Health Policy and Planning. 2008 Jan;23(1):67-75. Abstract: Attention has focused recently on the importance of adequate and equitable provision of health personnel to raise levels of skilled attendance at delivery and thereby reduce maternal mortality. Indonesia has a village-based midwife programme that was intended to increase the rate of professional delivery care and redress the urban/rural imbalance in service provision by posting a trained midwife in every village in the country. We present findings on the distribution of midwifery provision in our study area: 10% of villages do not have a midwife but a nurse as a midwifery provider; there is a deficit in midwife density in remote villages compared with urban areas; those assigned to remote areas are less experienced; midwives manage few births and this may compromise their capacity to maintain professional skills; over 90% of non-hospital deliveries take place in the woman's (64%) or the midwife's (28%) home; three-quarters of midwives did not make regular use of the fee exemption scheme; midwives who live in their assigned village spend more days per month on clinical work there. We conclude that adequate provider density is an important factor in effective health care and that efforts should be made to redress the imbalance in provision, but that this can only contribute to reducing maternal mortality in the context of a supportive professional environment and timely access to emergency obstetric care. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | QUESTIONNAIRES | MIDWIVES AND MIDWIFERY | RURAL AREAS | RURAL HEALTH SERVICES | MATERNAL HEALTH | MATERNAL MORTALITY | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | Developing Countries | Asia, Southeastern | Asia | Health Personnel | Delivery of Health Care | Health | Geographic Factors | Population | Health Services | Mortality | Population Dynamics | Demographic Factors | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation Document Number: 314034 |
| 9. Title: Community-based approaches to combating malnutrition and poor education among girls in resource-poor settings: report of a large scale intervention in Pakistan. Author: Pappas G; Agha A; Rafique G; Khan KS; Badruddin SH; Peermohamed H Source: Rural and Remote Health. 2008 Jul-Sep;8(3):820. Abstract: INTRODUCTION: Malnutrition and low levels of education continue to be major problems in many developing countries, especially for female children. METHODS: In Pakistan, a large-scale school lunch program was implemented in 29 of the poorest rural districts through a public-private partnership. The project provided freshly prepared meals in 4035 government primary girls' schools over a 2 year period. The primary strategy was empowerment of women in the community who volunteered to plan the meals, purchase the food, and cook and serve the meals. The project collected data from growth monitoring, attendance records, pre- and post-intervention community based surveys, focus group discussions, and the use of other ethnographic methods. A study on changes in the levels of malnutrition was based on an analytical sample of 203,116 girls who received at least two sets of body measurements at least 6 months apart. RESULTS: Over the intervention period, wasting declined by almost half and school enrolment increased by 40%. Girls who entered the program early were found to have similar levels of malnutrition to girls who entered late, suggesting that factors external to the program were not associated with the decrease in malnutrition. CONCLUSION: This study demonstrates the potential success and scalability of school feeding programs in Pakistan. Lessons learned include that synergies are found when working across sectors (health, education, and empowerment) and that there are challenges to intersectoral projects. Globalization may undermine this successful model as Pakistan considers expanded school feeding programs. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | MEDICAL STUDENTS | RURAL POPULATION | PERCEPTION | SATISFACTION | RURAL HEALTH SERVICES | CLINICS | TRAINING PROGRAMS | FEEDBACK | CLINIC ACTIVITIES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Students | Education | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Health Services | Delivery of Health Care | Health | Health Facilities | Evaluation Methodology | Evaluation | Program Activities | Programs | Organization and Administration Document Number: 328881 |
| 10. Title: Improving the health of the poor in Mexico. Author: Center for Global Development Source: Washington, D.C., Center for Global Development, [2007]. 9 p. (Millions Saved Initiative Case 9) Abstract: Among the rural poor in Mexico, the incidence of preventable childhood and adult illnesses, poor reproductive outcomes (including low birth weight), and infant mortality are high-the result of unhygienic living conditions, poor nutrition, and social deprivation. The Programa de Educacion, Salud y Alimentacion (Progresa)-now known as Oportunidades-was designed to provide incentives in the form of cash transfers to poor families; to improve use of preventive and other basic health services, nutrition counseling, and supplementary foods; and to increase school enrollment and attendance. The program was designed to affect household-level decisions by providing incentives for behaviors that would result in improved social outcomes. The program was based on a compact of "co-responsibility" between the government and the recipients: The government would provide significant levels of financial support directly to poor households, but only if the beneficiaries did their part by taking their children to clinics for immunizations and other services and sending them to school. Expenditures on Progresa totaled about $770 million per year by 1999 and $1 billion in 2000, translating into fully 0.2 percent of the country's GDP and about 20 percent of the federal budget. Of that, administrative costs are estimated to absorb about 9 percent of total program costs. A well-designed evaluation revealed that Progresa significantly improved both child and adult health, which accompanied increased use of health services. Children under 5 years of age in Progresa, who were required to seek well-child care and received nutritional support, had a 12 percent lower incidence of illness than children not included in the program. Adult beneficiaries of Progresa between 18 and 50 years had 19 percent fewer days of difficulty with daily activities due to illness than their non-Progresa counterparts. For beneficiaries over 50 years, those in Progresa had 19 percent fewer days of difficulty with daily activities, 17 percent fewer days incapacitated, and 22 percent fewer days in bed, compared with similar individuals who did not receive program benefits. (author's) Language: English Keywords: MEXICO | RESEARCH REPORT | EVALUATION | LOW INCOME POPULATION | RURAL POPULATION | RURAL HEALTH SERVICES | INTERVENTIONS | COST EFFECTIVENESS | UTILIZATION OF HEALTH CARE | PREVENTIVE HEALTH CARE | North America | Americas | Developing Countries | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Evaluation Indexes | Quantitative Evaluation Document Number: 320727 |
| 11. Peer Reviewed Title: Community workers key to improving Africa's primary care. Author: Brown H Source: Lancet. 2007 Sep 29;370(9593):1115-1117. Abstract: In parts of rural Africa, where conflict and neglect have destroyed any remnants of a functioning health system, there is one long-running public-health programme that is not only surviving but thriving-by capitalising on communities' desires to help themselves. Hannah Brown reports. Standing at the dark doorway of a large wattle-and-daub hut, Michel Mazogo, a health worker in a remote village of northern Democratic Republic of Congo (DRC), proudly shows off his charge: a makeshift health centre, built by the villagers themselves, to serve ten neighbouring communities. The building's cramped interior houses four individual rooms, but little in the way of equipment: a small trolley displaying a few tired surgical instruments sits under a window; a fragile-looking maternity bed doubles as a bike stand in one room; and some empty shelves line the walls of another. Mazogo, who trained for 3 years at technical college for this post, says he has just aspirin, paracetamol, chloroquine, quinine, adrenaline, and iron to distribute to patients who visit. If he writes a prescription for other treatments, or if patients present with symptoms he cannot address, then they must travel 50 km on foot along a dirt track, to obtain the drugs from the regional town of Buta, an hour and a half's flight north over dense rainforest from DRC's second city, Kisangani. (excerpt) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | CRITIQUE | RURAL AREAS | RURAL HEALTH SERVICES | PRIMARY HEALTH CARE | COMMUNITY WORKERS | COMMUNITY-BASED DISTRIBUTION | COMMUNITY PARTICIPATION | DRUGS | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Geographic Factors | Population | Health Services | Delivery of Health Care | Health | Health Personnel | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Treatment | Medical Procedures | Medicine Document Number: 321168 |
| 12. Title: A decade of inequality in maternity care: Antenatal care, professional attendance at delivery, and caesarean section in Bangladesh (1991 -- 2004). Author: Collin SM; Anwar I; Ronsmans C Source: International Journal for Equity in Health. 2007 Aug 30;6(1):9. Abstract: Bangladesh is committed to the fifth Millennium Development Goal (MDG-5) target of reducing its maternal mortality ratio by three-quarters between 1990 and 2015. Since the early 1990s, Bangladesh has followed a strategy of improving access to facilities equipped and staffed to provide emergency obstetric care (EmOC). We used data from four Demographic and Health Surveys conducted between 1993 and 2004 to examine trends in the proportions of live births preceded by antenatal consultation, attended by a health professional, and delivered by caesarean section, according to key socio-demographic characteristics. Utilization of antenatal care increased substantially, from 24% in 1991 to 60% in 2004. Despite a relatively greater increase in rural than urban areas, utilization remained much lower among the poorest rural women without formal education (18%) compared with the richest urban women with secondary or higher education (99%). Professional attendance at delivery increased by 50% (from 9% to 14%, more rapidly in rural than urban areas), and caesarean sections trebled (from 2% to 6%), but these indicators remained low even by developing country standards. Within these trends there were huge inequalities; 86% of live births among the richest urban women with secondary or higher education were attended by a health professional, and 35% were delivered by caesarean section, compared with 2% and 0.1% respectively of live births among the poorest rural women without formal education. The trend in professional attendance was entirely confounded by socioeconomic and demographic changes, but education of the woman and her husband remained important determinants of utilization of obstetric services. Despite commendable progress in improving uptake of antenatal care, and in equipping health facilities to provide emergency obstetric care, the very low utilization of these facilities, especially by poor women, is a major impediment to meeting MDG-5 in Bangladesh. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | SURVEYS | MATERNAL MORTALITY | OBSTETRICS | PROGRAM ACCESSIBILITY | ANTENATAL CARE | QUALITY OF HEALTH CARE | MATERNAL HEALTH SERVICES | CESAREAN SECTION | SOCIOECONOMIC FACTORS | EDUCATIONAL STATUS | INEQUALITIES | RURAL HEALTH SERVICES | Developing Countries | Asia, Southern | Asia | Sampling Studies | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Maternal-Child Health Services | Primary Health Care | Health Services Evaluation | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Economic Factors | Socioeconomic Status Document Number: 314216 |
| 13. Peer Reviewed Title: Barriers to the utilization of maternal health care in rural Mali. Author: Gage AJ Source: Social Science and Medicine. 2007;:[17] p. Abstract: This study used data from the 2001 Demographic and Health Survey and multilevel logistic regression models to examine area- and individual-level barriers to the utilization of maternal health services in rural Mali. The analysis highlights a range of area-level influences on the use made of maternal health services. While the dearth of health facilities was a barrier to receipt of prenatal care in the first trimester, transportation barriers were more important for four or more prenatal visits, and distance barriers for delivery assistance by trained medical personnel and institutional delivery. Women's odds of utilizing maternal health services were strongly influenced by the practices of others in their areas of residence and by living in close proximity to people with secondary or higher education. Household poverty and personal problems were negatively related to all outcomes considered. The results highlight the importance of antenatal care and counseling about pregnancy complications for increasing the likelihood of appropriate delivery care, particularly among women living 15-29km from a health facility. Area-level factors explained a greater proportion of the variation in delivery care than in prenatal care However, significant area variation in the utilization of maternal health services remained unexplained. (author's) Language: English Keywords: MALI | RESEARCH REPORT | SURVEYS | STATISTICAL REGRESSION | MATERNAL HEALTH SERVICES | RURAL HEALTH SERVICES | ANTENATAL CARE | UTILIZATION OF HEALTH CARE | OBSTACLES | PROGRAM ACCESSIBILITY | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Sampling Studies | Studies | Research Methodology | Data Analysis | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Organization and Administration | Program Evaluation | Programs Document Number: 314218 |
| 14. Peer Reviewed Title: Prospects for new tuberculosis vaccines. Author: Hussey G Source: South African Medical Journal. 2007 Oct;97(10):1001-1002. Abstract: The world urgently requires a new vaccine to combat the problem of tuberculosis (TB). The failure of BCG vaccine, the emergence of extensively drug-resistant TB and the increasing global TB-related mortality has emphasised the urgent need to develop more effective TB vaccines to combat this scourge. The development of new genetic technology and the sequencing of the Mycobacterium tuberculosis genome in the late nineties have made the rational development of new TB vaccines a reality. The ideal TB vaccine should be affordable, especially in the poorest countries of the world where it is most needed, and should be more cost-effective than BCG vaccine. It should be easily administered at or soon after birth, and be safe, immunogenic and effective at all ages and in all populations. It is unlikely that a single new vaccine candidate will meet all or even most of these requirements, and it is likely that more than one new vaccine will be needed. TB is a leading opportunistic infection in HIV-positive persons. New TB vaccines would therefore have to be safe, immunogenic and effective in this at-risk population as well. Recently the WHO has recommended that children who are known to be HIV positive, even if they are asymptomatic, should not be given BCG vaccine because of the high risk of possibly developing disseminated BCG disease. (excerpt) Language: English Keywords: SOUTH AFRICA | RECOMMENDATIONS | EVALUATION | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | VACCINES | HIV INFECTIONS | COMPLICATIONS | RESEARCH AND DEVELOPMENT | PRIVATE SECTOR | ANTIGENS | CAPACITY BUILDING | RURAL HEALTH SERVICES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Technology | Economic Factors | Macroeconomic Factors | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Program Sustainability | Programs | Organization and Administration Document Number: 330647 |
| 15. Peer Reviewed Title: Inequalities in maternal health care utilization in rural Bangladesh. Author: Mahabub-ul-Anwar M; Rob U; Talukder MN Source: International Quarterly of Community Health Education. 2007;27(4):281-297. Abstract: The article examines the inequalities in utilization of maternal health care in rural areas of Bangladesh. It also attempts to identify the expenditure pattern for these services. Findings suggest that large disparities in the maternal health care utilization exist between the poorest and the richest population in Bangladesh. Two in three women in the highest wealth group receive antenatal care from qualified doctors as opposed to one in five women in the lowest wealth group. Almost all the deliveries occur at home among the lowest wealth group, whereas 16% of deliveries occur at health facilities among the highest wealth group. Wealth is also associated with the seeking of care for delivery-related complications. The practice of seeking services during post-natal period is not common and it varies positively with economic condition. Family savings is found to be the dominant source of paying the maternal health care services among the women in the highest wealth group. Cost has been found to be the most commonly cited reason for not seeking care for delivery complications. Eighty-four percent of women in the lowest wealth group compared to 13% of women in the highest wealth group did not seek treatment for delivery complications due to cost. Lack of perceived need of antenatal care (ANC) and postnatal care is the most pressing reason for not seeking these services. The study findings contain a number of implications for policy purposes that could be useful in devising ways to increase the utilization of maternal health care services. (author's) Language: English Keywords: BANGLADESH | MATERNAL HEALTH SERVICES | RURAL AREAS | RURAL HEALTH CENTERS | RURAL HEALTH SERVICES | LOW INCOME POPULATION | ANTENATAL CARE | INEQUALITIES | FEES | Developing Countries | Asia, Southern | Asia | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Geographic Factors | Population | Health Facilities | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Financial Activities Document Number: 327468 |
| 16. Peer Reviewed Title: Meeting the need for emergency obstetric care in Mozambique: Work performance and histories of medical doctors and assistant medical officers trained for surgery. Author: Pereira C; Cumbi A; Malalane R; Vaz F; McCord C Source: BJOG: An International Journal of Obstetrics and Gynaecology. 2007 Dec;114(12):1530-1533. Abstract: Nonphysicians in Mozambique have been performing major surgery for more than 20 years, with documented outcomes equivalent to those of specialists. The purpose of this study was to make an inventory of all government hospitals so as to document obstetric surgery performed by 'tecnicos de cirurgia' (TCs) and to elucidate their retention at district level. The design used was a cross-sectional study of surgical procedures during 2002; longitudinal study of TCs and doctors graduating in 1987, 1988 and 1996. The setting for the study was all 34 hospitals with an operating theatre in Mozambique. Records of 12 178 major surgical obstetric operations were examined, and 59 medical officers and 34 TCs were interviewed. The methods used was analysis of all surgical registers during 2002 in all government rural, provincial, general and central hospitals in Mozambique. TCs and doctors who had graduated in the specified years were traced and interviewed; health ministry records were reviewed to confirm assignments. The main outcome measures were proportion of major obstetric surgeries performed by TCs. Proportion of TCs and medical doctors still at rural/district level at 7 years after graduation. Major obstetric surgery is conducted by nonphysicians in 57% of the 12 178 operations scrutinised. In district hospitals, they conducted 92% of 3246 operations. Retention of TCs and medical doctors at district hospital level differed markedly: after 7 years, 88% of the TCs remained in post compared with none of the medical doctors. Nonphysicians, trained in surgery, do most of the emergency obstetric surgery in Mozambique, and almost all of that performed in district hospitals. Nonphysicians, compared with physicians, stay longer in rural areas. After 7 years, around 90% of nonphysicians are still working in district hospitals, while almost no physicians remain there. (author's) Language: English Keywords: MOZAMBIQUE | RESEARCH REPORT | HEALTH PERSONNEL | OBSTETRICAL SURGERY | EMERGENCY SERVICES | HUMAN RESOURCES | NEEDS | TRAINING PROGRAMS | HOSPITALS | RURAL HEALTH SERVICES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Delivery of Health Care | Health | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Economic Factors | Education | Health Facilities Document Number: 322225 |
| 17. Peer Reviewed Title: Coming back from the dead: Living with HIV as a chronic condition in rural Africa. Author: Russell S; Seeley J; Ezati E; Wamai N; Were W Source: Health Policy and Planning. 2007 Sep;22(5):344-347. Abstract: Scaling-up of anti-retroviral therapy (ART) in resource-poor settings has dramatically reduced mortality and morbidity for those with access, but considerable challenges remain for people who are trying to live with HIV as a manageable chronic condition. A return to 'normal life' for people on ART depends on the assurance of an uninterrupted, affordable and accessible supply of medication. However, many poor people also require economic support to re-establish their livelihoods, particularly where productive and financial assets have been depleted because of long-term illness. ART programmes need to seek convergence with economic programmes that have expertise in livelihood support and promotion, and with social protection initiatives. The future for those on ART depends not only on the provision of medicine but also on economic and social support for rebuilding lives and livelihoods. (author's) Language: English Keywords: AFRICA | AFRICA, SUB SAHARAN | AFRICA, NORTH | CRITIQUE | RURAL AREAS | RURAL POPULATION | RURAL HEALTH SERVICES | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | LIVELIHOOD | ECONOMIC FACTORS | CARE AND SUPPORT | INTEGRATED PROGRAMS | HEALTH AND WELFARE PLANNING | HEALTH POLICY | Developing Countries | Geographic Factors | Population | Population Characteristics | Demographic Factors | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | HIV | Resources | Organization and Administration | Programs | Social Planning | Policy | Political Factors | Sociocultural Factors Document Number: 313784 |
| 18. Peer Reviewed Title: Socio-cultural factors influencing the prevalence, care and support in HIV / AIDS among the Yoruba of Southwestern Nigeria. Author: Suleiman AA Source: African Journal of Health Sciences. 2007;14(1-2):61-61-69. Abstract: This paper is a part of a bigger ethnographic study conducted in two states from the Yoruba society of the Southwestern Nigeria to examine the social and cultural factors influencing the prevalence of HIV/AIDS and care and support systems in those states. This is in recognition of the need to arrest the increasing rate of the spread of the epidemic and the desire to create better care for People Living with HIV/AIDS (PLWAs) in those states. The study employed both qualitative and quantitative methods using key-informant interviews, in-depth interviews, focus group discussions and case-study analyses. The study engaged in intensive fieldwork, which lasted for 24 months. The study examined in historical perspective, the condition of health facilities in the study area before the outbreak of HIV/AIDS and how such facilities have coped with HIV/AIDS. The study revealed that the socio-cultural condition of the society is not conducive to fighting HIV/AIDS. Poverty, low literacy capacity, the urbanization process, inadequate health care facilities, the location of tertiary institutions, and certain contesting issues in HIV/AIDS were found to account for the continued prevalence of HIV/AIDS in the study-area. In addition to the above, is the neglect of rural communities in HIV/AIDS programmes, despite the fact that PLWAs often return to their rural communities after contracting HIV/AIDS in their urban residence. HIV/AIDS is seen as a disease associated with human development, hence, action against the disease should involve the overhauling of the entire development process in the community studied. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | KAP SURVEYS | EPIDEMIOLOGIC METHODS | FOCUS GROUPS | CASE STUDIES | RURAL POPULATION | PERSONS LIVING WITH HIV/AIDS | CULTURE | PREVALENCE | HIV INFECTIONS | AIDS PREVENTION | ANTHROPOLOGY, CULTURAL | RURAL HEALTH SERVICES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Sociocultural Factors | Measurement | AIDS | Anthropology | Social Sciences | Science | Health Services | Delivery of Health Care | Health Document Number: 324426 |
| 19. Peer Reviewed Title: Hepatitis B vaccination of newborn infants in rural China: Evaluation of a village-based, out-of-cold-chain delivery strategy. Author: Wang L; Li J; Chen H; Li F; Armstrong GL Source: Bulletin of the World Health Organization. 2007 Sep;85(9):688-694. Abstract: The objective was to prevent perinatal transmission of hepatitis B virus (HBV), WHO recommends that the first dose of hepatitis B (HepB) vaccine be given within 24 hours after birth. This presents a challenge in remote areas with limited cold-chain infrastructure and where many children are born at home. Rural townships in three counties in China's Hunan Province were randomized into three groups with different strategies for delivery of the first dose of HepB vaccine. In group 1, vaccine was stored within the cold chain and administered in township hospitals. In group 2, vaccine was stored out of the cold chain in villages and administered by village-based health workers to infants at home. Group 3 used the same strategy as group 2, but vaccine was packaged in a prefilled injection device. Training of immunization providers and public communication conveying the importance of the birth dose was performed for all groups. Among children born at home, timely administration (within 24 hours after birth) of the first dose of HepB vaccine increased in all groups after the study: group 1, from 2.4% to 25.2%; group 2, from 2.6% to 51.8%; and group 3, from 0.6% to 66.7%; P < 0.001 in each case. No significant difference in antibody response to vaccine was observed between the groups. Timely administration of the first dose of HepB vaccine was improved by communication and training activities, and by out-of-cold-chain storage of vaccine and administration at the village level, especially among children born at home. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | INFANT | RURAL AREAS | HEPATITIS | VACCINATION | COLD CHAIN | TIME FACTORS | INTERVENTIONS | RURAL HEALTH SERVICES | PROGRAM EFFECTIVENESS | HEALTH SERVICES EVALUATION | IMPACT | Asia, Eastern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Geographic Factors | Viral Diseases | Diseases | Immunization | Primary Health Care | Health Services | Delivery of Health Care | Health | Logistics | Management | Organization and Administration | Population Dynamics | Programs | Program Evaluation | Communication Document Number: 319936 |
| 20. Title: Beyond national rural health mission 2005: Issues of national concern. Author: Gulati SC Source: Demography India. 2006 Jul-Dec;35(2):177-191. Abstract: The Preamble of the National Rural Health Mission (NRHM) Document released with lot of fanfare by our Prime Minister in April 2005 recognizes the importance of health in the process of social and economic development and improving the quality of life of our citizens. The Goal of the Mission is to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children. Emphasis on the rural health in the Mission's documents in terms of strategies, plan of action, allocation of resources, architectural or operational corrections seems to have relegated other crucial issues of national concern like informed choice of quality contraception, urban health, and ageing to the background. This article examines overlooked crucial issues such as: a) Neglect of role of contraception towards fertility regulation and population stabilization process in India; (b) Neglect of increasing elderly populations with prospective ageing process in India; and (c) Neglect of urban health care with perspectives on urbanization and rural-urban migration process in India. (excerpt) Language: English Keywords: INDIA | PROGRESS REPORT | STATISTICAL STUDIES | OLDER ADULTS | RURAL POPULATION | GOVERNMENT PROGRAMS | DECENTRALIZATION | RURAL HEALTH SERVICES | HEALTH SERVICES ADMINISTRATION | INSTITUTION BUILDING | PERFORMANCE IMPROVEMENT | FAMILY PLANNING PROGRAM EVALUATION | CONTRACEPTIVE PREVALENCE | POPULATION POLICY | MATERNAL-CHILD HEALTH SERVICES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Health Services | Delivery of Health Care | Health | Management | Program Sustainability | Family Planning Programs | Family Planning | Contraceptive Usage | Contraception | Social Policy | Policy | Primary Health Care Document Number: 324129 |
| 21. Peer Reviewed Title: Evaluation of the healthy village program in Kapit district, Sarawak, Malaysia. Author: Kiyu A; Steinkuehler AA; Hashim J; Hall J; Lee PF Source: Health Promotion International. 2006 Mar;21(1):13-18. Abstract: Sarawak, Malaysia has a large population of ethnic minorities who live in longhouses in remote rural areas where poverty, non-communicable diseases, accidents and injuries, environmental hazards and communicable diseases all contribute to a lower quality of life than is possible to achieve in these regions. To address these issues and improve the quality of life for longhouse people, the Kapit Divisional Health Office implemented the World Health Organization's Healthy Village programme in 2000. An evaluation was undertaken in 2003 to determine physical and behavioural changes resulting from the programme. The main changes evaluated were those involving smoking habits, exercise habits, health screening, fire safety, environmental improvements and food preparation and hygiene. A qualitative evaluation was conducted using participant observation and key-informant interviews, focus groups and observation. Results indicate that the programme is inspiring changes in various behavioural and physical characteristics of the study population. It is clear that the Healthy Village programme is a widely accepted way of improving health outcomes in longhouses, and that it is succeeding in making beneficial health changes. (author's) Language: English Keywords: MALAYSIA | RURAL AREAS | RESEARCH REPORT | EVALUATION | ETHNIC GROUPS | LOW INCOME POPULATION | RURAL HEALTH SERVICES | QUALITY OF LIFE | RESIDENCE CHARACTERISTICS | BEHAVIOR CHANGE | PROGRAM EFFECTIVENESS | Developing Countries | Asia, Southeastern | Asia | Geographic Factors | Population | Cultural Background | Population Characteristics | Demographic Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Health Services | Delivery of Health Care | Health | Social Welfare | Population Distribution | Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 316003 |
| 22. Peer Reviewed Title: Performance of the rural health improvement scheme in reducing the incidence of waterborne diseases in rural Sarawak, Malaysia. Author: Liew KB; Lepesteur M Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2006 Oct;100(10):949-955. Abstract: This study evaluates and discusses the impact of the rural health improvement scheme in reducing the incidence of dysentery, enteric fever, cholera and viral hepatitis in Sarawak, Malaysia, using data compiled from state and federal health department reports. This study suggests that from 1963 to 2002, water supply intervention contributed to a more than 200-fold decrease in dysentery and a 60-fold decrease in enteric fever. Variations in reporting of viral hepatitis during that period make it difficult to detect a trend. Cholera was still endemic in 2002. Cholera and dysentery outbreaks, occurring when rural populations relied on contaminated rivers for their water supply, suggested that sanitation intervention was not as effective in reducing waterborne diseases. Recommendations are made for successive one-component interventions focusing on catchment management to ensure protection of current and alternative water supplies. (author's) Language: English Keywords: MALAYSIA | LITERATURE REVIEW | RETROSPECTIVE STUDIES | RURAL HEALTH SERVICES | PERFORMANCE IMPROVEMENT | DISEASE TRANSMISSION CONTROL | FEVER | CHOLERA | HEPATITIS | WATER SUPPLY | SANITATION | INTERVENTIONS | Asia, Southeastern | Asia | Developing Countries | Studies | Research Methodology | Health Services | Delivery of Health Care | Health | Management | Organization and Administration | Prevention and Control | Diseases | Body Temperature | Physiology | Biology | Bacterial and Fungal Diseases | Infections | Viral Diseases | Natural Resources | Environment | Public Health | Programs Document Number: 305992 |
| 23. Peer Reviewed Title: Forced evictions in Africa create healthcare crisis. Author: Moszynski P Source: BMJ. British Medical Journal. 2006 Oct 14;333(7572):774. Abstract: Amnesty International has warned that an "epidemic" of forced evictions in Africa is leading to a development and healthcare crisis. New research conducted by Amnesty International and the Geneva based Centre on Housing Rights and Evictions concludes that more than three million Africans have been forcibly evicted from their homes since 2000. "The figures are truly staggering and clearly indicate that forced evictions are one of the most widespread and unrecognised human rights violations in Africa," said Kolawole Olaniyan, director of Amnesty International's Africa programme. Primary healthcare clinics and water and sanitation systems are often demolished along with homes when an informal settlement is forcibly evicted, says the researcher Deanna Fowler, one of the authors of the report and coordinator of the centre's global forced evictions programme. She said, "It takes considerable time and resources for the poor to rebuild clinics and networks of community healthcare workers, and if they move to periurban or rural areas there are fewer clinics." (excerpt) Language: English Keywords: AFRICA | AFRICA, SUB SAHARAN | AFRICA, NORTH | ZIMBABWE | TANZANIA | SUDAN | SUMMARY REPORT | HEALTH PERSONNEL | PRIMARY HEALTH CARE | HEALTH FACILITIES | RURAL HEALTH SERVICES | SETTLEMENT AND RESETTLEMENT | CLINICS | PHYSICIAN'S OFFICE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa, Eastern | Africa, North | Delivery of Health Care | Health | Health Services | Migration | Population Dynamics | Demographic Factors | Population Document Number: 309175 |
| 24. Title: Do home visits by health workers make a difference in service utilization? Findings from a longitudinal study in rural India. Author: Sinha RK; Mohanty SK; Roy TK; Koenig M Source: Demography India. 2006 Jul-Dec;35(2):219-232. Abstract: The recent emphasis on the reproductive and child health approach has all the more increased the importance of the services provided by a health worker. Apart from actual delivery of services, their role also involves in creation of awareness about the importance of the various services in the population. Hence they assist in creation of necessary demand for these services. In India, there exists considerable ignorance about how and why these services are crucial. Very little is known about whether health workers are regularly visiting women in their area. However, during the 1998 survey, the home visit of a health worker or family planning worker during the last 12 months was enquired from all the interviewed women followed by frequency of visit and the discussion on different matters relating to RCH services. The 1998 survey data shows that only 13 per cent of women age 15-49 in India received home visit from a health or family planning worker in 12 months preceding the survey. There exists substantial state level variation in the incidence of home visit by health workers. The home visit, among the major states, was the highest in Gujarat (33 per cent) and lowest in Punjab (2 per cent). The greater emphasis in the programme on quality of care and services is of recent origin, initiated after the ICPD. It will be of interest to find out whether the home visits by workers have increased, and more importantly to know the effectiveness of the home visits. The present study is an attempt in this direction based on a longitudinal study, in which women interviewed in 1998 have been re-interviewed in 2002. More specifically, the study focuses on the following issues: 1) The changes, if any, in the incidence of home visits and regularity of such visit, 2) The pattern of visit; how women of different socio-economic groups receive home visits and, 3) Whether women who receive home visits act more favourably towards utilization of the various services provided by the programme. (exceprt) Language: English Keywords: INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | KAP SURVEYS | HEALTH PERSONNEL | COMMUNITY WORKERS | RURAL POPULATION | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | UTILIZATION OF HEALTH CARE | HOME VISITS | MATERNAL-CHILD HEALTH SERVICES | RURAL HEALTH SERVICES | ANTENATAL CARE | DEMOGRAPHIC FACTORS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Surveys | Sampling Studies | Delivery of Health Care | Health | Population Characteristics | Population | Economic Development | Economic Factors | Health Services | Communication | Primary Health Care | Maternal Health Services Document Number: 324131 |
| 25. Title: Clinical correlates and trends in hospital maternal mortality in rural Nigeria. Author: Umeora OU; Ejikeme BN Source: Journal of Obstetrics and Gynaecology. 2006 Feb;26(2):139-140. Abstract: The estimated Nigerian national maternal mortality ratio (MMR) of 1,000/100,000 live births (NHDR 2001) may be an underestimate as higher figures are reported from rural areas (Adamu 2001), where maternity services are scanty. Little information on the relative weighting of the known major causes in a rural setting is available locally. The present study aims to correct this deficiency. This is a retrospective review of all maternal deaths in a mission hospital in rural Ebonyi State, Nigeria, from January 1990 to December 2004. Data was analysed using the Epi Info Statistical software package version 3.2. Chi square (x/2) was used to test for significance, a p value of less than 0.05 is taken as significant. (excerpt) Language: English Keywords: NIGERIA | RURAL AREAS | RESEARCH REPORT | RETROSPECTIVE STUDIES | MATERNAL MORTALITY | CAUSES OF DEATH | HOSPITALS | SOCIOECONOMIC STATUS | RURAL HEALTH SERVICES | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Health Facilities | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors | Health Services Document Number: 316007 |
| 26. Title: Achieving the Millennium Development Goals [letter] Author: Adams S Source: Lancet. 2005 Mar 19;365:1030. Abstract: I could not agree more with J D Sachs and J W McArthur about the need for urgent action in 2005 if the Millennium Development Goals are to be met. The scaling up of investments in targeted sectors and regions must be combined with the development of indigenous capacity to deliver them; in health, nothing short of a revolution is required. If equity in health is ever to be a possibility, the major pharmaceutical companies must overhaul their policies and prices of drugs for the poorest people and initiatives should focus on motivating and equipping staff to work effectively in rural areas. Immediate quick-win solutions are tempting, particularly when they are linked to numerical targets, but unless measures are taken to build infrastructure in places where it does not exist, the rural poor will see no benefit. In fact the gulf between the rich and poor in less developed countries will continue to widen as the international community strives to show that it can, at least partly, reach these fundamental targets at the expense of those who will continue to suffer. (excerpt) Language: English Keywords: GLOBAL | CRITIQUE | LOW INCOME POPULATION | GOALS | INEQUALITIES | CAPACITY BUILDING | DELIVERY OF HEALTH CARE | RURAL HEALTH SERVICES | PROGRAM ACCESSIBILITY | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Planning | Organization and Administration | Program Sustainability | Programs | Health | Health Services | Program Evaluation Document Number: 282031 |
| 27. Title: Politics of rural health in India. Author: Banerji D Source: Indian Journal of Public Health. 2005 Jul-Sep;49(3):113-122. Abstract: The setting up of the National Rural Health Mission is yet another political move by the present government of India to make yet another promise to the long suffering rural population to improve their health status. As has happened so often in the past, it is based on questionable premises. It adopts a simplistic approach to a highly complex problem. The Union Ministry of Health and Family Welfare and its advisors, either because of ignorance or otherwise, have doggedly refused to learn from the many experiences of the past, both in terms of the efforts to earlier somewhat sincere efforts to develop endogenous mechanisms to offer access to health services as well as from the devastative impact on the painstakingly built rural health services of the imposition of prefabricated, ill-conceived, ill-formulated, techno-centric vertical programmes on the people of India. The also ignore some of the basic postulates of public health practice in a country like India. That did not substantiate the bases of some of their substantive contentions with scientific data obtained from health systems research reveals that they are not serious about their promise to rural population. This is yet another instance of what Romesh Thaper had called 'Baba Log playing government government'. (author's) Language: English Keywords: INDIA | HISTORICAL REVIEW | CRITIQUE | RURAL POPULATION | GOVERNMENT | POLITICAL FACTORS | RURAL HEALTH SERVICES | HEALTH SERVICES ADMINISTRATION | QUALITY OF HEALTH CARE | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Health Services | Delivery of Health Care | Health | Management | Organization and Administration | Health Services Evaluation | Program Evaluation | Programs Document Number: 293760 |
| 28. Title: The National Rural Health Mission (NRHM): a critical overview. Author: Dasgupta R; Qadeer I Source: Indian Journal of Public Health. 2005 Jul-Sep;49(3):138-140. Abstract: This paper explores the forces that led to the conceptualisation of the National Rural Health Mission (NRHM) including the role of the Common Minimum Programme and the Structural Adjustment Programme. The paper analyses the key components of the NRHM in terms of the theoretical frameworks of decentralisation, integration of programmes, primary health care, community health workers and standards. (author's) Language: English Keywords: INDIA | CRITIQUE | RURAL POPULATION | GOVERNMENT | COMMUNITY WORKERS | HEALTH PERSONNEL | RURAL HEALTH SERVICES | HEALTH SERVICES ADMINISTRATION | DECENTRALIZATION | INTEGRATED PROGRAMS | PRIMARY HEALTH CARE | HEALTH POLICY | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Political Factors | Sociocultural Factors | Delivery of Health Care | Health | Health Services | Management | Organization and Administration | Programs | Policy Document Number: 293788 |
| 29. Peer Reviewed Title: National Rural Health Mission (NRHM). Author: Dubey RD Source: Journal of the Indian Medical Association. 2005 Oct;103(10):[2] p.. Abstract: When the Honourable Prime Minister announced National Rural Health Mission (NRHM), it was welcomed by everybody. It generated a new hope among the majority of Indians living in the rural areas. Perhaps now they will be able to get potable drinking water, safe latrines, the basic amenities of health and at least proper primary medical care in their villages. Perhaps no child will die untreated, no mother will bleed to death, no road traffic accident victim will die unattended even in the remotest corner of the country, no farmer will succumb to snake or scorpion bite in the paddy field and no labourer will die due to heat stroke. Great expectation and belief replaced the gloom and despair. Perhaps all the essential medicines will be available in the primary health centres. Perhaps rickety and malnourished Ramu and Dhania will be able to get rid of scabies, lice and intestinal worms infestations and their complexion will change from pale to pink. Nothing of the sort is going to happen. NRHM is going to be yet another red herring. Do not get misled by the middle words "Rural Health". In fact it is a National Mission for opening more medical colleges, even by relaxing or removing MCI norms for infrastructure, staff and clinical material requirements. Private entrepreneurs will be given all help to open these medical colleges flouting the MCI rules. Even the government district hospitals will be given to businessmen to utilise them for medical colleges. (excerpt) Language: English Keywords: INDIA | CRITIQUE | RURAL POPULATION | RURAL HEALTH SERVICES | PRIMARY HEALTH CARE | HEALTH EDUCATION | GOVERNMENT | HEALTH POLICY | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Education | Political Factors | Sociocultural Factors | Policy Document Number: 307493 |
| 30. Title: Need of training for health professionals on national rural health mission. Author: Dutta PK Source: Indian Journal of Public Health. 2005 Jul-Sep;49(3):133-137. Abstract: Training plays a key role in health manpower development and management of health care system. Since NRHM is a new concept, due weight-age has to be given to various components of the Mission. For the efficient and effective performance of medical and paramedical workers a certain level of competence in the form of knowledge, skill and attitude are essential. Various aspects of training activities to be included in training programmes have been discussed in the paper. (author's) Language: English Keywords: INDIA | CRITIQUE | RURAL POPULATION | HEALTH PERSONNEL | RURAL HEALTH SERVICES | HEALTH SERVICES ADMINISTRATION | TRAINING PROGRAMS | QUALITY OF HEALTH CARE | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Health Services | Management | Organization and Administration | Education | Health Services Evaluation | Program Evaluation | Programs Document Number: 293792 |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |