1.  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 |
| 2. 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 |
| 3. 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 |
| 4. Title: Exporting labor: the impact of expatriate workers on the home country. Author: Aggarwal R; Khera I Source: INTERNATIONAL MIGRATION/MIGRATIONS INTERNATIONALES/MIGRACIONES INTERNACIONALES. 1987 Dec;25(4):415-25. Abstract: The economic impact of emigration on the source country is analyzed through a literature review and a discussion of costs, benefits, and public policy implications. It is noted that "information collected from different sources and settings is needed for cross-validation of assessments and conclusions. Second....the cost/benefit analysis of emigration should be undertaken on a case by case basis. Third...these costs and benefits must be assessed in a long-term framework that considers the socio-economic conditions and the goals of the country....Fourth, effective governmental policies...need to recognize that emigrants generally are highly motivated people [who] are adept at overcoming legal or other obstacles in their path." (SUMMARY IN FRE AND SPA) (EXCERPT) Language: English Keywords: GLOBAL | LABOR FORCE | MIGRATION | INTERNATIONAL MIGRATION | SOCIOECONOMIC FACTORS | MIGRATION POLICY | POLICY | DATA SOURCES | COST BENEFIT ANALYSIS | ORIGIN | GOALS | GOVERNMENT | MOTIVATION | RELIABILITY | ECONOMIC CONDITIONS | ECONOMIC DEVELOPMENT | SOCIAL DEVELOPMENT | MIGRANTS | LITERATURE REVIEW | Human Resources | Economic Factors | Population Dynamics | Demographic Factors | Population | Population Policy | Social Policy | Data Collection | Research Methodology | Quantitative Evaluation | Evaluation | Planning | Organization and Administration | Political Factors | Psychological Factors | Behavior | Measurement | Macroeconomic Factors Document Number: 205432 |
| 5. Title: Subjective and objective methods of evaluating social programs. Author: Alemi F Source: EVALUATION REVIEW. 1987 Dec;11(6):765-74. Abstract: Reviewers have compared experimental methods with case studies or with analytical studies. These reviews facilitate the practitioners' understanding of the trade-off between experimental evaluation and more qualitative approaches, but leave the distinction between subjective and objective methods unanswered. This article focuses on the distinction between these 2 methods and the trade-offs involved in choosing 1 of them. The evaluator who categorically relies on either subjective or objective methods might be foregoing the advantages provided by the alternative approach. This article argues how the choice between Bayesian versus traditional statistics, decision versus cost-benefit analysis, and anthropological versus more traditional case studies involves balancing the advantages of 1 against the other method. These comparisons exemplify some of the trade-offs between subjective and objective methods. These comparisons suggest that each method is valuable in a particular situation. The diversity of methods available to the evaluator is the sign of a healthy science capable of adjusting techniques to the particular situation at hand. Future research and cumulation of experience in this area may lead to a contingent prescription of when to use which method. For now, it is important that the awareness of alternative methods be increased. Language: English Keywords: COST BENEFIT ANALYSIS | EVALUATION METHODOLOGY | CASE STUDIES | RESEARCH METHODOLOGY | PROGRAM EVALUATION | QUALITATIVE EVALUATION | RESEARCH REPORT | Quantitative Evaluation | Evaluation | Studies | Programs | Organization and Administration Document Number: 270177 |
| 6. Title: High technology: the pendulum must swing back. Author: Attinger EO Source: WORLD HEALTH FORUM. 1987;8(3):305-11. Abstract: High technology has been vastly expanded and misused in the health care systems of many countries. Entrepreneurs underestimated development which led to the premature application of new technologies such as the artificial heart. Also, a free-market philosophy was applied to a services system differing basically from any other industry or public utility. When technologies for prevention, control and cure are developed they are relatively simple and inexpensive, whereas the more spectacular technologies for palliation and repair, such as open heart surgery, are very costly and often of only marginal benefit to the patient. The modern health care industry in the US has often been focused on large, uncritical captive markets. Little has been done to develop better technologies for the solution of of some very common health problems. Periodic licensing of all expensive, complex and potentially dangerous technologies should be mandatory. We should strive for equal access to basic health care. The rational application of any technology involves the 3 basic issues of purpose, quality and price. Funds should be redirected towards technologies that can effectively improve the health status of the whole population. Rational limitations on technology might restore the caring function of the medical profession to its proper place. Language: English Keywords: UNITED STATES OF AMERICA | NORTH AMERICA | HEALTH SERVICES | SOCIOECONOMIC FACTORS | DELIVERY OF HEALTH CARE | MEDICINE | TECHNOLOGY | PRIMARY HEALTH CARE | NEEDS | COST BENEFIT ANALYSIS | CRITIQUE | Developed Countries | Americas | Health | Economic Factors | Quantitative Evaluation | Evaluation Document Number: 269990 |
| 7. Peer Reviewed Title: Evaluating healthy days of life gained from health projects. Author: Barnum H Source: Social Science and Medicine. 1987;24(10):833-41. Abstract: The question of evaluating healthy days of life in health policy is examined. The healthy days concept has been utilized to provide a vehicle to bring into focus several issues related to any effort to move cost-effectiveness analysis beyond the confines of its current applications to single diseases and interventions. Attention is drawn to the importance of incorporating weights for time preference and productivity in using the concept of healthy days of life lost to evaluate healthy projects. 2 alternative health strategies ar defined for Ghana and evaluated, over a range of discount rates from 0% to 20%, with regard to the present value of productive life saved. It is found that the relative ranking of the projects is sensitive to the choice of discount rates. The sensitivity of disase rankings to the underlying morbidity and fatality rates is also examined and the results underline the importance of obtaining better epidemiological baseline data and information on project effectiveness if the potential usefulness of the healthy days of life approach to project evaluation is to be fully realized. Language: English Keywords: HEALTH SERVICES EVALUATION | GHANA | EVALUATION INDEXES | PRODUCTIVITY | HEALTH STATUS INDEXES | HEALTH | SOCIOECONOMIC FACTORS | MEASUREMENT | COST BENEFIT ANALYSIS | THEORETICAL MODELS | PROGRAM EFFECTIVENESS | DEMOGRAPHIC IMPACT | METHODOLOGICAL STUDIES | Program Evaluation | Programs | Organization and Administration | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Quantitative Evaluation | Evaluation | Economic Development | Economic Factors | Research Methodology | Population Dynamics | Demographic Factors | Population Document Number: 269546 |
| 8. Title: A role for water supply and sanitation in the child survival revolution. Author: Briscoe J Source: BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1987;21(2):93-105. This article will also be published in Spanish in the Boletin de la Oficina Sanitaria Panamericana, volume 104, 1988 Abstract: Current strategy for the "child survival revolution," as supported by by agencies such as UNICEF and USAID, give low priority to improvements in water supply and sanitation, because it has been concluded that these interventions are not cost-effective. This conclusion is incorrect. Because water supply and sanitation projects have multiple impacts, care needs to be used in applying conventional cost-effectiveness techniques. Because adequate water supply and sanitation facilities are necessary but not sufficient conditions for health improvements, the provision of improved facilities may be essential even though it does not have a large, immediate impact on health status. The long-run effect on child survival is probably much greater than would be expected on the basis of assessment of immediate effects on diarrheal disease. Morbidity due to diarrheal diseases is generally substantially affected by water supply and sanitation improvement projects. It appears that there are serious flaws in the analytic methods being used to decide on priorities for child survival activities. Language: English Keywords: DEVELOPING COUNTRIES | CHILD MORTALITY | CHILD HEALTH | COST BENEFIT ANALYSIS | WATER SUPPLY | SANITATION | PUBLIC HEALTH | NEEDS | DIARRHEA | DIARRHEA, INFANTILE | GASTROINTESTINAL EFFECTS | DISEASES | COMMUNICABLE DISEASE CONTROL | HEALTH AND WELFARE PLANNING | POLICY | CRITIQUE | CHANGES | Mortality | Population Dynamics | Demographic Factors | Population | Health | Quantitative Evaluation | Evaluation | Natural Resources | Environment | Economic Factors | Physiology | Biology | Health Services | Delivery of Health Care | Social Planning | Social Change Document Number: 270051 |
| 9. Title: Estimates of public costs for teenage childbearing: a review of recent studies and estimates of 1985 public costs. Author: Burt MR; Levy F Source: In: Risking the future: adolescent sexuality, pregnancy, and childbearing, volume 2. Washington, D.C., National Academy Press, 1987. :264-93. Abstract: The paper 1st reviews 6 studies (2 national US and 4 local US) that estimate costs for teenaged childbearing. 3 studies made 20-year projections of the public cost of a single teen birth and of the cohort of teen births from a single year. 2 studies estimate the public cost incurred during a single year that was attributable to teenage childbearing, whatever the current age of the mother. 1 study estimated the total cost, public and private, through 1983 of all babies born to teenagers in 1979-1983. The most easily comparable estimates from these studies are for single birth costs: the range is from $13,852 to $18,710 in public cost, over the 20 years from the time a woman experiences a 1st birth as a teenager. Cost estimates always rest on a set of assumptions and are only as good as their assumptions. The rest of Part II presents 2 types of estimates: single year per public cost estimates and single birth/single cohort public cost estimates. Each presentation has 3 sections: 1) the tabular statement of the cost estimate; 2) a brief comparison of the estimate with earlier estimates, noting possible reasons for differences where these exist; and 3) the assumptions on which the estimate rests. Language: English Keywords: UNITED STATES OF AMERICA | NORTH AMERICA | ADOLESCENT PREGNANCY | PREGNANCY | CHILD REARING | SOCIAL BEHAVIOR | SOCIAL WELFARE | SOCIAL DEVELOPMENT | COST BENEFIT ANALYSIS | EVALUATION METHODOLOGY | LITERATURE REVIEW | Developed Countries | Americas | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Reproduction | Behavior | Economic Factors | Quantitative Evaluation | Evaluation Document Number: 044869 |
| 10. Peer Reviewed Title: Primary health care is not cheap: a case study from Guinea Bissau. Author: Chabot J; Waddington C Source: INTERNATIONAL JOURNAL OF HEALTH SERVICES. 1987;17(3):387-409. Abstract: In 1977 the Ministry of Health in Guinea Bissau started 2 regional community health projects. In this article the progress of the Tombali project is described. 3 aspects are discussed: the "Learning Process Approach" used in the project; measurement of the effectiveness of the project and the problems of collecting and interpreting these data; and the ratio of investment to recurrent cost and the proportions borne by government and by villagers. Primary health care projects evolve slowly, and the importance of the willingness of project workers, donor agencies, and the national government to work without a blueprint plan is emphasized. This paper discusses ways of evaluating the success of primary health care schemes; the measurement of any change in health status is difficult and discounts other benefits that may result, such as encouraging community participation and involving villagers in government activities. Both government and villagers contribute significantly to the scheme, the government and donors bearing most of the investment costs, while most of the recurrent costs fall on the villagers. The data show that for neither government nor villagers is the scheme a cheap option to secure health care for rural populations. Finally, the lessons to be leaned by national governments, donor agencies, and health workers from this attempt to implement a primary health care program are discussed. (author's modified) Language: English Keywords: GUINEA-BISSAU | PRIMARY HEALTH CARE | COMMUNITY HEALTH SERVICES | EVALUATION | COMMUNITY PARTICIPATION | GOVERNMENT PROGRAMS | RURAL HEALTH SERVICES | HEALTH SERVICES EVALUATION | COST BENEFIT ANALYSIS | COMMUNITY FINANCING | RESEARCH REPORT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Health Services | Delivery of Health Care | Health | Organization and Administration | Programs | Program Evaluation | Quantitative Evaluation | Financial Activities | Economic Factors Document Number: 269634 |
| 11. Title: Index to the population, health and nutrition technical note series [of the World Bank]. Author: Chester LA Source: Washington, D.C., The World Bank, Population, Health and Nutrition Department, Policy and Research Division, 1987 Mar. xv, 64 p. Abstract: The Population, Health, and Nutrition Department (PHN) of the World Bank initiated a Technical Note series in 1983 to give wider circulation to selected papers, which might be of interest to people outside the PHN department and outside the World Bank. The Technical Note series includes 100 papers written or commissioned by PHN staff covering topics pertaining to financing and investment, management information systems and cost-effectiveness of health, nutrition, and family planning programs. This particular work is a complete index of all Notes published as of March 31, 1987. The table of contents lists titles by subject and gives the page number for the corresponding abstracts. An author index follows the subject index. Abstracts appear chronologically, beginning with the most recent releases and are arranged by subject. In addition, information is provided for those who wish to obtain individual copies of papers. Language: English Keywords: NUTRITION PROGRAMS | FERTILITY | HEALTH SERVICES EVALUATION | AFRICA, SUB SAHARAN | POPULATION DYNAMICS | COST BENEFIT ANALYSIS | RESOURCE ALLOCATION | AFRICA | ASIA | FAMILY PLANNING PROGRAM EVALUATION | DEMOGRAPHIC IMPACT | BIBLIOGRAPHY | SOCIAL DEVELOPMENT | Primary Health Care | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Program Evaluation | Programs | Organization and Administration | Developing Countries | Quantitative Evaluation | Evaluation | Financial Activities | Economic Factors | Family Planning Programs | Family Planning Document Number: 269584 |
| 12. Title: Cost-effectiveness of immunization in Colombia. Author: Creese AL; Dominguez-Uga MA Source: WORLD HEALTH FORUM. 1987;8(2):221-6. Abstract: The cost of Colombia's 1984 national immunization campaign is compared to that of the country's routine immunization services. Although the cost per immunization was broadly similar in the 2 cases, cost per fully immunized infant was twice as high for the campaign as for the routine services. The cost of routine services was assessed by identifying the type and quantities of human and physical resources deployed for immunization at each health post, and by apportioning a share of the immunization resources at the regional, departmental and national levels to the units. The campaign substantially boosted the number of immunizations performed. During its 3 days, 636,000 doses of DPT were given to infants, nearly 190,000 infants received a 3rd dose of the vaccine, and 98,000 began and completed DPT schedules. It cost between US$0.55 and US$11.90 to provide an immunization, the mean from the sample for routine services was US$2.54 and for the campaign the mean additional cost was US$3.56. Possible alternative delivery strategies and variations in campaign strategy are considered. Prior assessment of cost-effectiveness as an aid to option appraisal is advocated. Language: English Keywords: LATIN AMERICA | COLOMBIA | SOUTH AMERICA | AMERICAS | IMMUNIZATION | VACCINATION | PREVENTIVE MEDICINE | HEALTH SERVICES EVALUATION | COST BENEFIT ANALYSIS | COMPARATIVE STUDIES | RESEARCH REPORT | Developing Countries | South America, Northern | Developed Countries | Primary Health Care | Health Services | Delivery of Health Care | Health | Medicine | Program Evaluation | Programs | Organization and Administration | Quantitative Evaluation | Evaluation | Studies | Research Methodology Document Number: 269672 |
| 13. Title: Cost-effectiveness of immunization programs in Colombia. Author: Creese AL; Dominguez-Uga MA Source: BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1987;21(4):377-94. This article will also be published in Spanish in the Boletin de la Oficina Sanitaria Panamericana, vol. 103, 1987 Abstract: An investigation was done to estimate the cost per immunization contact for routinely available vaccination services in Colombia, and to compare these figures with the incremental costs for the additional immunization contacts resulting from the 1984 National Vaccination Campaign. Some 636,000 doses of DPT were given to infants during the campaign's 3 vaccination days. Nearly 190,000 infants received a 3rd dose of DPT on those days. Approximately 98,000 infants began and completed their DPT immunization schedules on the vaccination days. % of infants covered, however, remains uncertain. Infant coverage in 1983 was around 42-44%. The coverage survey showed 66.7% of the infant population covered with DPT by the time of the survey (November/December 1984) but only 50% covered on the actual vaccination days. Infant coverage for polio was 44%, and for measles, 43%. Having national immunization days increased routine immunization program costs by 120%, a substantial amount. In terms of program cost and impact, the national prerequisites for success are probably more related to general development of the necessary communication than to the health sector's physical infrastructure. The national campaign could conceivably eclipse the continuous multipurpose routine services--detracting not only from their immunization efforts but from other preventive and promotional activities. Language: English Keywords: COLOMBIA | LATIN AMERICA | SOUTH AMERICA | IMMUNIZATION | VACCINATION | COST BENEFIT ANALYSIS | PREVENTIVE MEDICINE | EVALUATION | AMERICAS | PROGRAM EVALUATION | INFANT | CHILD | CHILD HEALTH SERVICES | SUMMARY REPORT | South America, Northern | Developing Countries | Primary Health Care | Health Services | Delivery of Health Care | Health | Quantitative Evaluation | Medicine | Developed Countries | Programs | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Maternal-Child Health Services Document Number: 047058 |
| 14. Title: Informal security mechanisms and population retention in rural India. Author: Das Gupta M Source: ECONOMIC DEVELOPMENT AND CULTURAL CHANGE. 1987 Oct;36(1):101-20. Abstract: "The aim of this paper is to demonstrate the importance of traditional security mechanisms in raising the opportunity cost of rural-urban migration in rural India. The security takes the form of institutional access to community resources as well as to the personal property resources of those owning land. However, it is also found that, over time, there has been an erosion in the access to these resources. Thus, on the one hand, it appears that the flow of rural poor into urban slums might accelerate in coming years. On the other hand, there are a number of rural development projects in operation that seek to generate income-earning opportunities in the villages. It remains to be seen whether these efforts succeed in keeping the rate of rural-urban migration low." The data were collected in 1984 and 1985 from "two Indian villages (one prosperous and one poor) as well as from households in three shanty towns in Delhi...." (EXCERPT) Language: English Keywords: INDIA | MIGRATION | INTERNAL MIGRATION | RURAL-URBAN MIGRATION | COST BENEFIT ANALYSIS | SOCIOECONOMIC FACTORS | SOCIOECONOMIC STATUS | RESOURCES | RESOURCE ALLOCATION | SOCIAL WELFARE | LAND TENURE | LOW INCOME POPULATION | POVERTY | ECONOMIC DEVELOPMENT | URBANIZATION | MIGRATION POLICY | POLICY | DEVELOPMENT PLANNING | SOCIAL PROBLEMS | SLUMS | HUMAN RESOURCES | MANPOWER NEEDS | RURAL POPULATION | RURAL DEVELOPMENT | COMMUNITY DEVELOPMENT | SOCIAL CHANGE | OBSTACLES | MICROECONOMIC FACTORS | Asia, Southern | Asia | Developing Countries | Population Dynamics | Demographic Factors | Population | Quantitative Evaluation | Evaluation | Economic Factors | Organization and Administration | Financial Activities | Social Class | Urban Population Distribution | Population Distribution | Geographic Factors | Population Policy | Social Policy | Population Characteristics | Social Development Document Number: 206653 |
| 15. Title: [The value of BCG] La valeur du BCG Author: Deverson A Source: BULLETIN D'EPIDEMIOLOGIE ET DE SANTE PUBLIQUE. 1987 Jun;1(1):15. Abstract: Tuberculosis is the most important cause of death in Haiti. The incidence is estimated to be approimately 2-3% of the population and in recent years this disease has become the most prevalent cause of pulmonary disease in children. This study of the efficacy of vaccination with BCG (bovine proded anti-tuberculin vaccine) outlines the techniques and complications of the vaccination procedure as well as suggesting groups which should be given priority for vaccination. In addition, cost-benefit annalysis is included. The author suggests that the vaccine should be given to all children shortly after birth when the incidence of TB positive tests in preschoolers is greater than 2% of the population; when the incidence is lower, vaccination should be postponed until adolescence. Prior testing for TB is not considered necessary before vaccination, thus reducing the number of times the patient needs to be seen by the practitioner and thereby increasing compliance. The cost of BCG administration is cost effective even in countries such as Australia where the incidence of TB is relatively low and in developing nations the economic benefits can be expected to be enormous. Language: French Keywords: HAITI | CARIBBEAN | PREVENTIVE MEDICINE | EVALUATION | VACCINATION | HEALTH AND WELFARE PLANNING | TUBERCULOSIS | COST BENEFIT ANALYSIS | DISEASE TRANSMISSION CONTROL | BACTERIAL AND FUNGAL DISEASES | RESEARCH REPORT | PREVENTION AND CONTROL | DEVELOPED COUNTRIES | Developing Countries | Americas | Medicine | Health Services | Delivery of Health Care | Health | Immunization | Primary Health Care | Social Planning | Economic Factors | Infections | Diseases | Quantitative Evaluation Document Number: 270021 |
| 16. Title: The revenue generating potential of user fees in Kenyan government health facilities. Author: Ellis RP Source: Social Science and Medicine. 1987;25(9):995-1002. Abstract: The health care delivery system in Kenya is typical of many developing countries in that government-owned hospitals, health centers, and small dispensaries provide health care services as well as numerous missionary and private facilities. Financial support for the public facilities is generated almost entirely from tax revenues and foreign grants, which have barely kept pace with Kenya's rapid population growth. Chronic financial stringency has resulted in frequent drug shortages, undermaintenance of equipment, and underpayment of personnel; and has seriously eroded the quality of services provided in the public health care system. In light of this experience, the Kenyan government is exploring various alternatives for supplementing the revenue available for public health facilities, including user fees. This paper develops and implements a methodology for estimating the total revenue that would result from a system of user fees for health services provided by public facilities in a developing country. After setting out a set of principles based on efficiency, equity, and administrative goals upon which the user fees should be founded, a formula for estimating total revenue generated is presented which reflects 6 different factors affecting total revenues. These factors include reductions in demand due to imposing fees, exemption of selected services from any fees, forgiving fees from those unable to pay, and leakage of revenue due to bribes. 3 specific fee structures are then examined for Kenya, and the total revenue to be generated is predicted. The revenue totals are large, on the order of 10-22% of the government's total recurrent health costs, suggesting that even modest user fees can make a significant contribution to public health costs. Language: English Keywords: KENYA | FEES | FINANCIAL ACTIVITIES | PROGRAM ACTIVITIES | HEALTH SERVICES ADMINISTRATION | THEORETICAL MODELS | COST BENEFIT ANALYSIS | FUNDS | RESEARCH REPORT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Economic Factors | Programs | Organization and Administration | Management | Research Methodology | Quantitative Evaluation | Evaluation Document Number: 270143 |
| 17. Title: Economic aspects of Singapore's selective family planning policy. Author: Evans DB Source: ASIAN AND PACIFIC POPULATION FORUM. 1987 Aug;1(4):1-8. Abstract: In the mid 1980s Singapore instituted a selective family planning policy which encouraged poorly educated women to prevent pregnancy while university graduates were discouraged from using family planning. The intent of this policy was to restructure the population and the economy into a more skill-intensive industrial society and to produce effective leaders for the future governing of the country. Monetary incentives were offered to both groups of women for their compliance with the policy, including grants to poor women agreeing to undergo steriliaztion. This study undertakes a cost benefit analysis of this family planning policy, taking into account parameters of economic growth, marginal value product of labor, and the consumption levels. Results of this analysis suggest that society may benefit more by prevention the birth of a potential university student than by preventing the birth of a potential primary school graduate. However, this study does not take into account the value of educated citizens in technical advancement which would raise the productivity of the uskilled workers in the country, nor some of the real economic conditions in Singapore such as the virtually unlimited availability of labor from other Asian countries (who come without dependents and are expatriated when they become unproductive). Training cost and the timing of benefits are critical to the outcome of this analysis. It is shown that, under some reasonable conditions, the selective family planning policy might not be economically warranted. Language: English Keywords: SINGAPORE | FAMILY PLANNING POLICY | SOCIOECONOMIC FACTORS | POPULATION POLICY | FAMILY PLANNING | ECONOMIC DEVELOPMENT | COST BENEFIT ANALYSIS | HUMAN RESOURCES | SOCIOECONOMIC STATUS | INCENTIVES | DISINCENTIVES | QUALITATIVE EVALUATION | RESEARCH REPORT | TEMPORARY MIGRATION | Developed Countries | Asia, Southeastern | Asia | Social Policy | Policy | Economic Factors | Quantitative Evaluation | Evaluation | Migration | Population Dynamics | Demographic Factors | Population Document Number: 045142 |
| 18. Title: [New estimates of child costs in Canada] Nouvelles estimations du cout de l'enfant au Canada. Author: Gauthier AH Source: CAHIERS QUEBECOIS DE DEMOGRAPHIE. 1987 Oct;16(2):187-208. Abstract: "In order to be able to appraise to what extent policy measures compensate for the cost of rearing a child, one needs an estimate of this cost. In this paper, the author presents a new model which is applied to data obtained from the survey of family expenditures, made in 1982 by Statistics Canada. The first part is devoted to the methodological and theoretical considerations on which the model is based, and the second part analyses the estimates of the cost of a child, according to age and rank of the child, and standard of living of the family." (SUMMARY IN ENG AND SPA) (EXCERPT) Language: French Keywords: CANADA | NORTH AMERICA | ESTIMATION TECHNIQUES | CHILD | CHILD REARING | SOCIOECONOMIC FACTORS | STANDARD OF LIVING | COST BENEFIT ANALYSIS | POLICY | ECONOMIC MODEL | THEORETICAL MODELS | EXPENDITURES | FINANCIAL ACTIVITIES | AGE FACTORS | BIRTH ORDER | SOCIOECONOMIC STATUS | MICROECONOMIC FACTORS | FAMILY POLICY | FAMILY AND HOUSEHOLD | METHODOLOGICAL STUDIES | THEORETICAL STUDIES | North America, Northern | Americas | Developed Countries | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Behavior | Economic Factors | Quantitative Evaluation | Evaluation | Family Relationships | Family Characteristics | Social Policy Document Number: 227828 |
| 19. Title: Labor migration and remittances between OPEC members and non-oil LDCs. Author: Hallwood P Source: MIDDLE EAST REVIEW. 1987 Spring;19(3):39-48. Abstract: Labor migration between the non-oil-producing and oil-producing Arab countries is studied. The costs and benefits of this migration are discussed, with particular reference to the economic impact of remittances on the countries of origin. (ANNOTATION) Language: English Keywords: MIDDLE EAST | ASIA | AFRICA, NORTHERN | AFRICA | MIGRATION | INTERNATIONAL MIGRATION | SOCIOECONOMIC FACTORS | REMITTANCES | COST BENEFIT ANALYSIS | LABOR FORCE | MANPOWER NEEDS | HUMAN RESOURCES | ORIGIN | ECONOMIC CONDITIONS | CHANGES | ENERGY SUPPLY | Developing Countries | Population Dynamics | Demographic Factors | Population | Economic Factors | Microeconomic Factors | Quantitative Evaluation | Evaluation | Macroeconomic Factors | Social Change | Natural Resources | Environment Document Number: 227625 |
| 20. Title: State and local issues surrounding elderly seasonal migrants. Author: Happel S Source: [Unpublished] 1987. 12, [2] p. Abstract: This paper examines elderly migration to mobile home and travel trailer parks in the Phoenix area in Arizona. Annual park censuses since 1984 find 75,000 to 95,000 seasonal occupants in the peak month of February. Surveys indicate that these retirees (often referred to as "snowbirds" because they migrate to warmer places in the winter for from one to over six months each year) are rather well-educated, have relatively high incomes, often stay four months or more, and live active lifestyles in the parks. They inject several hundred million dollars into local economies during their stay, but they also create road congestion and other planning problems for government officials. The result is an ongoing, and often heated, debate about actual numbers and appropriate zoning, tax, and development responses. Given the increased prevalence of seasonal migration nationwide, there is more likely to be a growing demand for such data in the future, and Census Bureau involvement will become critical. Language: English Keywords: ARIZONA | UNITED STATES OF AMERICA | NORTH AMERICA | TEMPORARY MIGRATION | MIGRATION | MIGRANTS | OLDER ADULTS | ADULTS | RETIREMENT | COST BENEFIT ANALYSIS | EVALUATION METHODOLOGY | GOVERNMENT | Developed Countries | Americas | Population Dynamics | Demographic Factors | Population | Age Factors | Population Characteristics | Employment Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Quantitative Evaluation | Evaluation | Political Factors Document Number: 200903 |
| 21. Title: The use of demographics to predict response to direct marketing campaigns--a discriminant analysis. Author: Haynie SP Source: [Unpublished] 1987. 26 p. Abstract: Direct marketing companies reach their potential customers by mail or telephone. Since it is often costly to produce and mail literature, it is sometimes more profitable to mail to selected segments of a list. The analysis objective is to identify those segments with the highest probability of responding to a direct mail campaign. Unprofitable segments can then be removed from the list. Often, the results of a past mailing campaign are known. That is, for every name and address mailed, it is known whether or not the household purchased, donated, ordered or in some way responded positively. The research question becomes - given the response pattern of a set of households, and available data on characteristics of each household, how can this information be used to identify other households with a similar propensity to respond? One statistical technique applicable to this question is 2-group discriminant analysis. This paper presents the results of performing a discriminant function analysis on a charitable donation solicitation campaign. The segmentation efficiency of three levels of predictor data is compared. The 3 levels are 1) Household, 2) Black Group, and 3) Zip Code. The model using household level data produced the most segmentation. That is, the Household Level Model was able to discriminate best between responders and nonresponders, as shown by actual response rates. The models using Block Group and Zip Code data produced substantial segmentation, but less than the household level data. When choosing the level of data to be used in a segmentation analysis, the costs of the data must be weighed against that of mailing segments with lower response rates. Also, although the models presented are statistically significant, their absolute predictive powers are not perfect. Based on financial information on cost of mailing, average donations, and profit contribution, a financial analysis was performed. The financial analysis enables decisions to be made as to how much of the list can be profitably mailed. The highly profitable segments of completely new lists can be identified using the model predictions, thus minimizing the client's risk in a new campaign. Language: English Keywords: DEMOGRAPHICS | DEMOGRAPHY | SOCIAL SCIENCES | MARKETING | COMMERCE | MACROECONOMIC FACTORS | THEORETICAL MODELS | RESEARCH METHODOLOGY | UNITED STATES OF AMERICA | NORTH AMERICA | HOUSEHOLDS | COST EFFECTIVENESS | COST BENEFIT ANALYSIS | EVALUATION METHODOLOGY | BEHAVIOR | Economic Factors | Developed Countries | Americas | Family and Household | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 045528 |
| 22. Title: The safe motherhood initiative: proposals for action. Author: Herz B; Measham AR Source: Washington, D.C., The World Bank, 1987. iv, 52 p. Abstract: In developing countries (LDCs) maternal mortality (MM) is often the leading cause of death of women of childbearing age. 500,000 women worldwide die each year from pregnancy-related complications with 99% of these deaths occurring in LDCs. Women in these countries run 50-100 greater risk than women in modern industrialized countries. Risks vary per individual, but in general are greater for: very young women and women over age 35; woman in their 1st pregnancy or after their 4th; women with preexisting health conditions; women who are poor, malnourished, and uneducated; and women who are living in rural areas without access to health care. 75% of MM are direct obstetric deaths especially from hemorrhage, sepsis, toxemia, obstructed labor, and illegal and primitive abortion. Improving the income, education, health, and nutritional status could significantly improve MM rates. Access to family planning information and services could ultimately prevent 25-40% of MM. 3 major elements in any plan to address MM are prevention of complications, routine care, and backup measures for high risk and emergency cases. Current evidence suggests that screening techniques could identify the high risk population amongst pregnant women, thereby concentrating resources where they are most needed. Any strategy to provide the 3 necessary elements should use a 3-pronged approach: 1) stonger community-based care including screening and referral methods, provision of prenatal care, and access to family planning services; 2) stronger referral facilities including hospitals and health centers to provide care for complicated deliveries and obstetrical emergencies, and clinical and surgical methods of family planning; 3) an alarm and transport system to transfer women with high risk pregnancies from communities to referral facilities. 2 cost models to implement such an approach were developed. The 1st model represents a US$2/capita/annum expenditure. A 2nd model would involve a US$1/capita/annum expenditure. The 2nd model, while not preventing as many maternal deaths, is more cost-effective. Any initiative to improve maternal health depends upon political commitment, allocation of necessary resources to maternal health and family planning services, and support from media and other non-governmental sectors in terms of health education. Language: English Keywords: MATERNAL MORTALITY | MATERNAL HEALTH SERVICES | DEVELOPING COUNTRIES | GOALS | POLICY | PREGNANCY COMPLICATIONS | NEEDS | COST BENEFIT ANALYSIS | RESOURCES | RESOURCE ALLOCATION | RURAL HEALTH SERVICES | RECOMMENDATIONS | TECHNICAL REPORT | LITERATURE REVIEW | PREVENTION AND CONTROL | Mortality | Population Dynamics | Demographic Factors | Population | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Planning | Organization and Administration | Diseases | Economic Factors | Quantitative Evaluation | Evaluation | Financial Activities Document Number: 045075 |
| 23. Title: Policies for financing the health sector. Author: Hoare G Source: HEALTH POLICY AND PLANNING. 1987;2(1):1-16. Abstract: Health services in both developed and developing countries are in trouble because current policies have failed to mobilize sufficient financial, human, and other resources to meet existing or anticipated needs. Recognizing that most developing country governments will be unable to allocate sufficient resources to the health sector in the foreseeable future to satisfy basic needs, this discussion considers some of the practical policy options available, identifying both their advantages and disadvantages. Several broad policy options can be identified in the literature: mobilizing additional resources from outside the health sector (by increasing public expenditure or by increasing external assistance); mobilizing additional resources from inside the health sector (e.g., by making households contribute more in the form of user fees or insurance schemes); increasing the efficiency with which existing resources are utilized and developing incentives which will encourage desired policy objectives; and altering the organizational composition of the health sector and shifting responsibility for the provision of some services to the private sector. These options focus either on relieving resource constraints by generating additional resources or attempt to reduce problems by making better use of available resources. Additional resources may be generated from outside the health sector in 2 ways: by increasing the level of external assistance for health or by increasing the amount of public expenditure allocated to the health sector. The foreseeable prospects for significant increases from either of these sources are poor. Charging for health services is viewed with disfavor in many countries, and until recently there were efforts in many developing nations to reduce or eliminate prices at public facilities. Charging consumers for services at the point of consumption is only 1 approach to greater cost recovery through the use of prices. Users in many countries also may "pay for coverage" in so far as they belong to risk-sharing schemes or institutions that cover some or all of their health care needs. 1 way of bridging the resource gap is to make better use of existing health resources by increasing efficiency or by reducing spending on low priority services. The scope for increased efficiency is great. The mechanisms which have been developed to generate health resources are reviewed in detail, classified as either public or private sources of finance: public and quasi-public sources of finance -- general tax revenues, deficit financing and the use of inflation, earmarked taxes, social insurance, and lotteries and betting; and private sources of finance -- private health insurance, employer-financed schemes, charitable and voluntary contributions, community financing and self-help, and direct household expenditure. Language: English Keywords: DEVELOPED COUNTRIES | DEVELOPING COUNTRIES | HEALTH SERVICES | FUNDS | FINANCIAL ACTIVITIES | PROGRAM ACTIVITIES | HEALTH SERVICES ADMINISTRATION | ORGANIZATION AND ADMINISTRATION | DELIVERY OF HEALTH CARE | GOVERNMENT FINANCING | SOCIAL SECURITY | TAXATION | PREVENTIVE MEDICINE | COST BENEFIT ANALYSIS | EVALUATION METHODOLOGY | NATIONAL HEALTH SERVICES | GOVERNMENT PROGRAMS | Health | Economic Factors | Programs | Management | Medicine | Quantitative Evaluation | Evaluation Document Number: 043307 |
| 24. Title: Population and technical change in the manufacturing sector of developing countries. Author: James J Source: In: Population growth and economic development: issues and evidence, edited by D. Gale Johnson and Ronald D. Lee. Madison, Wisconsin, University of Wisconsin Press, 1987. :225-56. (Social Demography.) Abstract: This chapter contends that the impact of population on technical change in the manufacturing sector of contemporary developing countries needs to be sharply distinguished from 2 other phenomena: 1) the impact of population on technical change in the manufacturing sector during the comparable stage of development in the now developed countries and 2) that impact in the agricultural sector of developing countries. These differential impacts are shown to derive from a combination of the historical conditions of latecomer industrialization (particularly those associated with a pronounced degree of technological dependency), the role and size of manufacturing in the overall economy, and particular development policies pursued in the post-war period. This chapter examines the 4 mechanisms through which population variables transmit an influence on technical change in manufacturing, and in none was any simple relationship found to exist. This lack of unidirectionality is reflected partly in the absence of significant correlations between the population variables and cross-country data for productivity growth, and partly in the highly disparate degree of success with which the induced innovation mechanism has recently operated in most developing countries, compared to both the contemporary East Asian experience and the historical experience of the Industrial Revolution. It therefore becomes necessary to postulate a more complex set of relationships, and in particular, to identify the circumstances in which population variables do exert an influence in the direction that is posited by each causal mechanism. The analysis discusses a variety of conditioning factors, including 1) growth rate or size as influenced by labor supply or induced innovation, 2) growth rate or size as influenced by economies of scale from market size, 3) density as influenced by economies of scale from infrastructural investment, and 4) size as influenced by the enhanced capability to produce domestic capital goods and scientific knowledge for indigenous innovations. Language: English Keywords: DEVELOPING COUNTRIES | DEVELOPED COUNTRIES | POPULATION GROWTH | POPULATION DYNAMICS | TECHNOLOGY | ECONOMIC DEVELOPMENT | DEVELOPMENT PLANNING | MACROECONOMIC FACTORS | INDUSTRIALIZATION | CHANGES | DEVELOPMENT POLICY | PRICING | INFORMATION | IEC | COST BENEFIT ANALYSIS | EVALUATION METHODOLOGY | POPULATION SIZE | URBANIZATION | Demographic Factors | Population | Economic Factors | Social Change | Policy | Marketing | Program Activities | Programs | Organization and Administration | Quantitative Evaluation | Evaluation | Urban Population Distribution | Population Distribution | Geographic Factors Document Number: 200751 |
| 25. Title: High technology: the case of obstetrics. Author: Jordan B Source: WORLD HEALTH FORUM. 1987;8(3):312-9. Abstract: Obstetric high technology is being increasingly exported to developing countries, where, more often than not, it is eagerly received. The traditional view that childbirth is a normal event to be handled by family and community is superseded by the aims of universal hospital delivery. The replacement of indigenous methods and technology can lead to new health risks for mothers and babies due to shortages of drugs and adequately trained staff. Modern obstetrics often serves the economic and social interests of elites rather than those of the great majority of women in need of basic care. High technology hospitals consume vast resources and are decidedly wasteful. High technology also tends to produce a hierarchical distribution of decision-making power and the transformation of social relationships. Appropriate technology in health care has never been clearly defined. What is needed is a radical questioning of the effects of technologies on the social systems into which they are introduced. Language: English Keywords: DEVELOPING COUNTRIES | TECHNOLOGY | HEALTH SERVICES | SOCIOECONOMIC FACTORS | DELIVERY OF HEALTH CARE | MEDICINE | CULTURAL BACKGROUND | TRADITIONAL MEDICINE | INDIGENOUS HEALTH SERVICES | CULTURE | SOCIAL CHANGE | NEEDS | COST BENEFIT ANALYSIS | MATERNAL HEALTH SERVICES | CRITIQUE | Economic Factors | Health | Population Characteristics | Demographic Factors | Population | Quantitative Evaluation | Evaluation | Maternal-Child Health Services | Primary Health Care Document Number: 269991 |
| 26. Title: The cash opportunity costs of childbearing: an approach to estimation using British data. Author: Joshi H Source: London, England, Centre for Economic Policy Research, 1987 Nov. iii, 44 p. (Centre for Economic Policy Research Discussion Paper No. 208) Abstract: "The opportunity costs of rearing British children, in terms of cash earnings forgone by their mother, are estimated for a typical family. Data from the 1980 Women and Employment Survey provide estimates for hourly pay as a function of work experience and current hours of work. In addition, these data are used to generate participation and hours profiles for representative women with different numbers of children. These are then combined with the earnings function to simulate lifetime income. The simulations indicate that the earnings forgone as a result of bearing and rearing two children can be decomposed into three effects, of approximately equal magnitude: on participation, hours and pay. These effects exceed the direct costs of children and do not rise proportionally with family size." There is commentary on the contrasts between these findings and those reported in 1985 and 1986 by Calhoun and Espenshade for U.S. mothers. (EXCERPT) Language: English Keywords: EUROPE | EUROPE, NORTHERN | UNITED KINGDOM | ESTIMATION TECHNIQUES | ECONOMIC MODEL | THEORETICAL MODELS | CHILD REARING | INCOME | MACROECONOMIC FACTORS | EMPLOYMENT STATUS | WAGES | LABOR FORCE | PARITY | MOTHERS | EMPLOYMENT | FAMILY AND HOUSEHOLD | CHILD WORTH | SOCIOECONOMIC FACTORS | SOCIOECONOMIC STATUS | FAMILY SIZE | COST BENEFIT ANALYSIS | FAMILY CHARACTERISTICS | WOMEN | UNITED STATES OF AMERICA | COMPARATIVE STUDIES | Developed Countries | Europe, Western | Research Methodology | Behavior | Economic Factors | Human Resources | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Parents | Family Relationships | Microeconomic Factors | Quantitative Evaluation | Evaluation | North America | Americas | Studies Document Number: 228104 |
| 27. Title: Advantages and disadvantages of pregnancy and contraception: teenagers' perception. Author: Kalmuss D; Lawton AI; Namerow PB Source: POPULATION AND ENVIRONMENT. 1987 Spring;9(1):23-40. Abstract: Research has shown that teenagers' perceptions of the advantages and disadvantages of pregnancy and contraception are significant predictors of pregnancy risk taking. This analysis examines the content and determinants of these cost-benefit sets, using data gathered at a New York City youth center from 425 sexually active female adolescents. Results indicate that teens' perceptions of the advantages and disadvantages of pregnancy and contraception are neither strongly nor systematically related to each other. Moreover, the determinants of the 4 cost-benefit sets are varied, although there is some overlap between sets. Family planning programs might be more effective if they redirected their educational efforts from emphasis on contraception to include a focus on pregnancy, stressing its disadvantages for teenagers and challenging teens' perceptions of its advantages. Language: English Keywords: UNITED STATES OF AMERICA | NORTH AMERICA | ADOLESCENTS, FEMALE | SEX BEHAVIOR | PREMARITAL SEX BEHAVIOR | ADOLESCENT PREGNANCY | CONTRACEPTIVE USAGE | REPRODUCTIVE BEHAVIOR | PREGNANCY | PERCEPTION | COST BENEFIT ANALYSIS | PSYCHOLOGICAL FACTORS | Developed Countries | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Fertility | Population Dynamics | Contraception | Family Planning | Reproduction | Quantitative Evaluation | Evaluation Document Number: 270171 |
| 28. Title: Epidemiologic identification of infants with low birthweight in urban areas of Latin America: I. organization, population, and methodology of the Guatemalan perinatal study. Author: Kestler E; Dorgan J; Sibrian R; Aquino O; Villar J Source: BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1987;21(4):369-76. This article will also be published in Spanish in the Boletin de la Oficina Sanitaria Panamericana Abstract: A prospective epidemiologic study of pregnant women was conducted within a lower middle class population of Guatemala City residents. The aims were to develop a statistically-based risk score for identifying pregnant women at high risk of delivering low birthweight infants as early in gestation as possible; to evaluate the sensitivity, specificity, and predictive value of this risk score, using a different sample of women from the same population; and to develop a methodology for promoting use of risk approach during prenatal care in other countries of the region. Detailed information is provided about the study population, organization of the study, methods and materials used, quality control of the data, and results of data reliability analysis. Demographic comparisons were made between women delivering babies at the 3 public hospitals in Guatemala City during 1983. Data were collected on illiteracy; % of women from homes lacking electricity, piped water, and plumbing; % of women who were homemakers; and % delivering infants with low birthweights. Kappa values for inter-rater agreement on dichotomized variables were ascertained for marital status, vitamins and minerals, analgesics, merconium during delivery, whether the last child had a low birthweight, and edema during pregnancy. Simplified computer programs for the most complex calculations, prepared for use by mid-level personel, are avaiable. Language: English Keywords: EPIDEMIOLOGIC METHODS | GUATEMALA | SOUTH AMERICA, CENTRAL | LATIN AMERICA | LOW BIRTH WEIGHT | COMPUTER PROGRAMS AND PROGRAMMING | POPULATION AT RISK | PREGNANCY OUTCOMES | EVALUATION INDEXES | INTERMEDIATE VARIABLES | RESEARCH REPORT | DEVELOPED COUNTRIES | Research Methodology | Developing Countries | Central America | Americas | South America | Birth Weight | Body Weight | Physiology | Biology | Information Processing | Information | Pregnancy | Reproduction | Quantitative Evaluation | Evaluation | Population Dynamics | Demographic Factors | Population Document Number: 047057 |
| 29. Title: The economics of mass migration in the twentieth century. Author: Klein S Source: New York, New York, Paragon House Publishers, 1987. xi, 179 p. (A Washington Institute Book) Abstract: "This book contains a general methodological approach to the costs and benefits of mass international migration, as well as analysis of the economic consequences of mass migration for India, the Republic of Korea, Australia, New Zealand, and selected nations in South America." The book consists of four studies by individual authors preceded by an introduction to the history of mass migrations in general. Consideration is given to both economic and noneconomic factors and to the impact of mass migration on both sending and receiving countries. (EXCERPT) Language: English Keywords: INDIA | REPUBLIC OF KOREA | ASIA, EASTERN | AUSTRALIA | OCEANIA | NEW ZEALAND | SOUTH AMERICA | AMERICAS | GLOBAL | MIGRATION | INTERNATIONAL MIGRATION | SOCIOECONOMIC FACTORS | POPULATION DYNAMICS | ECONOMIC CONDITIONS | LATIN AMERICA | METHODOLOGICAL STUDIES | HISTORICAL REVIEW | COST BENEFIT ANALYSIS | Asia, Southern | Asia | Developing Countries | Developed Countries | Demographic Factors | Population | Economic Factors | Macroeconomic Factors | Quantitative Evaluation | Evaluation Document Number: 225971 |
| 30. Title: Cost recovery in family planning. Author: Lewis MA Source: ECONOMIC DEVELOPMENT AND CULTURAL CHANGE. 1987 Oct;36(1):161-82. Abstract: Cost recovery is an important option for developing country goverments and other providers who wish to reduce their financial burden for family planning and continue to facilitate family planning use for couples who cannot afford or reach commercial products. The question is whether users are willing and able to pay some portion of the cost. Based on evidence presented in surveys of developing countries, contraception represents a small proportion of household income, even for lower income families. Given that some level of cost recovery is possible, by far the most efficient distribution method is contraceptive social marketing (CSM), as opposed to clinic-based family planning and the resource intensive community-based distribution (CBD). CSM provides the most extensive cost recovery experience in developing countries because CSM efforts build on existing networks and distributor lines and sufficient economic incentives to attract and maintain local retailers and suppliers. For example, a study of Colombia's Profamilia program showed that CSM covered 126% of costs, the clinical program covered between 20% and 28% of costs, and the CBD covered 50% of urban and 17% rural costs. In general, studies show that the twin objectives of cost recovery and continued family planning utilization can be met; for example, programs in Sri Lanka, Jamaica, Colombia, and Thailand had raised prices and generated revenue, while maintaining utilization rates. The level of subsidy, however, was only reduced, not eliminated. Methods to maximize revenues and minimize utilization loss need futher study. Language: English Keywords: DEVELOPING COUNTRIES | COST BENEFIT ANALYSIS | COST EFFECTIVENESS | DISTRIBUTIONAL ACTIVITIES | CONTRACEPTIVE DISTRIBUTION | SOCIAL MARKETING | MARKETING | INDIA | SRI LANKA | NEPAL | BANGLADESH | SOUTH AMERICA | COLOMBIA | CARIBBEAN | JAMAICA | COMMUNITY-BASED DISTRIBUTION | NONCLINICAL DISTRIBUTION | FINANCIAL ACTIVITIES | FAMILY PLANNING PROGRAM ADMINISTRATION | LITERATURE REVIEW | PUBLIC SECTOR | PRIVATE SECTOR | Quantitative Evaluation | Evaluation | Evaluation Indexes | Program Activities | Programs | Organization and Administration | Economic Factors | Asia, Southern | Asia | Latin America | Americas | South America, Northern | Family Planning Programs | Family Planning | Macroeconomic Factors Document Number: 076951 |
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