| 1. Title: Attitudes of healthcare providers towards patients with HIV/AIDS in Bandar Abbas. Author: Aghamolaei T; Tavafian SS; Hasani L; Zare S Source: Archives of Iranian Medicine. 2009 May;12(3):298-301. Abstract: We aimed to investigate the attitudes of healthcare providers towards patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in Bandar Abbas, south of Iran. In this cross-sectional study, a random sample of 250 healthcare providers completed a 20-item questionnaire from January first through February 30th, 2007. There were five domains of attitudes towards patients with HIV. The items measured as a five-point Likert scale ranging from strongly disagree to strongly agree. The mean age of the healthcare providers was 31.3 (SD=7.3) years. Of them 24.4% were males, 42.4% had received Bachelor of Science degree, 19.2% were physicians, 63.2% were nurses, and 17.6% were laboratory technicians. The respondents had fairly positive attitudes towards patients with HIV. Men, older age, more educated participants, and laboratory technicians had more favorable attitude towards HIV (P<0.05). Language: English Keywords: IRAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HEALTH PERSONNEL | CLIENTS | PERSONS LIVING WITH HIV/AIDS | STAFF ATTITUDE | HIV INFECTIONS | AIDS | LABORATORY PROCEDURES | Middle East | Developing Countries | Research Methodology | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services Document Number: 342660 |
| 2. Title: HIV/AIDS knowledge, attitudes, practices and perceptions of rural nurses in South Africa. Author: Delobelle P; Rawlinson JL; Ntuli S; Malatsi I; Decock R; Depoorter AM Source: Journal of Advanced Nursing. 2009 May;65(5):1061-73. Abstract: AIM: This paper is a report of a study exploring HIV/AIDS-related knowledge, attitudes, practices and perceptions of nurses in the largely black and rural Limpopo Province of South Africa. BACKGROUND: Studies of HIV/AIDS knowledge, attitudes and practices among healthcare workers in developing countries have shown gaps in knowledge and fear of contagion, coupled with ambivalent attitudes in caring for patients with HIV/AIDS and inconsistent universal precautions adherence. METHOD: A cross-sectional study of a random sample of primary health care (PHC) (n = 71) and hospital nurses (n = 69) was carried out in 2005, using a questionnaire, focus groups and in-depth interviews. FINDINGS: Hospital nurses reported a higher frequency of care for patients with HIV/AIDS (P < 0.05), but less HIV/AIDS training when compared to PHC nurses (P < 0.001). HIV/AIDS knowledge was moderately adequate and associated with professional rank, frequency of care and training (P < 0.001). Attitudes towards patients with HIV/AIDS were mainly positive and were statistically significantly correlated with HIV/AIDS knowledge (P < 0.01) and training (P < 0.05). Three out of four nurses reported that they practised universal precautions (76.1%), but fear of occupational HIV transmission and lack of injection safety was found. Seven in 10 nurses reported previous needlestick injuries, but postexposure prophylaxis was not available in all healthcare facilities. Participants reported a higher workload because of HIV/AIDS, lack of training impacting negatively on their work, and stigma and shared confidentiality affecting them emotionally.CONCLUSION: There is a need for accelerated HIV/AIDS training of rural nurses and for wider implementation of universal precautions and postexposure prophylaxis availability in public health facilities in southern Africa. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | RURAL AREAS | NURSES AND NURSING | STAFF ATTITUDE | KNOWLEDGE | BEHAVIOR | HIV INFECTIONS | AIDS | PERCEPTION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Attitudes | Psychological Factors | Sociocultural Factors | Viral Diseases | Diseases Document Number: 342073 |
3.  Peer Reviewed Title: Conceptualising abortion stigma. Author: Kumar A; Hessini L; Mitchell EM Source: Culture, Health and Sexuality. 2009 May 12;:1. Abstract: Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor 'essential' and relies upon power disparities and inequalities for its formation. In this paper, we identify social and political processes that favour the emergence, perpetuation and normalisation of abortion stigma. We hypothesise that abortion transgresses three cherished 'feminine' ideals: perpetual fecundity; the inevitability of motherhood; and instinctive nurturing. We offer examples of how abortion stigma is generated through popular and medical discourses, government and political structures, institutions, communities and via personal interactions. Finally, we propose a research agenda to reveal, measure and map the diverse manifestations of abortion stigma and its impact on women's health. Language: English Keywords: CRITIQUE | KAP SURVEYS | POLICYMAKERS | ABORTION | STIGMA | SEX DISCRIMINATION | SOCIAL DISCRIMINATION | INEQUALITIES | POLITICAL FACTORS | SOCIAL PROBLEMS | FEMALE ROLE | PUBLIC OPINION | Surveys | Sampling Studies | Studies | Research Methodology | Administrative Personnel | Organization and Administration | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Social Behavior | Behavior | Attitudes | Psychological Factors Document Number: 341497 |
| 4. Peer Reviewed Title: Assessment of the Chinese version of HIV and homosexuality related stigma scales. Author: Liu H; Feng T; Rhodes AG; Liu H Source: Sexually Transmitted Infections. 2009 Feb;85(1):65-69. Abstract: Objectives: To design and assess HIV and homosexuality related stigma scales in a developing world context. Methods: A respondent-driven sampling survey was conducted among 351 men who have sex with men (MSM) in Shenzhen, China. Exploratory and confirmatory factor analyses were used to examine and determine the latent factors of stigma subscales. Results: Factor analyses identified three subscales associated with homosexuality and HIV stigma: public homosexual stigma (10 items), self homosexual stigma (8 items) and public HIV stigma (7 items). There were no items with cross-loadings onto multiple factors, supporting the distinctness of the constructs that these scales were meant to measure. The fit indices in confirmatory factor analysis provide evidence for the hypothesised three-factor structure of associations (the x2/degree ratio=1.84, CFI=0.91, RMSEA=0.05 and SRMR=0.05). Reliability of the three scales was excellent (Cronbach's alpha: 0.78-0.85) and stable across split samples and for the data as a whole. Conclusions: The selection of three latent factors was supported by both psychometric properties and theories of stigmatisation. The scales are brief and suitable for use in developing countries where less time-consuming measurement is preferable. Language: English Keywords: CHINA | RESEARCH REPORT | METHODOLOGICAL STUDIES | KAP SURVEYS | QUESTIONNAIRE DESIGN | EVALUATION INDEXES | FACTOR ANALYSIS | HOMOSEXUALS | MEN HAVING SEX WITH MEN | PERSONS LIVING WITH HIV/AIDS | STIGMA | HIV INFECTIONS | PUBLIC OPINION | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Surveys | Sampling Studies | Survey Methodology | Quantitative Evaluation | Evaluation | Data Analysis | Sex Behavior | Behavior | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Attitudes | Psychological Factors Document Number: 340113 |
| 5. Title: Doesn't the public have the right to know that male circumcision protects against HIV? [editorial] Author: Madhivanan P; Krupp K Source: Indian Journal of Medical Ethics. 2009 Jan-Mar;6(1):5-6. Abstract: This editorial examines the issue of male circumcision (MC) in India and discusses doctor's challenges' with the question,"Doesn't the public have the right to know that male circumcision protects against HIV?" It describes the reluctance of the Government of India to disclose this information due to the controversy that may erupt between conservative Hindus and the Muslims in the country in which male circumcision is a marker of religious identity. Language: English Keywords: INDIA | CRITIQUE | PUBLIC OPINION | HUMAN RIGHTS | MALE CIRCUMCISION | INFORMATION DISTRIBUTION | HIV PREVENTION | Asia, Southern | Asia | Developing Countries | Attitudes | Psychological Factors | Behavior | Political Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Communication | HIV Infections | Viral Diseases | Diseases Document Number: 330900 |
| 6. Title: Concerns, attitudes, and practices of orthopaedic surgeons towards management of patients with HIV/AIDS in Nigeria. Author: Obalum DC; Eyesan SU; Ogo CN; Enweani UN; Ajoku JO Source: International Orthopaedics. 2009 Jun;33(3):851-4. Abstract: The increasing number of people living with HIV/AIDS is causing concern among surgeons over risk of occupationally acquired HIV infection. This may influence their attitude to such patients. The purpose of this study was to develop a cross-sectional survey of orthopaedic surgeons to assess their concerns, attitudes, and practices towards management of HIV-positive patients in Nigeria. All respondents were males, 55 (73.3%) of them indicated concern over the risk of occupational acquisition of HIV infection and 37 (49.3%) had examined or operated on at least one HIV/AIDS patient. Sixty (79.9%) were willing to be tested for HIV and 51 (67.9%) were previously tested. Fifty-seven (75.9%) would order preoperative HIV screening of high risk patients, and 67 (89.3%) would operate on HIV-positive patients. Most orthopaedic surgeons in Nigeria would operate on HIV-positive patients. Language: English Keywords: NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | PHYSICIANS | PERSONS LIVING WITH HIV/AIDS | STAFF ATTITUDE | SURGERY | OCCUPATIONAL HEALTH | MANAGEMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Program Activities | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Treatment | Medical Procedures | Medicine | Health Services Document Number: 342674 |
| 7. Title: Attitude of health care workers to patients and colleagues infected with human immunodeficiency virus. Author: Sadoh AE; Sadoh WE; Fawole AO; Oladimeji A; Sotiloye O Source: SAHARA J. 2009 Mar;6(1):17-23. Abstract: Discrimination against persons living with HIV/AIDS in hospital settings has been documented. This study examined the attitude of health care workers (HCWs) to nurses, doctors and patients infected with HIV. A total of 345 respondents selected by multistage sampling techniques were surveyed, using a semi-structured questionnaire, which explored respondents' attitude to HIV-infected patients and colleagues with HIV/AIDS. HCWs were unwilling to accept that medical procedures be carried out on them by HIV-infected doctors and nurses, with almost 80% refusing surgery or assistance at surgery on them by an HIV-infected doctor or nurse. They were also significantly more unwilling to accept that medical procedures be carried out on them by an infected colleague, compared with their carrying out the same procedure on an HIV-infected patient. Thus, HCWs seemed to believe that the risk of contracting HIV was higher if an infected HCW were to perform medical procedures on them, and fear of contracting HIV seemed to be the driving force for their negative attitudes. Education on occupational risks of HIV, provision of a safe working environment with enforcement of universal precautions, as well as provision of post-exposure prophylaxis are suggested as ways to enable HCWs to change their attitudes. Language: English Keywords: NIGERIA | RESEARCH REPORT | SAMPLING STUDIES | HEALTH PERSONNEL | CLIENTS | PERSONS LIVING WITH HIV/AIDS | STAFF ATTITUDE | HIV INFECTIONS | STIGMA | FEAR | HIV TESTING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Social Problems | Sociocultural Factors | Emotions | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services Document Number: 341416 |
| 8. Peer Reviewed Title: The 'problem' of Asian women's sexuality: public discourses in Aotearoa/New Zealand. Author: Simon-Kumar R Source: Culture, Health and Sexuality. 2009 Jan;11(1):1-16. Abstract: Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicized as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them. Language: English Keywords: NEW ZEALAND | CRITIQUE | EVALUATION | ASIANS | WOMEN | IMMIGRANTS | ETHNIC GROUPS | SEXUALITY | SEX BEHAVIOR | RISK BEHAVIOR | ABORTION RATE | CULTURE | PSYCHOSOCIAL FACTORS | PUBLIC OPINION | FEMINISM | Oceania | Developed Countries | Cultural Background | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Personality | Psychological Factors | Behavior | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Attitudes Document Number: 341121 |
| 9. Title: Dental school deans' and dentists' perceptions of infection control and HIV/AIDS patient care: a challenge for dental education in Mexico. Author: Vazquez-Mayoral EE; Sanchez-Perez L; Olguin-Barreto Y; Acosta-Gio AE Source: AIDS Patient Care and STDs. 2009 Jul;23(7):557-62. Abstract: HIV/AIDS patients face unique oral diagnostic and treatment challenges. The aim of this investigation among dental school deans (DSD) and graduate school applicants (GSA) who had qualified from 30 different dental schools was to assess their perceptions on dental education relevant to infection control (IC) and HIV/AIDS patient care. The questionnaire included Likert-type scale evaluations of agreement with statements. Of 158 questionnaires, 23 DSD (68% response rate), and 123 GSA (100% response rate) returned valid questionnaires. Fifteen (65%) DSD and 89 (72%) GSA ranked as "very strong" their perception that infection control prevents the transmission of blood borne viruses. However, the perception prevailed, among DSD and GSA, that HIV infection was a "very strong" to "strong" occupational hazard. Special reprocessing of instruments used on HIV patients was frequently reported. Many considered "very strong" to "strong" that HIV/AIDS patients must be treated in specialized clinics, and nearly half (48%) of the DSD and one third (35%) of the GSA stated that their school does refer HIV/AIDS patients to dental treatment in specialized clinics. These results indicate that many dental schools in Mexico must provide better education on IC and HIV/AIDS patient care to enhance attitudes toward HIV/AIDS patients. Language: English Keywords: MEXICO | RESEARCH REPORT | QUESTIONNAIRES | DENTISTS | PERCEPTION | HIV INFECTIONS | AIDS | STAFF ATTITUDE | IEC | NEEDS | RISK FACTORS | FEAR | North America | Americas | Developing Countries | Health Personnel | Delivery of Health Care | Health | Psychological Factors | Behavior | Viral Diseases | Diseases | Attitudes | Program Activities | Programs | Organization and Administration | Economic Factors | Emotions Document Number: 342982 |
| 10. Title: Attitudes to HIV testing among carers of children admitted to Port Moresby General Hospital, Papua New Guinea. Author: Allison WE; Iobuna V; Kalebe V; Kiromat M; Vince J; Schaefer M; Kaldor J Source: Journal of Paediatrics and Child Health. 2008 Nov;44(11):618-21. Abstract: AIM: To assess the acceptability of voluntary counselling and testing among the carers of children admitted to hospital in Papua New Guinea. METHODS: Forty semistructured interviews were carried out between February and April 2007. RESULTS: All the carers interviewed were women, mostly from Port Moresby. Virtually all of them attended primary school. About half of them attended secondary school but none completed it. Half of them knew an adult or child with HIV. Three quarters of the women interviewed would consent to having a child in their care tested for HIV, and over half of those who had never been tested would agree to be tested themselves. Correct answers to more than half the HIV knowledge questions posed were significantly related to agreement to an HIV test. CONCLUSIONS: This study supports the need for further evaluation of knowledge about HIV/AIDS and opportunities for health promotion in this group of women, particularly in view of the implication for voluntary counselling and testing and prevention of mother-to-child HIV transmission programmes in Papua New Guinea. Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | KAP SURVEYS | HEALTH PERSONNEL | CHILDREN | WOMEN IN DEVELOPMENT | HOSPITALS | STAFF ATTITUDE | VOLUNTARY COUNSELING AND TESTING | CHILD HEALTH SERVICES | Developing Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Health Facilities | Attitudes | Psychological Factors | Behavior | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 330405 |
11.  Title: HIV: death sentence or chronic and manageable disease? Changing attitudes of health providers and politicians towards women living with HIV in India. Author: Anand S Source: Exchange on HIV / AIDS, Sexuality and Gender. 2008;(2):5-6. Abstract: The Right to Health is universally acknowledged as a human right and Article 21 of the Constitution of India considers it as inherent to the Right to Life. State health-care providers are obliged by law to provide medical treatment to all persons without discrimination of HIV status in emergency and nonemergency situations. A recent assessment by the Positive Women Network (PWN+) on the availability and accessibility of HIV/AIDS care and treatment in India found that health care is greatly influenced by gender and that women and children living with HIV face huge hurdles in accessing treatment and care because of discrimination by government health-care providers. Through focus groups discussions, PWN+ found a discrepancy between the government stance and realities on the ground. Language: English Keywords: INDIA | SUMMARY REPORT | WOMEN | PERSONS LIVING WITH HIV/AIDS | HEALTH PERSONNEL | STAFF ATTITUDE | CHANGES | SOCIAL NETWORKS | INFORMATION NETWORKS | HIV | COUNSELING | STIGMA | SOCIAL DISCRIMINATION | PROGRAM ACCESSIBILITY | Developing Countries | Asia, Southern | Asia | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | Attitudes | Psychological Factors | Behavior | Social Change | Sociocultural Factors | Friends and Relatives | Family and Household | Communication | Clinic Activities | Program Activities | Programs | Organization and Administration | Social Problems | Program Evaluation Document Number: 308006 |
| 12. Peer Reviewed Title: The medical profession and the defense and promotion of sexual and reproductive rights. Author: Briozzo L; Faúndes A Source: International Journal of Gynecology and Obstetrics. 2008 Mar;100(3):291-294. Abstract: The values of the medical profession and other healthcare providers allow assessment of the relationship between physicians, healthcare teams, patients, and healthcare networks regarding the defense and promotion of sexual and reproductive health and rights. This paper questions the traditional model of the relationship between healthcare professionals and patients, based on the classic paternalistic role of the physician. It describes the tools available to the medical profession and healthcare teams for the promotion of sexual and reproductive rights, and proposes specific actions that would lead to improvements for women and communities. (author's) Language: English Keywords: LATIN AMERICA | PHILOSOPHICAL OVERVIEW | PHYSICIANS | PROVIDERS WITH CLIENTS | REPRODUCTIVE RIGHTS | VALUE ORIENTATION | HUMAN RIGHTS | PHYSICIAN-PATIENT RELATIONS | CLIENT-STAFF RELATIONS | STAFF ATTITUDE | Americas | Developing Countries | Health Personnel | Delivery of Health Care | Health | Health Services | Political Factors | Sociocultural Factors | Psychological Factors | Behavior | Interpersonal Relations | Attitudes Document Number: 324882 |
| 13. Title: Discriminatory attitudes towards patients with HIV/AIDS by dental professionals in Nigeria. Author: Bukar A; Gofwen R; Adeleke OA; Taiwo OO; Danfillo IS Source: Odonto - Stomatologie Tropicale. 2008 Jun;31(122):34-40. Abstract: AIMS AND OBJECTIVES: The study sought to investigate whether there are discriminatory practices towards HIV/AIDS patients among dental professionals in Nigeria, how receptive are dental professionals and institutions to treating People Living With Aids (PLWA), and what underlying factors if any that may contribute to any discriminatory practices. METHODS AND MATERIALS: It was a cross-sectional study conducted in one randomly selected State in each of the six geo-political zones of Nigeria. Data collection was by self administered questionnaire. The questionnaire asked about demographic information, general knowledge of HIV/AIDS, adequacy of infection control, fear of occupational exposure, attitudes towards HIV positive patients and areas of need for further training. A total of 75 dental professionals participated in the study. RESULTS: The results of the study suggest that significant number of dental professionals in Nigeria reported attitudes and behaviour towards HIV patients which are discriminatory. CONCLUSION: Further efforts should be made to promote accessibility of discrimination-free quality oral and dental care to this population. Language: English Keywords: NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | QUESTIONNAIRES | RESPONDENTS | DENTISTS | PERSONS LIVING WITH HIV/AIDS | KNOWLEDGE | POPULATION CHARACTERISTICS | HIV INFECTIONS | AIDS | HIV PREVENTION | FEAR | EXPOSURE | STAFF ATTITUDE | SOCIAL DISCRIMINATION | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Surveys | Sampling Studies | Studies | Health Personnel | Delivery of Health Care | Health | Viral Diseases | Diseases | Sociocultural Factors | Demographic Factors | Population | Emotions | Psychological Factors | Behavior | Risk Factors | Attitudes | Social Problems | Programs | Organization and Administration Document Number: 329845 |
| 14. Peer Reviewed Title: Pharmacovigilance of antimalarial treatment in Uganda: community perceptions and suggestions for reporting adverse events. Author: Bukirwa H; Nayiga S; Lubanga R; Mwebaza N; Chandler C Source: Tropical Medicine and International Health. 2008 Sep;13(9):1143-52. Abstract: OBJECTIVES: The deployment of new antimalarials in Africa provides an important opportunity to develop systems for pharmacovigilance. To inform strategies for reporting adverse events in Uganda, we investigated local perceptions and experiences with antimalarial treatment, and evaluated existing and potential systems for pharmacovigilance. METHODS: Focus group discussions (FGD) were conducted with community members and health workers from urban and rural Uganda exploring knowledge of fever/malaria, perceptions and expectations of treatment, understanding of adverse effects, and experiences with adverse events. Sessions were recorded, transcribed into English, and analysed using a coding scheme developed from pre-defined topics together with themes emerging from the data. RESULTS: Between April and July 2006, we conducted 25 FGDs; 16 with community members and nine with health workers. All respondents had extensive experience with malaria and its treatment. Community members commonly recognized adverse effects of antimalarial therapy. However, events were uncommonly reported, and certain events were often interpreted as signs of successful treatment. Community members often felt that the costs of reporting or seeking additional care outweighed the potential benefits. Health workers were unfamiliar with formal pathways for reporting, and were deterred by the additional work of reporting and fear of incrimination. Respondents provided suggestions for incentives and methods of reporting, emphasizing that pharmacovigilance should ideally encompass the public and private sector, and the community. CONCLUSIONS: To be successful, pharmacovigilance relying on voluntary reporting will require active participation of patients and health workers. Addressing the costs and benefits of reporting, and providing sensitization, training and feedback will be important. Language: English Keywords: UGANDA | RESEARCH REPORT | FOCUS GROUPS | COMMUNITY | HEALTH PERSONNEL | COMMUNITY WORKERS | ANTIMALARIAL DRUGS | PERCEPTION | KNOWLEDGE | FEVER | PUBLIC OPINION | USER COMPLIANCE | SIDE EFFECTS | FEAR | STIGMA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Delivery of Health Care | Health | Malaria | Parasitic Diseases | Diseases | Psychological Factors | Behavior | Sociocultural Factors | Body Temperature | Physiology | Biology | Attitudes | Treatment | Medical Procedures | Medicine | Health Services | Emotions | Social Problems Document Number: 328968 |
| 15. Peer Reviewed Title: Policies around sexual and reproductive health and rights in Peru: Conflict, biases and silence. Author: Caceres C; Cueto M; Palomino N Source: Global Public Health. 2008;3(S2):39-57. Abstract: This study is aimed at examining how subsequent Peruvian governments, since 1990, have addressed reproductive rights, HIV/AIDS prevention and treatment, and sexual diversity rights, as well as the drastic policy shifts and its many contradictions. Abortion and contraception consistently generated the deepest public controversies and debates, which made progress in reproductive rights difficult. HIV/AIDS was often portrayed as having the potential to affect everyone, which allowed advocates and activists to achieve some success in advancing HIV/AIDS-related rights. Sexual diversity rights, perceived as a demand made by "others", were generally trivialised and disdained by politicians, officials, and the general population. Positive changes occurred as long as the issue was given a low political and institutional profile. The analysis of policy-making and programme implementation in these three areas reveals that: (1) Weaknesses in national institutional frameworks concerning reproductive health made it possible for governments to adopt two very different (even contradictory) approaches to the issue within the past 15 years; (2) Policies were presented as rights-based in order to garner political legitimacy when, in fact, they evidenced a clear disregard for the rights of individual citizens; and (3) By favouring low-profile "public health" discourses, and marginalising "the sexual" in official policies related to sexuality, advocacy groups sometimes created opportunities for legal changes but failed to challenge conservative powers opposing the recognition of sexual and reproductive rights and the full citizenship of women and sexual minorities. (author's) Language: English Keywords: PERU | REPRODUCTIVE HEALTH | REPRODUCTIVE RIGHTS | HIV INFECTIONS | HIV PREVENTION | AIDS | GOVERNMENT AGENCIES | POLITICAL SYSTEMS | ADVOCACY | BIAS | PUBLIC OPINION | South America, Western | South America | Latin America | Americas | Developing Countries | Health | Human Rights | Political Factors | Sociocultural Factors | Viral Diseases | Diseases | Organizations | Communication | Error Sources | Measurement | Research Methodology | Attitudes | Psychological Factors | Behavior Document Number: 327684 |
| 16. Peer Reviewed Title: Nigeria struggles to contain poliomyelitis. Author: Cheng MH Source: Lancet. 2008 Oct 11;372(9646):1287-90. Abstract: Nigeria has had several setbacks in its bid to control poliomyelitis, including false rumours about vaccine safety. Now public anger over the failure of the ailing health system to deliver for its people threatens to derail the country's eradication campaign. Margaret Harris Cheng reports. Not only is Nigeria struggling to contain its poliomyelitis outbreak, it is now exporting the virus across its porous borders, and the disease is using the region's ancient trade routes to spread itself across Africa once more. (excerpt) Language: English Keywords: NIGERIA | PROGRESS REPORT | EVALUATION | INFLUENTIALS | CHILDREN | IMMIGRANTS | POLIO | PUBLIC OPINION | CAMPAIGNS | DISEASE PREVENTION | ADVOCACY | LEADERSHIP | IMMUNIZATION | BORDER CROSSING | HEALTH POLICY | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Knowledge Sources | Communication | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Communication Programs | Prevention and Control | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | International Migration | Policy | Political Factors | Sociocultural Factors Document Number: 329066 |
| 17. Title: Emergency contraception: when the pharmacist conscience clause restricts access. Author: Day AS Source: Nursing for Women's Health. 2008 Aug;12(4):343-6. Abstract: The pharmacist conscience clause was not intended to obstruct the access to an oral contraceptive. Yet this is precisely what is occurring in rural communities when pharmacists allow their personal beliefs to override the health needs of their patients. The implications of the pharmacist conscience clause in relation to Plan B shows a clear need to focus on evidence-based practice and to seriously consider following the recommendations in this article to help women in rural communities access Plan B in a timely manner consistent with the promotion of optimal outcomes. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | CASE STUDIES | PHARMACISTS | NURSES AND NURSING | RURAL POPULATION | PHARMACY DISTRIBUTION | EMERGENCY CONTRACEPTION | OPPOSITION TO FAMILY PLANNING | ETHICS | LOW-DOSE PROGESTINS | TIME FACTORS | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE MODE OF ACTION | Developed Countries | North America | Americas | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Attitudes | Psychological Factors | Behavior | Sociocultural Factors | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Population Dynamics | Drugs | Treatment | Medical Procedures | Medicine | Health Services Document Number: 329219 |
| 18. Peer Reviewed Title: Contraptions for intrauterine contraception. Author: Edouard L Source: Journal of Family Planning and Reproductive Health Care. 2008 Jul;34(3):199-201. Abstract: Intrauterine contraception is underutilised largely due to its reputed association with infections. The Copper T-380A, one of the most cost-effective methods of contraception and the most widely used intrauterine contraceptive device in the world, is effective for at least 12 years and is also used for emergency contraception. The levonorgestrel-releasing intrauterine system (LNG IUS) is extremely useful for treating menorrhagia. A renaissance of intrauterine contraception is overdue and will necessitate community-wide information campaigns to stimulate demand generation, implementation of service guidelines that avoid restrictive eligibility criteria, and access to service providers with special training in counselling and clinical skills. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | WOMEN | COST EFFECTIVENESS | UTILIZATION OF HEALTH CARE | IUD, COPPER RELEASING | IUD, HORMONE RELEASING | LEVONORGESTREL | EMERGENCY CONTRACEPTION | MENORRHAGIA | PUBLIC OPINION | FAMILY PLANNING POLICY | IUD COMPLICATIONS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Evaluation Indexes | Quantitative Evaluation | Evaluation | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Diseases | Attitudes | Psychological Factors | Behavior | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors Document Number: 327779 |
| 19. Title: Fertility concern in Finland and Russia: Economic thinking and ideal family size in the rhetoric of population polices. Author: Isola AM Source: Finnish Yearbook of Population Research. 2008;43:63-84. Abstract: This article deals with fertility concern in Russian and Finnish population policies. The article points out that some commonly known discourses are persistently used as arguments in fertility-related population policies. In Finland, these include, for instance, discourses on "ageing nation" and "economic competitiveness". Russian policymakers use a "crisis discourse" that consists of three sub-discourses: "demographic crisis", "reproductive health in crisis" and "family crisis". The Russian government implements pronatalist population policies, whereas Finnish authorities hesitate to use the term "population policy" because of its emphasis on reproductive rights on the one hand, and the negative associations of population policy on the other. Russia has both population and family programs, as well as a new law with a specifically pronatalist emphasis. Conversely, Finland uses family policy as a tool of population policy. (author's) Language: English Keywords: FINLAND | RUSSIA | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | POPULATION | FAMILY SIZE, IDEAL | HOME ECONOMICS | POPULATION POLICY | FAMILY PLANNING POLICY | PUBLIC OPINION | PERCEPTION | DEMOGRAPHIC AGING | REPRODUCTIVE HEALTH | PRONATALIST POLICY | REPRODUCTIVE RIGHTS | Developed Countries | Europe, Northern | Europe | Asia, Northern | Asia | Developing Countries | Comparative Studies | Studies | Research Methodology | Family Size | Family Characteristics | Family and Household | Sociocultural Factors | Microeconomic Factors | Economic Factors | Social Policy | Policy | Political Factors | Family Planning | Attitudes | Psychological Factors | Behavior | Population Dynamics | Demographic Factors | Health | Human Rights Document Number: 326069 |
| 20. Peer Reviewed Title: "We grandmothers know plenty": Breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi. Author: Kerr RB; Dakishoni L; Shumba L; Msachi R; Chirwa M Source: Social Science and Medicine. 2008 Mar;66(5):1095-1105. Abstract: This paper has two purposes: first of all, we examine grandmothers' role and views of child feeding practices in northern Malawi, and their influence on younger women's practices. Secondly, we consider the implications of these findings for health promotion activities and models of health education. Data were collected from semi-structured interviews, focus groups and a participatory workshop. Findings demonstrate that, to address child feeding practices which have an effect on nutrition, attention must be paid to the broader context that influences child nutrition, including extended family relations. Paternal grandmothers have a powerful and multifaceted role within the extended family in northern Malawi, both in terms of childcare and in other arenas such as agricultural practices and marital relations. Grandmothers often differ in their ideas about early child feeding from conventional Western medicine. Some practices have existed in the area at least since colonial times, and have strong cultural significance. Despite the important integrated role, older women have within households and communities in this part of Malawi, hospital personnel often have disparaging and paternalistic attitudes towards 'grannies' and their knowledge. Health education rarely involves grandmothers, and even if they are involved, their perspectives are not taken into consideration. Hospital staff often reject grandmother knowledge as part of a broader modernization paradigm which views 'traditional knowledge' as backward. Grandmothers view current child health conditions within a broader context of changing livelihood conditions and a high prevalence of HIV/ AIDS. The paper concludes by discussing the challenges of involving grandmothers in health education, and the difficulties of incorporating local knowledge into a medical system that largely rejects it. (author's) Language: English Keywords: MALAWI | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | GRANDPARENTS | WOMEN IN DEVELOPMENT | HOSPITAL PERSONNEL | SUPPLEMENTARY FEEDING | BREASTFEEDING | FAMILY RELATIONSHIPS | INFANT NUTRITION | WORKSHOPS | CHILD CARE | STAFF ATTITUDE | TRADITIONAL HEALTH PRACTICES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Health Personnel | Delivery of Health Care | Health | Nutrition | Education | Child Rearing | Behavior | Attitudes | Psychological Factors | Culture Document Number: 324417 |
| 21. Peer Reviewed Title: Access to and utilisation of health services for the poor in Uganda: a systematic review of available evidence. Author: Kiwanuka SN; Ekirapa EK; Peterson S; Okui O; Rahman MH; Peters D; Pariyo GW Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Nov;102(11):1067-74. Abstract: Inequalities in the burden of disease and access to health care is a prominent concern in Uganda and other sub-Saharan African countries. This is a systematic review of socio-economic differences in morbidity and access to health care in Uganda. It includes published studies from electronic databases and official reports from surveys done by government, bilateral and multilateral agencies and universities. The outcome measures studied were: the distribution of HIV/AIDS; maternal and child morbidity; and access to and utilisation of health services for people belonging to different socio-economic and vulnerability groups. Forty-eight of 678 identified studies met our inclusion criteria. Results indicate that the poor and vulnerable experience a greater burden of disease but have lower access to health services than the less poor. Barriers to access arise from both the service providers and the consumers. Distance to service points, perceived quality of care and availability of drugs are key determinants of utilisation. Other barriers are perceived lack of skilled staff in public facilities, late referrals, health worker attitude, costs of care and lack of knowledge. Longitudinal and controlled studies are needed to see if strategies to improve access to services reach the poor. Language: English Keywords: UGANDA | LITERATURE REVIEW | KAP SURVEYS | HEALTH SURVEYS | LOW INCOME POPULATION | PROGRAM ACCESSIBILITY | DELIVERY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | POVERTY | INEQUALITIES | SOCIOECONOMIC STATUS | DISTANCE | QUALITY OF HEALTH CARE | PERCEPTION | STAFF ATTITUDE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Health | Social Class | Socioeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration | Health Services | Geographic Factors | Population | Health Services Evaluation | Psychological Factors | Behavior | Attitudes Document Number: 330409 |
| 22. Peer Reviewed Title: Bulgaria: Ethnic differentials in rapidly declining fertility. Author: Koytcheva E; Philipov D Source: Demographic Research. 2008 Jul 1;19(13):361-402. Abstract: This chapter provides a detailed description of the fertility changes in Bulgaria during recent decades and discusses possible reasons and consequences. It also gives an overview of the steps that the government has undertaken to offset the considerable decline in fertility. Before the fall of communism, fertility trends in Bulgaria were stable and characterized by a nearly universal entry into parenthood, dominance of a two-child family model, an early start and early end of childbearing, stable mean ages at entry into childbearing and marriage, and low percentages of non-marital births. During the 1990s and in the first years of the new century, we observe a marked, rapid change in fertility behaviour. Together with the severe decline in overall fertility rates, demographic data reveal a significant postponement of entry into motherhood and marriage, a decline of the two-child family model, and an emergence of new family forms. Most research attributes these changes to the particular political and social situation in Bulgaria since 1989. (author's) Language: English Keywords: BULGARIA | RESEARCH REPORT | FERTILITY CHANGES | FERTILITY DECLINE | FERTILITY DETERMINANTS | ETHNIC GROUPS | MARRIAGE PATTERNS | DIVORCE | ABORTION | CONTRACEPTIVE USAGE | EDUCATION | PUBLIC OPINION | FAMILY POLICY | FERTILITY INCENTIVES | GOVERNMENT | Europe, Southeastern | Europe | Developing Countries | Fertility | Population Dynamics | Demographic Factors | Population | Cultural Background | Population Characteristics | Marriage | Nuptiality | Fertility Control, Postconception | Family Planning | Contraception | Attitudes | Psychological Factors | Behavior | Social Policy | Policy | Political Factors | Sociocultural Factors | Pronatalist Policy | Population Policy Document Number: 327721 Notification |
| 23. Title: Mirror on the media. Gender and tabloids in Southern Africa. Author: Morna CL; Ndlovu S Source: Johannesburg, South Africa, Gender Links, 2008. 100 p. Abstract: This report is part of Mirror on the Media series of monitoring reports coordinated by GL with the support of the Open Society Initiative of Southern Africa (OSISA) on gender and the media. Previous studies include: Gender and Advertising in Southern Africa; Who talks on radio talk shows and Who makes the news, an analysis of the 2005 Global Media Monitoring Project (GMMP) results in Southern Africa. The study focused on gender and tabloids in three Southern African countries with the highest density of tabloids, defined both in terms of size and content. It included monitoring of three newspapers in each country over the month of June 2007. The monitoring covered a total of 2546 news items: 859 in Mauritius; 1203 in South Africa and 484 in Tanzania (where tabloids are much fewer pages than in the other countries). Researchers also conducted desk top research; interviewed editors; gathered case material and administered an audience survey to 280 readers in the three countries. (excerpt) Language: English Keywords: AFRICA, SOUTHERN | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | CELEBRITIES | GENDER ISSUES | NEWSPAPERS | SPORTS | SEX FACTORS | MONITORING | PUBLIC OPINION | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Influentials | Knowledge Sources | Communication | Sociocultural Factors | Printed Media | Mass Media | Social Behavior | Behavior | Population Characteristics | Demographic Factors | Population | Evaluation | Attitudes | Psychological Factors Document Number: 325692 |
| 24. Title: Are country reputations for good and bad leadership on AIDS deserved? An exploratory quantitative analysis. Author: Nattrass N Source: Journal of Public Health. 2008 Dec;30(4):398-406. Abstract: Some countries (e.g. Brazil) have good reputations on AIDS policy, whereas others, (notably South Africa) have been criticized for inadequate leadership. Cross-country regression analysis reveals that these 'poster children' for AIDS leadership have indeed performed better or worse than expected given their economic and institutional constraints and the demographic and health challenges facing them. Regressions were run on HAART coverage (number on highly active antiretroviral therapy as percentage of total need) and MTCTP coverage (pregnant HIV+ women accessing mother-to-child-transmission prevention services as percentage of total need). Brazil, Cambodia, Thailand and Uganda (all of whom have established reputations for good leadership on AIDS performed consistently better than expected-as did Burkina-Faso, Suriname, Paraguay Costa Rica, Mali and Namibia. South Africa, which has the worst reputation for AIDS leadership, performed significantly below expectations-as did Uruguay and Trinidad and Tobago. The paper thus confirms much of the conventional wisdom on AIDS leadership at country level and suggests new areas for research. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | STATISTICAL REGRESSION | CROSS-CULTURAL COMPARISONS | INFLUENTIALS | POLICYMAKERS | LEADERSHIP | AIDS PREVENTION | HIV PREVENTION | PUBLIC OPINION | PERCEPTION | HEALTH POLICY | ANTIRETROVIRAL THERAPY | MOTHER-TO-CHILD TRANSMISSION | Data Analysis | Research Methodology | Comparative Studies | Studies | Knowledge Sources | Communication | Administrative Personnel | Organization and Administration | AIDS | HIV Infections | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors | HIV | Transmission | Infections Document Number: 331076 |
| 25. Title: A retrospective content analysis of studies on factors constraining the implementation of health sector reform in Ghana. Author: Sakyi EK Source: International Journal of Health Planning and Management. 2008 Jul-Sep;23(3):259-285. Abstract: Ghana has undertaken many public service management reforms in the past two decades. But the implementation of the reforms has been constrained by many factors. This paper undertakes a retrospective study of research works on the challenges to the implementation of reforms in the public health sector. It points out that most of the studies identified: (1) centralised, weak and fragmented management system; (2) poor implementation strategy; (3) lack of motivation; (4) weak institutional framework; (5) lack of financial and human resources and (6) staff attitude and behaviour as the major causes of ineffective reform implementation. The analysis further revealed that quite a number of crucial factors obstructing reform implementation which are particularly internal to the health system have either not been thoroughly studied or overlooked. The analysis identified lack of leadership; weak communication and consultation; lack of stakeholder participation, corruption and unethical professional behaviour as some of the missing variables in the literature. The study, therefore, indicated that there are gaps in the literature that needed to be filled through rigorous reform evaluation based on empirical research particularly at district, sub-district and community levels. It further suggested that future research should be concerned with the effects of both systems and structures and behavioural factors on reform implementation. Language: English Keywords: GHANA | RESEARCH REPORT | RETROSPECTIVE STUDIES | HEALTH SERVICES ADMINISTRATION | MANAGEMENT | PROGRAM EVALUATION | PROGRAM ACTIVITIES | PUBLIC SECTOR | PERSONNEL MANAGEMENT | STAFF ATTITUDE | HUMAN RESOURCES | POLICY | LEADERSHIP | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Organization and Administration | Programs | Macroeconomic Factors | Economic Factors | Attitudes | Psychological Factors | Behavior | Political Factors | Sociocultural Factors Document Number: 307991 |
| 26. Peer Reviewed Title: Antiretroviral therapy in Zambia: colours, 'spoiling', 'talk' and the meaning of antiretrovirals. Author: Schumaker LL; Bond VA Source: Social Science and Medicine. 2008 Dec;67(12):2126-34. Abstract: We examine responses to the roll-out of antiretroviral drugs (ARVs) in Zambia in 2004, focusing on material features of the drugs (colour, shape, size, origin), 'spoiling' (concern about toxicity, side effects of the drugs) and rumours ('talk' about the drugs). Data consists of interviews with 10 people living with HIV and 21 healthcare practitioners. We found that the colour symbolism of 'traditional medicine' has some influence on ideas about ARVs, suggesting possible 'meaning responses' that could affect treatment outcomes. Respondents also become concerned when colours, shapes and side effects differ from expectations. 'Talk' about ARVs concerns risks of medication, sustainability of treatment programmes and people's feelings of vulnerability within larger socio-economic contexts in which countries like Zambia are disadvantaged. Understanding the associations that pharmaceuticals evoke can improve treatment programmes by elucidating public and patient concerns and sensitising healthcare professionals to the historical and political circumstances that condition the 'meaning' of ARVs. Language: English Keywords: ZAMBIA | RESEARCH REPORT | OPERATIONS RESEARCH | KAP SURVEYS | ADMINISTRATIVE PERSONNEL | AIDS PREVENTION | ANTIRETROVIRAL THERAPY | TOXICITY | SIDE EFFECTS | BELIEFS | TRADITIONAL HEALTH PRACTICES | PERCEPTION | PROGRAM SUSTAINABILITY | ECONOMIC DEVELOPMENT | PUBLIC OPINION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Program Evaluation | Programs | Organization and Administration | Surveys | Sampling Studies | Studies | AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Culture | Sociocultural Factors | Psychological Factors | Behavior | Economic Factors | Attitudes Document Number: 331064 |
| 27. Title: Emergency contraception: Overestimated effectiveness and questionable expectations. Author: Stanford JB Source: Clinical Pharmacology and Therapeutics. 2008 Jan;83(1):19-21. Abstract: Reproductive-health advocates have advocated tirelessly for increased awareness of, access to, and utilization of emergency contraception, particularly levonorgestrel (Plan B), with considerable success in the face of much opposition. Unfortunately, the associated political and ideological struggles have diverted attention from two key issues around the use of this drug: how effective it really is and the impact of its use at the population level. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | NEW JERSEY | UNITED KINGDOM | CRITIQUE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE USE-EFFECTIVENESS | TIME FACTORS | PUBLIC OPINION | IMPACT | NEEDS | RESEARCH AND DEVELOPMENT | Developed Countries | North America | Americas | Europe, Western | Europe | Contraception | Family Planning | Contraceptive Effectiveness | Population Dynamics | Demographic Factors | Population | Attitudes | Psychological Factors | Behavior | Communication | Economic Factors | Technology Document Number: 323628 |
| 28. Peer Reviewed Title: A community-based bacteriological study of quality of drinking-water and its feedback to a rural community in western Maharashtra, India. Author: Tambe PV; Daswani PG; Mistry NF; Ghadge AA; Antia NH Source: Journal of Health, Population and Nutrition. 2008 Jun;26(2):139-150. Abstract: A longitudinal study of the bacteriological quality of rural water supplies was undertaken for a movement towards self-help against diseases, such as diarrhoea, and improved water management through increased community participation. Three hundred and thirteen water samples from different sources, such as well, tank, community standpost, handpumps, percolation lakes, and streams, and from households were collected from six villages in Maharashtra, India, over a one-year period. Overall, 49.8% of the 313 samples were polluted, whereas 45.9% of the samples from piped water supply were polluted. The quality of groundwater was generally good compared to open wells. Irregular and/or inadequate treatment of water, lack of drainage systems, and domestic washing near the wells led to deterioration in the quality of water. No major diarrhoeal epidemics were recorded during the study, although a few sporadic cases were noted during the rainy season. As a result of a continuous feedback of bacteriological findings to the community, perceptions of the people changed with time. An increased awareness was observed through active participation of the people cutting across age-groups and different socioeconomic strata of the society in village activities. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | RURAL POPULATION | COMMUNITY | WATER SUPPLY | BACTERIAL AND FUNGAL DISEASES | FEEDBACK | COMMUNITY PARTICIPATION | COMMUNITY HEALTH SERVICES | ENVIRONMENTAL POLLUTION | DIARRHEA | EPIDEMICS | PUBLIC OPINION | INTERVENTIONS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Natural Resources | Environment | Infections | Diseases | Evaluation Methodology | Evaluation | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Environmental Degradation | Attitudes | Psychological Factors | Behavior | Programs Document Number: 327781 |
| 29. Title: Differential community response to introduction of zinc for childhood diarrhea and combination therapy for malaria in southern Mali. Author: Winch PJ; Doumbia S; Kante M; Male AD; Swedberg E Source: Journal of Nutrition. 2008 Mar;138:642-645. Abstract: Developing effective, affordable, and sustainable delivery strategies for the isolated low-income populations that stand to gain the most from micronutrient interventions has proven difficult. We discuss our experience with implementation of zinc as treatment for diarrhea in children less than 5 y of age over the course of 3 operational research studies in rural Sikasso Region, Mali, West Africa. The initial formative research study highlighted how malaria affects perceptions of diarrhea and its causes and that malaria and diarrhea are not necessarily viewed as distinct conditions. The second-phase pilot introduction demonstrated that, in introducing zinc treatment in malaria-endemic regions, it is especially important that both community and facility-level providers be trained to manage sick children presenting with multiple symptoms. The third-phase study on large-scale implementation detected that the experience with implementation of new treatments for malaria is distinct from that of diarrhea. To some extent zinc treatment is the solution to a problem that communities may not recognize at all. Interventions to improve case management of sick children must be integrated across diseases and nutritional problems at both the facility and community levels. Operational research can identify points where integration should occur and how it should be carried out. Programs targeting single diseases or single nutritional problems can have a variety of deleterious effects on health systems, no matter how well they are planned. (author's) Language: English Keywords: MALI | RESEARCH REPORT | OPERATIONS RESEARCH | FORMATIVE RESEARCH | PILOT PROJECTS | CHILDREN | COMMUNITY | ZINC | FOOD SUPPLEMENTATION | PUBLIC OPINION | DIARRHEA | COMMUNITY RELATIONS | COMMUNITY PARTICIPATION | MALARIA | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Program Evaluation | Programs | Organization and Administration | |