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Title: Kangaroo mother care for low birth weight babies: a prospective observational study.
Source: Journal of Nepal Paediatric Society. 2009 Jan-Jun;29(1):6-9.
Abstract: Introduction: Kangaroo Mother Care is the low cost, humane technique for caring low birth weight babies by direct skin to contact with the mother. Objective: The Prospective observational study was done to see the effect of KMC especially on weight gain on low birth weight babies weighing 2000 grams or less at Special Care Baby Unit of Paropakar Maternity and Women's hospital, Kathmandu. Method: The study was conducted in Special Care Baby Unit (SCBU) of Paropakar Maternity and Women's Hospital over 7 months period May 2007 to Nov. 2008 (from Baishakh 2064 to Kartik 2065). The method of care consisted of skin to skin contact between the mother and the infant. Result: It was observed that babies had good weight gain of average 30gms/day and had short duration of hospital stay of average 9 days. Babies had less morbidities like hypothermia, apnea, skin infections and oral thrush.100% babies had exclusive breast feeding and KMC was acceptable to mothers. Conclusion: Kangaroo Mother Care shows early and good weight gain in low birth weight babies. It is simple, low cost technique and well acceptable by mother and family and can be continued at home.
Language: English
Keywords:
NEPAL | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | LOW BIRTH WEIGHT | TREATMENT | INFANT HEALTH | GESTATIONAL AGE | BREASTFEEDING, EXCLUSIVE | COST EFFECTIVENESS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Birth Weight | Body Weight | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Child Health | Fetus | Pregnancy | Reproduction | Breastfeeding | Infant Nutrition | Nutrition | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 341512

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Peer Reviewed

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

Peer Reviewed

Title: Expanding antiretroviral options in resource-limited settings--a cost-effectiveness analysis.
Author: Bendavid E; Wood R; Katzenstein DA; Bayoumi AM; Owens DK
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):106-13.
Abstract: BACKGROUND: Current World Health Organization (WHO) guidelines for treatment of HIV in resource-limited settings call for 2 antiretroviral regimens. The effectiveness and cost-effectiveness of increasing the number of antiretroviral regimens is unknown. METHODS: Using a simulation model, we compared the survival and costs of current WHO regimens with two 3-regimen strategies: an initial regimen of 3 nucleoside reverse transcriptase inhibitors followed by the WHO regimens and the WHO regimens followed by a regimen with a second-generation boosted protease inhibitor (2bPI). We evaluated monitoring with CD4 counts only and with both CD4 counts and viral load. We used cost and effectiveness data from Cape Town and tested all assumptions in sensitivity analyses. RESULTS: Over the lifetime of the cohort, 25.6% of individuals failed both WHO regimens by virologic criteria. However, when patients were monitored using CD4 counts alone, only 6.5% were prescribed additional highly active antiretroviral therapy due to missed and delayed detection of failure. The life expectancy gain for individuals who took a 2bPI was 6.7-8.9 months, depending on the monitoring strategy. When CD4 alone was available, adding a regimen with a 2bPI was associated with an incremental cost-effectiveness ratio of $2581 per year of life gained, and when viral load was available, the ratio was $6519 per year of life gained. Strategies with triple-nucleoside reverse transcriptase inhibitor regimens in initial therapy were dominated. Results were sensitive to the price of 2bPIs. CONCLUSIONS: About 1 in 4 individuals who start highly active antiretroviral therapy in sub-Saharan Africa will fail currently recommended regimens. At current prices, adding a regimen with a 2bPI is cost effective for South Africa and other middle-income countries by WHO standards.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | THEORETICAL MODELS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | COST EFFECTIVENESS | MONITORING | WHO | IMMUNOLOGICAL EFFECTS | LIFE EXPECTANCY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Evaluation Indexes | Quantitative Evaluation | Evaluation | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Immunity | Immune System | Physiology | Biology | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 342908

4.
Title: Targeted screening and treatment for latent tuberculosis infection using QuantiFERON-TB Gold is cost-effective in Mexico.
Author: Burgos JL; Kahn JG; Strathdee SA; Valencia-Mendoza A; Bautista-Arredondo S; Laniado-Laborin R; Castaneda R; Deiss R; Garfein RS
Source: International Journal of Tuberculosis and Lung Disease. 2009 Aug;13(8):962-8.
Abstract: OBJECTIVE: To assess the cost-effectiveness of screening for latent tuberculosis infection (LTBI) using a commercially available detection test and treating individuals at high risk for human immunodeficiency virus (HIV) infection in a middle-income country. DESIGN: We developed a Markov model to evaluate the cost per LTBI case detected, TB case averted and quality-adjusted life year (QALY) gained for a cohort of 1000 individuals at high risk for HIV infection over 20 years. Baseline model inputs for LTBI prevalence were obtained from published literature and cross-sectional data from tuberculosis (TB) screening using QuantiFERON-TB Gold In-Tube (QFT-GIT) testing among sex workers and illicit drug users at high risk for HIV recruited through street outreach in Tijuana, Mexico. Costs are reported in 2007 US dollars. Future costs and QALYs were discounted at 3% per year. Sensitivity analyses were performed to evaluate model robustness. RESULTS: Over 20 years, we estimate the program would prevent 78 cases of active TB and 55 TB-related deaths. The incremental cost per case of LTBI detected was US$730, cost per active TB averted was US$529 and cost per QALY gained was US$108. CONCLUSIONS: In settings of endemic TB and escalating HIV incidence, targeting LTBI screening and treatment among high-risk groups may be highly cost-effective.
Language: English
Keywords:
MEXICO | RESEARCH REPORT | SCREENING | TUBERCULOSIS | COST EFFECTIVENESS | TREATMENT | North America | Americas | Developing Countries | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Diseases | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 342957

Peer Reviewed

Title: Cost savings from the provision of specific methods of contraception in a publicly funded program.
Author: Foster DG; Rostovtseva DP; Brindis CD; Biggs MA; Hulett D; Darney PD
Source: American Journal of Public Health. 2009 Mar;99(3):446-51.
Abstract: OBJECTIVES: We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955,000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program. METHODS: We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies. RESULTS: More than half of the 178,000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43. CONCLUSIONS: All contraceptive methods were cost-effective-they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods.
Language: English
Keywords:
UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | COST EFFECTIVENESS | CONTRACEPTIVE METHODS | ORAL CONTRACEPTIVES | INJECTABLES | BARRIER METHODS | IUD | CONTRACEPTIVE IMPLANTS | Developed Countries | North America | Americas | Evaluation Indexes | Quantitative Evaluation | Evaluation | Contraception | Family Planning
Document Number: 330488

Title: A prospective study evaluating clinical outcomes and costs of three NNRTI-based HAART regimens in Kerala, India.
Author: George C; Yesoda A; Jayakumar B; Lal L
Source: Journal of Clinical Pharmacy and therapeutics. 2009 Feb;34(1):33-40.
Abstract: OBJECTIVE: This prospective, observational, study evaluates the clinical outcomes, drug utilization patterns, and adherence to treatment of patients on highly active anti retroviral therapy (HAART) at a government institution in Kerala, India. METHODS: Patients who met criteria for treatment of HIV/AIDS were enrolled into the study, given free NNRTI-based combination therapy, and were followed for a period of 6 months. Data regarding demographics, clinical outcome, laboratory results, drug utilization, adherence and adverse effects were collected. Analysis was conducted utilizing descriptive statistics, anova, Fisher-exact, andt-test. RESULTS: One hundred and forty-two patients with HIV-1 were enrolled in the study into three treatment groups. The mean age was 37.88 years, 64% of the patients were male, and 92% were married. Group 1 was given zidovudine, lamivudine, and nevirapine [n = 52 (37%)], group 2 was given lamivudine, stavudine, and nevirapine [n = 51 (36%)], and group 3 was given lamivudine, stavudine, and efavirenz [n = 39 (27%)]. The increase in CD4 was 107.46 (SD: 106.25). Mean medication adherence for the 104 patients who completed the study, was 90.7%; for group 1: 92.06%, group 2: 93.37%1, and group 3: 85.71% (P > 0.05). Forty (38%) patients have at least one adverse event to HARRT, with headache being the most common side effect (11.5%). Mortality rate was 3.5% during the course of the study. CONCLUSION: Provision of free NNRTI-based combination therapy to patients in Kerala, India, resulted in greater than 90% adherence leading to better clinical outcomes in terms of increasing CD4 counts and low mortality, for patients consistently attending a treatment clinic.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | COST BENEFIT ANALYSIS | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | COST EFFECTIVENESS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | HEADACHE | SIDE EFFECTS | DEATH RATE | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Evaluation Indexes | HIV | Behavior | Signs and Symptoms | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 330372

9.
Title: Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys.
Author: Hanson K; Marchant T; Nathan R; Mponda H; Jones C; Bruce J; Mshinda H; Schellenberg JA
Source: BMJ. 2009;339:b2434.
Abstract: OBJECTIVES: To evaluate the impact of the Tanzania National Voucher Scheme on the coverage and equitable distribution of insecticide treated nets, used to prevent malaria, to pregnant women and their infants. DESIGN: Plausibility study using three nationally representative cross sectional household and health facility surveys, timed to take place early, mid-way, and at the end of the roll out of the national programme. SETTING: The Tanzania National Voucher Scheme was implemented in antenatal services, and phased in on a district by district basis from October 2004 covering all of mainland Tanzania in May 2006. PARTICIPANTS: 6115, 6260, and 6198 households (in 2005, 2006, and 2007, respectively) in a representative sample of 21 districts (out of a total of 113). INTERVENTIONS: A voucher worth $2.45 ( pound1.47, euro1.74) to be used as part payment for the purchase of a net from a local shop was given to every pregnant woman attending antenatal services. MAIN OUTCOME MEASURES: Insecticide treated net coverage was measured as household ownership of at least one net and use of a net the night before the survey. Socioeconomic distribution of nets was examined using an asset based index. RESULTS: Steady increases in net coverage indicators were observed over the three year study period. Between 2005 and 2007, household ownership of at least one net (untreated or insecticide treated) increased from 44% (2686/6115) to 65% (4006/6198; P<0.001), and ownership of at least one insecticide treated net doubled from 18% (1062/5961) to 36% (2229/6198) in the same period (P<0.001). Among infants under 1 year of age, use of any net increased from 33% (388/1180) to 56% (707/1272; P<0.001) and use of an insecticide treated net increased from 16% (188/1180) to 34% (436/1272; P<0.001). After adjusting for potential confounders, household ownership was positively associated with time since programme launch, although this association did not reach statistical significance (P=0.09). Each extra year of programme operation was associated with a 9 percentage point increase in household insecticide treated net ownership (95% confidence interval -1.6 to 20). In 2005, only 7% (78/1115) of nets in households with a child under 1 year of age had been purchased with a voucher; this value increased to 50% (608/1211) in 2007 (P<0.001). In 2007, infants under 1 year in the least poor quintile were more than three times more likely to have used an insecticide treated net than infants in the poorest quintile (54% v 16%; P<0.001). CONCLUSIONS: The Tanzania National Voucher Scheme was associated with impressive increases in the coverage of insecticide treated nets over a two year period. Gaps in coverage remain, however, especially in the poorest groups. A voucher system that facilitates routine delivery of insecticide treated nets is a feasible option to "keep up" coverage.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HOUSEHOLDS | PREGNANT WOMEN | INFANT | MALARIA PREVENTION | BED NETS | COST EFFECTIVENESS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 342233

10.

Title: Cost-effectiveness analysis of alternative first-trimester pregnancy termination strategies in Mexico City.
Author: Hu D; Grossman D; Levin C; Blanchard K; Goldie SJ
Source: BJOG. 2009 May;116(6):768-79.
Abstract: OBJECTIVE: To assess the comparative health and economic outcomes associated with three alternative first-trimester abortion techniques in Mexico City and to examine the policy implications of increasing access to safe abortion modalities within a restrictive setting. DESIGN: Cost-effectiveness analysis. SETTING: Mexico City. POPULATION: Reproductive-aged women with unintended pregnancy seeking first-trimester abortion. METHODS: Synthesising the best available data, a computer-based model simulates induced abortion and its potential complications and is used to assess the cost-effectiveness of alternative safe modalities for first-trimester pregnancy termination: (1) hospital-based dilatation and curettage (D&C), (2) hospital-based manual vacuum aspiration (MVA), (3) clinic-based MVA and (4) medical abortion using vaginal misoprostol. MAIN OUTCOME MEASURES: Number of complications, lifetime costs, life expectancy, quality-adjusted life expectancy. RESULTS: In comparison to the magnitude of health gains associated with all safe abortion modalities, the relative differences between strategies were more pronounced in terms of their economic costs. Assuming all options were equally available, clinic-based MVA was the least costly and most effective. Medical abortion with misoprostol provided comparable benefits to D&C, but cost substantially less. Enhanced access to safe abortion was always more influential than shifting between safe abortion modalities. CONCLUSIONS: This study demonstrates that the provision of safe abortion is cost-effective and will result in reduced complications, decreased mortality and substantial cost savings compared with unsafe abortion. In Mexico City, shifting from a practice of hospital-based D&C to clinic-based MVA and enhancing access to medical abortion will have the best chance to minimise abortion-related morbidity and mortality.
Language: English
Keywords:
MEXICO | RESEARCH REPORT | COST EFFECTIVENESS | ABORTION | PREGNANCY, FIRST TRIMESTER | HEALTH | ECONOMIC FACTORS | SAFETY | North America | Americas | Developing Countries | Evaluation Indexes | Quantitative Evaluation | Evaluation | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Public Health
Document Number: 342068 Notification

11.

Title: Dried blood spots versus plasma for the quantification of HIV-1 RNA using the manual (PCR-ELISA) amplicor monitor HIV-1 version 1.5 assay in Yaounde, Cameroon.
Author: Ikomey GM; Atashili J; Okomo-Assoumou MC; Mesembe M; Ndumbe PM
Source: Journal of the International Association of Physicians in AIDS Care. 2009 May-Jun;8(3):181-4.
Abstract: OBJECTIVES: Considering the recent accrued need for viral load quantification in resource-limited settings, this study evaluated the use of dried blood spots (DBS) compared to plasma as a means of sample collection and storage for HIV-1 RNA quantification using a non-automated assay. METHODS: Venous blood was collected from 60 consenting HIV-1-positive patients, plasma separated within 4 hours, and stored at -20 degrees C. Venous blood, 50 microL, was blotted on 4 designated areas of Whatman filter paper and air-dried at room temperature for 2 hours. RESULTS: There was a strong statistically significant correlation between HIV-1 RNA viral load using plasma and DBS (r = .955, P < .001). On average plasma viral loads were only slightly higher than DBS viral loads (mean difference: 0.06 log(10) copies/mL). CONCLUSION: Even when using an entirely manual HIV-quantification assay, DBS may provide a reliable, cost-effective method for sample collection and storage for HIV-1 RNA quantification in resource-limited settings.
Language: English
Keywords:
CAMEROON | RESEARCH REPORT | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HEMATOLOGIC TESTS | MONITORING | LABORATORY PROCEDURES | COST EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation | Evaluation Indexes | Quantitative Evaluation
Document Number: 342457

12.

Title: Audit for maternal and newborn health services in resource-poor countries.
Author: Kongnyuy EJ; van den Broek N
Source: BJOG. 2009 Jan;116(1):7-10.
Abstract: Each year more than 536 000 women worldwide die from complications of pregnancy and childbirth. Many more survive but will suffer ill health and disability as a result of these complications. In addition, an estimated 4 million neonatal deaths occur each year, accounting for almost 40% of all deaths in children younger than 5 years. The key strategies that have been identified to reduce this global burden are the presence of skilled birth attendants, the availability of essential (or emergency) obstetric care4 and newborn care. To have major effects on maternal outcomes, it is crucial that these elements are not just available but also of high quality. And assessment of quality requires effective clinical audit. However, anyone who has undertaken a clinical audit will realise that the practice is not as simple as the theory, and 'closing the loop' (to achieve the desired endpoint of improvements in clinical care) is often difficult. So the process of clinical audit itself must be critically evaluated. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | INFANT | INFANT HEALTH | QUALITY OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | NEEDS ASSESSMENT | PERFORMANCE IMPROVEMENT | COST EFFECTIVENESS | MEASUREMENT | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Health | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Evaluation | Management | Evaluation Indexes | Quantitative Evaluation | Research Methodology
Document Number: 330471

13.
Peer Reviewed

Title: Directing diarrhoeal disease research towards disease-burden reduction.
Author: Kosek M; Lanata CF; Black RE; Walker DG; Snyder JD; Salam MA; Mahalanabis D; Fontaine O; Bhutta ZA; Bhatnagar S; Rudan I
Source: Journal of Health, Population, and Nutrition. 2009 Jun;27(3):319-31.
Abstract: Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research questions; the efficacy and effectiveness of the intervention resulting from the research; the maximal potential for disease-burden reduction of the interventions derived from the research; the affordability, deliverability, and sustainability of the intervention supported by the research; and the overall effect of the research-derived intervention on equity. Experts scored each research option independently to delineate the best investments for diarrhoeal disease control in the developing world to reduce the burden of disease by 2015. Priority scores obtained for health policy and systems research obtained eight of the top 10 rankings in overall scores, indicating that current investments in health research are significantly different from those estimated to be the most effective in reducing the global burden of diarrhoeal disease by 2015.
Language: English
Keywords:
DEVELOPING COUNTRIES | EVALUATION REPORT | RESEARCH ACTIVITIES | DIARRHEA | PREVENTION AND CONTROL | INTERVENTIONS | PROGRAM EFFECTIVENESS | PROGRAM SUSTAINABILITY | CHILD HEALTH | GOALS | DELIVERY OF HEALTH CARE | COST EFFECTIVENESS | Evaluation | Research Methodology | Diseases | Programs | Organization and Administration | Program Evaluation | Health | Planning | Evaluation Indexes | Quantitative Evaluation
Document Number: 341924

14.

Peer Reviewed

Title: The effect of interrupted 5-day training on Integrated Management of Neonatal and Childhood Illness on the knowledge and skills of primary health care workers.
Author: Kumar D; Aggarwal AK; Kumar R
Source: Health Policy and Planning. 2009 Mar;24(2):94-100.
Abstract: The conventional 8-day Integrated Management of Neonatal and Childhood Illness (IMNCI) training package poses several operational constraints, particularly due to its long duration. A 5-day training package was developed and administered in an interrupted mode of 3 days and 2 days duration with a break of 4 days in-between, in a district of Haryana state in northern India. Improvement in the knowledge and skills of 50 primary health care workers following the interrupted 5-day training was compared with that of 35 primary health care workers after the conventional 8-day IMNCI training package. The average score increased significantly (P < 0.05) from 46.3 to 74.6 in 8-day training and from 40.0 to 73.2 in 5-day training. Knowledge score improved for all health conditions, like anaemia, diarrhoea, immunization, malnutrition, malaria, meningitis and possible severe bacterial infection, and for breastfeeding in 8-day as well as in 5-day training. Average skills score for respiratory problems increased from 38 to 57 in 8-day training and from 41 to 91 in 5-day training. Corresponding increases in skill scores for diarrhoea assessment were from 28 to 67 and 48 to 75, and for breastfeeding assessment from 33 to 84 and 42 to 86 in 8-day and 5-day training, respectively. Average counselling skill score also rose from 42 to 89 in 8-day and from 37 to 70 in 5-day training. A direct cost saving of US$813 for a batch of 25 trainees and an indirect cost saving of 3 days per trainee and resource person makes the interrupted 5-day IMNCI training more cost-effective.
Language: English
Keywords:
INDIA | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | COST BENEFIT ANALYSIS | HEALTH PERSONNEL | TRAINING PROGRAMS | NEONATAL DISEASES AND ABNORMALITIES | CHILD HEALTH | INTEGRATED PROGRAMS | TIME FACTORS | PRIMARY HEALTH CARE | KNOWLEDGE | EXAMINATIONS AND DIAGNOSES | COST EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Delivery of Health Care | Health | Education | Diseases | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Health Services | Sociocultural Factors | Medical Procedures | Medicine | Evaluation Indexes
Document Number: 331230

15.

Peer Reviewed

Title: Actual cost of providing long-acting reversible contraception: a study of Implanon((R)) cost.
Author: Lipetz C; Phillips C; Fleming C
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):75-9.
Abstract: BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) has judged Implanon((R)) to be the most cost effective of the long-acting reversible contraception (LARC) methods, and its cost effectiveness is enhanced with increased duration of use. Gwent Sexual and Reproductive Health service provides unrestricted use of Implanon, and with the number of implants fitted increasing annually the service wanted to know how long clients were keeping their contraceptive implants in and the cost of implant provision. METHODS: The actual cost of providing Implanon was calculated in a cohort of 493 patients within a community-based sexual and reproductive health service, and compared to that predicted in the NICE Clinical Guideline 30 on LARC. RESULTS: The annual cost for the method (using Implanon) was pound77.49, 25% lower than the estimate made by NICE, despite a shorter duration of use of the method. CONCLUSION: The actual cost in this community-based sexual and reproductive health service may not be transferable to other settings such as general practice.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | COST BENEFIT ANALYSIS | COHORT ANALYSIS | WOMEN | CONTRACEPTIVE IMPLANTS | COST EFFECTIVENESS | COMMUNITY HEALTH SERVICES | FAMILY PLANNING PROGRAM EVALUATION | TIME FACTORS | Developed Countries | Europe, Western | Europe | Research Methodology | Quantitative Evaluation | Evaluation | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Evaluation Indexes | Primary Health Care | Health Services | Delivery of Health Care | Health | Family Planning Programs | Population Dynamics
Document Number: 330950

16.

Peer Reviewed

Title: The cost-effectiveness of a long-acting reversible contraceptive (Implanon) relative to oral contraception in a community setting.
Author: Lipetz C; Phillips CJ; Fleming CF
Source: Contraception. 2009 Apr;79(4):304-9.
Abstract: BACKGROUND: Within the setting of a UK community sexual health service, the cost-effectiveness of Implanon and oral contraception provision over a 36-month period was compared. STUDY DESIGN: A case-controlled retrospective cost-effectiveness study was done on a cohort of 493 Implanon users and 493 oral contraceptive users. The actual cost of provision of both methods was calculated. Cost-effectiveness was calculated based on provision of method and pregnancy costs of each cohort. RESULTS: Implanon provision is more cost-effective than oral contraception at all time points. After 12 months of use, Implanon is half the cost of oral contraception. Oral contraception reached similar annual cost to Implanon at 36 months of use. CONCLUSIONS: Long-acting reversible contraception is perceived to be expensive. It is reassuring to contraception providers that Implanon is, in fact, highly cost-effective when compared to oral contraception with typical use.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | COST EFFECTIVENESS | ORAL CONTRACEPTIVES | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Evaluation Indexes | Quantitative Evaluation | Evaluation | Contraceptive Methods | Contraception | Family Planning
Document Number: 330557

17.

Peer Reviewed

Title: Costs of providing care for HIV-infected adults in an urban HIV clinic in Soweto, South Africa.
Author: Martinson N; Mohapi L; Bakos D; Gray GE; McIntyre JA; Holmes CB
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Mar 1;50(3):327-30.
Abstract: BACKGROUND: As access to antiretroviral therapy (ART) in sub-Saharan Africa expands, estimates of the costs of initiating and maintaining patients on ART are important to program planning, budgeting, and cost-effectiveness analyses. METHODS: Total costs of providing HIV care, including ART, in an urban, nongovernmental, adult clinic in Soweto, South Africa, were estimated from October 2004 through March 2005. Personnel costs were estimated using individuals' work time and salary, and for across-organization services (eg, information technology), a proportion of entire annual costs was applied. Utilization of medications, laboratories, and radiographic tests were estimated by a random sample of patient charts (10%) and applied to the entire cohort. RESULTS: Nine hundred sixty-six adult patients received care during the study period (75% female, median age 34 years, median CD4 count at ART initiation: 109 cells/mm). Seventeen percent were stable on ART at entry, 61% initiated ART, and 22% did not receive ART over the course of the study. Mean cost of the entire program (in US $) was $92,388 per month, and mean per patient cost of care-regardless of ART treatment status-was $98.1 per month. Among adults on ART, costs were lowest for those already on ART ($119.0/month) and highest for those initiating ART ($209.7/month) in the first month and $130.0 the following month. Human resources and antiretrovirals each accounted for one third of overall costs. CONCLUSIONS: The monthly cost of treating HIV-infected patients in an urban South African clinic was highest in the month of initiation and lower for stable patients, with costs driven predominantly by antiretrovirals and personnel.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | URBAN AREAS | CLINIC VISITS | PERSONS LIVING WITH HIV/AIDS | FEES | COST EFFECTIVENESS | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Service Statistics | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Financial Activities | Economic Factors | Evaluation Indexes | Quantitative Evaluation | Evaluation | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 330891

18.

Title: Misoprostol priming prior to second trimester medical abortion.
Author: Moreno-Ruiz NL; Vesona JL; Betstadt SJ; Feng KT; Borgatta L
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 7;
Abstract: Priming refers to the use of medication or procedures to ready the cervix and uterus, producing more effective uterine contractions and shortening the course of labor. Priming is used extensively before induction of labor for term pregnancy. Effective pharmacologic agents used for cervical priming at term include 10-mg dinoprostone vaginal inserts, 0.5-mg dinoprostone vaginal gel, misoprostol 25-50 �g vaginally, and mifepristone 200 mg orally. In the United States, neither misoprostol nor mifepristone is approved for priming. Our experience suggests that misoprostol has potential as a priming agent for women who undergo induction termination of pregnancy. In our small sample, it appeared that the effect was more marked in multiparous women. Further evaluation, including comparison with mifepristone, would be useful.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | MISOPROSTOL | PREGNANCY, SECOND TRIMESTER | ABORTION | CERVICAL DILATATION | ADMINISTRATION AND DOSAGE | TIME FACTORS | COST EFFECTIVENESS | Developed Countries | North America | Americas | Research Methodology | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Population Dynamics | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 341462

20.

Title: Approaches to tuberculosis screening and diagnosis in people with HIV in resource-limited settings.
Author: Reid MJ; Shah NS
Source: Lancet Infectious Diseases. 2009 Mar;9(3):173-84.
Abstract: Tuberculosis is the main cause of morbidity and mortality in people living with HIV/AIDS worldwide. Early diagnosis and treatment is essential to addressing the dual epidemic of tuberculosis and HIV. Increasing recognition of the importance of integrating tuberculosis services--including screening--into HIV care has led to global policies and the beginnings of implementation of joint activities at the national level. However, debate remains about the best methods of screening for pulmonary tuberculosis among people living with HIV/AIDS in resource-limited settings. Mycobacterial culture, the gold standard for tuberculosis diagnosis, is too slow and complex to be a useful screening test in such settings. More widely available methods, such as symptom screening, sputum smear microscopy, chest radiography, and tuberculin skin testing have important shortcomings, especially in people living with HIV/AIDS. However, until simpler, cheaper, and more sensitive diagnostics for tuberculosis are available in peripheral healthcare settings, a strategy must be developed that uses current evidence to combine available screening tools.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EVALUATION | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | SCREENING | COMPLICATIONS | EXAMINATIONS AND DIAGNOSES | INTEGRATED PROGRAMS | LABORATORY EXAMINATIONS AND DIAGNOSES | TIME FACTORS | SIGNS AND SYMPTOMS | PHYSICAL EXAMINATIONS AND DIAGNOSES | COST EFFECTIVENESS | HIV Infections | Viral Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Evaluation Indexes | Quantitative Evaluation
Document Number: 330983

21.
Title: Long-acting reversible contraception: reducing unintended pregnancies.
Author: Ruddick C
Source: Community Practitioner. 2009 Sep;82(9):24-7.
Abstract: This paper gives a brief history of the development of contraception and looks at the methods available in the U.K., with particular emphasis on National Institute for Health and Clinical Excellence guidance about long-acting reversible contraception--injections, implants and intrauterine methods. These methods have the potential to reduce unintended pregnancies, but at present remain underused. Providing positive messages about their ease of use and reversibility, and describing them as 'lasting' rather than 'long-acting' may increase their acceptability.
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | PREGNANCY, UNPLANNED | INJECTABLES | CONTRACEPTIVE IMPLANTS | IUD | CONTRACEPTIVE MODE OF ACTION | KNOWLEDGE | PRIMARY HEALTH CARE | CONTRACEPTIVE METHOD ACCEPTABILITY | COST EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Sociocultural Factors | Health Services | Delivery of Health Care | Health | Contraceptive Usage | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 342927

22.

23.

Peer Reviewed

Title: Improving control of African schistosomiasis: towards effective use of rapid diagnostic tests within an appropriate disease surveillance model.
Author: Stothard JR
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Apr;103(4):325-32.
Abstract: Contemporary control of schistosomiasis is typically reliant upon large-scale administration of praziquantel (PZQ) to school age children. Whilst PZQ treatment of each child is inexpensive, the direct and indirect costs of preventive chemotherapy for the whole school population are more substantive and, at the national level where many schools are targeted, maximising cost effectiveness and the health impact are essential requirements for ensuring longer-term sustainability (i.e. >5 years). To this end, the WHO has issued a set of treatment guidelines, inclusive of re-treatment schedules, such that, where possible, treatment decisions by school are based upon local disease prevalence as determined by parasitological and/or questionnaire methods. As each diagnostic method has known shortcomings, presumptive treatment of at-risk schools may initially be preferred, especially if the existing infrastructure for disease surveillance is poor. It is against this background of school-based preventive chemotherapy that a rapid diagnostic test (RDT) for schistosomiasis is most urgently needed, not only to improve initial disease surveillance but also to focus drug delivery better through time. In this paper, the development, evaluation and application of selected diagnostic tests are reviewed to identify barriers that impede progress, foremost of which is that a new disease surveillance and evaluation model is required where the in-country price of each RDT ideally needs to be less than US$1 to be cost effective both in the short- and long-term perspective.
Language: English
Keywords:
AFRICA, SUB SAHARAN | TECHNICAL REPORT | SCHISTOSOMIASIS | PREVENTION AND CONTROL | DRUGS | COST EFFECTIVENESS | PREVALENCE | EXAMINATIONS AND DIAGNOSES | ANTIGENS | WHO | OBSTACLES | Africa | Developing Countries | Parasitic Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Measurement | Research Methodology | Immunologic Factors | Immunity | Immune System | Physiology | Biology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Organization and Administration
Document Number: 342377

24.

Title: Cost-effectiveness of misoprostol and prenatal iron supplementation as maternal mortality interventions in home births in rural India.
Author: Sutherland T; Bishai DM
Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):189-93.
Abstract: OBJECTIVE: To determine the cost-effectiveness of prenatal iron supplementation and misoprostol use as interventions to prevent maternal mortality in home births in rural India. METHODS: A cost-effectiveness analysis depicted three hypothetical cohorts of 10,000 pregnant women delivering at home in rural India: one with no intervention, one receiving standard prenatal iron supplements, and 1 receiving 600 microg of misoprostol in the third stage of labor. RESULTS: Misoprostol used to prevent postpartum hemorrhage resulted in a 38% (95% CI, 5%-73%) decrease in maternal deaths, while prenatal iron supplementation resulted in a 5% (95% CI, 0%-47%) decrease. Misoprostol cost a median US $1401 (IQR US $1008-$1848) prenatal iron supplementation cost a median US $2241 (IQR No Lives Saved-$3882) per life saved compared with the standard care outcome. CONCLUSION: Misoprostol is a cost-effective maternal mortality intervention for home births. Iron supplementation may be worthwhile to improve women's health, but it is uncertain whether it can prevent mortality after hemorrhage.
Language: English
Keywords:
INDIA | RURAL AREAS | RESEARCH REPORT | STATISTICAL STUDIES | PREGNANT WOMEN | MATERNAL MORTALITY | INTERVENTIONS | MISOPROSTOL | IRON | FOOD SUPPLEMENTATION | COST EFFECTIVENESS | ANEMIA | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Population Characteristics | Demographic Factors | Mortality | Population Dynamics | Programs | Organization and Administration | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Metals | Vitamins and Minerals | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Diseases
Document Number: 341385

25.
Title: The cost of intensified case finding and isoniazid preventive therapy for HIV-infected patients in Battambang, Cambodia.
Author: Sutton BS; Arias MS; Chheng P; Eang MT; Kimerling ME
Source: International Journal of Tuberculosis and Lung Disease. 2009 Jun;13(6):713-8.
Abstract: SETTING: The current study evaluates one of four pilot sites initiated in Cambodia to establish feasible and effective ways to manage patients with human immunodeficiency virus (HIV) infection and tuberculosis (TB). OBJECTIVE: To measure the costs of intensified case finding (ICF) and isoniazid preventive therapy (IPT) services for HIV-infected patients in Battambang Province, Cambodia. DESIGN: We analyzed cost data retrospectively from September 2003 to February 2006 using a microcosting or ingredients-based approach and interviewed clinic personnel to determine the cost of ICF and IPT per person. RESULTS: Adherence to IPT at Battambang IPT clinic was high (86%) relative to other reported studies of IPT among HIV patients in developing countries. The estimated cost per TB case averted through ICF was US$363, while the estimated cost per TB case averted through IPT was US$955. CONCLUSION: Economic evaluations of TB-HIV integrated services are necessary as countries move to establish or scale-up these services. Based upon the estimated effectiveness of ICF and IPT used by other studies examining the provision of integrated HIV-TB services, the cost per TB case prevented by ICF and IPT in Battambang, Cambodia, is less than the reported cost of treating a new smear-positive TB case.
Language: English
Keywords:
CAMBODIA | RESEARCH REPORT | PILOT PROJECTS | RETROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | TUBERCULOSIS | SCREENING | INTEGRATED PROGRAMS | COST EFFECTIVENESS | DRUGS | USER COMPLIANCE | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Treatment | Behavior
Document Number: 342165

26.

Peer Reviewed

Title: Cost effectiveness of contraceptives in the United States.
Author: Trussell J; Lalla AM; Doan QV; Reyes E; Pinto L; Gricar J
Source: Contraception. 2009 Jan;79(1):5-14.
Abstract: BACKGROUND: The study was conducted to estimate the relative cost effectiveness of contraceptives in the United States from a payer's perspective. METHODS: A Markov model was constructed to simulate costs for 16 contraceptive methods and no method over a 5-year period. Failure rates, adverse event rates and resource utilization were derived from the literature. Sensitivity analyses were performed on costs and failure rates. RESULTS: Any contraceptive method is superior to "no method". The three least expensive methods were the copper-T intrauterine device (IUD) (US$647), vasectomy (US$713) and levonorgestrel (LNG)-20 intrauterine system (IUS) (US$930). Results were sensitive to the cost of contraceptive methods, the cost of an unintended pregnancy and plan disenrollment rates. CONCLUSION: The copper-T IUD, vasectomy and the LNG-20 IUS are the most cost-effective contraceptive methods available in the United States. Differences in method costs, the cost of an unintended pregnancy and time horizon are influential factors that determine the overall value of a contraceptive method.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLIENTS | COST EFFECTIVENESS | MARKOV CHAIN | CONTRACEPTION | VAGINAL BARRIER METHODS | IUD, COPPER RELEASING | FEES | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Evaluation Indexes | Quantitative Evaluation | Evaluation | Probability | Statistical Studies | Studies | Research Methodology | Family Planning | Barrier Methods | Contraceptive Methods | IUD | Financial Activities | Economic Factors
Document Number: 330541

27.

Peer Reviewed

Title: Nurse auxiliaries as providers of intrauterine devices for contraception in Guatemala and Honduras.
Author: Vernon R
Source: Reproductive Health Matters. 2009 May;17(33):51-60.
Abstract: Nurse auxiliaries staff the majority of primary health service delivery outlets in low-income countries, particularly in rural areas with high unmet need for contraception. Yet often service delivery guidelines prohibit them from providing contraceptive methods such as the intrauterine device (IUD). Operations research in Guatemala and Honduras in 1997-2005, described in this paper, have shown that nurse auxiliaries can provide IUDs in a safe and clinically appropriate fashion, which can help improve women's choice of methods and decrease costs in health centres with physicians and professional nurses, and health posts. Empowering these health workers requires commitment at the health system and policy levels to a long-term strategy in which small pilot studies are first conducted, followed by phased scaling-up of the strategies, which can require several years. Training can be conducted both in high volume clinics or on-site in health posts. Simple measures such as mentioning the method during counselling and to users of different services and providing women and communities with printed materials have been effective in increasing requests for IUDs. These studies also showed that nurse auxiliaries can take on other reproductive health services, such as contraceptive injections.
Language: English
Keywords:
GUATEMALA | HONDURAS | CRITIQUE | OPERATIONS RESEARCH | PARAMEDICAL PERSONNEL | IUD | INJECTABLES | TRAINING PROGRAMS | NEEDS | COST EFFECTIVENESS | Central America | Latin America | Americas | Developing Countries | Research Methodology | Program Evaluation | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Education | Economic Factors | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 341668

28.

29.

Title: AWARENESS Project. Comparison of Standard Days Method user tools.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [67] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: The Guatemalan Ministry of Public Health and Social Assistance (MOH) collaborated with Georgetown University Institute for Reproductive Health (IRH) to conduct a study comparing two service delivery tools for providing the Standard Days Method� (SDM). The tools were CycleBeads� and a user card printed on paper with an image of CycleBeads and instructions for use. The study, implemented by APROVIME, a local NGO experienced in family planning service delivery research, compared provider and user perspectives, correct use, couple communication, and costs. (excerpt)
Language: English
Keywords:
GUATEMALA | TECHNICAL REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | DELIVERY OF HEALTH CARE | PROGRAM EVALUATION | FAMILY PLANNING TRAINING | CONTRACEPTIVE METHOD ACCEPTABILITY | KNOWLEDGE | CONTRACEPTION CONTINUATION | PARTNER COMMUNICATION | MEN'S INVOLVEMENT | COST EFFECTIVENESS | Central America | Latin America | Americas | Developing Countries | Family Planning | Health | Programs | Organization and Administration | Training Programs | Education | Contraceptive Usage | Contraception | Sociocultural Factors | Interpersonal Relations | Behavior | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 327637

30.

Title: Social marketing final report: three country overview.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Mar. [40] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: While unmet need is growing in sub-Saharan Africa, where contraceptive prevalence is lowest, unmet need remains even in countries where contraceptive prevalence is high, such as in Latin America. Due to rapid growth in the population and increase in the numbers of couples interested in planning and spacing births, reproductive health programs in developing countries face a major challenge: to provide a greater variety of products and services to a rapidly increasing number of users. This challenge must be met in the context of stagnant or decreasing donor funding for contraception. Thus, efforts to meet this unmet need must involve cost-effectively expanding options and access to couples. Social marketing concepts have been successfully applied to increase access and use of many modern contraceptives. The present study was conducted to research the potential of socially-marketing the Standard Days Method� (SDM) in three countries: Ecuador, Benin and the Democratic Republic of the Congo (DRC). The impact of mass media campaigns on knowledge, sales and distribution of the SDM, quality of information provided by pharmacists and providers, and correct use by pharmacy and clinic SDM users was assessed. The aim of the study was to answer the following research questions: What is the impact of a mass media campaign on knowledge, attitudes, sales and free distribution of the SDM?; Can pharmacists and health providers provide high quality information about the SDM?; How do characteristics of women who purchase the SDM from pharmacies compare with those obtain it at a lower or no cost from a clinic?; Can women who purchase the SDM from a pharmacy use the method correctly? (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | LATIN AMERICA | EVALUATION REPORT | CROSS-CULTURAL COMPARISONS | KAP SURVEYS | WOMEN IN DEVELOPMENT | SOCIAL MARKETING | FERTILITY AWARENESS | COST EFFECTIVENESS | MASS MEDIA | FAMILY PLANNING EDUCATION | PHARMACY DISTRIBUTION | CLINICAL DISTRIBUTION | CONTRACEPTIVE EFFECTIVENESS | Africa | Developing Countries | Americas | Evaluation | Comparative Studies | Studies | Research Methodology | Surveys | Sampling Studies | Economic Development | Economic Factors | Marketing | Family Planning | Evaluation Indexes | Quantitative Evaluation | Communication | Education | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception
Document Number: 327650


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