1.  Title: Expanding access to injectable contraception. Author: Family Health International [FHI] Source: [Unpublished] [2009]. 12 p. Abstract: A number of technological developments can make injections safer for administration, whether by health personnel, trained community workers or the women themselves: sub-cutaneous injections, which have less complications than intra-muscular injections; non-reusable disposable syringes Distribution by community health workers needs special attention to: the possibility that a woman is already pregnant (or seeking an abortion by using an injectable); the screening of women with pre-existing conditions or on medications; the need for counselling for side-effects (in particular: vaginal bleeding irregularities, amenorrhea, weight gain, delay in return to fertility); the safety of injections to the woman and to the health worker; the possible confusion between different injectables --provided by public and private sectors. To complement pre-service and in-service training, a number of job aids are available to support community workers providing injectables: medical eligibility criteria wheel to screen for eligibility; pregnancy checklist; simplified material for the management of side-effects (bleeding, amenorrhea, weight changes, etc). (Excerpt) Language: English Keywords: GLOBAL | TABLES AND CHARTS | INJECTABLES | DEPO-PROVERA | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE AVAILABILITY | PROGRAM ACCESSIBILITY | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTIVE SAFETY | MATERNAL MORTALITY | CAUSES OF DEATH | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Usage | Program Evaluation | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Safety | Public Health | Health | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 331838 |
| 2. Title: Quick reference guide to family planning research. Author: Family Health International [FHI] Source: [Research Triangle Park, North Carolina], FHI, 2009 Jan. 51 p. (Research to Practice) Abstract: This document is a summary of research and program findings that FHI believes could improve family planning and reproductive health services if they were more widely incorporated into policies and programs. The following topics are covered: Preventing Mother-to-Child Transmission of HIV through Family Planning; Integrating HIV Voluntary Testing and Counseling and Family Planning Services; Intrauterine Devices; Emergency Contraceptive Pills; Vasectomy; Male Condoms; Female Condoms; Standard Days Method; Eligibility Screening and Provider Checklists; Community-Based Services and Distribution; Youth (ages 10-24); Implants; Contraceptive Continuation; Male Circumcision and HIV; Contraceptive Counseling and Job Aids; Healthy Timing and Spacing of Pregnancies; Postpartum Family Planning. Language: English Keywords: GLOBAL | CATALOG | RESEARCH ACTIVITIES | FAMILY PLANNING POLICY | CONTRACEPTIVE METHODS | HIV/FP INTEGRATION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | EMERGENCY CONTRACEPTION | CONTRACEPTION CONTINUATION | MALE CIRCUMCISION | COMMUNITY-BASED DISTRIBUTION | COUNSELING | YOUTH PROGRAMS | POSTPARTUM PROGRAMS | Research Methodology | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors | Family Planning | Contraception | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | Contraceptive Usage | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Clinic Activities | Family Planning Programs Document Number: 331689 |
| 3. Title: Use of and unmet need for injectable contraception. Author: Family Health International [FHI] Source: [Unpublished] 2009 Jun 8. 12 p. Abstract: Understanding trends in contraceptive use and unmet need for family planning is critical to creating policies which respond to current gaps in service delivery and address future needs for services to meet existing and unmet demand. Creating non clinic-based mechanisms to deliver services has the potential to expand access to underserved populations and reduce pressure on weak health systems. This document examines patterns of the current use of and unmet demand for injectable services. Trends in use of clinic and non clinic-based services for injectables, differentials in injectable use by place of residence, and potential negative consequences of increased use of injectables are explored. Information described in this paper is intended to inform the Technical Consultation on Expanding Access to Injectable Contraception. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | INJECTABLES | CONTRACEPTIVE USAGE | NEEDS | COMMUNITY-BASED DISTRIBUTION | CLINICAL DISTRIBUTION | PHARMACIES | CONTRACEPTIVE DISTRIBUTION | GEOGRAPHIC FACTORS | CONTRACEPTION CONTINUATION | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Health Facilities | Delivery of Health Care | Health Document Number: 331836 |
| 4. Title: Community-based distribution of injectable contraceptives. Approaches that work. Author: Futures Group International. Health Policy Initiative Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Apr. [1] p. Abstract: Contraceptive prevalence rates in many sub-Saharan African countries surged in the mid-1990s. Much of this increase can be attributed to additional resources devoted to family planning (FP) programs and the uptake of specific methods, including injectable contraceptives. For example, use of injectables in Malawi grew from 2 percent in 1992 to 18 percent in 2004. Surveys in many African countries have found that women prefer injectable contraceptives; in some cases, preference for injectables is 2-1 over oral contraceptives and other methods. In recent years, however, these same countries have experienced a stagnation or decline in overall contraceptive prevalence. Particularly in rural areas, modern contraceptives are often scarce, and few trained professionals are available to provide FP services. One way to increase access to and use of family planning is to promote community-based distribution (CBD) of injectables. Countries struggling with stagnating contraceptive prevalence can begin to alterthis trend by training and empowering community-based workers to provide injectable contraceptives. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | CONTRACEPTIVE PREVALENCE | INJECTABLES | ORAL CONTRACEPTIVES | COMMUNITY-BASED DISTRIBUTION | PRIVATE SECTOR | HEALTH SERVICES | Contraceptive Usage | Contraception | Family Planning | Contraceptive Methods | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Macroeconomic Factors | Economic Factors | Delivery of Health Care | Health Document Number: 331532 |
| 6. Title: WHO / USAID / FHI Technical Consultation: Expanding Access to Injectable Contraception, 15-17 June 2009, Room M405, WHO, Geneva. Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI] Source: [Unpublished] 2009. 5 p. Abstract: The agenda for the consultation is presented. The objectives of the consultation were: To review systematically the evidence and programmatic experience on interventions designed to expand access to / provision of contraceptive injectables, focusing on non clinic-based services and programs; To reach conclusions on issues: (a) for which evidence is consistent and strong; (b) for which evidence is mixed; and (c) for which evidence is marginal or entirely lacking and, thus requires additional research; To document discussions and conclusions of the Consultation, including policy and program implications, and to disseminate these widely. Language: English Keywords: GLOBAL | TABLES AND CHARTS | CONFERENCES AND CONGRESSES | WHO | USAID | INJECTABLES | CONTRACEPTIVE AVAILABILITY | INTERVENTIONS | NEEDS | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION CONTINUATION | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Government Agencies | Contraceptive Methods | Contraception | Family Planning | Programs | Organization and Administration | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Contraceptive Usage Document Number: 331853 |
7.  Title: The morning-after pill [letter] Author: Abell S Source: Clinical Pediatrics. 2009 Apr;48(3):341-2; discussion 342. Abstract: This is a question from a reader to the journal's Medical Doctor about the morning-after pill. The Dr. clearly confirms that the morning-after pill is not causing abortion. Her description helps us better understand how this pill (usually levonorgestrel), a progestin, works in preventing a pregnancy. This approach, which is now known as Plan B™, has received strong support in the prevention of unplanned pregnancies from both the American College of Obstetrics and Gynecology and the American Academy of Pediatrics in also circumventing the need for abortions in women of all ages, especially in adolescent girls. Some pharmacists have resisted filling these Plan B prescriptions, so it will be important for pediatricians to know which pharmacies in your community will accept your Plan B™ prescriptions. Sadly, teenage pregnancies continue to have a major impact on disadvantaged teenagers. This group of individuals also may have limited access to Plan B prescriptions, which requires that they should be taken within 5 days of unprotected intercourse in order for them to be effective in preventing unwanted pregnancies. Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE MODE OF ACTION | ABORTION | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | NAUSEA | VOMITING | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Fertility Control, Postconception | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases Document Number: 331244 Notification |
| 8. Title: A case study of reproductive health supplies in Ghana. Author: Akitobi E; Leahy E; Nerquaye-Tetteh J Source: Washington, D.C., Population Action International, 2009 Jun. 30 p. Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Ghana. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt) Language: English Keywords: GHANA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors Document Number: 331428 |
| 9. Peer Reviewed Title: Judicialisation of the right to health in Brazil. Author: Biehl J; Petryna A; Gertner A; Amon JJ; Picon PD Source: Lancet. 2009 Jun 27;373(9682):2182-4. Abstract: This article examines Brazil's constitutional right to health and their pharmaceutical access. It states that Brazil must raise their funding for essential medicines and pursue strategies to ensure universal availability of medicines that the government has a legal responsibility to provide in order to reduce vulnerability to disease. Language: English Keywords: BRAZIL | SUMMARY REPORT | HUMAN RIGHTS | PUBLIC HEALTH | HEALTH POLICY | ANTIRETROVIRAL DRUGS | PHARMACY DISTRIBUTION | PROGRAM EFFICIENCY | FEES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Political Factors | Sociocultural Factors | Health | Policy | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Program Evaluation | Financial Activities | Economic Factors Document Number: 342054 |
| 10. Peer Reviewed Title: Pharmacy worker practices related to use of misoprostol for abortion in one Mexican state. Author: Billings DL; Walker D; Mainero del Paso G; Clark KA; Dayananda I Source: Contraception. 2009 Jun;79(6):445-51. Abstract: BACKGROUND: Pharmacies are important sites for access to health information and medications in Mexico. Most workers are not trained in health issues and may provide inaccurate information to consumers. Misoprostol is used by women throughout Mexico for early abortion and often is purchased from pharmacies. This study aims to understand the practices of pharmacy workers when asked for advice about and medications for abortion, in particular misoprostol. STUDY DESIGN: A random sample of pharmacies in both urban and rural areas of one state of Mexico included both chain and independent pharmacies (n=169). Two mystery clients (MCs) visited the pharmacies, requesting medication for "bringing down the period" and then asking for misoprostol. MCs recorded information about the interactions following each visit in standardized formats. Bivariate comparisons were made between spontaneous and prompted discussions of misoprostol. Associations were considered statistically significant at alpha<.05. RESULTS: Ninety percent of pharmacy workers attending to the MCs discussed misoprostol as an abortifacient, either spontaneously or after being prompted by the MCs. Misoprostol was for sale in most (61%) of these pharmacies. The majority of pharmacy workers (75%) did not request a prescription. Over 75% of all pharmacy workers provided the MCs referral to trained medical providers with whom they could seek a follow-up visit. Sixteen percent of pharmacy workers suggested a regimen consistent with evidence and recommendations for using misoprostol for early abortion. Regimens that were underdosages were common, and few workers recommended a potentially harmful overdosage. Instructions about side effects and risks were rare. The price of misoprostol ranged from 900 to 1800 pesos (US$83-167) for a bottle of 28 tablets (200 mcg each) or US$4.07 per tablet, on average. CONCLUSIONS: Pharmacy workers in both urban and rural areas of Mexico are increasingly becoming aware of misoprostol as an effective abortifacient and are willing to provide the information to consumers. However, their information is limited and often inaccurate. Strategies need to be developed so that they receive timely and correct information, consistent with evidence-based recommendations. The legal context of abortion in Mexico (with restrictions in every state, except Mexico City), the restricted registration of misoprostol as a therapeutic agent only for gastric ulcers and the fact that the majority of pharmacy workers are not considered to be health workers are among the most important barriers to advances in training pharmacy workers in the correct application of misoprostol. Language: English Keywords: MEXICO | RESEARCH REPORT | CLIENTS | PHARMACY DISTRIBUTION | MISOPROSTOL | ABORTION | INFORMED CHOICE | INFORMATION | North America | Americas | Developing Countries | Program Activities | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Contraceptive Usage | Contraception Document Number: 342599 Notification |
| 11. Title: [Contraceptive compliance - why is contraceptive failure still so frequent?] Kontrazeptive Compliance - warum kommt es immer wieder zum Versagen der Author: Bitzer J Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):137-43. Abstract: Contraceptive compliance is defined as the correct use (according to the method specific prescriptions given by a medical professional and/or in written form as patient information leaflet) of a contraceptive method. Non-compliance describes a mismatch between the real behaviour of a user and the correct or ideal behaviour. There are various indicators that in general contraceptive compliance is far from ideal. Many studies report a rate of unintended pregnancies of 50%, half of them terminating in abortion. The abortion rate remains high even in countries with availability of advanced contraceptive technology. Especially with hormonal contraception and barrier methods the gap between correct and real use is large. Discontinuation rates per year reach up to 50%. Reasons for Non Compliance are (a) Lack of motivation to prevent a pregnancy due to ambivalence regarding the wish for a child as well as sexual and relationship issues (b) Cognitive factors (False information, misconceptions, irrational fears) (c) Difficult or lacking access to contraceptive methods (d) Behavioral errors and mistakes (Forgetting, loosing etc.) and (e) Side effects of the methods used. Three strategies to improve compliance can be distinguished: (a) Improving counselling; (b) Developing contraceptive methods which demand a low level of compliant behaviour by the user; (c) Improving quality of life of users by minimizing the negative side effects and maximizing the non contraceptive health benefits. Language: German Keywords: BRAZIL | RESEARCH REPORT | CONTRACEPTION FAILURE | USER COMPLIANCE | PRESCRIPTIONS | CONTRACEPTIVE METHODS | QUALITY OF LIFE | PREGNANCY, UNPLANNED | CONTRACEPTIVE EFFECTIVENESS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Contraceptive Usage | Contraception | Family Planning | Behavior | Distributional Activities | Program Activities | Programs | Organization and Administration | Social Welfare | Economic Factors | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 329568 |
| 12. Peer Reviewed Title: Involving pharmacists in sexual health research: experience from an emergency contraception study. Author: Black K; Anderson C; Kubba A; Wellings K Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):41-3. Abstract: BACKGROUND: Community pharmacists are expanding their sphere of activity within primary health care, increasing their role not only in health care but also research. METHODS AND RESULTS: We describe the challenges encountered in carrying out a pilot study of women obtaining emergency hormonal contraception through different providers, including pharmacies, highlighting deficiencies in understanding and experience of the research process, which impacted on the study in substantial ways. CONCLUSIONS: As pharmacists expand their role, training and professional development will need to be enhanced to support them in their contribution to health care and research. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | PHARMACISTS | EDUCATION | HOME CARE | PHARMACY DISTRIBUTION | SEX EDUCATION | HEALTH | RESEARCH AND DEVELOPMENT | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Health Personnel | Delivery of Health Care | Care and Support | Health Services | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Technology | Economic Factors Document Number: 329636 |
| 13. Peer Reviewed Title: Developments and challenges in emergency contraception. Author: Black KI Source: Best Practice and Research: Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):221-231. Abstract: Emergency contraception (EC) methods, available in oral and intrauterine forms, seek to prevent pregnancy after unprotected intercourse or contraceptive failure. Levonorgestrel EC is more effective and has fewer side effects than the previously used combined oral hormonal method; the Yuzpe regimen. In recent years, levonorgestrel has increased in use, and has become available over the counter in pharmacies in many countries. compared with oral methods, the copper intra-uterine device offers greater protection against unplanned pregnancy but requires a clinical consultation. The much hoped for potential of EC methods to reduce unintended pregnancy is yet to be demonstrated at population level. Language: English Keywords: GLOBAL | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | EMERGENCY CONTRACEPTION | LEVONORGESTREL | RU-486 | IUD | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | PHARMACY DISTRIBUTION | IUD, COPPER RELEASING | NAUSEA | VOMITING | FATIGUE | PAIN | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Methods | Oral Contraceptives | Contraceptive Safety | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases Document Number: 341506 |
| 14. Peer Reviewed Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study. Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA Source: BMC Women's Health. 2009 Mar 26;9(1):7. Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 330849 |
| 15. Title: [Assessment of factors associated with patients' comprehension of treatment at the start of antiretroviral therapy] Evaluacion de factores asociados a la comprension del tratamiento en pacientes Author: Braga Ceccato MG; Acurcio Fde A; Vallano A; Comini Cesar C; Crosland Guimaraes MD Source: Enfermedades Infecciosas Y Microbiologia Clinica. 2009 Jan;27(1):7-13. Abstract: OBJECTIVE: The aim of this study was to evaluate factors associated with patients' comprehension of antiretroviral therapy (ART). METHOD: Cross-sectional analysis in which patients at 2 HIV/AIDS public referral centers (Belo Horizonte, Brazil) were interviewed after initiating ART. Information was recorded on variables related to the patient's characteristics, the treatment prescribed, and the healthcare professional involved. A score indicating the patients' level of comprehension regarding the medications prescribed was obtained using a latent trait model estimated by the item response theory. RESULTS: A total of 406 patients were interviewed. Mean (SD) age was 35 (10) years, 227 were men (56%), 302 of Afro-American ethnicity (77%), and 213 had <8 years of education (53%). The regression model determined that 52.25% of the variability of comprehension was explained by the individual's characteristics. Variables associated (P<0.05) with poorest understanding about ART were lower education (<8 years), lack of knowledge about treatment duration and clinical severity, inadequate information provided by physicians, inability to understand pharmaceutical information, daily number of tablets, and the ART regimen prescribed. CONCLUSION: Comprehension of information about the ART regimen prescribed varies considerably between individuals. Nonetheless, several factors were found to be associated with the level of understanding: characteristics of the patient (education, clinical severity), characteristics of treatment (daily number of tablets, ART regimen prescribed), and contribution of healthcare professionals (information from physicians and pharmacists). Strategies to reinforce information about ART should be a priority for patients with a low level of understanding. Language: Spanish Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INTERVIEWS | CLIENTS | ETHNIC GROUPS | PRESCRIPTIONS | EDUCATIONAL STATUS | KNOWLEDGE | TREATMENT | INFORMATION | PHYSICIAN-PATIENT RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Demographic Factors | Population | Distributional Activities | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior Document Number: 341238 |
| 16. Peer Reviewed Title: The "seeded" focus group: a strategy to recruit HIV+ community members into treatment research. Author: Busza J; Zaba B; Urassa M Source: Sexually Transmitted Infections. 2009 Jun;85(3):212-5. Abstract: OBJECTIVE(S): We piloted an innovative community-based recruitment approach to contact known HIV+ individuals for referral to treatment without endangering their confidentiality. METHODS: Nested within an HIV cohort study, operations research to monitor and improve rural uptake of antiretroviral therapy (ART) was conducted alongside the introduction of Tanzania's national treatment programme. We confronted the challenge of recruiting participants without inadvertently disclosing their HIV status to family or other community members. During post-test counselling, nurses compiled a list of HIV+ persons who expressed interest in being contacted when ART became available. Study numbers, but not names, of 12 "seeds" were added to a randomly generated list of residents, matched by age group and sex, and all were invited to participate in focus-group discussions on community perceptions of treatment. After the discussion, the original counsellors met each participant in private, inviting the "seed" for ART referral and offering VCT to others. RESULTS: Ten "seeds" were successfully located and attended the local focus-group discussion; all subsequently volunteered to undergo clinical tests in advance of receiving antiretroviral therapy. They also agreed to participate in a study of barriers to ART access. The other focus-group members contributed useful information on levels of understanding and support for treatment, and several came forward for HIV testing. CONCLUSIONS: The "seeded" focus group is a very straightforward and easily arranged method of recruiting HIV+ people for research or service delivery within a wider context of engaging with local community perceptions. Language: English Keywords: TANZANIA | RESEARCH REPORT | PILOT PROJECTS | COHORT ANALYSIS | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RECRUITMENT ACTIVITIES | ANTIRETROVIRAL THERAPY | PERCEPTION | COMMUNITY-BASED DISTRIBUTION | HIV TESTING | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Program Activities | HIV | Psychological Factors | Behavior | Nonclinical Distribution | Distributional Activities | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342673 |
| 17. Title: Preventing student pregnancy in Guinea’s Forest Region. Author: Castle S Source: Washington, D.C., CORE Group, [2009]. 8 p. Abstract: Plan International implemented the Forest Region Sustainable Community-Based Reproductive and Sexual Health Project, a 3.5-year intervention to increase knowledge and use of family planning in five prefectures of Guinea's forest region. In partnership with the Association Guinenne pour le Bien-Etre Familiale (AGBEF), Plan International used a community-based approach that included recruiting and training nearly 800 community-based services agents to offer information, some modern methods, and referrals to women, men, and couples in the project zone. From the outset, the Forest Region Project also took a strong interest in the sexual health and FP needs of young people, knowing that early sexual activity combined with low FP use commonly led to unwanted pregnancy and school abandonment and/or unsafe abortion. Language: English Keywords: GUINEA | SUMMARY REPORT | PILOT PROJECTS | STUDENTS | SUGAR DADDIES | PEER EDUCATORS | TEACHERS | FAMILY PLANNING PROGRAMS | SCHOOL-BASED SERVICES | ADOLESCENT PREGNANCY | EDUCATION | COMMUNITY-BASED DISTRIBUTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Sex Behavior | Behavior | Family Planning | Programs | Organization and Administration | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Nonclinical Distribution | Distributional Activities | Program Activities Document Number: 330603 |
| 18. Title: Age and height predict neuropathy risk in patients with HIV prescribed stavudine. Author: Cherry CL; Affandi JS; Imran D; Yunihastuti E; Smyth K; Vanar S; Kamarulzaman A; Price P Source: Neurology. 2009 Jul 28;73(4):315-20. Abstract: OBJECTIVE: Sensory neuropathy is a common problem in HIV-infected patients and is the dose-limiting toxicity of stavudine. Affordable methods of predicting neuropathy risk are needed to guide prescribing in countries where some use of stavudine remains an economic necessity. We therefore aimed to identify factors predictive of neuropathy risk before antiretroviral use. METHODS: A total of 294 patients attending clinics in Melbourne, Kuala Lumpur, and Jakarta were enrolled in a cross-sectional neuropathy screening program in 2006. Neuropathy was defined by the presence of symptoms and signs on the AIDS Clinical Trials Group Brief Peripheral Neuropathy Screen. Demographic, laboratory, and treatment details were considered as possible risk factors for neuropathy. The role of patient demographics in predicting stavudine neuropathy were then assessed in 181 patients who reported that they were free of neuropathy symptoms when first prescribed this drug. RESULTS: The prevalence of neuropathy was 42% in Melbourne (n = 100), 19% in Kuala Lumpur (n = 98), and 34% in Jakarta (n = 96). In addition to treatment exposures, increasing age (p = 0.002) and height (p = 0.001) were independently associated with neuropathy. Age and height cutoffs of > or=170 cm or > or =40 years predicted neuropathy. Among 181 patients who were asymptomatic before stavudine exposure, the risk of neuropathy following stavudine was 20% in younger, shorter patients, compared with 66% in older, taller individuals. CONCLUSIONS: Stavudine neuropathy risk increases with patient age and height. Prioritizing older and taller patients for alternative agents would be an inexpensive strategy to reduce neuropathy rates in countries where the burden of HIV disease limits treatment options. Language: English Keywords: INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | SCREENING | NEUROLOGIC EFFECTS | TREATMENT | PRESCRIPTIONS | ANTIRETROVIRAL DRUGS | AGE FACTORS | BODY HEIGHT | Asia, Southern | Asia | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Distributional Activities | Program Activities | Programs | Organization and Administration | Population Characteristics | Demographic Factors | Population Document Number: 342727 |
| 19. Peer Reviewed Title: Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia. Author: Chi BH; Cantrell RA; Zulu I; Mulenga LB; Levy JW; Tambatamba BC; Reid S; Mwango A; Mwinga A; Bulterys M; Saag MS; Stringer JS Source: International Journal of Epidemiology. 2009 Jun;38(3):746-56. Abstract: BACKGROUND: High-level adherence to antiretroviral therapy (ART) is associated with favourable patient outcomes. In resource-constrained settings, however, there are few validated measures. We examined the correlation between clinical outcomes and the medication possession ratio (MPR), a pharmacy-based measure of adherence. METHODS: We analysed data from a large programmatic cohort across 18 primary care centres providing ART in Lusaka, Zambia. Patients were stratified into three categories based on MPR-calculated adherence over the first 12 months: optimal (> or =95%), suboptimal (80-94%) and poor (<80%). RESULTS: Overall, 27 115 treatment-naive adults initiated and continued ART for > or =12 months: 17 060 (62.9%) demonstrated optimal adherence, 7682 (28.3%) had suboptimal adherence and 2373 (8.8%) had poor adherence. When compared with those with optimal adherence, post-12-month mortality risk was similar among patients with sub-optimal adherence [adjusted hazard ratio (AHR) = 1.0; 95% CI: 0.9-1.2] but higher in patients with poor adherence (AHR = 1.7; 95% CI: 1.4-2.2). Those <80% MPR also appeared to have an attenuated CD4 response at 18 months (185 cells/microl vs 217 cells/microl; P < 0.001), 24 months (213 cells/microl vs 246 cells/microl; P < 0.001), 30 months (226 cells/microl vs 261 cells/microl; P < 0.001) and 36 months (245 cells/microl vs 275 cells/microl; P < 0.01) when compared with those above this threshold. CONCLUSIONS: MPR was predictive of clinical outcomes and immunologic response in this large public sector antiretroviral treatment program. This marker may have a role in guiding programmatic monitoring and clinical care in resource-constrained settings. Language: English Keywords: ZAMBIA | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | IMMUNOLOGICAL EFFECTS | PHARMACY DISTRIBUTION | MORTALITY | HEMOGLOBIN LEVEL | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Behavior | Immunity | Immune System | Physiology | Biology | Nonclinical Distribution | Distributional Activities | Population Dynamics | Demographic Factors | Population | Hemic System Document Number: 342460 |
| 20. Peer Reviewed Title: One versus multiple packs for women starting oral contraceptive pills: a comparison of two distribution regimens. Author: Chin-Quee D; Otterness C; Wedderburn M; McDonald O; Janowitz B Source: Contraception. 2009 May;79(5):369-74. Abstract: BACKGROUND: Despite World Health Organization and International Planned Parenthood Federation recommendations to provide multiple pill cycles to new users, many programs in developing countries still give only one pill cycle to new acceptors. STUDY DESIGN: To compare provision of a single versus multiple packs of pills, new pill users in 20 matched public sector clinics in Jamaica were assigned to one of two pill regimens in which they received either one (then subsequently three) or four pill cycles at method initiation. The primary outcome was the proportion of women who used pills beyond 4 months. RESULTS: Among 655 women, those receiving one cycle of pills at initiation, followed by counseling and a three-pack resupply, were no more likely to be using pills after 4 months than women who received four packs at initiation (odds ratio=1.33; 95% confidence interval=0.88-2.0). In both pill regimen groups, returning late to the clinic for resupply was a problem. However, more women in the 1+3-pack regimen group returned late to study clinics to obtain their fifth cycle of pills than their counterparts in the 4-pack regimen group (53% vs. 28%). CONCLUSION: Our findings support the recommendation that pill users should be given more than one cycle to start, because an extra visit for resupply contributes to clinic and provider costs. Moreover, providing more pill cycles at initiation would decrease the likelihood that women experience a gap in pill use between cycles. Language: English Keywords: JAMAICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | COMPARATIVE STUDIES | WOMEN IN DEVELOPMENT | CONTRACEPTIVE DISTRIBUTION | PACKAGING | ORAL CONTRACEPTIVES | TIME FACTORS | COUNSELING | USER COMPLIANCE | CONTRACEPTIVE PREVALENCE | CONTRACEPTION CONTINUATION | Caribbean | Americas | Developing Countries | Family Planning Surveys | Family Planning | Studies | Research Methodology | Economic Development | Economic Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Marketing | Contraceptive Methods | Contraception | Population Dynamics | Demographic Factors | Population | Clinic Activities | Behavior | Contraceptive Usage Document Number: 330940 |
| 21. Peer Reviewed Title: Contraception in historical and global perspective. Author: Cleland J Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):165-176. Abstract: This chapter describes the rise in contraceptive practice and fall in fertility from around 1880 to the present day. Two main phases are identified: the first confined to European populations and involving methods of low efficacy, and the second embracing the whole planet involving modern methods. Today, sub-Saharan Africa is the only region where low levels of contraceptive use and high fertility persist. Nevertheless, nearly half of pregnancies worldwide are still unintended, and much scope remains for improvement in contraceptive protection. The main international priority is Africa, where demographic factors jeopardize the goals of reducing poverty and hunger. Language: English Keywords: AFRICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE | SOCIAL MARKETING | POPULATION GROWTH | CONTRACEPTIVE METHODS CHOSEN | PREGNANCY, UNPLANNED | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION | FAMILY PLANNING PROGRAMS | Developing Countries | Contraceptive Usage | Family Planning | Marketing | Economic Factors | Population Dynamics | Demographic Factors | Population | Reproductive Behavior | Fertility | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 329659 |
| 22. Peer Reviewed Title: [Antiretroviral drug supply in Argentina: National Program to Combat Human Retroviruses, AIDS, and STDs] Suministro de antirretrovirales en Argentina: Programa Nacional de Lucha contra Author: Colautti M; Luppi I; Salamano M; Traverso ML; Botta C; Palchik V Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2009 Jan;25(1):62-8. Abstract: OBJECTIVES: To evaluate the supply cycle of antiretroviral (ARV) drugs, overseen by the National Program to Combat Human Retroviruses, AIDS, and STDs, through its order fulfillment indicators, and to obtain input from supply chain stakeholders. METHODS: A study was carried out from April-September 2005 in the pharmacies of two hospitals in Rosario, Argentina, involving both a quantitative analysis of indicators and secondary sources and a qualitative evaluation using semistructured interviews. RESULTS: The indicators reveal the impact that interruptions in ARV supply stream from the Program (central level) have and the overstocking that takes place at the pharmacies (local level) to manage the shortages. Changes in ARV treatment account for over 50% of the prescriptions. Fulfillments fall short of the reference value. The interviewees shared possible strategies for overcoming the communication gaps between levels, for building-up stock, for guaranteeing availability, and for shortening waiting times; reached informal agreements to deal with the lack of policies and the shortage of staff; acknowledged the challenges facing the jurisdictions (central, intermediate, and local/community); and recognized local efforts to improve management. CONCLUSIONS: These challenges could be the starting point for building teams to work on effectively decentralizing the entire supply chain and allowing the Program to fulfill its much-needed oversight role. Language: Spanish Keywords: ARGENTINA | RESEARCH REPORT | EVALUATION | EQUIPMENT AND SUPPLIES | LOGISTICS | AIDS | ANTIRETROVIRAL DRUGS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | PRESCRIPTIONS | MANAGEMENT | South America, Southern | South America | Latin America | Americas | Developing Countries | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Distributional Activities | Program Activities | Programs Document Number: 341540 |
| 23. Title: Guatemala: Using supply chain modeling and simulation to analyze the Ministry of Health supply chain. Author: Gibney J; Sanchez A; Lamadrid C Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009 Mar. 38 p. (USAID Contract No. GPO-I-01-06-00007-00) Abstract: This activity analyzed the characteristics of the integrated logistics system in three departments in Guatemala: Sololá, Totonicapán, and Jutiapa. This paper identifies some of the obstacles to achieving contraceptive availability for the underserved and vulnerable populations; it also offers options for improving equity in access for family planning commodities. The study identifies elements in the Ministry of Public Health and Social Welfare’s (MSPAS) logistics system that could impede the availability and accessibility of contraceptives. By using supply chain simulation and optimization modeling software, with geographic information system tools, the authors propose system-related solutions that could improve the performance of the overall MSPAS. Language: English Keywords: GUATEMALA | RECOMMENDATIONS | GOVERNMENT AGENCIES | LOGISTICS | HEALTH SERVICES EVALUATION | CONTRACEPTIVE AVAILABILITY | OBSTACLES | NEEDS | CONTRACEPTIVE DISTRIBUTION | PERFORMANCE IMPROVEMENT | GEOGRAPHY | INFORMATION RETRIEVAL SYSTEMS | TRANSPORTATION | Central America | Latin America | Americas | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Program Evaluation | Programs | Contraception | Family Planning | Economic Factors | Distributional Activities | Program Activities | Social Sciences | Science | Data Storage and Retrieval | Information Processing | Information Document Number: 331663 |
| 24. Peer Reviewed Title: [Pharmacy records as an indicator of non-adherence to antiretroviral therapy by HIV-infected patients] Utilizacao dos registros de dispensacao da farmacia como indicador da nao-adesao Author: Gomes RR; Machado CJ; Acurcio Fde A; Guimaraes MD Source: Cadernos De Saude Publica. 2009 Mar;25(3):495-506. Abstract: The objectives of this study were to evaluate anti-retroviral (ARV) prescription pickups during twelve months following the first prescription and to identify factors associated with irregular pickups or permanent dropout in two public HIV/AIDS referral centers in Belo Horizonte, Minas Gerais State, Brazil. Participants (n = 323) were antiretroviral naive and were recruited from May 2001 to May 2002. A total of 98 (30.3%) patients abandoned treatment, and 187 (57.9%) had at least one irregular pickup. Patients with irregular pickups and dropouts were compared to those with regular pickups. Multinomial multivariate analysis showed that living outside Belo Horizonte, CD4+ T-lymphocyte count greater than 200/mm(3), and antiretroviral regimen without protease inhibitors were associated with irregular pickups. In addition to these variables, not being on other medications, and any non-adherence recorded on patient charts were associated with treatment dropout. Pharmacy records are important potential indicators of non-adherence and should be incorporated as such in clinical practice. Strategies should be prioritized to reach out to dropouts or patients with irregular ARV pickups. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | EVALUATION | PERSONS LIVING WITH HIV/AIDS | CLIENTS | DROPOUTS | USER COMPLIANCE | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | PRESCRIPTIONS | HIV INFECTIONS | TREATMENT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Behavior | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Distributional Activities Document Number: 342667 |
| 25. Peer Reviewed Title: Exploring emergency contraception knowledge, prescription practices, and barriers to prescription for adolescents in the emergency department. Author: Goyal M; Zhao H; Mollen C Source: Pediatrics. 2009 Mar;123(3):765-70. Abstract: OBJECTIVE: The objective of this study was to assess the proportion of emergency medicine physicians who had prescribed emergency contraception pills to adolescents, to identify potential barriers to emergency contraception pill prescription for adolescents, and to assess physician knowledge of emergency contraception pills. PARTICIPANTS AND METHODS: A cross-sectional, anonymous, Internet-based survey of members of the American Academy of Pediatrics Section of Emergency Medicine was conducted. Providers were included in analysis if they were attending physicians caring for children (<22 years of age) in the emergency department setting >30% of the time. Survey questions included demographics, emergency contraception pill prescription rates for adolescents, attitudes toward emergency contraception pills for adolescents, and emergency contraception pill knowledge questions. RESULTS: A total of 1005 Section of Emergency Medicine members were contacted; 424 (42%) responded, and 133 did not meet inclusion criteria. Of the 291 eligible respondents, 282 had complete surveys. Eighty-five percent of the respondents stated that they had prescribed emergency contraception pills to adolescents, 71% within the previous year. Of those, 81% prescribed emergency contraception pills <5 times. The 5 most frequently cited barriers were concern for lack of follow-up (72%), time constraints (40%), lack of clinical resources (33%), discouraging regular contraceptive use (29%), and concern about birth defects (27%). Thirty-nine percent of respondents identified >/=5 barriers to emergency contraception pill prescriptions for adolescents. Forty-three percent incorrectly answered >50% of the questions. Physicians were more likely to report prescribing emergency contraception pills if they had answered >3 of the knowledge-based questions correctly and were less likely to report prescribing if they identified >5 barriers. CONCLUSIONS: Although a large proportion of emergency department physicians reported prescribing emergency contraception pills to adolescents, the pills were prescribed infrequently. Factors associated with nonprescription were decreased knowledge of emergency contraception pills and identifying >5 barriers. Identification of these potential barriers and education regarding emergency contraception pills may ultimately improve adolescent access to emergency contraception pills in the emergency department. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS | EMERGENCY CONTRACEPTION | PRESCRIPTIONS | FERTILITY CONTROL, POSTCOITAL | CONTRACEPTION | KNOWLEDGE | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | Distributional Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors Document Number: 330466 |
| 26. Title: Self-reported sexually transmitted disease symptoms and treatment-seeking behaviors in China. Author: Guan J; Wu Z; Li L; Lin C; Rotheram-Borus MJ; Detels R; Hsieh J Author: NIMH Collaborative HIV/STD Prevention Trial Group Source: AIDS Patient Care and STDs. 2009 Jun;23(6):443-8. Abstract: In recent decades, sexually transmitted diseases (STDs) have reemerged and spread as a major public health problem in China. However, little effort has been made on promoting appropriate health-seeking behaviors among people living with STDs. A randomly selected sample of market vendors in Fuzhou (N = 4510) was recruited and assessed from 2003 to 2004 to examine their choice of pharmacy versus hospital, and folk remedy versus Western medicine when having STD symptoms. Approximately 11.3% of the sample (4.0% of men and 17.8% of women) reported having had abnormal genital discharge or genital ulcer during the past 6 months. More (over 60%) people chose Chinese folk remedy to treat symptoms or prevent transmission when they had genital discharge and/or genital ulcer. Approximately 30% of study participants with reported STD symptoms visited pharmacies only to seek treatment, and 17% visited neither hospital nor pharmacies. Visiting a pharmacy only for STD treatment was marginally significantly associated with being female (prevalence ratio [PR] = 1.665, confidence interval [CI] = 0.980, 2.831) and never married (PR = 1.984, CI = 1.098, 3.594) after controlling for other potential confounders. Education about appropriate health-seeking behaviors to obtain effective treatment of STD must be a top priority to control the rapid spread of STDs in China. Language: English Keywords: CHINA | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | TRADITIONAL HEALTH PRACTICES | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | PHARMACY DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Delivery of Health Care | Health | Culture | Sociocultural Factors | Nonclinical Distribution | Distributional Activities Document Number: 342431 |
| 27. Peer Reviewed Title: Development of a framework for evaluating the sustainability of community-based dengue control projects. Author: Hanh TT; Hill PS; Kay BH; Quy TM Source: American Journal of Tropical Medicine and Hygiene. 2009 Feb;80(2):312-8. Abstract: There are currently no frameworks developed specifically for assessing community-based dengue control project sustainability. We first review the literature for frameworks for assessing project sustainability and second validate the framework criteria against the oldest community-based intervention using Mesocyclops in Xuan Phong commune, Nam Dinh province, north Vietnam, the subject of an intervention in 1998-2000. The framework used 13 criteria, clustered into three categories: 1) maintenance of health benefits from the original project, 2) continued delivery of community activities, and 3) human resource development. To provide consistency between criteria and to allow comparison both over time and with non-intervention communes, a five-point scale for each criterion was used, with the overall sustainability score calculated as the mean of all criteria. The framework offers a practical tool for assessing sustainability, and is amenable to adaptation for specific interventions without compromising the framework as a whole. Language: English Keywords: VIETNAM | RESEARCH REPORT | LITERATURE REVIEW | EVALUATION | DENGUE | COMMUNITY-BASED DISTRIBUTION | PROGRAM SUSTAINABILITY | PREVENTION AND CONTROL | Asia, Southeastern | Asia | Developing Countries | Viral Diseases | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 330140 |
| 28. Title: [Providing emergency contraceptive pills in pharmacies] Author: Heidarsdottir ML; Almarsdottir AB; Geirsson RT Source: Laeknabladid. 2009 May;95(5):343-347. Abstract: Objective: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. Material and methods: A total of 46 pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). Results: Four of five used <5 minutes to discuss emergency contraception with the client, but almost all enquired about time from intercourse. While only 20% asked about the woman s health, most considered concomitant drug use and potential interaction with levonorgestrel. Only about 50% pointed out that EC did not protect against sexually transmitted disease, (3/4) pointed out the need for permanent contraceptive use, 95% asked about previous EC use, but only 30% would provide EC again in the same menstrual cycle. One half of the pharmacists sold EC to men/teenage boys and wished to assist them with taking responsibility, while the others only sold the drug to the woman. Of those prepared to give the drug to the men, 55% asked to speak over the telephone with the woman to ensure correct prescription and information. Nearly a third would never or rarely provide consultation in private. Conclusions: Pharmacists agree mostly about main points in supplying EC, but not as regards provision to women through their male partners. Provisons for consultation can be improved. Key words: Key contraception, emergency contraception, pregnancy. Correspondence: Reynir Tomas Geirsson, reynirg@landspitali.is. Language: Icelandic Keywords: RUSSIA | RESEARCH REPORT | QUESTIONNAIRES | WOMEN | SEXUAL PARTNERS | EMERGENCY CONTRACEPTION | PREGNANCY | PHARMACY DISTRIBUTION | Developing Countries | Asia, Northern | Asia | Demographic Factors | Population | Sex Behavior | Behavior | Contraception | Family Planning | Reproduction | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 341070 |
| 29. Title: A case study of reproductive health supplies in Mexico. Author: Indacochea CM Source: Washington, D.C., Population Action International, 2009 Jun. 36 p. Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders.This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Mexico. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt) Language: English Keywords: MEXICO | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | FUNDS | North America | Americas | Developing Countries | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors Document Number: 331429 |
| 30. Title: A case study of reproductive health supplies in Nicaragua. Author: Indacochea CM; Leahy E Source: Washington, D.C., Population Action International, 2009 Jun. 36 p. Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Nicaragua. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt) Language: English Keywords: NICARAGUA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | ADVOCACY | PROMOTION | KNOWLEDGE | Developing Countries | Central America | Latin America | Americas | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors | Communication | Marketing Document Number: 331430 |
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