Sample records for multi-country aids program

  1. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control.

    PubMed

    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-07-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries' national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions.

  2. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control

    PubMed Central

    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-01-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries’ national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions. PMID:19491291

  3. Yugoslavia: preventing the spread of HIV and STDs.

    PubMed

    Dzeletovic, A; Popovic, R

    1999-01-01

    This article discusses the specific actions taken by Yugoslavia in preventing the spread of HIV and AIDS in their country. Two years after the first HIV infection was diagnosed and recognized in 1985, a national level program was established based on the Global AIDS Strategy as defined in 1986 and the Global AIDS Program in 1987. Three essential elements in the program were prevention and control of risky behavior; safe public health procedures, and social tolerance. Among the first major activities organized was the First Conference on AIDS, held in 1987; it was followed in the following year by another conference which registered almost 150 papers regarding epidemiology, transfusiology, health education and drug dependence. In 1988, the Institute of Public Health of Serbia, Belgrade, published and distributed numerous pamphlets, folders, posters and video cassettes including 5,000 copies of the multi-colored poster "Beware of AIDS." The program activities have resulted in the design of a variety of projects that focused on specific problems and segments of the population, namely: AIDS Information for Dentists, The Health Education Program for Elementary School Children and AIDS, and Measures on AIDS Prevention in Health Facilities. Furthermore, The Resolution on Protecting the Population from STDs was passed in 1994 and a new Program of Protecting the Population from STDs was been adopted; this program includes activities on the prevention and control of HIV/AIDS, gonorrhea, syphilis and Hepatitis B.

  4. How much can we gain from improved efficiency? An examination of performance of national HIV/AIDS programs and its determinants in low- and middle-income countries

    PubMed Central

    2012-01-01

    Background The economic downturn exacerbates the inadequacy of resources for combating the worldwide HIV/AIDS pandemic and amplifies the need to improve the efficiency of HIV/AIDS programs. Methods We used data envelopment analysis (DEA) to evaluate efficiency of national HIV/AIDS programs in transforming funding into services and implemented a Tobit model to identify determinants of the efficiency in 68 low- and middle-income countries. We considered the change from the lowest quartile to the average value of a variable a "notable" increase. Results Overall, the average efficiency in implementing HIV/AIDS programs was moderate (49.8%). Program efficiency varied enormously among countries with means by quartile of efficiency of 13.0%, 36.4%, 54.4% and 96.5%. A country's governance, financing mechanisms, and economic and demographic characteristics influence the program efficiency. For example, if countries achieved a notable increase in "voice and accountability" (e.g., greater participation of civil society in policy making), the efficiency of their HIV/AIDS programs would increase by 40.8%. For countries in the lowest quartile of per capita gross national income (GNI), a notable increase in per capita GNI would increase the efficiency of AIDS programs by 45.0%. Conclusions There may be substantial opportunity for improving the efficiency of AIDS services, by providing more services with existing resources. Actions beyond the health sector could be important factors affecting HIV/AIDS service delivery. PMID:22443135

  5. USAID steps up anti-AIDS program.

    PubMed

    1991-01-01

    This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.

  6. Changing hearts and minds: Results from a multi-country gender and sexual diversity training.

    PubMed

    Poteat, Tonia; Park, Chulwoo; Solares, Diego; Williams, John K; Wolf, R Cameron; Metheny, Noah; Vazzano, Andrea; Dent, Juan; Gibbs, Ashley; Nonyane, Bareng Aletta Sanny; Toiv, Nora

    2017-01-01

    Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President's Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- and post-training study design. Findings suggest that sustainable decreases in negative attitudes toward gender and sexual minorities are achievable with a one-day training.

  7. Strange Bedfellows: The Catholic Church and Brazilian National AIDS Program in the Response to HIV/AIDS in Brazil

    PubMed Central

    Murray, Laura R.; Garcia, Jonathan; Muñoz-Laboy, Miguel; Parker, Richard G.

    2011-01-01

    The HIV epidemic has raised important tensions in the relationship between Church and State in many parts of Latin America where government policies frequently negotiate secularity with religious belief and doctrine. Brazil represents a unique country in the region due to the presence of a national religious response to HIV/AIDS articulated through the formal structures of the Catholic Church. As part of an institutional ethnography on religion and HIV/AIDS in Brazil, we conducted an extended, multi-site ethnography from October 2005 through March of 2009 to explore the relationship between the Catholic Church and the Brazilian National AIDS Program. This case study links a national, macro-level response of governmental and religious institutions with the enactment of these politics and dogmas on a local level. Shared values in solidarity and citizenship, similar organizational structures, and complex interests in forming mutually beneficial alliances were the factors that emerged as the bases for the strong partnership between the two institutions. Dichotomies of Church and State and micro and macro forces were often blurred as social actors responded to the epidemic while also upholding the ideologies of the institutions they represented. We argue that the relationship between the Catholic Church and the National AIDS Program was formalized in networks mediated through personal relationships and political opportunity structures that provided incentives for both institutions to collaborate. PMID:21324573

  8. A Critical Analysis of the Brazilian Response to HIV/AIDS: Lessons Learned for Controlling and Mitigating the Epidemic in Developing Countries

    PubMed Central

    Berkman, Alan; Garcia, Jonathan; Muñoz-Laboy, Miguel; Paiva, Vera; Parker, Richard

    2005-01-01

    The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. We critically analyze the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can aid the development of similar programs in other low- and middle-income and developing countries. Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that increasingly affects women, and special prevention and treatment programs for injection drug users. PMID:15933232

  9. Strengthening healthcare capacity through a responsive, country-specific, training standard: the KITSO AIDS training program's support of Botswana's national antiretroviral therapy rollout.

    PubMed

    Bussmann, Christine; Rotz, Philip; Ndwapi, Ndwapi; Baxter, Daniel; Bussmann, Hermann; Wester, C William; Ncube, Patricia; Avalos, Ava; Mine, Madisa; Mabe, Elang; Burns, Patricia; Cardiello, Peter; Makhema, Joseph; Marlink, Richard

    2008-01-01

    In parallel with the rollout of Botswana's national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana-Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana's health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges.

  10. What drives donor funding in population assistance programs? Evidence from OECD countries.

    PubMed

    van Dalen, Hendrik P; Reuser, Mieke

    2006-09-01

    The 1994 International Conference on Population and Development (ICPD) established goals for the expansion of population assistance. To date, the financial promises made by donor countries in 1994 have not been met. To unravel the gap between ambitions and contributions, we use panel estimation methods to see what lies behind the level of donor contributions and the sharing of burdens across the various categories of population and HIV/AIDS assistance in 21 donor countries for the years 1996-2002. Contributions by donors depend heavily on the economic wealth and subjective preferences of donor countries. The sharing of the ICPD burden within the group of OECD/DAC countries is in line with the countries' ability to pay, although within the aggregate we observe a specialization in channels for aid: small countries predominantly use multilateral aid agencies, whereas large countries rely more on bilateral aid channels. Catholic countries are averse to donating unrestricted funds (flowing primarily to multilateral agencies) or restricted funds targeted at family planning programs.

  11. Can AIDS prevention move to sufficient scale?

    PubMed

    Slutkin, G

    1993-05-01

    Much has been learned about which AIDS prevention interventions are effective and what an AIDS prevention program should look like. It is also clear that important program issues must be worked out at the country level if effective interventions are to be had. Programs with successful interventions and approaches in most countries, however, have yet to be implemented on a sufficiently large scale. While some national programs are beginning to use proven interventions and are moving toward implementing full-scale national AIDS programs, most AIDS prevention programs do not incorporate condom marketing, are not using mass media and advertising in a well-programmed way, do not have peer projects to reach most at-risk populations, and do not have systems in place to diagnose and treat persons with sexually transmitted diseases (STD). Far more planning and resources for AIDS prevention are needed from national and international public and private sectors. International efforts by the World Health Organization (WHO), UNICEF, UNDP, UNESCO, UNFPA, and the World Bank have increased markedly over the past few years. Bilaterally, the US, Sweden, United Kingdom, Canada, Netherlands, Norway, Denmark, Japan, Germany, France, and other countries are contributing to WHO/GPA and to direct bilateral AIDS prevention activities. USAID happens to be the largest single contributor to WHO/GPA and is also the largest bilateral program with its $168 millions AIDSCAP funded over 5 years. AIDSCAP integrates condom distribution and marketing, STD prevention and control, behavioral change and communication strategies through person-to-person and mass media approaches, and strong evaluation components. AIDSCAP can help fulfill the need to demonstrate that programs can be developed on a country-wide level by showing how behavior can be changed in a broad geographical area.

  12. Country watch: Malawi.

    PubMed

    Knox, G

    1995-01-01

    The Drought Network for information sharing eventually led to the establishment of the more formal Southern Region AIDS Network (SORAN) where representatives from government and nongovernmental organizations (NGOs) focused on awareness raising, lobbying, and advocacy. As an initial step towards networking on HIV/AIDS issues, a festival was organized in Blantyre on December 4, 1993, by NGOs, private companies, church groups, school children, and volunteers to bring about behavior change. About 2000 people gathered to listen to music, learn about HIV transmission through drama group presentations, watch videos with HIV/STD prevention messages, and learn about proper condom use. The participants officially established SORAN in February 1994 to act as a coordinating body for organizations working in prevention and care for HIV/STD-infected persons and their families. Network activities endeavored: to assist organizations interested in developing HIV/AIDS programs and activities; to encourage the business communities to participate in multisectoral coordination and to help channel funds from them to HIV/AIDS programs; to act as a resource center for information about HIV/AIDS; and to lobby among politicians as well as traditional local and religious leaders. When the first multi-party parliamentary election approached in May 1994, SORAN challenged representatives of 7 political parties and a women's organization to speak out publicly on what they envisioned doing about HIV/AIDS. The Grand Walk was also organized by SORAN members representing the Catholic Episcopal Conference of Malawi, the Protestant Blantyre Synod, a local brewery, and UNICEF. About 500 walkers received support from passersby. 70% were school children 10-18 years old who sang AIDS awareness songs and passed out flyers. Three months later the National AIDS Program's Big Walk for AIDS, following a National AIDS Crisis Conference, signaled the government's public recognition of the need for a multisectoral approach to combatting HIV/AIDS.

  13. Changing hearts and minds: Results from a multi-country gender and sexual diversity training

    PubMed Central

    Park, Chulwoo; Solares, Diego; Williams, John K.; Wolf, R. Cameron; Metheny, Noah; Vazzano, Andrea; Dent, Juan; Gibbs, Ashley; Nonyane, Bareng Aletta Sanny; Toiv, Nora

    2017-01-01

    Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- and post-training study design. Findings suggest that sustainable decreases in negative attitudes toward gender and sexual minorities are achievable with a one-day training. PMID:28926568

  14. Utilization of HIV-related services from the private health sector: A multi-country analysis.

    PubMed

    Wang, Wenjuan; Sulzbach, Sara; De, Susna

    2011-01-01

    Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status. The analysis indicates that the private for-profit health sector is active in HIV-related service delivery, although the level of participation varies by region and country. From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Investment in HIV/AIDS programs: Does it help strengthen health systems in developing countries?

    PubMed Central

    Yu, Dongbao; Souteyrand, Yves; Banda, Mazuwa A; Kaufman, Joan; Perriëns, Joseph H

    2008-01-01

    Background There is increasing debate about whether the scaled-up investment in HIV/AIDS programs is strengthening or weakening the fragile health systems of many developing countries. This article examines and assesses the evidence and proposes ways forward. Discussion Considerably increased resources have been brought into countries for HIV/AIDS programs by major Global Health Initiatives. Among the positive impacts are the increased awareness of and priority given to public health by governments. In addition, services to people living with HIV/AIDS have rapidly expanded. In many countries infrastructure and laboratories have been strengthened, and in some, primary health care services have been improved. The effect of AIDS on the health work force has been lessened by the provision of antiretroviral treatment to HIV-infected health care workers, by training, and, to an extent, by task-shifting. However, there are reports of concerns, too – among them, a temporal association between increasing AIDS funding and stagnant reproductive health funding, and accusations that scarce personnel are siphoned off from other health care services by offers of better-paying jobs in HIV/AIDS programs. Unfortunately, there is limited hard evidence of these health system impacts. Because service delivery for AIDS has not yet reached a level that could conceivably be considered "as close to Universal Access as possible," countries and development partners must maintain the momentum of investment in HIV/AIDS programs. At the same time, it should be recognized that global action for health is even more underfunded than is the response to the HIV epidemic. The real issue is therefore not whether to fund AIDS or health systems, but how to increase funding for both. Summary The evidence is mixed – mostly positive but some negative – as to the impact on health systems of the scaled-up responses to HIV/AIDS driven primarily by global health partnerships. Current scaled-up responses to HIV/AIDS must be maintained and strengthened. Instead of endless debate about the comparative advantages of vertical and horizontal approaches, partners should focus on the best ways for investments in response to HIV to also broadly strengthen the primary health care systems. PMID:18796148

  16. Assessing development assistance for child survival between 2000 and 2014: A multi-sectoral perspective.

    PubMed

    Lu, Chunling; Chu, Annie; Li, Zhihui; Shen, Jian; Subramanian, S V; Hill, Kenneth

    2017-01-01

    The majority of Countdown countries did not reach the fourth Millennium Development Goal (MDG 4) on reducing child mortality, despite the fact that donor funding to the health sector has drastically increased. When tracking aid invested in child survival, previous studies have exclusively focused on aid targeting reproductive, maternal, newborn, and child health (RMNCH). We take a multi-sectoral approach and extend the estimation to the four sectors that determine child survival: health (RMNCH and non-RMNCH), education, water and sanitation, and food and humanitarian assistance (Food/HA). Using donor reported data, obtained mainly from the OECD Creditor Reporting System and Development Assistance Committee, we tracked the level and trends of aid (in grants or loans) disbursed to each of the four sectors at the global, regional, and country levels. We performed detailed analyses on missing data and conducted imputation with various methods. To identify aid projects for RMNCH, we developed an identification strategy that combined keyword searches and manual coding. To quantify aid for RMNCH in projects with multiple purposes, we adopted an integrated approach and produced the lower and upper bounds of estimates for RMNCH, so as to avoid making assumptions or using weak evidence for allocation. We checked the sensitivity of trends to the estimation methods and compared our estimates to that produced by other studies. Our study yielded time-series and recipient-specific annual estimates of aid disbursed to each sector, as well as their lower- and upper-bounds in 134 countries between 2000 and 2014, with a specific focus on Countdown countries. We found that the upper-bound estimates of total aid disbursed to the four sectors in 134 countries rose from US$ 22.62 billion in 2000 to US$ 59.29 billion in 2014, with the increase occurring in all income groups and regions with sub-Saharan Africa receiving the largest sum. Aid to RMNCH has experienced the fastest growth (12.4%), followed by aid to Food/HA (9.4%), education (5.1%), and water and sanitation (5.0%). With the exception of RMNCH, the average per capita aid disbursed to each sector in the 74 Countdown countries was smaller than in non-Countdown countries. While countries with a large number of child deaths tend to receive the largest amount of disbursements, non-Countdown countries with small populations usually received the highest level of per capita aid for child survival among all 134 countries. Compared to other Countdown countries, those that met MDG 4 with a high reliance on health aid received much higher per capita aid across all sectors. These findings are robust to estimation methods. The study suggests that to improve child survival, better targeted investments should be made in the four sectors, and aid to non-health sectors could be a possible contributor to child mortality reduction. We recommend that future studies on tracking aid for child survival go beyond the health sector and include other sectors that directly affect child survival. Investigation should also be made about the link between aid to each of the four sectors and child mortality reduction.

  17. Why the tuberculosis incidence rate is not falling in New Zealand.

    PubMed

    Das, Dilip; Baker, Michael; Venugopal, Kamalesh; McAllister, Susan

    2006-10-13

    To assess the role of migration from high-incidence countries, HIV/AIDS infection, and prevalence of multi-drug resistant organisms as contributors to tuberculosis (TB) incidence in New Zealand (NZ) relative to ongoing local transmission and reactivation of disease. TB notification data and laboratory data for the period 1995 to 2004 and population data from the 1996 and 2001 Census were used to calculate incidence rates of TB by age and ethnicity, country of birth (distinguishing high and low -incidence countries), and interval between migration and onset of disease. Published reports of multi-drug-resistant TB for the period 1995 to 2004 were reviewed. Anonymous HIV surveillance data held by AIDS Epidemiology Group were matched with coded and anonymised TB surveillance data to measure the extent of HIV/AIDS coinfection in notified TB cases. Migration of people from high-TB incidence countries is the main source of TB in NZ. Of those who develop TB, a quarter does so within a year of migration, and a quarter of this group (mainly refugees) probably enter the country with pre-existing disease. Rates of local TB transmission and reactivation of old disease are declining steadily for NZ-born populations, except for NZ-born Maori and Pacific people under 40. HIV/AIDS and multi-drug-resistant organisms are not significant contributors to TB incidence in NZ and there is no indication that their role is increasing. TB incidence is not decreasing in NZ mainly due to migration of TB infected people from high-incidence countries and subsequent development of active disease in some of them in NZ. This finding emphasises the importance of regional and global TB control initiatives. Refugees and migrants are not acting as an important source of TB for most NZ-born populations. Those caring for them should have a high level of clinical suspicion for TB.

  18. Audio-Visual Aids for Pre-School and Primary School Children. A Training Document. Aids to Programming UNICEF Assistance to Education.

    ERIC Educational Resources Information Center

    Narayan, Shankar

    This discussion of the importance and scope of audiovisual aids in the educational programs and activities designed for children in developing countries includes the significance of audiovisual aids in pre-school and primary school education, types of audiovisual aids, learning from pictures, creative art materials, play materials, and problems…

  19. International epidemiology of HIV and AIDS among injecting drug users.

    PubMed

    Des Jarlais, D C; Friedman, S R; Choopanya, K; Vanichseni, S; Ward, T P

    1992-10-01

    HIV/AIDS and iv drug use (IVDU) are of significant multinational scope and growing. Supporting increased IVDU in many countries are countries' geographical proximity to illicit drug trafficking distribution routes, law enforcement efforts which increase the demand for more efficient drug distribution and consumption, and countries' infrastructural and social modernization. Given the failures of intensified law enforcement efforts to thwart the use and proliferation of illegal drugs, countries with substantial IVDU should look away from preventing use to preventing HIV transmission within drug user populations. With HIV seroprevalence rates rapidly reaching 40-50% in some developing country IVDU groups, a variety of prevention programs is warranted. Such programs should be supported and implemented while prevention remains feasible. This paper examines the variation in HIV seroprevalence among IVD users, rapid HIV spread among users, HIV among IVDUs in Bangkok, emerging issues in HIV transmission among IVDUs, non-AIDS manifestations of HIV infection among IVDUs, prevention programs and effectiveness, and harm reduction.

  20. Improvements in Spectrum's fit to program data tool.

    PubMed

    Mahiane, Severin G; Marsh, Kimberly; Grantham, Kelsey; Crichlow, Shawna; Caceres, Karen; Stover, John

    2017-04-01

    The Joint United Nations Program on HIV/AIDS-supported Spectrum software package (Glastonbury, Connecticut, USA) is used by most countries worldwide to monitor the HIV epidemic. In Spectrum, HIV incidence trends among adults (aged 15-49 years) are derived by either fitting to seroprevalence surveillance and survey data or generating curves consistent with program and vital registration data, such as historical trends in the number of newly diagnosed infections or people living with HIV and AIDS related deaths. This article describes development and application of the fit to program data (FPD) tool in Joint United Nations Program on HIV/AIDS' 2016 estimates round. In the FPD tool, HIV incidence trends are described as a simple or double logistic function. Function parameters are estimated from historical program data on newly reported HIV cases, people living with HIV or AIDS-related deaths. Inputs can be adjusted for proportions undiagnosed or misclassified deaths. Maximum likelihood estimation or minimum chi-squared distance methods are used to identify the best fitting curve. Asymptotic properties of the estimators from these fits are used to estimate uncertainty. The FPD tool was used to fit incidence for 62 countries in 2016. Maximum likelihood and minimum chi-squared distance methods gave similar results. A double logistic curve adequately described observed trends in all but four countries where a simple logistic curve performed better. Robust HIV-related program and vital registration data are routinely available in many middle-income and high-income countries, whereas HIV seroprevalence surveillance and survey data may be scarce. In these countries, the FPD tool offers a simpler, improved approach to estimating HIV incidence trends.

  1. AIDS Treatment In Brazil: Impacts And Challenges

    PubMed Central

    Nunn, Amy Stewart; Fonseca, Elize Massard da; Bastos, Francisco I.; Gruskin, Sofia

    2009-01-01

    Brazil has one of the developing world's largest, and arguably most successful, AIDS treatment programs. In this paper we review the treatment program, including controversial policies that Brazil has used to promote widespread local and global access to AIDS treatment. We also examine the lessons learned from this program and highlight the challenges Brazil faces, including the rising costs of AIDS treatment and changes in donors' funding priorities. Finally, we explore the relevance of Brazil's treatment program for other countries and its broad implications for global AIDS and health policy. PMID:19597210

  2. Strengthening Healthcare Capacity Through a Responsive, Country-Specific, Training Standard: The KITSO AIDS Training Program’s Sup-port of Botswana’s National Antiretroviral Therapy Rollout

    PubMed Central

    Bussmann, Christine; Rotz, Philip; Ndwapi, Ndwapi; Baxter, Daniel; Bussmann, Hermann; Wester, C. William; Ncube, Patricia; Avalos, Ava; Mine, Madisa; Mabe, Elang; Burns, Patricia; Cardiello, Peter; Makhema, Joseph; Marlink, Richard

    2008-01-01

    In parallel with the rollout of Botswana’s national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana–Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana’s health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges. PMID:18923699

  3. SOME CONNECTIONS BETWEEN ECONOMIC AND MILITARY ASSISTANCE PROGRAMS IN UNDERDEVELOPED AREAS,

    DTIC Science & Technology

    of U. S. objectives in undertaking aid programs in underdeveloped countries. The second is concerned with the role of nonmilitary objectives and...both economic and military aid programs . The first and second are closely related points; the third, clearly, is quite independent.

  4. Computer aided design environment for the analysis and design of multi-body flexible structures

    NASA Technical Reports Server (NTRS)

    Ramakrishnan, Jayant V.; Singh, Ramen P.

    1989-01-01

    A computer aided design environment consisting of the programs NASTRAN, TREETOPS and MATLAB is presented in this paper. With links for data transfer between these programs, the integrated design of multi-body flexible structures is significantly enhanced. The CAD environment is used to model the Space Shuttle/Pinhole Occulater Facility. Then a controller is designed and evaluated in the nonlinear time history sense. Recent enhancements and ongoing research to add more capabilities are also described.

  5. EIA models and capacity building in Viet Nam: an analysis of development aid programs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Doberstein, Brent

    2004-04-01

    There has been a decided lack of empirical research examining development aid agencies as 'agents of change' in environmental impact assessment (EIA) systems in developing countries, particularly research examining the model of environmental planning practice promoted by aid agencies as part of capacity building. This paper briefly traces a conceptual framework of EIA, then introduces the concept of 'EIA capacity building'. Using Viet Nam as a case study, the paper then outlines the empirical results of the research, focusing on the extent to which aid agency capacity-building programs promoted a Technical vs. Planning Model of EIA and on the coherencemore » of capacity-building efforts across all aid programs. A discussion follows, where research results are interpreted within the Vietnamese context, and implications of research results are identified for three main groups of actors. The paper concludes by calling for development aid agencies to reconceptualise EIA capacity building as an opportunity to transform developing countries' development planning processes.« less

  6. Development of Curriculum Content for a Unique Career Ladder Multi-Entry/Multi-Exit Nursing Program. Final Report.

    ERIC Educational Resources Information Center

    Rosbach, Ellen M.

    A project was undertaken to develop the curriculum content for a unique career ladder multi-entry/multi-exit nursing program that would provide training for nurse aides, practical nurses, and registered nurses. The major objectives of the project were to conduct a review of the literature on curriculum materials presently in use, to develop 11…

  7. Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance.

    PubMed

    Lee, Hwa-Young; Yang, Bong-Ming; Kang, Minah

    2016-01-01

    Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. This study examines the impact of two important dimensions of governance - control of corruption and democratic accountability - on the effectiveness of HIV/AIDS official development assistance. An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001-2010 datasets. Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below -2.269, aid has a detrimental effect on incidence of HIV/AIDS. The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention.

  8. Economic impact of refugees.

    PubMed

    Taylor, J Edward; Filipski, Mateusz J; Alloush, Mohamad; Gupta, Anubhab; Rojas Valdes, Ruben Irvin; Gonzalez-Estrada, Ernesto

    2016-07-05

    In 2015, the United Nations High Commission for Refugees accommodated over 15 million refugees, mostly in refugee camps in developing countries. The World Food Program provided these refugees with food aid, in cash or in kind. Refugees' impacts on host countries are controversial and little understood. This unique study analyzes the economic impacts of refugees on host-country economies within a 10-km radius of three Congolese refugee camps in Rwanda. Simulations using Monte Carlo methods reveal that cash aid to refugees creates significant positive income spillovers to host-country businesses and households. An additional adult refugee receiving cash aid increases annual real income in the local economy by $205 to $253, significantly more than the $120-$126 in aid each refugee receives. Trade between the local economy and the rest of Rwanda increases by $49 to $55. The impacts are lower for in-kind food aid, a finding relevant to development aid generally.

  9. Economic impact of refugees

    PubMed Central

    Taylor, J. Edward; Filipski, Mateusz J.; Alloush, Mohamad; Gupta, Anubhab; Rojas Valdes, Ruben Irvin; Gonzalez-Estrada, Ernesto

    2016-01-01

    In 2015, the United Nations High Commission for Refugees accommodated over 15 million refugees, mostly in refugee camps in developing countries. The World Food Program provided these refugees with food aid, in cash or in kind. Refugees’ impacts on host countries are controversial and little understood. This unique study analyzes the economic impacts of refugees on host-country economies within a 10-km radius of three Congolese refugee camps in Rwanda. Simulations using Monte Carlo methods reveal that cash aid to refugees creates significant positive income spillovers to host-country businesses and households. An additional adult refugee receiving cash aid increases annual real income in the local economy by $205 to $253, significantly more than the $120–$126 in aid each refugee receives. Trade between the local economy and the rest of Rwanda increases by $49 to $55. The impacts are lower for in-kind food aid, a finding relevant to development aid generally. PMID:27325782

  10. Development Aid: A Guide to Facts and Issues.

    ERIC Educational Resources Information Center

    de Silva, Leelananda

    This eight-chapter book provides information on Official Development Assistance (ODA), its importance in relation to developed and developing countries, and its prospects and limitations. Major areas discussed include: (1) the institutional evolution of development aid; (2) forms of ODA, including project aid, program aid, bilateral aid,…

  11. Home Making Around the World.

    ERIC Educational Resources Information Center

    Extension Service (USDA), Washington, DC.

    This book is designed to aid American home economists sent to other countries on technical assistance programs and home economists of other countries responsible for beginning such programs focused on the home and family. The information describes the pioneering experience of trained people in many countries and some ways in which basic principles…

  12. Global health diplomacy, national integration, and regional development through the monitoring and evaluation of HIV/AIDS programs in Papua New Guinea, Vanuatu, and Samoa.

    PubMed

    Kevany, Sebastian; Gildea, Amy; Garae, Caleb; Moa, Serafi; Lautusi, Avaia

    2015-04-27

    The South Pacific countries of Vanuatu, Samoa, and Papua New Guinea have ascended rapidly up the development spectrum in recent years, refining an independent and post-colonial economic and political identity that enhances their recognition on the world stage. All three countries have overcome economic, political and public health challenges in order to stake their claim to sovereignty. In this regard, the contributions of national and international programs for the diagnosis, treatment and prevention of HIV/AIDS, with specific reference to their monitoring and evaluation (M&E) aspects, have contributed not just to public health, but also to broader political and diplomatic goals such as 'nation-building'. This perspective describes the specific contributions of global health programs to the pursuit of national integration, development, and regional international relations, in Vanuatu, Samoa and Papua New Guinea, respectively, based on in-country M&E activities on behalf of the Global Fund to Fight AIDS, Tuberculosis (TB) and Malaria and the Australian Department of Foreign Affairs and Trade (DFAT) during 2014 and 2015. Key findings include: (1) that global health programs contribute to non-health goals; (2) that HIV/AIDS programs promote international relations, decentralized development, and internal unity; (3) that arguments in favour of the maintenance and augmentation of global health funding may be enhanced on this basis; and (4) that "smart" global health approaches have been successful in South Pacific countries. © 2015 by Kerman University of Medical Sciences.

  13. UNAIDS director visits Denmark to discuss collaboration on AIDS crisis in Africa.

    PubMed

    1999-10-18

    The executive director of the Joint United Nations Program on HIV/AIDS (UNAIDS), Peter Piot, visited Denmark to discuss collaboration on the AIDS crisis in sub-Saharan Africa. The discussion focused on the AIDS situation in the country and the need for resources and strategic investments from donor nations to help turn around the crisis. Piot stated that since the beginning of the epidemic, more than 11 million have died of AIDS and another 22 million are infected with HIV in Africa. In his visit, he stated the new international partnership against AIDS in Africa, which comprises African governments, donor countries, pan-African and other international organizations, UNAIDS and its co-sponsors, nongovernmental organizations, and the private sector. They will be working together in mobilizing governments, civil societies, and companies worldwide in increasing HIV/AIDS care and prevention strategies. Greater vigilance is stressed on the emergency nature of AIDS in many African countries.

  14. Plea to African heads-of-state: join the fight.

    PubMed

    Tyson, R

    1997-10-01

    Uganda's president, Yoweri Museveni, is the only African head-of-state who has led an all-out, extended campaign against AIDS, and Uganda is the only African country to realize a decline in HIV rates since the epidemic began spreading across central and southern Africa in the 1980s. While South Africa's President Nelson Mandela has spoken about AIDS in international forums, his country's programs against AIDS are in disarray. Rather than adopt a position of leadership against HIV/AIDS, African leaders have most often tried to cover up or ignore the AIDS threat. Zimbabwe and Nigeria are briefly discussed as examples. More than 100 delegates attended the HIV/AIDS workshop at the fourth African-African American Summit held in Harare, July 1997. After listening for 2 days to medical experts describe how the epidemic is destroying African economies and social structures, task force members called upon leaders of the 40 sub-Saharan African countries to acknowledge the threat of AIDS in their countries and to fight against the epidemic.

  15. International HIV and AIDS prevention: Japan/United States collaboration.

    PubMed

    Umenai, T; Narula, M; Onuki, D; Yamamoto, T; Igari, T

    1997-01-01

    As the epicenter of the HIV/AIDS pandemic shifts from Africa to Asia, Japan is becoming ever more aware of the importance of containing and preventing spread of the virus. International collaboration, particularly with the United States, is a logical approach because it allows utilization of expertise from countries in other stages of the pandemic, can prevent duplication of efforts, and complements efforts of the other countries. Further, both Japan and the United States can use their combined influence and prestige to encourage cooperation among all nations. In 1994, Japan established the Global Issues Initiative to extend cooperation to developing countries in the areas of population and AIDS control. It has disbursed more than $460 million (U.S.$) to promote active cooperation and stimulate international attention to the importance of addressing these health issues. Japan has established four main programs for international collaboration for control of HIV and AIDS, three operated by ministries and one by a Japanese nongovernmental organization. Japanese/United States collaboration is developing through the United States/Japan Cooperative Medical Sciences Program, the Common Agenda for Cooperation in Global Perspective, the Paris Summit, and the United Nations Joint Programme on AIDS. It is critical that Japan and the United States, as the two largest donors to international development, demonstrate, through their collaboration, ways to maximize the use of limited resources, reduce duplication, and promote sustainable development programs in which HIV prevention and AIDS care programs are systemically integrated.

  16. The impact of religion and cultural values on AIDS education programs in Malaysia and the Philippines.

    PubMed

    Osteria, T; Sullivan, G

    1991-01-01

    This paper examines the impact of cultural values and government policies on the content of AIDS educational literature prepared by public health agencies in Malaysia and the Philippines. The literature from these countries, which has been distributed to the public and is intended to inform them of the danger of AIDS, how the HIV is and is not transmitted, and how to avoid infection, is analyzed and evaluated for effectiveness and congruence with the dominant religious tenets and cultural practices in each country, and attitudes to sexual behavior. The paper also describes the response of these countries to the AIDS pandemic, and concludes with suggestions about how this form of AIDS education can be improved.

  17. Control of corruption, democratic accountability, and effectiveness of HIV/AIDS official development assistance

    PubMed Central

    Lee, Hwa-Young; Yang, Bong-Ming; Kang, Minah

    2016-01-01

    Background Despite continued global efforts, HIV/AIDS outcomes in developing countries have not made much progress. Poor governance in recipient countries is often seen as one of the reasons for ineffectiveness of aid efforts to achieve stated objectives and desired outcomes. Objective This study examines the impact of two important dimensions of governance – control of corruption and democratic accountability – on the effectiveness of HIV/AIDS official development assistance. Design An empirical analysis using dynamic panel Generalized Method of Moments estimation was conducted on 2001–2010 datasets. Results Control of corruption and democratic accountability revealed an independent effect and interaction with the amount of HIV/AIDS aid on incidence of HIV/AIDS, respectively, while none of the two governance variables had a significant effect on HIV/AIDS prevalence. Specifically, in countries with accountability level below −2.269, aid has a detrimental effect on incidence of HIV/AIDS. Conclusion The study findings suggest that aid programs need to be preceded or at least accompanied by serious efforts to improve governance in recipient countries and that democratic accountability ought to receive more critical attention. PMID:27189199

  18. AIDS: An International Perspective.

    ERIC Educational Resources Information Center

    Piot, Peter; And Others

    1988-01-01

    Discusses some of the worldwide problems associated with the acquired immunodeficiency syndrome (AIDS) and infection with the human immunodeficiency virus type 1 (HIV-1). Calls for programs for the prevention and control of AIDS as an immediate priority in all countries. (TW)

  19. Costs of vaccine programs across 94 low- and middle-income countries.

    PubMed

    Portnoy, Allison; Ozawa, Sachiko; Grewal, Simrun; Norman, Bryan A; Rajgopal, Jayant; Gorham, Katrin M; Haidari, Leila A; Brown, Shawn T; Lee, Bruce Y

    2015-05-07

    While new mechanisms such as advance market commitments and co-financing policies of the GAVI Alliance are allowing low- and middle-income countries to gain access to vaccines faster than ever, understanding the full scope of vaccine program costs is essential to ensure adequate resource mobilization. This costing analysis examines the vaccine costs, supply chain costs, and service delivery costs of immunization programs for routine immunization and for supplemental immunization activities (SIAs) for vaccines related to 18 antigens in 94 countries across the decade, 2011-2020. Vaccine costs were calculated using GAVI price forecasts for GAVI-eligible countries, and assumptions from the PAHO Revolving Fund and UNICEF for middle-income countries not supported by the GAVI Alliance. Vaccine introductions and coverage levels were projected primarily based on GAVI's Adjusted Demand Forecast. Supply chain costs including costs of transportation, storage, and labor were estimated by developing a mechanistic model using data generated by the HERMES discrete event simulation models. Service delivery costs were abstracted from comprehensive multi-year plans for the majority of GAVI-eligible countries and regression analysis was conducted to extrapolate costs to additional countries. The analysis shows that the delivery of the full vaccination program across 94 countries would cost a total of $62 billion (95% uncertainty range: $43-$87 billion) over the decade, including $51 billion ($34-$73 billion) for routine immunization and $11 billion ($7-$17 billion) for SIAs. More than half of these costs stem from service delivery at $34 billion ($21-$51 billion)-with an additional $24 billion ($13-$41 billion) in vaccine costs and $4 billion ($3-$5 billion) in supply chain costs. The findings present the global costs to attain the goals envisioned during the Decade of Vaccines to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all communities. By projecting the full costs of immunization programs, our findings may aid to garner greater country and donor commitments toward adequate resource mobilization and efficient allocation. As service delivery costs have increasingly become the main driver of vaccination program costs, it is essential to pay additional consideration to health systems strengthening. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Aid effectiveness and programmatic effectiveness: a proposed framework for comparative evaluation of different aid interventions in a particular health system.

    PubMed

    Haque, Hasibul; Hill, Philip C; Gauld, Robin

    2017-01-01

    Against a backdrop of changing concepts of aid effectiveness, development effectiveness, health systems strengthening, and increasing emphasis on impact evaluation, this article proposes a theory-driven impact evaluation framework to gauge the effect of aid effectiveness principles on programmatic outcomes of different aid funded programs in the health sector of a particular country. The foundation and step-by-step process of implementing the framework are described. With empirical evidence from the field, the steps involve analysis of context, program designs, implementation mechanisms, outcomes, synthesis, and interpretation of findings through the programs' underlying program theories and interactions with the state context and health system. The framework can be useful for comparatively evaluating different aid interventions both in fragile and non-fragile state contexts.

  1. The Multiplier Effect: The Case for Multi-School, Global Education Programs

    ERIC Educational Resources Information Center

    Dugan, Rik; Nink, Matt

    2010-01-01

    Multi-school and multi-country programs greatly enhance leadership development and global awareness in students and teachers, while creating better problem solvers, stronger relationships, and wider community impact than any single-school program. That's why Global Youth Leadership Institute (GYLI) and National Association of Independent Schools…

  2. Use of personal digital assistants for data collection in a multi-site AIDS stigma study in rural south Nyanza, Kenya.

    PubMed

    Onono, M A; Carraher, N; Cohen, R C; Bukusi, E A; Turan, J M

    2011-09-01

    To describe the development, cost effectiveness and implementation of a PDA based electronic system to collect, verify and manage data from a multi-site study on HIV/AIDS stigma and pregnancy in a rural, resource-poor area. We worked within a large prevention of mother-to-child-transmission (PMTCT) program in nine rural health facilities to implement a PDA-based data collection system and to study the feasibility of its use in a multisite HIV research study in rural Kenya. The PDAs were programmed for collecting screening and eligibility data, and responses to structured interviews on HIV/AIDS stigma and violence in three local languages. Between November 2007 and December 2008, nine PDAs were used by Clinic and Community Health Assistants to enrol 1,270 participants on to the PMTCT program. Successes included: capacity-building of interviewers, low cost of implementation, quick turnaround time of data entry with good data quality, and convenience. Our study demonstrated the feasibility of utilizing PDAs for data collection in a multi-site observational study on HIV/AIDS stigma conducted in remote rural health facilities in Kenya. However, appropriate and frequent data backup protocols need to be established and paper forms are still needed as backup tools in resource-poor settings.

  3. Evidence base for children affected by HIV and AIDS in low prevalence and concentrated epidemic countries: applicability to programming guidance from high prevalence countries.

    PubMed

    Franco, Lynne Miller; Burkhalter, Bart; de Wagt, Arjan; Jennings, Larissa; Kelley, Allison Gamble; Hammink, Marie-Eve

    2009-01-01

    As global commitment grows to protect and support children affected by HIV and AIDS, questions remain about how best to meet the needs of these children in low prevalence settings and whether information from high prevalence countries can appropriately guide programming in these settings. A 2007 search for the evidence in low prevalence settings on situational challenges of HIV and AIDS-affected children and interventions to address these challenges identified 413 documents. They were reviewed and judged for quality of documentation and scientific rigor. Information was compiled across eight types of challenges (health and health care, nutrition and food security, education, protection, placement, psychosocial development, socioeconomic status, and stigma/discrimination); and also assessed was strength of evidence for situational and intervention findings. Results were compared to three programming principles drawn from research in high prevalence countries: family-centered preventive efforts, treatment, and care; family-focused support to ensure capacity to care for and protect these children; and sustaining economic livelihood of HIV and AIDS-affected households. Findings show that children affected by HIV and AIDS in low prevalence settings face increased vulnerabilities similar to those in high prevalence settings. These findings support seeking and testing programmatic directions for interventions identified in high prevalence settings. However, low prevalence settings/countries are extremely diverse, and the strength of the evidence base among them was mixed (strong, moderate, and weak in study design and documentation), geographically limited, and had insufficient evidence on interventions to draw conclusions about how best to reduce additional vulnerabilities of affected children. Information on family, economic, sociocultural, and political factors within local contexts will be vital in the development of appropriate strategies to mitigate vulnerabilities.

  4. Crises in national leadership?

    PubMed

    Mahathir, M

    1998-01-01

    In Asia, an economic crisis has occurred simultaneously with an immense increase in the prevalence of HIV/AIDS fueled by inadequate responses to the epidemic. This response has been further weakened by sudden budget cuts and changes in government priorities, and the situation has been exacerbated by its suddenness and by the fact that large numbers of people are at risk and are unemployed. Also, Asian countries are now seeking entry into the pool of countries where donors support HIV/AIDS prevention and treatment programs just as donors are reducing their aid budgets. Prevention programs are being severely compromised even before they became effective, and efforts to secure treatment are hindered by high prices, by devalued national currencies, and by an increasing trend towards the privatization of health care. In the long run, efforts to restore economic stability will be hindered by the socioeconomic impact of the HIV/AIDS pandemic. In order to improve future prospects, the leadership of all national AIDS programs must reexamine the cost effectiveness of their priorities. Such a move would target marginalized groups, reduce use of expensive mass media campaigns, increase international cooperation over issues dealing with migrant workers, create programs recognizing the crucial role of women, increase the involvement of infected people in prevention programs, recognize the long-term socioeconomic benefits of providing adequate and equitable care and treatment, and recognize the benefits of prioritizing HIV/AIDS funding.

  5. Assessing the Sustainability of Japan's Foreign Aid Program: An Analysis of Development Assistance to Energy Sectors of Developing Countries

    ERIC Educational Resources Information Center

    Yamaguchi, Hideka

    2005-01-01

    This article examines the effect of Japan's official development assistance (ODA) over 10 years that proposed to facilitate environmental conservation in developing countries. Special emphasis is given to ODA disbursements in the energy sector to evaluate whether Japan's foreign aid has shifted its policy toward more environmentally sound goals.…

  6. Link to slower access to care: what is the stigma?: an Indian perspective.

    PubMed

    Kandwal, Rashmi; Bahl, Taru

    2011-12-01

    Stigma and discrimination have been "bed fellows" of HIV and AIDS in India. Perpetuated by lack of awareness, deep-rooted traditional beliefs, adherence to harmful practices, and a moralistic tag associated with a condition connected with sex (in India the method of HIV transmission being largely heterosexual in nature) and high-risk individuals such as sex workers, it made it difficult for the country to fight an epidemic that was hard to track, estimate, diagnose, and treat. Various interventions under India's National AIDS Control Program (NACP) have targeted stigma and discrimination among different groups. The program has been fairly successful in its outreach programs, bringing about a reduction in adult HIV prevalence and new infections. As the country transitions from NACP Phase III (2007-2012) to IV (2012-2017), making treatment and longevity its top priority, stigma is no longer such a terrifying word. This review discusses the social and cultural context of HIV/AIDS-related stigma in general and highlights various policies and intervention programs that have led India's campaign against HIV/AIDS-driven stigma into the testing, care, support, and treatment ambit.

  7. The Factors that Influence Data Utilization in Decision-Making: The Case of HIV/AIDS Programs in Mexico

    ERIC Educational Resources Information Center

    Rodriguez, Daniela Cristina

    2011-01-01

    In Mexico, as in many other countries, HIV/AIDS strategies are developed at the federal level and implemented at the state level. Local programs are expected to use data, in particular surveillance data, to drive their decisions on programmatic activities and prioritize populations with which the program will engage. Since the early 1980s Mexico…

  8. Integrating Social Marketing Into Fijian HIV/AIDS Prevention Programs: Lessons From Systematic Review.

    PubMed

    Sewak, Aarti; Singh, Gurmeet

    2017-01-01

    Social marketing techniques have been tested and proven useful within the health sector worldwide. In Fiji, social marketing was introduced in the early 1990s, and more rapidly during the last decade to improve national response to an increasing incidence of sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Given the limited amount of research in the area of program evaluation in Pacific Island Countries and Territories (PICTs), this study systematically analyzes five Fijian HIV/AIDS prevention programs through Andreasen's benchmark criteria, in order to identify gaps in program design that ultimately impact program effectiveness. Assessment results unveil some interesting trends regarding the focus and applications of past Fijian HIV/AIDS prevention programs in the past decade. This article discusses these findings and other valuable lessons for future HIV/AIDS prevention strategies in Fiji and elsewhere.

  9. Checkout/demonstration application program for the SEL 840MP Multi-Processing Control System: Version 1 (MPCS/1)

    NASA Technical Reports Server (NTRS)

    Anderson, W. F.; Conway, J. R.; Keller, L. C.

    1972-01-01

    The characteristics of the application program were developed to verify and demonstrate the SEL 840MP Multi-Processing Control System - Version I (MPCS/1). The application program emphasizes the display support and task control capabilities. The application program is further intended to be used as an aid to familization with MPCS/1. It complements the information provided in the MPCS/1 Users Guide, Volume I and II.

  10. Sustainability of ARV provision in developing countries: challenging a framework based on program history.

    PubMed

    Azeredo, Thiago Botelho; Oliveira, Maria Auxiliadora; Santos-Pinto, Cláudia Du Bocage; Miranda, Elaine Silva; Osorio-de-Castro, Claudia Garcia Serpa

    2017-08-01

    The provision of ARVs is central to HIV/AIDS programs, because of its impact on the course of the disease and on quality of life. Although first-line treatments costs have declined, treatment-associated expenses are steeper each year. Sustainability is therefore an important variable for the success of treatment programs. A conceptual framework on sustainability of ARV provision was developed, followed by data collection instruments. The pilot study was undertaken in Brazil. Bolivia, Peru and Mozambique, were visited. Key informants were identified and interviewed. Investigation of sustainability related to ARV provision involved implementation and routinization events of provision schemes. Evidence of greater sustainability potential was observed in Peru, where provision is implemented and routinized by the National HIV/AIDS program and expenditures met by the government. In Mozambique, provision is dependent on donations and external aid, but the country displays a great effort to incorporate ARV provision and care in routine healthcare activities. Bolivia, in addition to external dependence on financing and management of drug supply, presents problems regarding implementation and routinization. The conceptual framework was useful in recognizing events that influence sustainable ARV provision in these countries.

  11. Bridging the gap.

    PubMed

    Taniguchi, H

    1998-01-01

    This special report focuses on the progress made by countries who are cooperating to prevent HIV/AIDS. Cooperation occurred during the 12th World AIDS Conference held from June 28 to July 3, 1998. New development in research and treatment was reported. Of the 13,000 participants, 77% came from the North and 23% from the South. Press coverage included 1038 persons, of whom 89% were from the North. About 1000 people were in attendance due to a generous scholarship fund. In 1997, 2.3 million died of AIDS. From the beginning of the epidemic until 1997, there have been 11.7 million AIDS deaths. About 90% of the people with HIV infections live in developing countries. HIV is more prevalent in developed countries among marginalized populations. AIDS is a problem because it affects the productive age groups 15-49 years; it exacerbates poverty; it leads to higher levels of other diseases; and basic human rights of AIDS victims are often violated. HIV/AIDS is controversial because it touches on taboos. HIV-infected persons are avoided, excluded, and marginalized. Most countries have difficulty affording prevention programs or countermeasures. HIV/AIDS is an additional public health problem that is overwhelming inadequate health systems. Knowledge about HIV/AIDS is not widespread. There are proven ways to prevent AIDS. Donors are beginning to show interest in funding prevention in developing countries. Prices are being lowered by pharmaceutical companies. Hopefully, by the next conference in South Africa, a global dynamic response will be underway.

  12. The treatment action campaign and the three dimensions of lawyering: Reflections from the rainbow nation

    PubMed Central

    Ahmad, Hassan

    2013-01-01

    The spread and perpetuation of the HIV/AIDS epidemic in South Africa has hindered the country's social and economic growth after apartheid. This paper documents my experiences while working with the Projects Abroad Human Rights Office and specifically my interactions with the Treatment Action Campaign (TAC), an organization which has taken a multi-dimensional approach in order to educate people about HIV/AIDS and attempt to provide access to medicines for millions of South Africans afflicted with the disease. I discuss how TAC has used both traditional and non-traditional methods of advocacy to combat the epidemic and equate access to health care to a social justice issue by empowering marginalized communities. The paper's dual purpose is to applaud TAC's continuous success in combating HIV/AIDS with such a multi-dimensional approach and illustrate how other organizations can utilize such an approach in order to affect social change. To illustrate TAC's approach, I utilize Lucie White's three dimensions of lawyering and equate TAC to a single cause lawyer, signifying that White's characterization of multi-dimensional activism is not limited to individuals, but can rather be applied at the firm level. White's three dimensions include: (a) advocacy through litigation, (b) advocacy in stimulating progressive change, and (c) advocacy as a pedagogic process. From this analysis, I conclude that TAC's multi-dimensional approach and specifically its inherent practice of White's three dimensions has been the root of its success in educating millions about the virus and advocating for access to medicines for those who have contracted HIV. TAC's innovative advocacy has also mobilized a new generation of South African activists who have helped TAC grow into a vibrant and integral organization within the country's post-apartheid culture. Such an example can serve as a framework for future organizations who wish to tackle other challenges that face the country. PMID:23819672

  13. The Treatment Action Campaign and the three dimensions of lawyering: reflections from the rainbow nation.

    PubMed

    Ahmad, Hassan

    2013-03-01

    The spread and perpetuation of the HIV/AIDS epidemic in South Africa has hindered the country's social and economic growth after apartheid. This paper documents my experiences while working with the Projects Abroad Human Rights Office and specifically my interactions with the Treatment Action Campaign (TAC), an organization which has taken a multi-dimensional approach in order to educate people about HIV/AIDS and attempt to provide access to medicines for millions of South Africans afflicted with the disease. I discuss how TAC has used both traditional and non-traditional methods of advocacy to combat the epidemic and equate access to health care to a social justice issue by empowering marginalized communities. The paper's dual purpose is to applaud TAC's continuous success in combating HIV/AIDS with such a multi-dimensional approach and illustrate how other organizations can utilize such an approach in order to affect social change. To illustrate TAC's approach, I utilize Lucie White's three dimensions of lawyering and equate TAC to a single cause lawyer, signifying that White's characterization of multi-dimensional activism is not limited to individuals, but can rather be applied at the firm level. White's three dimensions include: (a) advocacy through litigation, (b) advocacy in stimulating progressive change, and (c) advocacy as a pedagogic process. From this analysis, I conclude that TAC's multi-dimensional approach and specifically its inherent practice of White's three dimensions has been the root of its success in educating millions about the virus and advocating for access to medicines for those who have contracted HIV. TAC's innovative advocacy has also mobilized a new generation of South African activists who have helped TAC grow into a vibrant and integral organization within the country's post-apartheid culture. Such an example can serve as a framework for future organizations who wish to tackle other challenges that face the country.

  14. Economic Returns to Investment in AIDS Treatment in Low and Middle Income Countries

    PubMed Central

    Resch, Stephen; Korenromp, Eline; Stover, John; Blakley, Matthew; Krubiner, Carleigh; Thorien, Kira; Hecht, Robert; Atun, Rifat

    2011-01-01

    Since the early 2000s, aid organizations and developing country governments have invested heavily in AIDS treatment. By 2010, more than five million people began receiving antiretroviral therapy (ART) – yet each year, 2.7 million people are becoming newly infected and another two million are dying without ever having received treatment. As the need for treatment grows without commensurate increase in the amount of available resources, it is critical to assess the health and economic gains being realized from increasingly large investments in ART. This study estimates total program costs and compares them with selected economic benefits of ART, for the current cohort of patients whose treatment is cofinanced by the Global Fund to Fight AIDS, Tuberculosis and Malaria. At end 2011, 3.5 million patients in low and middle income countries will be receiving ART through treatment programs cofinanced by the Global Fund. Using 2009 ART prices and program costs, we estimate that the discounted resource needs required for maintaining this cohort are $14.2 billion for the period 2011–2020. This investment is expected to save 18.5 million life-years and return $12 to $34 billion through increased labor productivity, averted orphan care, and deferred medical treatment for opportunistic infections and end-of-life care. Under alternative assumptions regarding the labor productivity effects of HIV infection, AIDS disease, and ART, the monetary benefits range from 81 percent to 287 percent of program costs over the same period. These results suggest that, in addition to the large health gains generated, the economic benefits of treatment will substantially offset, and likely exceed, program costs within 10 years of investment. PMID:21998648

  15. Multi-community command and control systems in law enforcement: An introductory planning guide

    NASA Technical Reports Server (NTRS)

    Sohn, R. L.; Garcia, E. A.; Kennedy, R. D.

    1976-01-01

    A set of planning guidelines for multi-community command and control systems in law enforcement is presented. Essential characteristics and applications of these systems are outlined. Requirements analysis, system concept design, implementation planning, and performance and cost modeling are described and demonstrated with numerous examples. Program management techniques and joint powers agreements for multicommunity programs are discussed in detail. A description of a typical multi-community computer-aided dispatch system is appended.

  16. Corruption and research.

    PubMed

    Luna, Florencia

    1999-07-01

    Last year there was a heated debate regarding clinical trials with AZT carried out in developing countries. AIDS vaccine trials also posed various dilemmas and ethical problems. In this paper I will consider the possibility of corruption in bioethics, and international multi-centre research will be taken as an example. International clinical trials will be seen from another perspective. I will try to show that the possibility of systemic corruption should be considered when designing an international multi-centre research trial which may involve countries in very different situations regarding corruption. I will analyze three different approaches to this problem and suggest some strategies regarding their capacity to exclude the possibility of corruption.

  17. How the Avahan HIV prevention program transitioned from the Gates Foundation to the government of India.

    PubMed

    Sgaier, Sema K; Ramakrishnan, Aparajita; Dhingra, Neeraj; Wadhwani, Alkesh; Alexander, Ashok; Bennett, Sara; Bhalla, Aparajita; Kumta, Sameer; Jayaram, Matangi; Gupta, Pankaj; Piot, Peter K; Bertozzi, Stefano M; Anthony, John

    2013-07-01

    Developing countries face diminishing development aid and time-limited donor commitments that challenge the long-term sustainability of donor-funded programs to improve the health of local populations. Increasing country ownership of the programs is one solution. Transitioning managerial and financial responsibility for donor-funded programs to governments and local stakeholders represents a highly advanced form of country ownership, but there are few successful examples among large-scale programs. We present a transition framework and describe how it was used to transfer the Bill & Melinda Gates Foundation's HIV/AIDS prevention program, the Avahan program, to the Government of India. Essential features recommended for the transition of donor-funded programs to governments include early planning with the government, aligning donor program components with government structures and funding models prior to transition, building government capacity through active technical and management support, budgeting for adequate support during and after the transition, and dividing the transition into phases to allow time for adjustments and corrections. The transition of programs to governments is an important sustainability strategy for efforts to scale up HIV prevention programs to reach the populations most at risk.

  18. Effects of donor proliferation in development aid for health on health program performance: A conceptual framework.

    PubMed

    Pallas, Sarah Wood; Ruger, Jennifer Prah

    2017-02-01

    Development aid for health increased dramatically during the past two decades, raising concerns about inefficiency and lack of coherence among the growing number of global health donors. However, we lack a framework for how donor proliferation affects health program performance to inform theory-based evaluation of aid effectiveness policies. A review of academic and gray literature was conducted. Data were extracted from the literature sample on study design and evidence for hypothesized effects of donor proliferation on health program performance, which were iteratively grouped into categories and mapped into a new conceptual framework. In the framework, increases in the number of donors are hypothesized to increase inter-donor competition, transaction costs, donor poaching of recipient staff, recipient control over aid, and donor fragmentation, and to decrease donors' sense of accountability for overall development outcomes. There is mixed evidence on whether donor proliferation increases or decreases aid volume. These primary effects in turn affect donor innovation, information hoarding, and aid disbursement volatility, as well as recipient country health budget levels, human resource capacity, and corruption, and the determinants of health program performance. The net effect of donor proliferation on health will vary depending on the magnitude of the framework's competing effects in specific country settings. The conceptual framework provides a foundation for improving design of aid effectiveness practices to mitigate negative effects from donor proliferation while preserving its potential benefits. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. New U.N. program promotes multisectoral approach to AIDS prevention. Q and A [with Peter Piot].

    PubMed

    1996-05-01

    The new joint United Nations (UN) Program on HIV/AIDS (UNAIDS) coordinates the HIV/AIDS activities of its six co-sponsors: the UN Children's Fund (UNICEF), the UN Development Program (UNDP), the UN Population Fund (UNFPA), the UN Educational, Scientific, and Cultural Organization (UNESCO), the World Health Organization (WHO), and the World Bank. In this interview, UNAIDS Executive Director Peter Piot discusses the program's goals and challenges. The UNAIDS program will be more multisectoral in scope than other efforts, involving all sectors of society that can affect the course of the epidemic or are affected by it. This includes the health and education sectors; ministries of trade, finance, planning, and development; nongovernmental and community organizations; people living with HIV and AIDS; research institutions; and the business sector. In each country, the UN agencies will form a "Theme Group on HIV/AIDS" to formulate intersectoral strategies.

  20. Development of a unified web-based national HIV/AIDS information system in China

    PubMed Central

    Mao, Yurong; Wu, Zunyou; Poundstone, Katharine; Wang, Changhe; Qin, Qianqian; Ma, Ye; Ma, Wei

    2010-01-01

    Background In the past, many data collection systems were in operation for different HIV/AIDS projects in China. We describe the creation of a unified, web-based national HIV/AIDS information system designed to streamline data collection and facilitate data use. Methods Integration of separate HIV/AIDS data systems was carried out in three phases. Phase 1, from January 2006 to December 2007, involved creating a set of unified data collection forms that took into account existing program needs and the reporting requirements of various international organizations. Phase 2, from January to October 2007, involved creating a web-based platform to host the integrated HIV/AIDS data collection system. Phase 3, from November to December 2007, involved pilot testing the new, integrated system prior to nationwide application. Results Eight web-based data collection subsystems based on one platform began operation on 1 January 2008. These eight subsystems cover: (i) HIV/AIDS case reporting; (ii) HIV testing and counselling; (iii) antiretroviral treatment (ART) for adults; (iv) ART for children; (v) behavioural interventions for high-risk groups; (vi) methadone maintenance treatment; (vii) sentinel and behavioural surveillance; and (viii) local county background information. The system provides real-time data to monitor HIV testing, prevention and treatment programs across the country. Conclusion China’s new unified, web-based HIV/AIDS information system has improved the efficiency of data collection, reporting, analysis and use, as well as data quality and security. It is a powerful tool to support policy making, program evaluation and implementation of the national HIV/AIDS program and, thus, may serve a model for other countries. PMID:21113041

  1. National nutrition planning in developing countries via gaming-simulation.

    PubMed

    Duke, R D; Cary, R

    1977-01-01

    A nutrition game designed for the Food Policy and Nutrition Division of the Food and Agriculture Organization of the United Nations to aid in planning national nutrition education programs in Third World countries is described. The Simulated Nutrition System Game allows high-level ministerial staff in developing countries to discuss, via a common language created by SNUS I, the issues, problems, and complexities of national nutrition programs.

  2. Condom acceptance and HIV prevention in reproductive health: the challenges.

    PubMed

    Mbizvo, M T

    1991-12-01

    The AIDS epidemic weighs heavily on the already burdened health care delivery systems of developing countries especially in central Africa. AIDS not only incurs high morbidity and mortality but has a severe impact on productivity, economic infrastructures, and development in those countries which need them the most. HIV is mainly spread through heterosexual intercourse in central Africa. Vertical transmission of HIV and breast feeding are other means. The key vehicle of HIV transmission in the US is still homosexual intercourse. Sexually transmitted diseases (STDs) facilitate HIV transmission via intercourse. Research shows that subsequent infection by other STDs hastens the development of AIDS in HIV-infected people. Some evidence indicates that pregnancy increases the risk of developing AIDS in a woman who is positive for HIV. The main means to prevent HIV transmission is the condom. Yet, in Rwanda, only 7% of women had ever used condoms despite the high rate (32%) of HIV-positive serology. The University of Zimbabwe Medical School believes adolescents are the most appropriate starting point for AIDS prevention since they tend to experiment with sexual behaviors. Its youth counseling program involves education and prevention messages within and outside educational settings through youth meeting places, youth workers, and other mass media. It hosts workshops at meeting places which use the problem solving approach to risk reduction behavior. The program invites schools, churches, and other educational settings to form Anti-AIDS Clubs. It advocates use of drama and music to promote AIDS awareness. The program has also branched out into community counseling where it works to eliminate the stigma and guilt associated with talking about sexual transmission of AIDS. Governments must learn who the STD and HIV transmission high risk groups are and then target them with information, education, and communication AIDS prevention programs.

  3. Epidemiology of AIDS in Africa--part 2.

    PubMed

    Cigielski, J P

    1988-03-01

    A recently completed study involving over 10,000 people from 6 Central African countries found seroprevalence rates generally under 1% for the acquired immunodeficiency syndrome (AIDS); however, rates were significantly higher for urban residents, prostitutes and their sexual contacts, and patients attending sexually transmitted disease clinics. The 4 major modes of transmission of AIDS in Africa are sexual contact, perinatal transmission, transfusion of infected blood or blood products, and the reuse of equipment such as needles and syringes. In 1985, a 2nd AIDS virus, human immunodeficiency virus (HIV)-2, was discovered in West Africa--a finding with important implications for epidemiologic surveillance, screening programs, and clinical diagnostic testing. Although 45 of the 50 African countries have developed concrete public health policies and strategies for the prevention and control of AIDS, most nations of sub-Saharan Africa lack the economic and social resources to implement these programs effectively. Thus, international cooperation and a commitment on the part of the US and Western Europe to provide assistance will be essential. Needs must be addressed on 2 fronts: treatment of those already infected or suffering from the disease and containment of the AIDS epidemic. Public health efforts should focus initially on high risk behaviors through health education. At the same time, it should be recognized that AIDS is not the largest health issue facing Africans, and there is a complex interaction between AIDS and other health problems such as malnutrition, genital ulcers, diarrhea, and tuberculosis. An approach to AIDS requires an expansion of public health initiatives in areas such as clean water supplies, maternal-child health programs, nutrition and immunization programs, and sexually transmitted disease clinics.

  4. Lessons learned: Evaluating the program fidelity of UNWomen Partnership for Peace domestic violence diversion program in the Eastern Caribbean.

    PubMed

    Jeremiah, Rohan D; Quinn, Camille R; Alexis, Jicinta M

    2018-08-01

    To date, there have been a plethora of punitive and diversion programs to address domestic violence around the world. However, the evaluative scholarship of such programs overwhelmingly reflects studies in developed countries while barely showcasing the realities of addressing domestic violence in developing countries. This paper features a multi-year (2008-2011) evaluation study that measured the fidelity of the United Nations Partnership for Peace (PfP) domestic violence diversion program in the Eastern Caribbean country of Grenada. Our findings illuminate organic engagement strategies that were built within existing multi-sectoral partnerships that included magistrate court judges, law enforcement officials, and social service agencies. Furthermore, we documented how the locally-devised implementation strategies ensured the program's fidelity within a resource-limited context. This paper contributes to the global evaluative scholarship, highlighting the lessons learned about implementing culturally-adapted and theoretically-driven domestic violence diversion within a developing country. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. AIDS is your business.

    PubMed

    Rosen, Sydney; Simon, Jonathon; Vincent, Jeffrey R; MacLeod, William; Fox, Matthew; Thea, Donald M

    2003-02-01

    If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in countries where people are heavily affected by the epidemic. Fortunately, investments in programs that prevent infection and provide treatment for employees who have HIV/AIDS are profitable for many businesses--that is, they lead to savings that outweigh the programs' costs. Due to the long latency period between HIV infection and the onset of AIDS symptoms, a company is not likely to see any of the costs of HIV/AIDS until five to ten years after an employee is infected. But executives can calculate the present value of epidemic-related costs by using the discount rate to weigh each cost according to its expected timing. That allows companies to think about expenses on HIV/AIDS prevention and treatment programs as investments rather than merely as costs. The authors found that the annual cost of AIDS to six corporations in South Africa and Botswana ranged from 0.4% to 5.9% of the wage bill. All six companies would have earned positive returns on their investments if they had provided employees with free treatment for HIV/AIDS in the form of highly active antiretroviral therapy (HAART), according to the mathematical model the authors used. The annual reduction in the AIDS "tax" would have been as much as 40.4%. The authors' conclusion? Fighting AIDS not only helps those infected; it also makes good business sense.

  6. Unsung heroes in the South.

    PubMed

    1991-11-01

    While recognizing the important role played by lesbian women in HIV/AIDS prevention in many countries, and as members of some gay organizations in the South, this article focuses only on gay men. Even though formidable societal proscriptions against homosexuality exist in many developing countries and Eastern European countries, gay men served duty on the front lines as AIDS educators and care givers. The threat of the AIDS crisis impelled some to openly acknowledge their sexuality in an effort to reach gay men at risk. In the West, gay organizations had already laid a 10 year foundation of organization and community trust, when the AIDS epidemic appeared in the public spot light. This fact allowed them to act as effective educators of their own gay communities. They were so effective that the number of new HIV cases has leveled off in the gay community. In Central and South America, gay movement cohered in 1976 and responded quickly to AIDS in 1983. In Africa, homosexuality is often considered a contamination of the West and national gay organizations (NGOs) have only recently been formed in Ghana, Tanzania, and Nigeria. The only AIDS services organizations (ASOs) for black men exist in Zimbabwe and South Africa. In Asia NGOs are a new phenomenon that exist only in Hong Kong, Indonesia, India, Malaysia, Singapore, Taiwan and Thailand. All NGOs have several things in common. Governments are rarely interested in working with NGOs so they are forced to find their own funding and develop their own education campaigns. Even in countries that recognize the implications and magnitude of the AIDS crisis, their education programs and policies are often homophobic or anti-gay. In the countries where the government is sympathetic to the gay community they rely upon NGOs to help them develop national education programs for both gays and the rest of the population.

  7. Stepping Offshore: An Examination of Australia's Bilateral Program-Based Assistance for the Development of Vocational Education and Training in Its Region. Working Paper.

    ERIC Educational Resources Information Center

    Maglen, Leo; Hopkins, Sonnie

    This report examines the participation of Australia's vocational education and training sector in aid projects in Southeast Asia and the Pacific from 1980-1997. It begins with background information on training assistance to developing countries, and it outlines the economic and educational assumptions underlying Australia's aid program to six…

  8. WHO: World Health Assembly.

    PubMed

    McGregor, A

    1992-05-23

    1200 delegates from 175 member countries attended the 45th World Health Assembly in Geneva. Everyone at the Assembly ratified measures to prevent and control AIDS. 12 countries intended to do long term planning for community based care for AIDS patients. Further the Assembly denounced instances where countries and individuals denied the gravity of the AIDS pandemic. In fact, it expressed the importance for urgent and intensive action against HIV/AIDS. The assembly backed proposals to prevent and control sexually transmitted diseases that affect AIDS patients, especially hepatitis B. For example, in countries with hepatitis B prevalence 8% (many countries in Sub-Sahara Africa, Asia, the Pacific region, and South America), health officials should introduce hepatitis B vaccine into their existing immunization programs by 1995. By 1997, this vaccine should be part of all immunization programs. The Assembly was aware of the obstacles of establishing reliable cold chains for nationwide distribution, however. Delegates in Committee A objected to the fact that 50% of the populations of developing countries continued to have limited access to essential drugs. They also expressed disapproval in implementation of WHO's 1988 ethical criteria for promotion of drugs which WHO entrusted to the Council for International Organisations of Medical Sciences (CIOMS). CIOMS lacked WHO's status and thus could not effectively monitor drug advertising. In fact, the pharmaceutical industry as well as WHO provided the funds for a meeting of 25 experts to discuss principles included in the ethical criteria. At least 4 countries insisted that WHO have the ultimate authority in monitoring drug advertising. Delegates did adopt a compromise resolution on this topic which required that industry promotion methods be reported to the 1994 Assembly via the Executive Board. The Assembly requested WHO to establish an international advisory committee on nursing and midwifery and to improve the network of WHO collaborating centers which help national nursing groups.

  9. Building multi-country collaboration on watershed management: lessons on linking environment and public health from the Western Balkans

    EPA Science Inventory

    Community-based watershed resilience programs that bridge public health and environmental outcomes often require cross-boundary, multi-country collaboration. The CRESSIDA project, led by the Regional Environmental Center for Central and Eastern Europe (REC) and supported by the U...

  10. Transportation Improvement Program of the Mid-Ohio Regional Planning Commission

    DOT National Transportation Integrated Search

    1996-06-20

    The MORPC Transportation Improvement program (TIP) is a staged, multi-year schedule of regionally significant transportation improvements in the Columbus area. The Federal-aid Highway Act of 1962 and the federal Urban Mass Transportation Act of 1964 ...

  11. NATIONAL LABORATORIES: Better Performance Reporting Could Aid Oversight of Laboratory-Directed R&D Program

    DTIC Science & Technology

    2001-09-01

    Development ( LDRD ) program, which formalized a long-standing policy of allowing its multi-program national laboratories discretion to conduct self...initiated, independent research and development (R&D). DOE requires that LDRD work must focus on the advanced study of scientific or technical problems...

  12. Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects

    PubMed Central

    Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora; Preacely, Nykiconia; Luce, Richard; Antara, Simon; Imara, Hiari; Ndjakani, Yassa; Doyle, Timothy; Espinosa, Yescenia; Kazambu, Ditu; Delissaint, Dieula; Ngulefac, John; Njenga, Kariuki

    2011-01-01

    As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems. PMID:22187606

  13. The organized sector mobilizes against AIDS.

    PubMed

    Mehra-kerpelman, K

    1995-01-01

    Representatives of English speaking African countries attended the International Labor Organization Tripartite Workshop on the Role of the Organized Sector in Reproductive Health and the Prevention of AIDS held in Uganda. AIDS has robbed these countries of lawyers, physicians, teachers, managers, and other skilled professionals, all of whom are difficult to replace. HIV/AIDS mainly affects persons in their most productive years (20-40 years) and in the higher socioeconomic groups. Professionals with AIDS become ill and die at a faster rate than their replacements can be trained. The young, less experienced work force translates into an increase in breakdowns, accidents, delays, and misjudgments. International and national efforts to control HIV/AIDS have not stopped the spread of HIV in Sub-Saharan Africa (SSA). More than 8 million persons in SSA are HIV infected. 1.5 million in Uganda are HIV infected. As of October 1994, 30,000 persons in Zambia and 33,000 in Zimbabwe had AIDS. These numbers are just the tip of the iceberg due to underreporting. HIV/AIDS increases absenteeism among infected and healthy workers alike. It burdens the already existing scarce health care resources and equipment (e.g., in 1992, AIDS cases occupied 70% of hospital beds in Kigali, Rwanda). Unions, workers, and families must share knowledge about safer sex. The Zimbabwe Confederation of Trade Unions has had an HIV/AIDS education program since 1992. The Zambia Congress of Trade Unions strongly supports government efforts to sensitize the labor force and society to the effects of HIV/AIDS. The Federation of Uganda Employers has reached about 150,000 workers and more than 200 top executives through its AIDS prevention activities. Some company programs provide medical facilities for employees and their families. The Ubombo Ranches, Ltd. in Swaziland, a producer and processor of sugar cane, has a training-of-trainers program on HIV/AIDS and family planning for all village health workers and village headmen.

  14. CIDA funds AIDS counselling and care centre in Zambia.

    PubMed

    Meehan, S T

    1993-12-01

    In its fight against the spread of AIDS, which is inextricably linked to the issues of international development, the Canadian International Development Agency (CIDA) has focused support on strengthening existing health care systems, helping vulnerable groups gain control over their lives and health, promoting AIDS prevention measures, and building links to other related health services. Funding includes 1) a grant to Hope House in Zambia (counseling and support for persons with AIDS); 2) a contribution to the Canadian Public Health Association's $11 million Southern Africa AIDS Training Programme (helps regional organizations working in AIDS prevention and support through education, training, hospital outreach, peer education for vulnerable groups, assistance to women's shelters, and networking); 3) support for Laval University's Laval Centre for International Cooperation in Health and Development (runs a $22 million program in French-speaking West Africa that operates in over 10 countries and focuses on epidemiological surveillance, information, education, and communication, control of sexually transmitted diseases [STDs], and management of national AIDS programs); 4) support for the University of Manitoba's $3 million program with the University of Nairobi to slow the spread of HIV (strengthens local health care capabilities for STD/HIV diagnosis, treatment, and counseling, with special emphasis on training and education); 5) support in the past for a study of proposed AIDS legislation and its potential impact on the human rights of PLWHIV/AIDS in Thailand; 6) a contribution to help equip the office of the National Movement for Street Children, Rio de Janeiro (focuses on preventing the spread of AIDS among child prostitutes); and 7) long-term financial support to the Interagency Coalition on AIDS and Development, a coalition of Canadian development nongovernmental organizations responding to AIDS in developing countries. An address to obtain a pamphlet giving more information on Canada's contributions to the worldwide fight against AIDS is given.

  15. Family caregivers in rural Uganda: the hidden reality.

    PubMed

    Kipp, Walter; Tindyebwa, Denis; Rubaale, Tom; Karamagi, Ednah; Bajenja, Ellen

    2007-01-01

    We conducted 16 in-depth interviews with family caregivers of AIDS patients in three rural districts in western Uganda. They were selected from a client visitation list of the home-based care program for AIDS patients, based on volunteer participation. Family caregivers reported huge problems associated with providing the necessary psychological, social, and economic care. They also said that the physical and emotional demands of caregiving are overwhelming daily challenges. Most support to AIDS patients provided by family, friends, and the churches. The study highlights the great burden of caregivers, in sub-Saharan Africa who most often are elderly women and young girls. This study examine, the burden and related health issues of family caregivers, primarily women, for AIDS patients in Uganda. It was part of a broad research project using qualitative methods on family caregiving in the home environment in sub-Saharan Africa. As the requirements for family care giving are often overwhelming for women under the conditions as they exist in Uganda and in other developing countries, it constitutes a gender issue of great importance that has not been appreciated fully in the international literature. Family caregiving is also of international relevance, as HIV/AIDS is a global pandemic of previously unknown proportions. In many poor countries, family caregiving is the most common and often the only care that AIDS patients receive, because clinic-based care often is not available close to home or is not affordable. Therefore, family caregiver support programs to alleviate this burden are essential for all those countries where HIV/AIDS is prevalent. Family caregiver burden encompasses medical, social, and economic issues at the household level, which requires an interdisciplinary approach in order to fully understand and appreciate the different dimensions of the family caregiver burden and its negative impact on the lives of so many women in so many countries.

  16. International Scholarship Graduates Influencing Social and Economic Development at Home: The Role of Alumni Networks in Georgia and Moldova

    ERIC Educational Resources Information Center

    Campbell, Anne C.

    2016-01-01

    Many students from low- and middle-income countries seek scholarship support to pursue higher education overseas. Often scholarship programs mandate that recipients "give back" to their home countries following their studies so scholars "apply" their experiences to aid their countries of origin. In this comparative qualitative…

  17. Results of a model AIDS prevention program for high school students in the Philippines.

    PubMed

    Aplasca, M R; Siegel, D; Mandel, J S; Santana-Arciaga, R T; Paul, J; Hudes, E S; Monzon, O T; Hearst, N

    1995-07-01

    To describe the sexual practices of high school students; to describe the process of development of a school-based AIDS prevention program; and to evaluate the effect of this program on students' AIDS-related knowledge, attitudes and AIDS-preventive behaviors. A cluster-randomized, controlled trial with pretest/post-test evaluation was conducted in four demographically similar public high schools in a semi-urban district of Metro Manila, the Philippines. Of 845 high school students who participated in the baseline survey, 804 (95%) completed a postintervention questionnaire. An AIDS prevention program was developed by public high school teachers together with local AIDS experts, social scientists and health educators. The teacher-led AIDS program was designed to provide students with accurate information about AIDS, particularly in dispelling misconceptions about casual contagion, to foster positive attitudes towards people with AIDS and to develop skills aimed at clarifying values and assessing intended behavior. At baseline, 11% of students (20% of males and 4% of females) reported ever having had sexual intercourse (mean age 14 years). Among these, condom use was low (24%). After implementation of the AIDS prevention program, statistically significant effects favoring the intervention group were observed in knowledge and attitudes towards people with AIDS. While there was no statistically significant overall effect on intended preventive behavior, the program appeared to delay the students' intended onset of sexual activity. A sizable number of Filipino high school students are sexually active but condom use is low. School-based AIDS prevention programs can be developed and implemented in developing countries with the assistance of school personnel to address sexual issues. Our program was successful in increasing AIDS-related knowledge and improving attitudes towards people with AIDS. Supplementation with other preventive activities may be needed to achieve lasting changes in students' risk-taking behavior.

  18. Scale-up of national antiretroviral therapy programs: progress and challenges in the Asia Pacific region.

    PubMed

    Srikantiah, Padmini; Ghidinelli, Massimo; Bachani, Damodar; Chasombat, Sanchai; Daoni, Esorom; Mustikawati, Dyah E; Nhan, Do T; Pathak, Laxmi R; San, Khin O; Vun, Mean C; Zhang, Fujie; Lo, Ying-Ru; Narain, Jai P

    2010-09-01

    There has been tremendous scale-up of antiretroviral therapy (ART) services in the Asia Pacific region, which is home to an estimated 4.7 million persons living with HIV/AIDS. We examined treatment scale-up, ART program practices, and clinical outcome data in the nine low-and-middle-income countries that share over 95% of the HIV burden in the region. Standardized indicators for ART scale-up and treatment outcomes were examined for Cambodia, China, India, Indonesia, Myanmar, Nepal, Papua New Guinea, Thailand, and Vietnam using data submitted by each country to the WHO/The Joint United Nations Programme on HIV/AIDS (UNAIDS)/UNICEF joint framework tool for monitoring the health sector response to HIV/AIDS. Data on ART program practices were abstracted from National HIV Treatment Guidelines for each country. At the end of 2009, over 700,000 HIV-infected persons were receiving ART in the nine focus countries. Treatment coverage varies widely in the region, ranging from 16 to 93%. All nine countries employ a public health approach to ART services and provide a standardized first-line nonnucleoside reverse transcriptase inhibitor-based regimen. Among patients initiated on first-line ART in these countries, 65-88% remain alive and on treatment 12 months later. Over 50% of mortality occurs in the first 6 months of therapy, and losses to follow-up range from 8 to 16% at 2 years. Impressive ART scale-up efforts in the region have resulted in significant improvements in survival among persons receiving therapy. Continued funding support and political commitment will be essential for further expansion of public sector ART services to those in need. To improve treatment outcomes, national programs should focus on earlier identification of persons requiring ART, decentralization of ART services, and the development of stronger healthcare systems to support the provision of a continuum of HIV care.

  19. Knowledge, attitudes, beliefs, and behaviors of the business community relative to HIV-AIDS.

    PubMed Central

    Farnham, P G

    1991-01-01

    One of the goals of the Centers for Disease Control's (CDC) policy on the prevention of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) is to support business organizations in implementing HIV and AIDS information, education, and prevention activities. However, the response of the American business community to HIV infection and AIDS has been varied. Although company executives consider AIDS to be one of the leading problems in the country, surveys typically indicate that less than one-third of businesses have or are developing some type of AIDS policy. The workplace appears to be a valid site for AIDS information and education programs, given the weight employees attach to information received there. However, workplace education and information programs are undertaken primarily by large companies. Many small companies do not devote much time and effort to these activities, even though extensive, indepth educational programs are likely to have positive impacts on worker attitudes and behavior, whereas short programs or literature distribution may only increase workers' fears. The question of what is an effective workplace program still needs additional research. Very little is known about the magnitude of the costs of HIV infection and AIDS to business. These costs, which are affected by the changing roles of employer-based health insurance, cost shifting, and public programs, will influence how employers react to the epidemic and how they respond to CDC's prevention initiatives. PMID:1956975

  20. Inventory of Educational Innovations in Asia and the Pacific.

    ERIC Educational Resources Information Center

    Asian Centre of Educational Innovation for Development, Bangkok (Thailand).

    Fourteen innovative educational programs implemented by countries in Asia and the Pacific region are described to aid other educators engaged in planning and implementing innovative programs. The programs are: faculty-oriented breakfast programme (Australia); farm school on the air (India); multimedia, inservice teacher training for primary…

  1. [Cost-effectiveness of the HIV screening program carried out in Guangxi Zhuang Autonomous Region infectious disease special demonstration project areas].

    PubMed

    Lu, Huaxiang; Luo, Liuhong; Chen, Li; Zhang, Shizhen; Liang, Yingfang; Li, Li; Chen, Zhenqiang; Huo, Xiaoxing; Wu, Xinghua

    2015-06-01

    To analyze the cost effectiveness of HIV screening project in three Guangxi infectious disease special demonstration project countries in 2013. To calculate the funds used for the HIV screening project and to study the data on HIV/AIDS and HAART. A five-tree markov model was used to evaluate the quality adjusted life year (QALY) of this HIV screening project and to analyze the related cost effectiveness of the project. The cost of HIV screening in Guangxi infectious disease special demonstration project areas was 19.205 million Yuan and having identified 1 218 HIV/AIDS patients. The average costs for HIV/AIDS positive detection in three project countries were 14.562, 18.424 and 14.042 thousand Yuan per case. The QALYs gained from finding a HIV/AIDS case were 12.736, 8.523 and 8.321 on average, with the total number of QALYs gained from the project as 5 973.184, 3 613.752 and 2 704.325. The overall cost effectiveness ratio of the project was 1.562 thousand Yuan per QALY, and 1.143, 2.162 and 1.688 thousand Yuan per QALY in these three project countries. Project country "A" showed better cost effectiveness index than country B and C. The HIV screening project in Guangxi seemed relatively cost-effective but the average cost of HIV/AIDS positive detection was expensive. To strengthen HAART work for HIV/AIDS could improve the cost-effective of the project.

  2. HIV/AIDS-related social anxieties in adolescents in three African countries.

    PubMed

    Venier, J L; Ross, M W; Akande, A

    1998-02-01

    This study examines the social anxieties associated with HIV prevention in adolescents in three African countries (Nigeria, Kenya, and Zimbabwe). The subjects used in this study were black Africans in form 2 or grade 10 in public high schools (Nigeria, n = 387; Kenya, n = 274; Zimbabwe n = 313). Subjects responded to the 33 item AIDS Social Assertiveness Scale (ASAS). Data indicated similar factor structures for each of the three countries and included five factors. The combined sample factor intercorrelations were modestly but significantly correlated. The mean scores for each factor were compared, and ANOVA of the factors by country, by gender, and by interaction between country and gender were performed. The factor structures were very similar between countries, each including five factors that had similar themes: condom interactions, refusal of risk, confiding in significant others, contact with people with HIV/AIDS, and general assertiveness. These factor structures were also very similar to one found in previous studies of Australian adolescents on the ASAS. The Kenyan means for four of the five factors were significantly lower than those for Nigeria, and were also significantly lower than the Zimbabwean means for two of the five factors, suggesting that Kenyan students are less anxious about social situations related to HIV/AIDS than others. Significant variance was found for several factors due to gender, country, and the interaction between gender and country. These results have important implications for designing education programs. The similarities of anxieties regarding HIV/AIDS social situations suggest that these clusters of social barriers to reduction of HIV infection risk might form the basis of educational interventions, and that dimensions of HIV social anxieties are similar across countries.

  3. Clinical research, prophylaxis, therapy, and care for HIV disease in Africa.

    PubMed Central

    De Cock, K M; Lucas, S B; Lucas, S; Agness, J; Kadio, A; Gayle, H D

    1993-01-01

    By the end of the century, citizens of resource-poor countries will constitute 90% of the world's human immunodeficiency virus (HIV)-infected people. Clinical management of such persons in developing countries has been neglected; most AIDS research has concentrated on epidemiology, and donor agencies have generally invested in the prevention of HIV infection. The heavy burden of HIV disease in Africa requires that care for AIDS be addressed, and prevention and care should be seen as interrelated. Prevention and treatment of tuberculosis, the commonest severe infection in persons with AIDS in Africa, illustrate this interrelationship. We outline priorities for applied research on the management of HIV disease in a resource-poor environment, and discuss prophylaxis, therapy for opportunistic diseases, terminal care, and use of antiretroviral therapy. Research should define the standard of care that can realistically be demanded for HIV disease in a resource-poor environment. Research and public health programs for AIDS in developing countries must address AIDS care and attempt to reduce the widening gap between interventions available for HIV-infected persons in different parts of the world. PMID:8214225

  4. Teacher Performance Pay Programs and Necessary Communication Actions

    ERIC Educational Resources Information Center

    Heneman, Herbert G., III; Worth, Robin; Arrigoni, Jessica; Kimball, Steven M.; Milanowski, Anthony

    2013-01-01

    Teacher performance pay programs have proliferated across the country over the past 20 years. To aid in understanding their many variations, the seven major components of these programs are described. Three examples of teacher performance pay programs are provided for illustration: Denver ProComp, TAP, and Houston ASPIRE. Evidence is mixed on the…

  5. 75 FR 42189 - Foreign Institutions-Federal Student Aid Programs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-20

    ... the foreign institution in the U.S. except for independent research under very limited circumstances... home country; and For any program designed to prepare the student for employment in a recognized... independent research is conducted as part of a doctoral program as provided for in the definition of foreign...

  6. A focus on the consumer: social marketing for change.

    PubMed

    Lucaire, L E

    1985-01-01

    Social marketing is the application of commercial marketing principles to advance a social cause, issue, behavior, product, or service. Social marketing has added a framework to social efforts that heretofore lacked organization and has inspired projects that otherwise might never have been initiated. In the US, social marketing techniques have been particularly successful in the health field. Although advertising and other communications are central to social marketing, the discipline also depends upon other elements of what is termed the marketing mix: product, price, place, and promotion. Social marketing is a cyclical process involving 6 steps: analysis; planning; development, testing, and refining elements of the plan; implementation; assessment of in-market effectiveness; and feedback. In developing countries, health has similarly been the greatest beneficiary to date of applied social marketing techniques. Family planning programs and oral rehydration therapy (ORT) projects have used social marketing techniques effectively in numerous developing countries. Social marketing has been even more widely applied in the sale of contraceptives in developing countries. Contraceptive social marketing (CSM) programs are well established in Bangladesh, Sri Lanka, India, Thailand, Nepal, Colombia, El Salvador, Jamaica, Mexico, and Egypt. More recently programs have been established in Honduras, Guatemala, Barbados, St. Vincent, and St. Lucia. SOMARC (Social Marketing for Change) is a project funded by the US Agency for International Development (AID) and is working with existing CSM programs and helping to launch new CSM programs. CSM programs are successfully functioning as legitimate marketing organizations in developing countries and are using local private sector resources in the process. Program results are encouraging. Social marketing requires both experience and sensitivity to local conditions. Many developing countries now have their own marketing resources. Local private sector advertising and marketing agencies are helping public and private sector programs. In countries where local resources are scarce, AID has created several programs to provide technical assistance in social marketing.

  7. Public health the leading force of the Indonesian response to the HIV/AIDS crisis among people who inject drugs

    PubMed Central

    Mesquita, Fabio; Winarso, Inang; Atmosukarto, Ingrid I; Eka, Bambang; Nevendorff, Laura; Rahmah, Amala; Handoyo, Patri; Anastasia, Priscillia; Angela, Rosi

    2007-01-01

    Issue Indonesia has an explosive HIV/AIDS epidemic starting from the beginning of this century, and it is in process to build its response. Reported AIDS cases doubled from 2003 – 2004, and approximately 54% of these cases are in people who inject drugs. Setting Indonesia is the 4th largest country in population in the world, a predominantly Muslim country with strong views on drug users and people living with HIV/AIDS. Globally speaking, Indonesia has one of the most explosive epidemics in recent years. The project IHPCP (Indonesia HIV/AIDS Prevention and Care Project) is a joint support project (primarily AusAID-based) that works in partnership with the Government of Indonesia. IHPCP has been a key player of in the country's response, particularly pioneering NSP; stimulating and supporting methadone programs, and being key in promoting ARV for people who currently inject drugs. The project works via both the public health system and NGOs. Outcomes It is still early to measure the impact of current interventions; however, this paper describes the current status of Indonesia's response to the HIV/AIDS crisis among people who inject drugs, and analyses future challenges of the epidemic in Indonesia. PMID:17306033

  8. Enhancing the care of people with HIV.

    PubMed

    Goodwin, J

    1999-01-01

    30% of South Africa's adults are infected with HIV. Of those who have been infected with HIV, many have died and left behind orphans, making South Africa's large number of orphans one of the country's most important problems. As the number of people infected with HIV in the developing world has grown dramatically, the cost of their care has quickly surpassed regionally available resources. In countries where the HIV/AIDS epidemic is exacting the heaviest damage, most people have no access to antiretroviral therapies and routine prophylaxes against opportunistic infections. The search for cost-effective methods to treat and care for the ill has therefore become a global imperative. The Enhancing Care Initiative (ECI), a multinational program recently launched by the Harvard AIDS Institute, aims to improve the care of all HIV-infected people living in resource-scarce countries. Funded by an initial 5-year grant from the Merck Company Foundation, ECI is coordinated by the Harvard AIDS Institute. The core of ECI is its AIDS care teams, groups formed by, composed of, and led by people from the countries involved. The teams are comprised of regional experts in clinical care, epidemiology, international health, human rights, behavioral science, economics, political science, and public health working to initiate meaningful changes in regional AIDS policies.

  9. Women in Development.

    ERIC Educational Resources Information Center

    Cassara, Beverly Benner

    Women in development refers to the needs and problems of women in developing countries and the responsibility of industrialized countries to ensure that aid programs serve the best interests of these women. A concern of adult educators is the relationship between adult education and the challenges facing women in the development of their…

  10. A functional language approach in high-speed digital simulation

    NASA Technical Reports Server (NTRS)

    Ercegovac, M. D.; Lu, S.-L.

    1983-01-01

    A functional programming approach for a multi-microprocessor architecture is presented. The language, based on Backus FP, its intermediate form and the translation process are discussed and illustrated with an example. The approach allows performance analysis to be performed at a high level as an aid in program partitioning.

  11. [Present state of countermeasure to AIDS in the world today].

    PubMed

    Takakuwa, E

    1997-11-01

    1. Only about 10 years have passed since HIV was discovered but WHO presumes that there will be 30 to 40 million infected cases by the year 2,000. This then possesses the possibility of more frequent contact with such persons and thus means we must look for how to protect ourselves. I would like to discuss the present state of AIDS, particularly in eastern European countries such as Bulgaria, Hungary, Romania and Russia, based on recent data I have compiled. 2. AIDS-related laws at present in various countries. (1) Comparison of major laws (17 countries) including 1) patient (17 countries) and infected person (13 countries) notification, 2) protection of privacy (9 countries), 3) prohibiting infected person discrimination (3 countries) and 4) other matters including restraint on behavior to spread infection (6 countries). (2) Entry laws from foreign country (10 countries) applicable to patient and infected person for 1) entry (3 countries) and 2) long period of stay (8 countries). 3. Present countermeasures to AIDS. (1) Data for 8 countries including Japan, U.S.A. U.K., France, Germany and three eastern European countries with regard to 1) budgets, 2) examinations, 3) medical care, 4) consultation and guidance and 5) education. I shall also discuss the following 2 countermeasures in Japan. I have proposed to the Diet: 1) Examination to detect HIV-antibodies in donated blood. This measure is present in effect since Nov. 1st, 1986, as a result of my proposal made to the Diet on March 14th, 1986. 2) For person infected by transfusion of the blood products without heat treatment, I proposed that expenses should be defrayed according to the CD4 level at either CD4 < or = 200 or CD4 < or = 500. (2) Present situation in eastern European countries. Common features are as follows: 1) Infected person and patient are quarantined if they request, since they know their condition which was disclosed based on data from past mass screening test under communism. 2) At present infected persons are few in number. 3) This number will rapidly increase with greater active interchange with western countries following elimination of the Berlin Wall. 4) AIDS countermeasures such as blood and blood products examinations are inadequate due to insufficient funds. In Bulgaria, the government has conducted AIDS tests on more than half the population and in Romania, there is the tragic situation. (3) Guidelines for WHO-ILO countermeasures to AIDS at work places. 4. Present situation in research. The development of effective medicines and vaccines is the primary objective of AIDS research. Research programs may be enumerated as follows; 1) In the U.S.A., NIH and CDC are major organizations which lead research around the world. The major objective is synthetic medicine. 2) In U.K., the development of vaccines for monkey and cat is being sought. 3) In China, herb medicine is administrated to patients in Un-nan-sho where AIDS patients are quite numerous. 4) In Japan, a recombinant vaccine is being sought through use of BCG, vaccinia viruses and the like. 5. Topics related to AIDS include 1) informed consent to be treated by a AIDS-infected doctor, 2) suits against doctors who fail to make infected person known infection and 3) government control laws for AIDS in Russia.

  12. Mandela calls for greater commitment and leadership in fighting AIDS. The World Economic Forum -- Policy and business in a world of HIV / AIDS.

    PubMed

    Macinnis R

    1997-01-01

    The 27th annual meeting of the World Economic Forum in Davos, Switzerland, on February 3, 1997, was attended by 2000 political and financial leaders of countries and businesses around the world. The forum is the world's largest annual gathering of economic and political dignitaries. In his address to the forum, Nelson Mandela, president of South Africa, called for a global effort against AIDS and a strengthening of the world's political and business leaders' commitment against HIV/AIDS. The disease is creating global economic problems by affecting people in their prime productive and reproductive years. Mandela criticized political leaders for their limited actions in addressing the AIDS pandemic and called upon the world's business community to support government AIDS programs and help people affected by AIDS. All sectors and all spheres of society must be involved as equal partners in the war against HIV/AIDS, for neither the health sector nor government can meet the challenge on its own. If current HIV/AIDS trends continue in South Africa, AIDS will cost the country 1% of its domestic gross product by the year 2005, and up to 75% of the country's budget will be consumed by direct health costs related to HIV/AIDS. At a panel discussion preceding President Mandela's address, Dr. Peter Piot, executive director of UNAIDS, argued that the AIDS pandemic could have a devastating effect upon the global economy and urged business leaders to take strong action against the disease.

  13. 78 countries: immunization financing in developing and transitional countries.

    PubMed

    Deroeck, D; Levin, A

    1999-01-01

    The Special Initiative on Immunization Financing is a project that reviews available information on immunization costs and financing in developing countries in order to inform planned field-based activities to increase sustainability of immunization programs. While routine immunization costs just pennies a dose, newer vaccines such as hepatitis B vaccine cost much more; the full cost of making them routine are not yet known. However, a growing number of governments are paying for these vaccines. Three-quarters of the countries responding to the survey have immunization and vaccination programs in their national budgets. Moreover, international organizations have set up fund and procurement mechanisms to aid countries purchase low-cost, high-quality vaccines.

  14. A method for estimating maternal and newborn lives saved from health-related investments funded by the UK government Department for International Development using the Lives Saved Tool.

    PubMed

    Friberg, Ingrid K; Baschieri, Angela; Abbotts, Jo

    2017-11-07

    In 2010, the UK Government Department for International Development (DFID) committed through its 'Framework for results for reproductive, maternal and newborn health (RMNH)' to save 50,000 maternal lives and 250,000 newborn lives by 2015. They also committed to monitoring the performance of this portfolio of investments to demonstrate transparency and accountability. Methods currently available to directly measure lives saved are cost-, time-, and labour-intensive. The gold standard for calculating the total number of lives saved would require measuring mortality with large scale population based surveys or annual vital events surveillance. Neither is currently available in all low- and middle-income countries. Estimating the independent effect of DFID support relative to all other effects on health would also be challenging. The Lives Saved Tool (LiST) is an evidence based software for modelling the effect of changes in health intervention coverage on reproductive, maternal, newborn and child mortality. A multi-country LiST-based analysis protocol was developed to retrospectively assess the total annual number of maternal and newborn lives saved from DFID aid programming in low- and middle-income countries. Annual LiST analyses using the latest program data from DFID country offices were conducted between 2013 and 2016, estimating the annual number of maternal and neonatal lives saved across 2010-2015. For each country, independent project results were aggregated into health intervention coverage estimates, with and in the absence of DFID funding. More than 80% of reported projects were suitable for inclusion in the analysis, with 151 projects analysed in the 2016 analysis. Between 2010 and 2014, it is estimated that DFID contributed to saving the lives of 15,000 women in pregnancy and childbirth with health programming and 88,000 with family planning programming. It is estimated that DFID health programming contributed to saving 187,000 newborn lives. It is feasible to estimate the overall contribution and impact of DFID's investment in RMNH from currently available information on interventions and coverage from individual country offices. This utilization of LiST, with estimated population coverage based on DFID program inputs, can be applied to similar types of datasets to quantify programme impact. The global data were used to estimate DFID's progress against the Framework for results targets to inform future programming. The identified limitations can also be considered to inform future monitoring and evaluation program design and implementation within DFID.

  15. High-level manpower movement and Japan's foreign aid.

    PubMed

    Furuya, K

    1992-01-01

    "Japan's technical assistance programs to Asian countries are summarized. Movements of high-level manpower accompanying direct foreign investments by private enterprise are also reviewed. Proposals for increased human resources development include education and training of foreigners in Japan as well as the training of Japanese aid experts and the development of networks for information exchange." excerpt

  16. HIV/AIDS Stigmatizing Attitudes among Young People in Swaziland: Individual and Environmental Factors

    ERIC Educational Resources Information Center

    Buseh, Aaron G.; Park, Chang Gi; Stevens, Patricia E.; McElmurry, Beverly J.; Kelber, Sheryl T.

    2006-01-01

    A major shortcoming to the understanding and development of HIV/AIDS programs to mitigate social stigma is the paucity of research pertaining to how young people in sub-Saharan African countries perceive those infected with HIV, and how these stigmatizing attitudes are formed, projected and reinforced. The purpose of this study was to examine…

  17. Cultural conceptions of HIV/AIDS among teenagers in Bolivia, Chile and Mexico.

    PubMed

    Torres López, Teresa Margarita; Reynaldos Quinteros, Carolina; Lozano González, Aldo Favio; Munguía Cortés, Jazmín Aranzazú

    2010-10-01

    To understand the cultural dimensions of HIV/AIDS among adolescent students. A cognitive anthropological study was undertaken in Cochabamba (Bolivia), Talca (Chile) and Guadalajara (Mexico), during 2007 and 2008. A total of 184 teenagers (from 14 to 19 years old) were selected by purposeful sampling at secondary schools in each country. Free association lists and pile sorts were utilized. Terms associated with the concept of HIV/AIDS and groups of conceptual dimensions were investigated. Subsequently, consensus analysis was performed using factorial principal components and dimensional analysis through hierarchical clusters and multidimensional scales. The differences between the country contexts were in the degree of consensus in relation to the term HIV/AIDS, which was greater in Cochabamba. In Talca and Guadalajara the youths mentioned metaphors of fighting against HIV/AIDS, while in Cochabamba participants talked about help, support and love that infected people should receive. The similarities among conceptions by youth from the three countries were: the risk factors (unprotected sexual practice and contact with specific population groups), the consequences (physical and social death, being the latter understood as social rejection of people living with HIV/AIDS) and the prevention of illness (based on information and condom use). For adolescent students, HIV/AIDS is a disease caused by sexual practices and drug use and involves harm, pain and death. HIV/AIDS prevention programs for adolescents should promote science based information on the topic and not concentrate only on the emotional and social consequences of HIV/AIDS.

  18. Women and AIDS: introduction.

    PubMed

    Krieger, N; Margo, G

    1991-01-01

    Around the world, more and more women--principally poor women of color--are being diagnosed with and are dying of AIDS, the acquired immune deficiency syndrome. Yet, effective and appropriate prevention programs for women are sorely missing from the global program to control AIDS. To help us understand why this gap exists, and what we must do to close it, the three articles in this issue focus on women and AIDS. Examining the situation in such countries as Zimbabwe and South Africa, as well as in other economically underdeveloped and developed regions, the authors argue that women with the least control over their bodies and their lives are at greatest risk of acquiring AIDS. For example, the high rate of infection among women in Africa cannot be understood apart from the legacy of colonialism (including land expropriation and the forced introduction of a migrant labor system) and the insidious combination of traditional and European patriarchal values. Only by recognizing the socioeconomic and cultural determinants of both disease and sexual behavior, and only by incorporating these insights into our AIDS prevention programs, will we be able to curb the spread of this lethal disease.

  19. Relationships among Learning Styles and Motivation with Computer-Aided Instruction in an Agronomy Course

    ERIC Educational Resources Information Center

    McAndrews, Gina M.; Mullen, Russell E.; Chadwick, Scott A.

    2005-01-01

    Multi-media learning tools were developed to enhance student learning for an introductory agronomy course at Iowa State University. During fall 2002, the new interactive computer program, called Computer Interactive Multimedia Program for Learning Enhancement (CIMPLE) was incorporated into the teaching, learning, and assessment processes of the…

  20. Understanding The Relationships Between Noncommunicable Diseases, Unhealthy Lifestyles, And Country Wealth.

    PubMed

    Bollyky, Thomas J; Templin, Tara; Andridge, Caroline; Dieleman, Joseph L

    2015-09-01

    The amount of international aid given to address noncommunicable diseases is minimal. Most of it is directed to wealthier countries and focuses on the prevention of unhealthy lifestyles. Explanations for the current direction of noncommunicable disease aid include that these are diseases of affluence that benefit from substantial research and development into their treatment in high-income countries and are better addressed through domestic tax and policy measures to reduce risk-factor prevalence than through aid programs. This study assessed these justifications. First, we examined the relationships among premature adult mortality, defined as the probability that a person who has lived to the age of fifteen will die before the age of sixty from noncommunicable diseases; the major risk factors for these diseases; and country wealth. Second, we compared noncommunicable and communicable diseases prevalent in poor and wealthy countries alike, and their respective links to economic development. Last, we examined the respective roles that wealth and risk prevention have played in countries that achieved substantial reductions in premature mortality from noncommunicable diseases. Our results support greater investment in cost-effective noncommunicable disease preventive care and treatment in poorer countries and a higher priority for reducing key risk factors, particularly tobacco use. Project HOPE—The People-to-People Health Foundation, Inc.

  1. "The problem is ours, it is not CRAIDS' ". Evaluating sustainability of Community Based Organisations for HIV/AIDS in a rural district in Zambia.

    PubMed

    Walsh, Aisling; Mulambia, Chishimba; Brugha, Ruairi; Hanefeld, Johanna

    2012-11-28

    While sustainability of health programmes has been the subject of empirical studies, there is little evidence specifically on the sustainability of Community Based Organisations (CBOs) for HIV/AIDS. Debates around optimal approaches in community health have centred on utilitarian versus empowerment approaches. This paper, using the World Bank Multi-Country AIDS Program (MAP) in Zambia as a case study, seeks to evaluate whether or not this global programme contributed to the sustainability of CBOs working in the area of HIV/AIDS in Zambia. Lessons for optimising sustainability of CBOs in lower income countries are drawn. In-depth interviews with representatives of all CBOs that received CRAIDS funding (n = 18) and district stakeholders (n= 10) in Mumbwa rural district in Zambia, in 2010; and national stakeholders (n=6) in 2011. All eighteen CBOs in Mumbwa that received MAP funding between 2003 and 2008 had existed prior to receiving MAP grants, some from as early as 1992. This was contrary to national level perceptions that CBOs were established to access funds rather than from the needs of communities. FUNDING opportunities for CBOs in Mumbwa in 2010 were scarce.Health services: While all CBOs were functioning in 2010, most reported reductions in service provision. Home visits had reduced due to a shortage of food to bring to people living with HIV/AIDS and scarcity of funding for transport, which reduced antiretroviral treatment adherence support and transport of patients to clinics.Organisational capacity and viability: Sustainability had been promoted during MAP through funding Income Generating Activities. However, there was a lack of infrastructure and training to make these sustainable. Links between health facilities and communities improved over time, however volunteers' skills levels had reduced. Whilst the World Bank espoused the idea of sustainability in their plans, it remained on the periphery of their Zambia strategy. Assessments of need on the ground and accurate costings for sustainable service delivery, building on existing community strengths, are needed before projects commence. This study highlights the importance of enabling and building the capacity of existing CBOs and community structures, rather than creating new mechanisms.

  2. Scaling up towards international targets for AIDS, tuberculosis, and malaria: contribution of global fund-supported programs in 2011-2015.

    PubMed

    Katz, Itamar; Komatsu, Ryuichi; Low-Beer, Daniel; Atun, Rifat

    2011-02-23

    The paper projects the contribution to 2011-2015 international targets of three major pandemics by programs in 140 countries funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the largest external financier of tuberculosis and malaria programs and a major external funder of HIV programs in low and middle income countries. Estimates, using past trends, for the period 2011-2015 of the number of persons receiving antiretroviral (ARV) treatment, tuberculosis case detection using the internationally approved DOTS strategy, and insecticide-treated nets (ITNs) to be delivered by programs in low and middle income countries supported by the Global Fund compared to international targets established by UNAIDS, Stop TB Partnership, Roll Back Malaria Partnership and the World Health Organisation. Global Fund-supported programs are projected to provide ARV treatment to 5.5-5.8 million people, providing 30%-31% of the 2015 international target. Investments in tuberculosis and malaria control will enable reaching in 2015 60%-63% of the international target for tuberculosis case detection and 30%-35% of the ITN distribution target in sub-Saharan Africa. Global Fund investments will substantially contribute to the achievement by 2015 of international targets for HIV, TB and malaria. However, additional large scale international and domestic financing is needed if these targets are to be reached by 2015.

  3. State Programs to Provide Financial Support for and Coordination of Nonpublic Higher Education.

    ERIC Educational Resources Information Center

    Millard, Richard

    State aid to private higher education goes back to the beginning of higher education in this country. The forms of financial support for private higher education run the gamut from contracts for special services to general student aid available to students at both public and private institutions. By far the most important from the standpoint of…

  4. Artificial Intelligence and Its Potential as an Aid to Vocational Training and Education.

    ERIC Educational Resources Information Center

    Aleksander, I.; And Others

    This document contains a series of papers which attempt to de-mystify the subject of artificial intelligence and to show how some countries in the European Community (EC) are approaching the promotion of development and application of artificial intelligence systems that can be used as an aid in vocational training programs, as well as to…

  5. "Talkin' about a revolution": How electronic health records can facilitate the scale-up of HIV care and treatment and catalyze primary care in resource-constrained settings.

    PubMed

    Braitstein, Paula; Einterz, Robert M; Sidle, John E; Kimaiyo, Sylvester; Tierney, William

    2009-11-01

    Health care for patients with HIV infection in developing countries has increased substantially in response to major international funding. Scaling up treatment programs requires timely data on the type, quantity, and quality of care being provided. Increasingly, such programs are turning to electronic health records (EHRs) to provide these data. We describe how a medical school in the United States and another in Kenya collaborated to develop and implement an EHR in a large HIV/AIDS care program in western Kenya. These data were used to manage patients, providers, and the program itself as it grew to encompass 18 sites serving more than 90,000 patients. Lessons learned have been applicable beyond HIV/AIDS to include primary care, chronic disease management, and community-based health screening and disease prevention programs. EHRs will be key to providing the highest possible quality of care for the funds developing countries can commit to health care. Public, private, and academic partnerships can facilitate the development and implementation of EHRs in resource-constrained settings.

  6. Telemedicine as an innovative model for rebuilding medical systems in developing countries through multipartnership collaboration: the case of Albania.

    PubMed

    Latifi, Rifat; Dasho, Erion; Shatri, Zhaneta; Tilley, Elizabeth; Osmani, Kalterina L; Doarn, Charles R; Dogjani, Agron; Olldashi, Fatos; Koçiraj, Agim; Merrell, Ronald C

    2015-06-01

    The U.S. Government and other developed nations provide billions of dollars annually in relief assistance to countries around the world. The long-term benefits of this aid, however, are often difficult to elucidate. The aim of this article is to present a model of a multipartnership collaboration among U.S. governmental, nongovernmental organizations, and academia to rebuild medical systems using telemedicine as a sustainable model of foreign aid. The International Virtual e-Hospital implemented the "initiate-build-operate-transfer" strategy to establish an effective telemedicine system in Albania that includes the National Telemedicine Center and 12 regional telemedicine centers. This nationwide telemedicine network has active clinical programs, virtual educational programs, and an electronic library that has substantially improved the access to care while advancing medical education. We propose that telemedicine is an optimal, sustainable, low-cost model for rebuilding medical systems of developing countries when implemented through a multipartnership approach.

  7. Targeting burn prevention in Ukraine: evaluation of base knowledge in burn prevention and first aid treatment.

    PubMed

    Gamelli, Liza; Mykychack, Iryna; Kushnir, Antin; Driscoll, Daniel N; Fuzaylov, Gennadiy

    2015-01-01

    Burn prevention has been identified by the World Health Organization (WHO) as a topic in need of further investigation and education throughout the world, with an increased need in low-income countries. It has been noted that implementing educational programs for prevention in high income countries has aided in lowering the rate of burn injuries. The purpose of this study is to evaluate the current education level of knowledge of prevention and first aid treatment of scald burns. A prevention campaign will target these educational needs as a part of an outreach program to improve burn care in Ukraine. The research team evaluated the current health structure in Ukraine and how it could benefit from the increased knowledge of burn prevention and first aid. A test was designed to assess the baseline level of knowledge with regard to first aid and scald prevention in parents, pregnant woman, and healthcare and daycare providers. A total of 14,456 tests were sent to pediatric clinics, obstetrician clinics, and daycare facilities to test respondents. A total of 6,120 completed tests were returned. Doctors presented with the highest level of knowledge averaging 77.0% on prevention and 67.5% on first aid while daycare workers presented the largest gap in knowledge at 65.0% in prevention and 54.3% in first aid. Interest in further educational materials was reported by 92% of respondents. The results of this study clearly show a lack of knowledge in first aid and prevention of scald burn injury in all the populations tested.

  8. A workplace intervention program and the increase in HIV knowledge, perceived accessibility and use of condoms among young factory workers in Thailand.

    PubMed

    Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote

    2017-12-01

    Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.

  9. Factors influencing global antiretroviral procurement prices.

    PubMed

    Wirtz, Veronika J; Forsythe, Steven; Valencia-Mendoza, Atanacio; Bautista-Arredondo, Sergio

    2009-11-18

    Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

  10. Systematic Review of the Effectiveness of Mass Communication Programs to Change HIV/AIDS-Related Behaviors in Developing Countries

    ERIC Educational Resources Information Center

    Bertrand, Jane T.; O'Reilly, Kevin; Denison, Julie; Anhang, Rebecca; Sweat, Michael

    2006-01-01

    This review systematically examined the effectiveness of 24 mass media interventions on changing human immunodeficiency virus (HIV)-related knowledge, attitudes and behaviors. The intervention studies were published from 1990 through 2004, reported data from developing countries and compared outcomes using (i) pre- and post-intervention data, (ii)…

  11. Kenya AIDS Indicator Surveys 2007 and 2012: implications for public health policies for HIV prevention and treatment.

    PubMed

    Maina, William K; Kim, Andrea A; Rutherford, George W; Harper, Malayah; K'Oyugi, Boniface O; Sharif, Shahnaaz; Kichamu, George; Muraguri, Nicholas M; Akhwale, Willis; De Cock, Kevin M

    2014-05-01

    AIDS Indicator Surveys are standardized surveillance tools used by countries with generalized HIV epidemics to provide, in a timely fashion, indicators for effective monitoring of HIV. Such data should guide responses to the HIV epidemic, meet program reporting requirements, and ensure comparability of findings across countries and over time. Kenya has conducted 2 AIDS Indicator Surveys, in 2007 (KAIS 2007) and 2012-2013 (KAIS 2012). These nationally representative surveys have provided essential epidemiologic, sociodemographic, behavioral, and biologic data on HIV and related indicators to evaluate the national HIV response and inform policies for prevention and treatment of the disease. We present a summary of findings from KAIS 2007 and KAIS 2012 and the impact that these data have had on changing HIV policies and practice.

  12. 2016 RAD-AID Conference on International Radiology for Developing Countries: Gaps, Growth, and United Nations Sustainable Development Goals.

    PubMed

    Mollura, Daniel J; Soroosh, Garshasb; Culp, Melissa P

    2017-06-01

    The 2016 RAD-AID Conference analyzed the accelerated global activity in the radiology community that is transforming medical imaging into an effective spearhead of health care capacity building in low- and middle-income countries. Global health efforts historically emphasized disaster response, crisis zones, and infectious disease outbreaks. However, the projected doubling of cancer and cardiovascular deaths in developing countries in the next 15 years and the need for higher technology screening and diagnostic technologies in low-resource regions, as articulated by the United Nations' new Sustainable Development Goals of 2016, is heightening the role of radiology in global health. Academic US-based radiology programs with RAD-AID chapters achieved a threefold increase in global health project offerings for trainees in the past 5 years. RAD-AID's nonprofit radiology volunteer corps continue to grow by more than 40% yearly, with a volunteer base of 5,750 radiology professionals, serving in 23 countries, donating close to 20,000 pro bono hours globally in 2016. As a high-technology specialty interfacing with nearly all medical and surgical disciplines, radiology underpins vital health technology infrastructure, such as digital imaging archives, electronic medical records, and advanced diagnosis and treatment, essential for long-term future health care capacity in underserved areas of the world. Published by Elsevier Inc.

  13. Nurses' engagement in AIDS policy development.

    PubMed

    Richter, M S; Mill, J; Muller, C E; Kahwa, E; Etowa, J; Dawkins, P; Hepburn, C

    2013-03-01

    A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care. One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking. A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews. Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development. The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address gaps on the education, research and practice level. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

  14. Organ donation and transplantation-the Chennai experience in India.

    PubMed

    Shroff, S; Rao, S; Kurian, G; Suresh, S

    2007-04-01

    Tamil Nadu has been at the forefront of medical care in the country. It was the first state in the country that started a living kidney transplant program. It is also the first state to successfully start the cadaver programme after the passing of the "Transplantation of Human Organ Act" of 1994 and in the last 5 years has formed a network between hospitals for organ sharing. From the year 2000 to 2006 an organ sharing network was started in Tamil Nadu and the facilitator of this programme has been a non-government organization called MOHAN (acronym for Multi Organ Harvesting Aid Network) Foundation. The organs shared during the period number over 460 organs in two regions (both Tamil Nadu and Hyderabad). In Tamil Nadu the shared organs have included 166 Kidneys, 24 livers, 6 hearts, and 180 eyes. In 2003 sharing network was initiated by MOHAN in Hyderabad and to some extent the Tamil Nadu model was duplicated. with some success and 96 cadaver organs have been transplanted in the last 3 years. There are many advantages of organ sharing including the cost economics. At present there is a large pool of brain dead patients who could become potential organ donors in the major cities in India. Their organs are not being utilized for various support logistics. A multi-pronged strategy is required for the long term success of this program. These years in Tamil Nadu have been the years of learning, un-learning and relearning and the program today has matured slowly into what can perhaps be evolved as an Indian model. In all these years there have been various difficulties in its implementation and some of the key elements for the success of the program is the need to educate our own medical fraternity and seek their cooperation. The program requires trained counselors to be able to work in the intensive cares. The government's support is pivotal if this program to provide benefit to the common man. MOHAN Foundation has accumulated considerable experience to be able to evolve a model to take this program to the national level and more so as it recently has been granted 100% tax exemption on all donations to form a countrywide network for organ sharing.

  15. A Multi-Method Qualitative Study of a New Teacher Inservice Training Program to Improve Teaching in a Primary School

    ERIC Educational Resources Information Center

    James, Diann C.

    2017-01-01

    The purpose of this multi-method qualitative study was to collect data for a future development of an in-service training program for new teachers employed by Lake Forest Academy (pseudonym). New teachers of children with special educational needs faced challenges teaching in this Middle East country in addition to those faced by the new general…

  16. International Monetary Fund and aid displacement.

    PubMed

    Stuckler, David; Basu, Sanjay; McKee, Martin

    2011-01-01

    Several recent papers find evidence that global health aid is being diverted to reserves, education, military, or other sectors, and is displacing government spending. This is suggested to occur because ministers of finance have competing, possibly corrupt, priorities and deprive the health sector of resources. Studies have found that development assistance for health routed to governments has a negative impact on health spending and that similar assistance routed to private nongovernmental organizations has a positive impact. An alternative hypothesis is that World Bank and IMF macro-economic policies, which specifically advise governments to divert aid to reserves to cope with aid volatility and keep government spending low, could be causing the displacement of health aid. This article evaluates whether aid displacement was greater when countries undertook a new borrowing program from the IMF between 1996 and 2006. As found in existing studies, for each $1 of development assistance for health, about $0.37 is added to the health system. However, evaluating IMF-borrowing versus non-IMF-borrowing countries reveals that non-borrowers add about $0.45 whereas borrowers add less than $0.01 to the health system. On average, health system spending grew at about half the speed when countries were exposed to the IMF than when they were not. It is important to take account of the political economy of global health finance when interpreting data on financial flows.

  17. Sustainability of NGO capacity building in southern Africa: successes and opportunities.

    PubMed

    Humphries, Debbie; Gomez, Ligia; Hartwig, Kari

    2011-01-01

    Despite an increase in organizational capacity building efforts by external organizations in low and middle income countries, the documentation of these efforts and their effects on health programs and systems remains limited. This paper reviews key frameworks for considering sustainability of capacity building and applies these frameworks to an evaluation of the sustainability of an AIDS non-governmental organization (NGO) capacity building initiative. From 2004-2007 Bristol-Myers Squibb Foundation's Secure the Future(TM) initiative in southern Africa funded a five country program, the NGO Training Institute (NGOTI), to build capacity of NGOs working to address HIV/AIDS. Lessons learned from this project include issues of ownership, the importance of integrating planning for sustainability within capacity-building projects, and the value of identifying primary capacity-building objectives in order to select sustainability strategies that are focused on maintaining program benefits. Sustainability for capacity building projects can be developed by discussing key issues early in the planning process with all primary stakeholders. Copyright © 2010 John Wiley & Sons, Ltd.

  18. Blood, AIDS, and bureaucracy: the crisis and the tragedy.

    PubMed

    Schmidt, Paul J

    2011-10-01

    The politics of health were never tested more than when AIDS surfaced at the beginning of the 1980s in the industrialized nations. In those countries, it became the most important medical crisis of the last half of the 20th century. Today, the significance of AIDS remains as not only an unrelenting disease but also as a disease that continues to affect social and political life throughout the entire world. The connection between blood transfusion and AIDS is now under control in the industrialized countries but only because of lessons that took too long to learn over the past 25 years. That process had different roots and effects depending on the various national blood programs and policies in different countries. That is illustrated by comparing events in France, Japan, Canada, and the United States that differed in donor and patient populations and on decisions made and secrets kept. Some of the problems persist to this day in parts of the world. Overall, the lessons learned from what happened with blood early in the AIDS epidemic apply to other aspects of human disease and could help in facing the new problems that are sure to appear in the future. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Interventions to prevent HIV/AIDS among adolescents in less developed countries: are they effective?

    PubMed

    Magnussen, Lesley; Ehiri, John E; Ejere, Henry O D; Jolly, Pauline E

    2004-01-01

    The objective of this study was to summarize and critically assess the effects of interventions to prevent HIV/AIDS among adolescents in less developed countries. Reports of studies that evaluated interventions for preventing HIV/AIDS/STDs among persons aged 11-25 years were obtained from online computer databases, by searching conference proceedings and relevant journals, and by following up references cited in published reports. Studies were included if they investigated any educational, behavioral, psychosocial or other intervention that aimed to prevent or reduce HIV/AIDS/STD among persons aged 11-25 years in a less developed country. Only studies that included a control group, and which involved pre- and post-intervention assessments were included. Outcome measures included: (i) changes in safe sex practices (abstinence, condom use, limitation of sexual partners, avoidance of casual sex), (ii) knowledge about HIV/AIDS transmission and prevention methods, (iii) perception of HIV/AIDS/STD risks, (iv) self-efficacy with regard to condom negotiation and refusal of sex, (v) uptake of voluntary counseling and testing (VCT), and (vi) reduction in incidence of HIV/AIDS/STDs. Studies were assessed in terms of intervention format (e.g., education, role-play, video), duration, and setting (school or community). Reported improvements in outcome measures in intervention versus control groups were assessed. Sixteen studies met the inclusion criteria. Thirteen of these were conducted in Africa and three in Latin America. Twelve of the sixteen studies were school-based, and four were community-based. The interventions reviewed were not resoundingly successful in achieving their goals of increasing knowledge of HIV/AIDS, altering attitudes, improving negotiation and communication skills, or in influencing positive behavior evidenced through consistent condom use, abstinence, or reducing the number of partners. Considering the importance of HIV/AIDS prevention among adolescents, design of evaluation studies of programs in less developed countries need to be improved. The use of randomized controlled trials or other rigorous approaches for evaluating population-based behavioral interventions (e.g., Solomon Four design) is recommended.

  20. Evolution of antiretroviral drug costs in Brazil in the context of free and universal access to AIDS treatment.

    PubMed

    Nunn, Amy S; Fonseca, Elize M; Bastos, Francisco I; Gruskin, Sofia; Salomon, Joshua A

    2007-11-13

    Little is known about the long-term drug costs associated with treating AIDS in developing countries. Brazil's AIDS treatment program has been cited widely as the developing world's largest and most successful AIDS treatment program. The program guarantees free access to highly active antiretroviral therapy (HAART) for all people living with HIV/AIDS in need of treatment. Brazil produces non-patented generic antiretroviral drugs (ARVs), procures many patented ARVs with negotiated price reductions, and recently issued a compulsory license to import one patented ARV. In this study, we investigate the drivers of recent ARV cost trends in Brazil through analysis of drug-specific prices and expenditures between 2001 and 2005. We compared Brazil's ARV prices to those in other low- and middle-income countries. We analyzed trends in drug expenditures for HAART in Brazil from 2001 to 2005 on the basis of cost data disaggregated by each ARV purchased by the Brazilian program. We decomposed the overall changes in expenditures to compare the relative impacts of changes in drug prices and drug purchase quantities. We also estimated the excess costs attributable to the difference between prices for generics in Brazil and the lowest global prices for these drugs. Finally, we estimated the savings attributable to Brazil's reduced prices for patented drugs. Negotiated drug prices in Brazil are lowest for patented ARVs for which generic competition is emerging. In recent years, the prices for efavirenz and lopinavir-ritonavir (lopinavir/r) have been lower in Brazil than in other middle-income countries. In contrast, the price of tenofovir is US$200 higher per patient per year than that reported in other middle-income countries. Despite precipitous price declines for four patented ARVs, total Brazilian drug expenditures doubled, to reach US$414 million in 2005. We find that the major driver of cost increases was increased purchase quantities of six specific drugs: patented lopinavir/r, efavirenz, tenofovir, atazanavir, enfuvirtide, and a locally produced generic, fixed-dose combination of zidovudine and lamivudine (AZT/3TC). Because prices declined for many of the patented drugs that constitute the largest share of drug costs, nearly the entire increase in overall drug expenditures between 2001 and 2005 is attributable to increases in drug quantities. Had all drug quantities been held constant from 2001 until 2005 (or for those drugs entering treatment guidelines after 2001, held constant between the year of introduction and 2005), total costs would have increased by only an estimated US$7 million. We estimate that in the absence of price declines for patented drugs, Brazil would have spent a cumulative total of US$2 billion on drugs for HAART between 2001 and 2005, implying a savings of US$1.2 billion from price declines. Finally, in comparing Brazilian prices for locally produced generic ARVs to the lowest international prices meeting global pharmaceutical quality standards, we find that current prices for Brazil's locally produced generics are generally much higher than corresponding global prices, and note that these prices have risen in Brazil while declining globally. We estimate the excess costs of Brazil's locally produced generics totaled US$110 million from 2001 to 2005. Despite Brazil's more costly generic ARVs, the net result of ARV price changes has been a cost savings of approximately US$1 billion since 2001. HAART costs have nevertheless risen steeply as Brazil has scaled up treatment. These trends may foreshadow future AIDS treatment cost trends in other developing countries as more people start treatment, AIDS patients live longer and move from first-line to second and third-line treatment, AIDS treatment becomes more complex, generic competition emerges, and newer patented drugs become available. The specific application of the Brazilian model to other countries will depend, however, on the strength of their health systems, intellectual property regulations, epidemiological profiles, AIDS treatment guidelines, and differing capacities to produce drugs locally.

  1. Implementation and Utilization of Security Assistance: A Multi-Country Analysis

    DTIC Science & Technology

    2015-09-01

    related to this procurement (The Hague, 2012). The purchase of surplus Leopard battle tanks and other vehicles from Germany in 2012 confirmed a new... related programs NATO North Atlantic Treaty Organization NESA Near East South Asia OCO overseas contingency operations P&A price and...countries. B. RESEARCH QUESTIONS This project addresses several questions related to the implementation and use of security assistance programs. The

  2. A guide to federal-aid programs, projects, and other uses of highway funds

    DOT National Transportation Integrated Search

    2000-07-01

    This Guide, Volume 2 - Websites, is part of the International Guide to Highway Transportation Information, a multi-volume set of Guides that provide highway transportation information resources for domestic and international professionals. In this Vo...

  3. Assessing International Evaluations. An Example from USAID's Democracy and Governance Program

    ERIC Educational Resources Information Center

    Bollen, Kenneth; Paxton, Pamela; Morishima, Rumi

    2005-01-01

    Each year, hundreds of millions of dollars are spent in international and bilateral aid programs to assist developing countries in expanding democratic governance. Evaluating these efforts' effectiveness is important given the vast needs of the client population. This article reviews a sample of evaluations of the United States Agency for…

  4. Training and Further Training in the Federal Republic of Germany.

    ERIC Educational Resources Information Center

    Pakleppa, Hans

    The Federal Republic of Germany uses its development aid policy to support the growth of manpower resources in developing countries by means of a broad spectrum of training and further training programs of foreign specialists. In planning these programs and arranging scholarships, Germany tries to orient itself toward the educational policy…

  5. The KALI multi-arm robot programming and control environment

    NASA Technical Reports Server (NTRS)

    Backes, Paul; Hayati, Samad; Hayward, Vincent; Tso, Kam

    1989-01-01

    The KALI distributed robot programming and control environment is described within the context of its use in the Jet Propulsion Laboratory (JPL) telerobot project. The purpose of KALI is to provide a flexible robot programming and control environment for coordinated multi-arm robots. Flexibility, both in hardware configuration and software, is desired so that it can be easily modified to test various concepts in robot programming and control, e.g., multi-arm control, force control, sensor integration, teleoperation, and shared control. In the programming environment, user programs written in the C programming language describe trajectories for multiple coordinated manipulators with the aid of KALI function libraries. A system of multiple coordinated manipulators is considered within the programming environment as one motion system. The user plans the trajectory of one controlled Cartesian frame associated with a motion system and describes the positions of the manipulators with respect to that frame. Smooth Cartesian trajectories are achieved through a blending of successive path segments. The manipulator and load dynamics are considered during trajectory generation so that given interface force limits are not exceeded.

  6. Cross-country transferability of multi-variable damage models

    NASA Astrophysics Data System (ADS)

    Wagenaar, Dennis; Lüdtke, Stefan; Kreibich, Heidi; Bouwer, Laurens

    2017-04-01

    Flood damage assessment is often done with simple damage curves based only on flood water depth. Additionally, damage models are often transferred in space and time, e.g. from region to region or from one flood event to another. Validation has shown that depth-damage curve estimates are associated with high uncertainties, particularly when applied in regions outside the area where the data for curve development was collected. Recently, progress has been made with multi-variable damage models created with data-mining techniques, i.e. Bayesian Networks and random forest. However, it is still unknown to what extent and under which conditions model transfers are possible and reliable. Model validations in different countries will provide valuable insights into the transferability of multi-variable damage models. In this study we compare multi-variable models developed on basis of flood damage datasets from Germany as well as from The Netherlands. Data from several German floods was collected using computer aided telephone interviews. Data from the 1993 Meuse flood in the Netherlands is available, based on compensations paid by the government. The Bayesian network and random forest based models are applied and validated in both countries on basis of the individual datasets. A major challenge was the harmonization of the variables between both datasets due to factors like differences in variable definitions, and regional and temporal differences in flood hazard and exposure characteristics. Results of model validations and comparisons in both countries are discussed, particularly in respect to encountered challenges and possible solutions for an improvement of model transferability.

  7. PEPFAR Funding Associated With An Increase In Employment Among Males in Ten Sub-Saharan African Countries.

    PubMed

    Wagner, Zachary; Barofsky, Jeremy; Sood, Neeraj

    2015-06-01

    The President's Emergency Plan for AIDS Relief (PEPFAR) has provided billions of US tax dollars to expand HIV treatment, care, and prevention programs in sub-Saharan Africa. This investment has generated significant health gains, but much less is known about PEPFAR's population-level economic effects. We used a difference-in-differences approach to compare employment trends between ten countries that received a large amount of PEPFAR funding (focus countries) and eleven countries that received little or no funding (control countries). We found that PEPFAR was associated with a 13 percent differential increase in employment among males in focus countries, compared to control countries. However, we observed no change in employment among females. In addition, we found that increasing PEPFAR per capita funding by $100 was associated with a 9.1-percentage-point increase in employment among males. This rise in employment generates economic benefits equal to half of PEPFAR's cost. These findings suggest that PEPFAR's economic impact should be taken into account when making aid allocation decisions. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Global HIV/AIDS funding and health systems: Searching for the win-win.

    PubMed

    Levine, Ruth; Oomman, Nandini

    2009-11-01

    Donors, developing country governments, and NGOs are searching for ways to use funding for HIV/AIDS programs that strengthen the functioning of weak health systems. This is motivated both by the realization that a large share of donor funding for global health is and will continue to be dedicated to HIV/AIDS, and that the aims of more and better treatment, prevention, and care can be achieved only with attention to systemic capacities. For AIDS resources to strengthen health systems, decision makers should: (a) mitigate the risks that AIDS spending may weaken the ability of health systems to respond to other health problems; (b) find ways for procurement, supply chain, management information, and other systems that are created to support AIDS treatment to be broadened to serve other types of services; and (c) build upon the ways in which AIDS programs have overcome some demand-side barriers to use of services. In pursuing this agenda, donors should recognize that health system development is a function of the national and local political economy and place respect for national sovereignty as a central tenet of their policies and practices.

  9. Global HIV Prevention Programs for Long-Haul Truckers: Considerations for the U.S.

    ERIC Educational Resources Information Center

    Winkelman, Sloane Burke; Kimuna, Sitawa R.; Haithcox-Dennis, Melissa

    2012-01-01

    In the United States, an estimated 1.2 million people are living with HIV/AIDS, and approximately 50,000 new cases of HIV are diagnosed each year. Globally, it is estimated that 33.3 million people are living with HIV/AIDS. The role of mobile populations in the spread of STIs and HIV is well-documented in many countries around the world. Long-haul…

  10. Gates Foundation donates $25 million for AIDS vaccine.

    PubMed

    1999-05-07

    The International AIDS Vaccine Initiative (IAVI) received a $25 million five-year grant from Bill and Melinda Gates through the William H. Gates Foundation. This is the largest gift seen in the AIDS epidemic, and will allow IAVI to more than double vaccine development efforts. IAVI is currently developing two potential vaccines, hopes to study three others, and is working with the business community to insure that a successful vaccine is affordable in developing countries. With 16,000 new infections occurring daily, a vaccine is seen as the most effective way to stop the epidemic. The William H. Gates Foundation had donated $1.5 million to IAVI and $100 million for programs to speed the delivery of vaccines to children in poor countries. Internet addresses are included for both IAVI and the William H. Gates Foundation.

  11. Computer-aided decision making.

    Treesearch

    Keith M. Reynolds; Daniel L. Schmoldt

    2006-01-01

    Several major classes of software technologies have been used in decisionmaking for forest management applications over the past few decades. These computer-based technologies include mathematical programming, expert systems, network models, multi-criteria decisionmaking, and integrated systems. Each technology possesses unique advantages and disadvantages, and has...

  12. Program management aid for redundancy selection and operational guidelines

    NASA Technical Reports Server (NTRS)

    Hodge, P. W.; Davis, W. L.; Frumkin, B.

    1972-01-01

    Although this criterion was developed specifically for use on the shuttle program, it has application to many other multi-missions programs (i.e. aircraft or mechanisms). The methodology employed is directly applicable even if the tools (nomographs and equations) are for mission peculiar cases. The redundancy selection criterion was developed to insure that both the design and operational cost impacts (life cycle costs) were considered in the selection of the quantity of operational redundancy. These tools were developed as aids in expediting the decision process and not intended as the automatic decision maker. This approach to redundancy selection is unique in that it enables a pseudo systems analysis to be performed on an equipment basis without waiting for all designs to be hardened.

  13. Ten years of Developing International Volcanology Graduate Study Programs

    NASA Astrophysics Data System (ADS)

    Rose, W. I.

    2010-12-01

    In 2000 I reported at this symposium about multi-institutional graduate field trips to IAVCEI events, such as the Bali meeting and its importance in building international collegiality and awareness among the volcanology doctoral students. NSF was an enthusiastic supporter of these field sessions and this support has continued through the highly successful Pucon and Reykjavik sessions. International volcanology graduate program development began with several exchange programs. EHaz was a highly successful program (McGill, Simon Fraser, Michigan Tech, Buffalo, UNAM and Universidad de Colima) funded by the Department of Education (FIPSE) that moved students across North America where dozens of graduate students spent semesters of their study abroad and shared annual field trips and online student led graduate seminar classes. Michigan Tech’s volcanology graduate program started a Masters International program that combined Peace Corps service with hazards mitigation graduate study and students were placed by Peace Corps in countries with prominent natural hazards. The new program funded 2 year residences in foreign environments, principally in Pacific Latin America. NSF strongly supported this program from its inception, and eventually it gained NSF PIRE support. Dozens of students have initiated the 3 year program (15 completed) to date. A similar PIRE developed at UAF with a link to volcanology in the Russian Far East. One gain is the development of many socially-conscious research selections. Beginning this year transatlantic dual degree masters programs in volcanology are being offered by a consortium of US and European volcanology programs (Michigan Tech, Buffalo, Clermont Ferrand and University of Milan Bicocca), again aided by FIPSE funding. Students have dual advisors on both sides of the Atlantic and spend about half of their two year programs in Europe and half in US. Faculty also travel in the program and the four campuses are increasingly linked by coursework and research networks. Because the international developments of volcanology programs address the need for more robust coursework and research choices for students than are possible on one campus, and because they lead to a diverse network of professional contacts , we think the next decade will bring many more multi-university volcanology programs linked to field sites all over the world.

  14. A review of small canned computer programs for survey research and demographic analysis.

    PubMed

    Sinquefield, J C

    1976-12-01

    A variety of small canned computer programs for survey research and demographic analysis appropriate for use in developing countries are reviewed in this article. The programs discussed are SPSS (Statistical Package for the Social Sciences); CENTS, CO-CENTS, CENTS-AID, CENTS-AIE II; MINI-TAB EDIT, FREQUENCIES, TABLES, REGRESSION, CLIENT RECORD, DATES, MULT, LIFE, and PREGNANCY HISTORY; FIVFIV and SINSIN; DCL (Demographic Computer Library); MINI-TAB Population Projection, Functional Population Projection, and Family Planning Target Projection. A description and evaluation for each program of uses, instruction manuals, computer requirements, and procedures for obtaining manuals and programs are provided. Such information is intended to facilitate and encourage the use of the computer by data processors in developing countries.

  15. Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) case reporting in the World Health Organization European Region in 2006.

    PubMed

    Devaux, I; Alix, J; Likatavicius, G; Herida, M; Nielsen, S S; Hamers, F F; Nardone, A

    2008-09-25

    This article presents information on HIV and AIDS case reporting systems as part of a survey on HIV/AIDS surveillance practices in the World Health Organization (WHO) European Region. A standardised questionnaire was sent to the 53 national correspondents of the European Centre for the Epidemiological Monitoring of AIDS(EuroHIV). The HIV and AIDS case reporting section of the questionnaire comprised four parts: data collection system, HIV/AIDS case definition for surveillance, variables collected, and evaluation of surveillance systems). Individual-based data collection systems for HIV case reports have been implemented in 43 of 44 countries in the WHO European Region and for AIDS case reports in all the countries. For HIV case reports, a coded identifier is used in 28 countries, and full names are used in 11 countries. The European AIDS case definition has been adopted in 35 countries(80%). Information on molecular epidemiology is available in 30 countries, and HIV drug resistance is monitored in 11 countries.HIV/AIDS case reporting systems have been evaluated for underreporting in 17 countries and for completeness in 11 countries.This article outlines the future needs for HIV/AIDS surveillance and presents recommendations on how to improve data comparability across European countries in the WHO region.

  16. Sources of population and family planning assistance.

    PubMed

    1983-01-01

    This document assesses the current status of population and family planning assistance throughout the world and provides brief sketches of the available sources including national governments, intergovernmental agencies such as the UNFPA and other UN entities, and nongovernmental funding, technical assistance, or funding and technical assistance organizations. The descriptions of aid-granting organizations describe their purposes, sources of funding, and activities, and give addresses where further information may be sought. At present about $100 million of the US $1 billion spent for family planning in developing countries each year comes from individuals paying for their own supplies and services, over $400 million is spent by national governments on their own programs, and about $450 million comes from developed country governments and private agencies. Over half of external assistance appears to be channeled through international agencies, and only a few countries provide a substantial proportion of aid bilaterally. In the past decade several governments, particularly in Asia, significantly increased the share of program costs they assumed themselves, and the most populous developing countries, China, India, and Indonesia, now contribute most of the funding for their own programs. Although at least 130 countries have provided population aid at some time, most is given by 12 industrialized countries. The US Agency for International Development (USAID) is the largest single donor, but the US share of population assistance has declined to 50% of all assistance in 1981 from 60% in the early 1970s. Governments of Communist bloc countries have made only small contributions to international population assistance. Most governmental asistance is in cash grant form, but loans, grants in kind, and technical assistance are also provided. Private organizations give assistance primarily to other private organizations in developing countries, and have been major innovators in research, training and service delivery. Loan assistance is provided by the World Bank for combined health, nutrition, and population projects as well as poupulation education. Although international population assistance from donor governments and private organizations increased from about $165 million in 1971 to about $445 million in 1980, the increase in constant value was only about 10% after inflation. About 2/3 of international assistance goes to family planning services and contraceptives; other activities receiving support are basic data collection, research, and IEC. Greatly increased expenditures will be needed if population stability is to be achieved.

  17. Financing the response to HIV among gay men and other men who have sex with men: Case studies from eight diverse countries.

    PubMed

    Grosso, Ashley; Ryan, Owen; Tram, Khai Hoan; Baral, Stefan

    2015-01-01

    Despite reductions in the number of new HIV infections globally, the HIV epidemic among men who have sex with men (MSM) is expanding. This study characterises financing of HIV programmes for MSM and the impact of criminalisation on levels of funding, using data from five countries that criminalise same-sex sexual practices (Ethiopia, Mozambique, Guyana, India and Nigeria) and three that do not (China, Ukraine and Vietnam). For each country, all publicly available documents from the Global Fund to Fight AIDS, Tuberculosis and Malaria for approved HIV/AIDS grants in Rounds 5-9 and Country Operational Plans detailing investments made through the President's Emergency Plan for AIDS Relief (PEPFAR) from US fiscal year (FY) 2007-2009 were examined. Eleven of 20 HIV proposals to the Global Fund contained programmes for MSM totalling approximately $40 million or 6% of proposed budgets. In six countries providing activity-level data on MSM programming, PEPFAR funding that served this population and others ranged from $23.3 million in FY2007 to $35.4 million in FY2009, representing 0.5-25.9% of overall, non-treatment funding over this period. Countries that criminalise same-sex sexual practices spend fewer resources on HIV programmes serving MSM. However, they also show consistent underfunding of programmes serving MSM regardless of context or geography.

  18. [Innovative Programs in Adult Education: Foreign.

    ERIC Educational Resources Information Center

    World Education, Inc., New York, NY.

    The six descriptive position papers were prepared after selection for the Multi-National Workshop on Basic and Functional Education for Adults. Those selected are significant innovative programs of adult education in other countries that may have direct applicability to improving program practices in various parts of the world. The six programs…

  19. The United States President's Emergency Plan for AIDS Relief: a story of partnerships and smart investments to turn the tide of the global AIDS pandemic.

    PubMed

    Goosby, Eric; Dybul, Mark; Fauci, Anthony S; Fauci, Anthony A; Fu, Joe; Walsh, Thomas; Needle, Richard; Bouey, Paul

    2012-08-15

    The United States President's Emergency Plan for AIDS Relief (PEPFAR) has played a key leadership role in the global response to the HIV/AIDS pandemic. PEPFAR was inspired by the principles of the historic Monterrey Consensus (United Nations. Monterrey Consensus on Financing for Development, Monterrey, Mexico, March 18-22, 2002. New York: United Nations; 2002. Available at: http://www.un.org/esa/ffd/monterrey/MonterreyConsensus.pdf. Accessed April 21, 2012), which changed the underlying conceptual framework for international development, and therefore global health--a shift from paternalism to partnership that begins with country ownership and requires good governance, a results-based approach, and engagement of all sectors of society. PEPFAR began with a focus on the growing emergency of the HIV/AIDS pandemic by rapidly expanding HIV services, building clinical capacity, implementing strategic information systems, and building a coalition of partners to lead the response. Within the first years of implementation, there was a shift to sustainability, including the advent of Partnership Frameworks. The PEPFAR reauthorization in 2008 codified into law, the evolution in policies and programs for the next phase of implementation. In 2011 alone, PEPFAR supported nearly 4 million people on treatment, supported programs that provided more than 1.5 million HIV-positive pregnant women with antiretroviral drugs to prevent HIV transmission to their children, and supported HIV testing for more than 40 million people. This article provides an overview of how smart investments and partnerships across sectors and US agencies have helped achieve unprecedented results in increasing HIV/AIDS services and engaging partner countries and organizations in sharing the responsibility for an AIDS-free generation.

  20. Bidirectional multi-qubit quantum teleportation in noisy channel aided with weak measurement

    NASA Astrophysics Data System (ADS)

    Yang, Guang; Lian, Bao-Wang; Nie, Min; Jin, Jiao

    2017-04-01

    Not Available Project supported by the National Natural Science Foundation of China (Grant No. 61172071), the Scientific Research Program Funded by Shaanxi Provincial Education Department, China (Grant No. 16JK1711), the International Scientific Cooperation Program of Shaanxi Province, China (Grant No. 2015KW-013), and the Natural Science Foundation Research Project of Shaanxi Province, China (Grant No. 2016JQ6033).

  1. Factors influencing global antiretroviral procurement prices

    PubMed Central

    2009-01-01

    Background Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. Methods An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Results Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. Conclusion One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this. PMID:19922690

  2. China’s Foreign Aid and Government-Sponsored Investment Activities: Scale, Content, Destinations, and Implications

    DTIC Science & Technology

    2013-01-01

    Ecuador , Brazil, Chile, and Venezuela. Before 2005, many of the regional programs focused on infrastructure, including power plants...prior academic work on China’s pro- grams have focused on Africa and include Davies et al. and Brautigam. Both these provide detailed case studies...Chinese engage- ment there is concentrated on four resource-rich countries: Venezuela, Brazil, Argentina, and Ecuador . 26 China’s Foreign Aid and

  3. 1980 ASEAN programme roundup: a model in the making.

    PubMed

    1981-01-01

    Association of Southeast Asian Nations (ASEAN) experts and heads of national population programs held their 4th meeting in Singapore from November 24-28, 1980. Program heads resolved to take steps to link their national activities in the population field with those of the ASEAN Population Program and carry out studies and a joint programming exercise in 1981. Progress reports on the following Phase 1 projects were given: 1) integration of population and rural development policies and programs in ASEAN countries including Indonesia, Malaysia, Philippines, Singapore, and Thailand; 2) development of an inter-country modular training program for personnel in population and rural development; 3) multi-media support for population programs in the context of rural development in ASEAN countries; 4) utilization of research findings in population and family planning for policy formulation and program management in ASEAN countries; and 5) migration in relation to rural development. Phase 2 projects approved by ASEAN country participants were also discussed: 1) institutional development and exchange of personnel, 2) women in development, 3) developing and strengthening national population information systems and networks in ASEAN countries, 4) population and development dynamics and the man/resource balance, 5) studies on health and family planning in ASEAN countries, 6) population migration movement and development, and 7) development of ASEAN social indicators.

  4. Australia to fund HIV / AIDS projects in Southeast Asia.

    PubMed

    1994-12-19

    Australia will fund 23 new HIV-AIDS projects in Southeast Asian countries, the government announced. "Asia is predicted to be the major growth area for human immunodeficiency virus (HIV) infections over the next decade, " Minister for Development Cooperation Gordon Bilney said. "These projects, worth some $4.35 million over three years, will help meet the challenge of preventing the spread of the disease in the region." The projects--in Thailand, Vietnam, the Philippines, Indonesia, Malaysia and Cambodia--emphasize education and prevention activities as well as programs which focus on the care and support of people living with HIV, Bilney said. He also said a variety of Australian and overseas organizations will implement the projects, many of which will feature the significant involvement of communities at risk and people with HIV. "It is in keeping with the fundamental spirit of the aid program that we should seek to share this expertise with our neighbors in the region." Bilney said one Australian success story--the creative "Streetwize comics" (publications in Australia which help street kids and under privileged kids understand HIV/AIDS problems)--will be piloted in Vietnam in conjunction with the Vietnam Youth Federation. He said Vietnamese staff will be trained in the production of a series of bilingual mini-comics on HIV-AIDS prevention for youth. "This project will receive funding of $187,500 over three years," Bilney said. Bilney said the projects would help minimize the individual and social impact of the epidemic in the targeted countries. full text

  5. Management information systems in maternal and child health/family planning programs: a multi-country analysis.

    PubMed

    Keller, A

    1991-01-01

    A diagnosis was conducted of management information systems (MIS) for maternal and child health and family planning programs in 27 African, 5 Asian, and 8 Latin American and Caribbean countries. The diagnosis covered the collection and use of information on physical infrastructure, human resources, equipment/supplies, services provided, coverage attained, and program quality and impact. It was found that many programs do not produce certain basic input and output indicators and that even among those that do, information is too infrequently brought to bear on management decision-making. Constraints under which the MIS operate in these countries are identified, and some rudimentary calculations of what would be required to improve MIS functioning are made.

  6. Measures which host countries and countries of origin could adopt to promote the return of migrants.

    PubMed

    Debart, M H

    1986-03-01

    The immigration wave in the 1960s and 1970s brought scores of migrants to Europe. Most intended to work a few years in a foreign country and return to their homeland; however, poor economies in their own countries discouraged their return. At the same time, jobs became scarcer in their host countries. Several European countries today are resorting to measures designed to promote the return of migrants to their countries of origin. This paper outlines the two major options open to governments in their reintegration efforts. Option 1 requires instituting a definite reintegration policy. Public aid to promote reintegration may be provided. For example, the French give aid contingent upon the return of foreign workers in the labor force to the country of origin and not just upon their departure from the host country. Classical methods pay conpensation to the foreign worker; the problem then is to determine at what point to limit the funds. It must be decided whether or not unemployment benefits should be capitalized and whether or not to reimburse social security and old age contributions. It is also desirable for foreign workers to have access to a specialized organization which is able to advise them on setting up a project or business on their return; ideally, this organization should finance the project. Perhaps the best solution is to enlist participation of the governments of the countries of origin to make job openings known to their nationals desiring to return. Option 2 requires that reintegration be introduced into other economic and social programs. Returning foreign workers would be included as a factor in overall policy planning. Vocational training for return migrants could be proposed to job seekers as well as to dismissed workers. A portion of money used to finance housing projects could be earmarked for construction or reservation of housing in the country of origin. Bilateral vocational training programs can be addressed to nationals who want to return home. A portion of bilateral public development aid may also be used in support of reintegration projects. Finally, it should be possible to propose small development projects in the country of origin for nationals desiring to return.

  7. “The problem is ours, it is not CRAIDS’ ”. Evaluating sustainability of Community Based Organisations for HIV/AIDS in a rural district in Zambia

    PubMed Central

    2012-01-01

    Background While sustainability of health programmes has been the subject of empirical studies, there is little evidence specifically on the sustainability of Community Based Organisations (CBOs) for HIV/AIDS. Debates around optimal approaches in community health have centred on utilitarian versus empowerment approaches. This paper, using the World Bank Multi-Country AIDS Program (MAP) in Zambia as a case study, seeks to evaluate whether or not this global programme contributed to the sustainability of CBOs working in the area of HIV/AIDS in Zambia. Lessons for optimising sustainability of CBOs in lower income countries are drawn. Methods In-depth interviews with representatives of all CBOs that received CRAIDS funding (n = 18) and district stakeholders (n= 10) in Mumbwa rural district in Zambia, in 2010; and national stakeholders (n=6) in 2011. Results Funding: All eighteen CBOs in Mumbwa that received MAP funding between 2003 and 2008 had existed prior to receiving MAP grants, some from as early as 1992. This was contrary to national level perceptions that CBOs were established to access funds rather than from the needs of communities. Funding opportunities for CBOs in Mumbwa in 2010 were scarce. Health services: While all CBOs were functioning in 2010, most reported reductions in service provision. Home visits had reduced due to a shortage of food to bring to people living with HIV/AIDS and scarcity of funding for transport, which reduced antiretroviral treatment adherence support and transport of patients to clinics. Organisational capacity and viability: Sustainability had been promoted during MAP through funding Income Generating Activities. However, there was a lack of infrastructure and training to make these sustainable. Links between health facilities and communities improved over time, however volunteers’ skills levels had reduced. Conclusions Whilst the World Bank espoused the idea of sustainability in their plans, it remained on the periphery of their Zambia strategy. Assessments of need on the ground and accurate costings for sustainable service delivery, building on existing community strengths, are needed before projects commence. This study highlights the importance of enabling and building the capacity of existing CBOs and community structures, rather than creating new mechanisms. PMID:23192013

  8. Health aid and governance in developing countries.

    PubMed

    Fielding, David

    2011-07-01

    Despite anecdotal evidence that the quality of governance in recipient countries affects the allocation of international health aid, there is no quantitative evidence on the magnitude of this effect, or on which dimensions of governance influence donor decisions. We measure health-aid flows over 1995-2006 for 109 aid recipients, matching aid data with measures of different dimensions of governance and a range of country-specific economic and health characteristics. Everything else being equal, countries with more political rights receive significantly more aid, but so do countries with higher corruption levels. The dependence of aid on political rights, even when we control for other governance indicators, suggests that health aid is sometimes used as an incentive to reward political reforms. Copyright © 2010 John Wiley & Sons, Ltd.

  9. An appeal for large scale production of antiretroviral drugs in Africa

    PubMed Central

    Martial, Nkamedjie Pete Patrick; Sieleunou, Isidore

    2016-01-01

    The Acquired Immuno Deficiency Syndrome (AIDS) remains a major global public health challenge especially in Africa. The deadline set for the Millennium Development Goals (MDGs) has elapsed, meanwhile most low and middle income countries did not reach the targets. With regards to the fight against HIV / AIDS, many African countries show slow progress in implementing efficient and effective strategies to counter this pandemic. The fact that most HIV/AIDS programs in Sub-Saharan African countries are still very dependent on external funding to carry out their activities, including the supply of Antiretroviral Treatment (ART), highlights the concern of sustainability. So far, solutions that have been proposed are mainly symptomatic, claiming more budget commitment from government. Without rejecting this view, we call for the implementation of sustainable solutions to deal with the long term ART challenges. A way forward is to promote the establishment of an effective machinery for the manufacturing and large scale distribution of ART. In addition to the health gains, we argue that such an initiative would have a three-dimensional impact: (i) political, (ii) economic and (iii) social. PMID:28154710

  10. Effectiveness of a training program to increase the capacity of health care providers to provide HIV/AIDS care and treatment in Swaziland.

    PubMed

    Kamiru, H N; Ross, M W; Bartholomew, L K; McCurdy, S A; Kline, M W

    2009-11-01

    Implementation of HIV care and treatment programs in sub-Saharan Africa is a complex undertaking that requires training of health care providers (HCPs). Many sub-Saharan African countries have introduced training programs to build human resources for health. Evaluation of the ongoing trainings is warranted so that programs can be improved. The purpose of this study was to evaluate Baylor International Pediatric AIDS Initiative's (BIPAI) HCP training program in Swaziland. The specific aims were: (1) to assess coverage and delivery of the training program; and (2) to determine the impact of the training program on HCPs' knowledge about HIV and pediatric practices, attitudes toward HIV/AIDS patients, and self-efficacy to provide antiretroviral therapy (ART). The evaluation was a multimethod design with two types of data collection and analysis: (1) one-group pretest-posttest survey with 101 HCPs; and (2) semi-structured in-depth interviews with seven trainers from Baylor College of Medicine and 16 local HCPs in Swaziland. Quantitative data were analyzed using Stata Statistical Software version 8.2 for descriptive and multivariate analysis while factor analysis was done using Statistical Program for Social Sciences version 14. The transcribed interviews were analyzed using a didactic approach. Process evaluation showed that the training had good coverage, was delivered as intended, and improved as the work progressed. The training program led to a significant increase (p=0.0000) in HCPs' knowledge about HIV/AIDS, ART, and relevant clinical pediatrics practices between pretest (mean 68.7% SD 13.7) and post training (mean 84.0% SD 12.0). The training program also increased trainees' self-efficacy to provide ART and their attitudes toward AIDS patients (p=0.0000 and 0.02, respectively). In conclusion, BIPAI training program in Swaziland had good coverage of all health care facilities and HCPs in Swaziland. The training was effective in imparting knowledge and skills to HCPs and in their attitudes toward HIV/AIDS patients.

  11. [Is there risk of AIDS among adolescents?].

    PubMed

    Molina Cartes, R

    1988-01-01

    No data are as yet available on the information and attitudes of the adolescent population of Chile regarding AIDS. A survey of 800 adolescents aged 16-19 in Massachusetts, US, indicated that 29% had no knowledge of AIDS, 70% were sexually active, and 15% would not change their sex habits to avoid AIDS. A study in Santiago, Chile, showed that young people with the least information on sex and reproduction had the earliest initiation of sexual activity and the most frequent relations. Surveys throughout Latin America have indicated that a significant proportion of adolescents have active sex lives, leaving them potentially vulnerable to risk of sexually transmitted diseases. The risk is increased by frequent changes of partners among couples not yet strongly committed to each other. The World Health Organization considers prevention of sexually transmitted diseases to be one of the main objectives of family planning programs for adolescents. Studies in various countries found that proportion of sexually active adolescents who routinely used condoms was low. The evidence thus indicates that adolescents are at substantial risk of AIDS through their lack of information about AIDS, their significant sexual activity, and their failure to use condoms. Measures to combat or minimize the threat of AIDS among adolescents should begin with educational programs beginning with teachers and families. Efforts should be made to reach young people in the informal sector who are at greatest risk through community based programs.

  12. Decision support in vaccination policies.

    PubMed

    Piso, B; Wild, C

    2009-10-09

    Looking across boarders reveals that the national immunization programs of various countries differ in their vaccination schedules and decisions regarding the implementation and funding of new vaccines. The aim of this review is to identify decision aids and crucial criteria for a rational decision-making process on vaccine introduction and to develop a theoretical framework for decision-making based on available literature. Systematic literature search supplemented by hand-search. We identified five published decision aids for vaccine introduction and program planning in industrialized countries. Their comparison revealed an overall similarity with some differences in the approach as well as criteria. Burden of disease and vaccine characteristics play a key role in all decision aids, but authors vary in their views on the significance of cost-effectiveness analyses. Other relevant factors that should be considered before vaccine introduction are discussed to highly differing extents. These factors include the immunization program itself as well as its conformity with other programs, its feasibility, acceptability, and equity, as well as ethical, legal and political considerations. Assuming that the most comprehensive framework possible will not provide a feasible tool for decision-makers, we suggest a stepwise procedure. Though even the best rational approach and most comprehensive evaluation is limited by remaining uncertainties, frameworks provide at least a structured approach to evaluate the various aspects of vaccine implementation decision-making. This process is essential in making consistently sound decisions and will facilitate the public's confidence in the decision and its realization.

  13. Women at greater risk of HIV infection.

    PubMed

    Mahathir, M

    1997-04-01

    Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.

  14. HIV vaccines advocacy: the role of UNAIDS. Research and accessibility.

    PubMed

    Piot, P

    1996-01-01

    This article presents an interview with Dr. Peter Piot, executive director of the Joint UN Program on HIV/AIDS (UNAIDS) on the role of UNAIDS in the advocacy of HIV vaccines. Piot stressed that an efficient HIV vaccine, truly protective against HIV infection, could make all the difference in the campaign against AIDS. To this effect, the role of the UNAIDS is to carry out advocacy in favor of research as well as to collaborate with the diverse private initiatives that already exist. Commenting on the issue of guaranteed accessibility of HIV vaccine for developing countries, Piot states that it is possible to sell the product through seeking the support of donor organizations. When vaccine trials in a country are supported, it will also be made sure that the basic guarantees exist for making that product accessible to the population. Moreover, considering the impact of the pandemic on the business and economic community, Piot emphasized that alliance between the public and private sector is necessary in the struggle against AIDS. In general, the role of UNAIDS in the evaluation of a preventive vaccine for HIV is centered around communication, impact on community, and impact on prevention programs.

  15. Human Rights and the Global Fund to Fight AIDS, Tuberculosis and Malaria: How Does a Large Funder of Basic Health Services Meet the Challenge of Rights-Based Programs?

    PubMed

    Jürgens, Ralf; Csete, Joanne; Lim, Hyeyoung; Timberlake, Susan; Smith, Matthew

    2017-12-01

    The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to greatly expand access to basic services to address the three diseases in its name. From its beginnings, its governance embodied some human rights principles: civil society is represented on its board, and the country coordination mechanisms that oversee funding requests to the Global Fund include representatives of people affected by the diseases. The Global Fund's core strategies recognize that the health services it supports would not be effective or cost-effective without efforts to reduce human rights-related barriers to access and utilization of health services, particularly those faced by socially marginalized and criminalized persons. Basic human rights elements were written into Global Fund grant agreements, and various technical support measures encouraged the inclusion in funding requests of programs to reduce human rights-related barriers. A five-year initiative to provide intensive technical and financial support for the scaling up of programs to reduce these barriers in 20 countries is ongoing.

  16. Financial Aid and Students' College Decisions: Evidence from the District of Columbia Tuition Assistance Grant Program

    ERIC Educational Resources Information Center

    Abraham, Katharine G.; Clark, Melissa A.

    2006-01-01

    The District of Columbia Tuition Assistance Grant Program (DCTAG), instituted in 1999, allows D.C. residents to attend public colleges and universities throughout the country at considerably lower in-state tuition rates. We use the sharp decline in the price of public colleges and universities faced by D.C. residents to estimate the effects of…

  17. Delivering Improved Nutrition: Dairy Ingredients in Food Aid Products.

    PubMed

    Schlossman, Nina

    2016-03-01

    The United States has a long history of food assistance for humanitarian need. The Food for Peace Act of 1954 established the United States' permanent food assistance program which has fed over 3 billion people in 150 countries worldwide through thousands of partner organizations. In 60 years, the program has evolved and will continue to do so. Recently, the program has gone from a focus on quantity of food shipped to quality food assistance from improved products, programs, and processes to effectively meet the needs of different vulnerable groups. The current debate focuses on the appropriateness of using fortified blended foods to prevent and treat malnutrition during the first 1000 days of life. Dairy ingredients have been at the center of this debate; they were included initially in fortified blended, removed in the 1980s, and now reincorporated into fortified therapeutic and supplemental foods. Improved quality food baskets and effective nutrition programming to prevent and treat malnutrition were developed through multisectoral collaboration between government and nongovernment organizations. The US Agency for International Development has focused on improving nutrition through development programs often tied to health, education, and agriculture. The years since 2008 have been a particularly intense period for improvement. The Food Aid Quality Review was established to update current food aid programming products, program implementation, cost-effectiveness, and interagency processes. Trials are underway to harmonize the areas of multisectoral nutrition programming and gather more evidence on the effects of dairy ingredients in food aid products. © The Author(s) 2016.

  18. Navigation Constellation Design Using a Multi-Objective Genetic Algorithm

    DTIC Science & Technology

    2015-03-26

    programs. This specific tool not only offers high fidelity simulations, but it also offers the visual aid provided by STK . The ability to...MATLAB and STK . STK is a program that allows users to model, analyze, and visualize space systems. Users can create objects such as satellites and...position dilution of precision (PDOP) and system cost. This thesis utilized Satellite Tool Kit ( STK ) to calculate PDOP values of navigation

  19. Country watch. Brazil.

    PubMed

    Turra, M D

    1994-01-01

    Persons who are infected with human immunodeficiency virus (HIV) or who suffer from acquired immunodeficiency syndrome (AIDS) often have their civil rights violated in Brazil. To remedy this, the Candido Mendes College in Rio de Janeiro introduced a voluntary course, "AIDS - Legal Approaches", into its law curriculum. Incentive was provided by the college's Model Law Office (MLO), where students learn to defend the rights of people in need. Class size is about 25; law professors use recent magazine and newspaper articles, and documentation on lawsuits concerning persons with HIV to teach the class. Course topics include relevant civil law (suits against blood banks), contract law (suits against private health insurance companies which refuse to cover treatment expenses related to HIV or AIDS), family law, inheritance law, labor law (unjust dismissal of persons with HIV), criminal law (intentional transmission of AIDS), violations of basic human rights, and comparative jurisprudence and constitutional law (a comparison of Brazilian law in this area to the laws of other countries). Students, during their field practice periods at the MLO, provide legal assistance to persons with HIV. Approximately 150 cases have been handled, often with positive outcomes, to date. Clients hear about the program via television, radio, and newspapers. Materials and information about lawsuits handled by the MLO are available to other colleges and universities with the hope of stimulating the formation of similar programs elsewhere.

  20. "Young blood" to head new UN AIDS body.

    PubMed

    1995-01-01

    Dr. Peter Piot has been appointed to run the UN Joint and Co-sponsored Programme on HIV/AIDS, which replaces the Global Programme on AIDS (GPA). Dr. Piot's reputation as an excellent scientist with awareness of social issues makes him acceptable to both the medical and development communities. He became an Associate Director of the GPA in 1992; served as President of the International AIDS Society from 1991-1994; and, as Director of Research and Development, was responsible for the GPA's initiative on sexually transmitted disease (STD) control and for promotion of the development of vaginal microbicides. Before joining the GPA, he worked at the Institute of Tropical Medicine in Belgium, where he launched a series of African projects concerned with acquired immunodeficiency syndrome (AIDS). These included Zaire's SIDA, the first international project on AIDS in a developing country. The new program will unite the AIDS activities of 6 UN agencies: the World Health Organization (WHO), the UN Children's Fund (UNICEF), the UN Development Programme (UNDP), the UN Educational, Scientific, and Cultural Organization (UNESCO), the UN Family Population Fund (UNFPA), and the World Bank. Dr. Piot will report directly to the UN Secretary-General, Dr. Boutros Boutros-Ghali. The program should be fully operational by 1996 and will be run from Geneva. Its budget is expected to be the largest in the international AIDS arena, and its political clout should be greater than its predecessor. There will be fewer posts in the new program.

  1. The reach and impact of social marketing and reproductive health communication campaigns in Zambia.

    PubMed

    Van Rossem, Ronan; Meekers, Dominique

    2007-12-18

    Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact on condom use. This paper assesses the reach of selected radio and television programs about family planning and HIV/AIDS and of communications about the socially marketed Maximum condoms in Zambia, as well as their impact on condom use, using data from the 2001-2002 Zambia Demographic and Health Survey. To control for self-selection and endogeneity, we use a two-stage regression model to estimate the effect of program exposure on the behavioural outcomes. Those who were exposed to radio and television programs about family planning and HIV/AIDS were more likely to have ever used a condom (OR = 1.16 for men and 1.06 for women). Men highly exposed to Maximum condoms social marketing communication were more likely than those with low exposure to the program to have ever used a condom (OR = 1.48), and to have used a condom at their last sexual intercourse (OR = 1.23). Findings suggest that the reproductive health and social marketing campaigns in Zambia reached a large portion of the population and had a significant impact on condom use. The results suggest that future reproductive health communication campaigns that invest in radio programming may be more effective than those investing in television programming, and that future campaigns should seek to increase their impact among women, perhaps by focusing on the specific constrains that prevent females from using condoms.

  2. The expanding role of civil society in the global HIV/AIDS response: what has the President's Emergency Program For AIDS Relief's role been?

    PubMed

    Coutinho, Alex; Roxo, Uchechi; Epino, Henry; Muganzi, Alex; Dorward, Emily; Pick, Billy

    2012-08-15

    Civil society has been part of the HIV/AIDS response from the very beginning of the epidemic, often becoming engaged before national governments. Traditional roles of civil society--advocacy, activism, serving as government watchdog, and acting as community caretaker--have been critical to the response. In addition, civil society organizations (CSOs) play an integral part in providing world-class HIV prevention and treatment services and helping to ensure continuity of care. The President's Emergency Program for AIDS Relief (PEPFAR) has significantly increased the global scale-up of combination antiretroviral therapy reaching for more than 5 million people in developing countries, as well as implementation of effective evidence-based combination prevention approaches. PEPFAR databases in 5 countries and annual reports from a centrally managed initiative were mined and analyzed to determine the numbers and types of CSOs funded by PEPFAR over a 5-year period (2006-2011). Data are also presented from Uganda showing the overall resource growth in CSO working for HIV. Case studies document the evolution of 3 indigenous CSOs that increased the capacity to implement activities with PEPFAR funding. A legacy of PEPFAR has been the growth of civil society to address social and health issues as well as recognition by governments that partnerships with beneficiaries and civil society result in better outcomes. Scale-up of the global response could not have happened without the involvement of civil society and people living with HIV. This game changing partnership to jointly tackle the problems that countries face may well be the greatest benefit emerging from the HIV epidemic.

  3. The role of the Technical Review Panel of the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria: an analysis of grant recommendations.

    PubMed

    Schmidt-Traub, Guido

    2018-04-01

    The independent Technical Review Panel (TRP) of the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria is a unique mechanism to review funding proposals and to provide recommendations on their funding. Its functioning and performance have received little attention in the scientific literature. We aimed to identify predictors for TRP recommendations, whether these were in line with the Global Fund's ambition to give priority to countries most in need, and whether they correlated with grant performance. We combined data on proposals and applications under the Rolling Continuation Channel, TRP recommendations and grant implementation during the rounds-based mechanism (2002-2010) with country characteristics. Ordered logistic and OLS regressions were used to identify predictors for per-capita funding requests, TRP recommendations, Global Fund funding and grant performance ratings. We tested for financial suppression of large funding proposals and whether fragile or English-speaking countries performed differently from other countries. We found that funding requests and TRP recommendations were consistent with disease burden, but independent of other country characteristics. Countries with larger populations requested less funding per capita, but there is no evidence of financial suppression by the TRP. Proposals from fragile countries were as likely to be recommended as proposals from other countries, and resulting grants performed equally well except for lower performance of HIV/AIDS grants. English-speaking countries obtained more funding for TB and malaria than other countries. In conclusion, the independent TRP acted in line with the guiding principles of the Global Fund to direct funding to countries most in need without ex ante country allocation. The Global Fund appears to have promoted learning on how to design and implement large-scale programs in fragile and non-fragile countries. Other pooled financing mechanisms may consider TRP operating principles to generate high-quality demand, to promote learning and to direct resources to countries most in need.

  4. How have Global Health Initiatives impacted on health equity?

    PubMed

    Hanefeld, Johanna

    2008-01-01

    This review examines the impact of Global Health Initiatives (GHIs) on health equity, focusing on low- and middle-income countries. It is a summary of a literature review commissioned by the WHO Commission on the Social Determinants of Health. GHIs have emerged during the past decade as a mechanism in development assistance for health. The review focuses on three GHIs, the US President's Emergency Plan For AIDS Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria. All three have leveraged significant amounts of funding for their focal diseases - together these three GHIs provide an estimated two-thirds of external resources going to HIV/AIDS. This paper examines their impact on gender equity. An analysis of these Initiatives finds that they have a significant impact on health equity, including gender equity, through their processes of programme formulation and implementation, and through the activities they fund and implement, including through their impact on health systems and human resources. However, GHIs have so far paid insufficient attention to health inequities. While increasingly acknowledging equity, including gender equity, as a concern, Initiatives have so far failed to adequately translate this into programmes that address drivers of health inequity, including gender inequities. The review highlights the comparative advantage of individual GHIs, which point to an increased need for, and continued difficulties in, harmonisation of activities at country level. On the basis of this comparative analysis, key recommendations are made. They include a call for equity-sensitive targets, the collection of gender-disaggregated data, the use of policy-making processes for empowerment, programmes that explicitly address causes of health inequity and impact assessments of interventions' effect on social inequities.

  5. Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications.

    PubMed

    Kennedy, Stephen B; Johnson, Knowlton; Harris, Albert O; Lincoln, Adams; Neace, William; Collins, David

    2004-03-01

    The purpose of this preliminary study was to assess the HIV/AIDS prevention needs, services, and resources in Liberia, including the readiness of local providers to conduct HIV/AIDS-related prevention programs based on a set of six key dimensions (prevention needs, knowledge, leadership, environment, risky behaviors, and resources). A valid self-administered qualitative-based health survey, based on a community readiness model, was utilized as the primary data collection source. A cross-sectional design that utilized a convenient sample of key informants such as health coordinators, program directors, and health administrator from both public and private HIV/AIDS-based organizations was used. Furthermore, an extensive review of the National Library of Medicine database of published articles from mid-1980 to 2002 was simultaneously conducted to gauge the extent of scientific publications on HIV/AIDS-related prevention services in Liberia. The findings from this study strongly suggest that Liberia is in a stage of vague awareness, as defined by the Tri-Ethnic Center community readiness framework, regarding HIV/AIDS-related activities, including a significant lack of HIV/AIDS-related resources and scientific publications. Accordingly, there is a critical need to acquire adequate resources and build capacity to implement effective HIV/AIDS-related prevention programming services in order to avert the negative public health consequences associated with HIV/AIDS, including the implementation of relevant evaluation and dissemination strategies. Most importantly, this model has the potential to be utilized in other resource-constraint settings, especially in the developing world, to assess prevention-related resources and programmatic readiness. This is the first published study to evaluate Liberia's HIV/AIDS prevention resources and to systematically document the extent and magnitude of the HIV/AIDS crises in the country.

  6. Preventing AIDS in the developing world.

    PubMed

    Horton, R

    1993-06-12

    The World Health Organization (WHO) was criticized at the 9th International Conference on AIDS in Berlin by an ACT UP spokesman for lacking a coordinated strategy against HIV and AIDS. ACT UP further called for the implementation of networks of effective treatment and care programs in lieu of continued pilot projects, and urged the World Bank to write off loans to nations most jeopardized by AIDS. Dr. Dean Jamison of the Bank discounted the viability of such loan forgiveness on the basis of equity. Funding should instead come from developing countries with the help of developed nations, the private sector, and international bodies. Declining age at first intercourse has led to half of all HIV infections worldwide occurring among individuals under age 25 years; HIV spread among the young is the main driving force behind the pandemic. Professor Peter Piot of WHO emphasized the importance of focusing efforts on women; paying attention to nongovernmental organizations as a group which receives 15% of WHO country funding; and taking issue with those who claim that no HIV/AIDS epidemic exists in Africa. Coordinated action taken to provide condoms, treat sexually transmitted diseases, and eradicate HIV could prevent up to 4 million infections in Africa, 4 million in Asia, and 1 million in Latin America. The director of the WHO's Global Program on AIDS, Dr. Michael Merson, asserted that half of all new HIV infections predicted for the developing world for the rest of the decade could be prevented if another $1.5-2.9 billion annually were invested in nations' HIV prevention strategies. These investments would save $90 billion in health costs and lost economic activity by the end of the century. Such an outlay is minuscule next to the $49 billion cost to Kuwait of the military Operation Desert Storm.

  7. Management of Hearing Aid Assembly by Urban-Dwelling Hearing-Impaired Adults in a Developed Country

    PubMed Central

    Keidser, Gitte; Hartley, Lisa; Caposecco, Andrea; Hickson, Louise; Meyer, Carly

    2011-01-01

    A self-fitting hearing aid, designed to be assembled and programmed without audiological or computer support, could bring amplification to millions of people in developing countries, who remain unaided due to the lack of a local, professional, audiological infrastructure. The ability to assemble and insert a hearing aid is fundamental to the successful use of a self-fitting device. In this study, the management of such tasks was investigated. Eighty older, urban-dwelling, hearing-impaired adults in a developed country were asked to follow a set of written, illustrated instructions to assemble two slim-fit behind-the-ear hearing aids. Participants were allowed to access assistance with the task from an accompanying partner. A range of personal and audiometric variables was measured through the use of structured questionnaires and standardized tests of health literacy, cognitive function, and manual dexterity. The results showed that 99% of participants were able to complete the hearing aid assembly task, either on their own or with assistance. Health literacy, or the ability to read and understand health-related text, and gender most strongly influenced participants’ ability to complete the assembly task independently and accurately. Higher levels of health literacy were associated with an increased likelihood of independent and successful task completion. Male participants were more likely to complete the task on their own, while female participants were more likely to assemble the device without errors. The results of this study will inform future work regarding development of educational material for the self-fitting hearing aid as well as candidacy for such a device. PMID:22200734

  8. Targeting the SAVA (Substance Abuse, Violence and AIDS) Syndemic among Women and Girls: A Global Review of Epidemiology and Integrated Interventions

    PubMed Central

    Gilbert, Louisa; Raj, Anita; Hien, Denise; Stockman, Jamila; Terlikbayeva, Assel; Wyatt, Gail

    2016-01-01

    Objectives Multiple pathways link gender-based violence (GBV) to HIV and other sexually transmitted infections (STIs) among women and girls who use or inject drugs. The aim of this paper is to synthesize global literature that examines associations among the synergistic epidemics of substance abuse, violence and HIV/AIDS, known as the SAVA syndemic. It also aims to identify a continuum of multi-level integrated interventions that target key SAVA syndemic mechanisms. Methods We conducted a selective search strategy, prioritizing use of meta-analytic epidemiological and intervention studies that address different aspects of the SAVA syndemic among women and girls who use drugs worldwide from 2000–2015 using PubMed, MEDLINE, and Google Scholar. Results Robust evidence from different countries suggests that GBV significantly increases the risk of HIV and other STIs among women and girls who use drugs. Multiple structural, biological and behavioral mechanisms link GBV and HIV among women and girls. Emerging research has identified a continuum of brief and extended multi-level GBV prevention and treatment interventions that may be integrated into a continuum of HIV prevention, testing, and treatment interventions to target key SAVA syndemic mechanisms among women and girls who use drugs. Conclusion There remain significant methodological and geographical gaps in epidemiological and intervention research on the SAVA syndemic, particularly in low and middle-income countries. This global review underscores the need to advance a continuum of multi-level integrated interventions that target salient mechanisms of the SAVA syndemic, especially for adolescent girls, young women and transgender women who use drugs. PMID:25978478

  9. PEPFAR's evolving HIV prevention approaches for key populations--people who inject drugs, men who have sex with men, and sex workers: progress, challenges, and opportunities.

    PubMed

    Needle, Richard; Fu, Joe; Beyrer, Chris; Loo, Virginia; Abdul-Quader, Abu S; McIntyre, James A; Li, Zhijun; Mbwambo, Jessie K K; Muthui, Mercy; Pick, Billy

    2012-08-15

    In most countries, the burden of HIV among people who inject drugs, men who have sex with men, and sex workers is disproportionately high compared with that in the general population. Meanwhile, coverage rates of effective interventions among those key populations (KPs) are extremely low, despite a strong evidence base about the effectiveness of currently available interventions. In its first decade, President's Emergency Plan for AIDS Relief (PEPFAR) is making progress in responding to HIV/AIDS, its risk factors, and the needs of KPs. Recent surveillance, surveys, and size estimation activities are helping PEPFAR country programs better estimate the HIV disease burden, understand risk behavior trends, and determine coverage and resources required for appropriate scale-up of services for KPs. To expand country planning of programs to further reduce HIV burden and increase coverage among KPs, PEPFAR has developed a strategy consisting of technical documents on the prevention of HIV among people who inject drugs (July 2010) and prevention of HIV among men who have sex with men (May 2011), linked with regional meetings and assistance visits to guide the adoption and scale-up of comprehensive packages of evidence-based prevention services for KPs. The implementation and scaling up of available and targeted interventions adapted for KPs are important steps in gaining better control over the spread and impact of HIV/AIDS among these populations.

  10. High medicine prices and poor affordability.

    PubMed

    Suh, Guk-Hee

    2011-07-01

    In developing countries, most people who need medicines have to pay for them out of their own pockets. This review focuses on publications to explore the affordability gap of medicines and ways to close it. Cardiovascular medicines were unaffordable in low-income to middle-income countries, whereas dementia medicines were only affordable in regions of wealth. In urban Mozambique, local mark-ups are up to two-thirds of final price in private pharmacies, whereas some governments consistently paid higher prices above the international reference prices to procure a number of medicines. Generics competition from India made an originator brand manufacturer of a AIDS drug willing to supply the drug at a cheaper rate to poorer countries, whereas a Brazilian national program to produce nonprofit generics against protected patent of originator brand products to provide free AIDS drugs had cut the number of people dying by half and hospitalization by 80%, which saved about half a billion US dollars, making the program almost fund itself. Although lowering the manufacturer's price has a greater effect on the cost, policies to eliminate duties and taxes on medicines and regulate mark-ups are practical strategies to avoid excessive add-on costs.

  11. Female condom importance acknowledged in HIV prevention.

    PubMed

    1996-12-09

    The Female Health Co. (FHC), London, United Kingdom, has signed a three-year agreement with the Joint United Nations Program on HIV/AIDS (UNAIDS) to provide a global public sector price for the female condom to 193 affiliated countries. An adjunct education and social marketing program, supported by UNAIDS, will be launched. High rates of acceptance have been shown previously when the female condom has been introduced with an effective educational approach. Negotiations between FHC and UNAIDS began in September 1996; 80 of 193 countries, upon inquiry, have already identified a requirement for over 7 million female condoms in 1997. UNAIDS estimates that nearly 50% of new human immunodeficiency virus (HIV) infections are in women; the female condom is the only woman-controlled product providing protection against sexually transmitted diseases (STDs), including HIV and acquired immunodeficiency syndrome (AIDS). Studies have indicated that the number of unprotected sex acts decreases when the female condom is available. Dr. Peter Piot (UNAIDS) states that the female condom is important in those cultures and situations where women have limited control over sexual decisions. Dr. Mary Ann Leeper (FHC) states that the company is committed to making the female condom available in developing countries.

  12. Treatment and disease outcomes of migrants from low- and middle-income countries in the Australian HIV Observational Database cohort.

    PubMed

    Tilley, Donna M; Griggs, Elizabeth; Hoy, Jennifer; Wright, Stephen T; Woolley, Ian; Burke, Michael; O'Connor, Catherine C

    2015-01-01

    People from culturally and linguistically diverse backgrounds, including low- and middle-income countries, account for a third of new HIV diagnoses in Australia and are a priority for HIV prevention and treatment programs. We describe the demographic and clinical characteristics of participants in the Australian HIV Observational Database (AHOD) and compare disease outcomes, progression to AIDS and treatment outcomes of those born in low- and middle-income countries, with those born in high-income countries and Australia. All participants enrolled in AHOD sites where country of birth is routinely collected were included in the study. Age, CD4 count, HIV viral load, antiretroviral therapy, hepatitis co-infection, all-cause mortality and AIDS illness were analysed. Of 2403 eligible participants, 77.3% were Australian born, 13.7% born in high-income countries and 9.0% born in middle- or low-income countries. Those born in Australia or high-income countries were more likely to be male (96%) than those from middle- or low-income countries (76%), p < .0001 and more likely to have acquired HIV via male to male sexual contact (77%; 79%) compared with those from middle- or low-income countries (50%), p < .0001. At enrolment, mean CD4 cell count was higher in Australian born (528 cells/µL) than both those born in high-income countries (468 cells/µL) and those born in middle- and low-income countries (451 cells/µL), p < .0001; whereas the mean HIV RNA level (log10 copies/mL) was similar in all three groups (4.44, 4.76 and 4.26, respectively), p = .19.There was no difference in adjusted incidence risk ratios for all-cause mortality and AIDS incidence in all three groups, p = .39. These findings reflect successful outcomes of people born in low- and middle-income countries once engaged in HIV care.

  13. Treatment and disease outcomes of migrants from low- and middle-income countries in the Australian HIV Observational Database cohort

    PubMed Central

    Tilley, Donna M.; Griggs, Elizabeth; Hoy, Jennifer; Wright, Stephen T.; Woolley, Ian; Burke, Michael; O’Connor, Catherine C.

    2018-01-01

    People from culturally and linguistically diverse backgrounds, including low- and middle-income countries, account for a third of new HIV diagnoses in Australia and are a priority for HIV prevention and treatment programs. We describe the demographic and clinical characteristics of participants in the Australian HIV Observational Database (AHOD) and compare disease outcomes, progression to AIDS and treatment outcomes of those born in low- and middle-income countries, with those born in high-income countries and Australia. All participants enrolled in AHOD sites where country of birth is routinely collected were included in the study. Age, CD4 count, HIV viral load, antiretroviral therapy, hepatitis co-infection, all-cause mortality and AIDS illness were analysed. Of 2403 eligible participants, 77.3% were Australian born, 13.7% born in high-income countries and 9.0% born in middle- or low-income countries. Those born in Australia or high-income countries were more likely to be male (96%) than those from middle- or low-income countries (76%), p < .0001 and more likely to have acquired HIV via male to male sexual contact (77%; 79%) compared with those from middle- or low-income countries (50%), p < .0001. At enrolment, mean CD4 cell count was higher in Australian born (528 cells/µL) than both those born in high-income countries (468 cells/µL) and those born in middle- and low-income countries (451 cells/µL), p < .0001; whereas the mean HIV RNA level (log10 copies/mL) was similar in all three groups (4.44, 4.76 and 4.26, respectively), p = .19. There was no difference in adjusted incidence risk ratios for all-cause mortality and AIDS incidence in all three groups, p = .39. These findings reflect successful outcomes of people born in low- and middle-income countries once engaged in HIV care. PMID:26679270

  14. Parents and Federal Education Programs. Volume 1: The Nature, Causes, and Consequences of Parental Involvement. The Study of Parental Involvement.

    ERIC Educational Resources Information Center

    Melaragno, Ralph J.; And Others

    Intended to provide a comprehensive view of parental involvement in school districts receiving federal education funds, this study collected data on four federal programs in 57 projects across the country. Titles I and VII of the Elementary Secondary Education Act, the Emergency School Aid Act, and Follow Through were examined. The entire study is…

  15. A School Based Intervention for Combating Food Insecurity and Promoting Healthy Nutrition in a Developed Country Undergoing Economic Crisis: A Qualitative Study

    ERIC Educational Resources Information Center

    Dalma, A.; Veloudaki, A.; Petralias, A.; Mitraka, K.; Zota, D.; Kastorini, C.-M.; Yannakoulia, M.; Linos, A.

    2015-01-01

    Introduction: Aiming at reducing the rates of food insecurity and promoting healthy diet for children and adolescents, we designed and implemented the Program on Food Aid and Promotion of Healthy Nutrition-DIATROFI, a school-based intervention program including the daily provision of a free healthy mid-day meal in disadvantaged areas across…

  16. Human Rights and the Global Fund to Fight AIDS, Tuberculosis and Malaria

    PubMed Central

    Jürgens, Ralf; Lim, Hyeyoung; Timberlake, Susan; Smith, Matthew

    2017-01-01

    Abstract The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to greatly expand access to basic services to address the three diseases in its name. From its beginnings, its governance embodied some human rights principles: civil society is represented on its board, and the country coordination mechanisms that oversee funding requests to the Global Fund include representatives of people affected by the diseases. The Global Fund’s core strategies recognize that the health services it supports would not be effective or cost-effective without efforts to reduce human rights-related barriers to access and utilization of health services, particularly those faced by socially marginalized and criminalized persons. Basic human rights elements were written into Global Fund grant agreements, and various technical support measures encouraged the inclusion in funding requests of programs to reduce human rights-related barriers. A five-year initiative to provide intensive technical and financial support for the scaling up of programs to reduce these barriers in 20 countries is ongoing. PMID:29302175

  17. Impact of fortified blended food aid products on nutritional status of infants and young children in developing countries.

    PubMed

    Pérez-Expósito, Ana B; Klein, Barbara P

    2009-12-01

    Fortified blended foods were developed in the 1960s to improve the nutritional status of children suffering from malnutrition. The present review was conducted to examine the impact that fortified blended foods used in humanitarian relief programs have had on the health and nutritional status of infants and young children with moderate malnutrition, or at risk of undernutrition, in developing countries. Published articles were identified using electronic databases and general Web searches. Search terms included commodity types and names and terms related to food assistance and fortification programs. Positive effects on recovery from moderate acute malnutrition and weight gain were observed when fortified blended foods were distributed as dietary supplements. Prevention of severe micronutrient deficiencies in populations reliant on food aid has been reported, but measurements of micronutrient status have rarely been conducted. Evidence of the efficacy of fortified blended foods for improving nutritional outcomes is currently limited and weak.

  18. Badriye's story. Women's forum.

    PubMed

    Mallat, J

    1995-02-01

    Badriye is a 40-year-old woman who lives in a remote village in Lebanon. Following the death of her husband due to AIDS, Badriye and the youngest of her two sons were overwhelmingly rejected by the community. People would no longer even pass in front of their house. The eldest son took to carrying a certificate which attested to the HIV-seronegative status of he and his brother. That Badriye's husband was infected with HIV and died due to AIDS was determined only after he died. An HIV test found Badriye to also be HIV positive. Badriye decided to make her HIV serostatus public on national television in an effort to explain her grief and subsequent banishment from the community as well as the facts about HIV/AIDS. A television show was produced in which Badriye, her doctor, the village chief, and the entire community were invited to participate in open discussion before the cameras. People in the community greeted and kissed Badriye immediately after the filming. The national broadcast of the program 2 weeks later produced empathy for Badriye's plight and admiration of her courage. One year later, Badriye has reconciled with the community, but not her in-laws, and now faces the challenge of securing treatment for her infection in a country with no social security system. Also over the period, the numbers of HIV and AIDS cases in Lebanon increased rapidly and the government mandated premarital HIV testing. Anonymous free testing has never been available in the country. The author argues in the wake of this experience that journalism in Lebanon can do little to effect positive change with regard to the prevention of HIV/AIDS in the country because, unlike in other countries, there is no infrastructure currently in place which is capable of responding to public pressure for action.

  19. Promoting country ownership and stewardship of health programs: The global fund experience.

    PubMed

    Atun, Rifat; Kazatchkine, Michel

    2009-11-01

    The Global Fund to Fight AIDS, Tuberculosis and Malaria was established in 2002 to provide large-scale financing to middle- and low-income countries to intensify the fight against the 3 diseases. Its model has enabled strengthening of local health leadership to improve governance of HIV programs in 5 ways. First, the Global Fund has encouraged development of local capacity to generate technically sound proposals reflecting country needs and priorities. Second, through dual-track financing-where countries are encouraged to nominate at least one government and one nongovernment principal recipient to lead program implementation-the Global Fund has enabled civil society and other nongovernmental organizations to play a critical role in the design, implementation, and oversight of HIV programs. Third, investments to strengthen community systems have enabled greater involvement of community leaders in effective mobilization of demand and scale-up for services to reach vulnerable groups. Fourth, capacity building outside the state sector has improved community participation in governance of public health. Finally, an emphasis on inclusiveness and diversity in planning, implementation, and oversight has broadly enhanced country coordination capacity. Strengthening local leadership capacity and governance are critical to building efficient and equitable health systems to deliver universal coverage of HIV services.

  20. Technical and Political Assessment of Peaceful Nuclear Power Program Prospects in North Africa and the Middle East

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Windsor, Lindsay K.; Kessler, Carol E.

    An exceptional number of Middle Eastern and North African nations have recently expressed interest in developing nuclear energy for peaceful purposes. Many of these countries have explored nuclear research in limited ways in the past, but the current focused interest and application of resources towards developing nuclear-generated electricity and nuclear-powered desalination plants is unprecedented. Consequently, questions arise in response to this emerging trend: What instigated this interest? To what end(s) will a nuclear program be applied? Does the country have adequate technical, political, legislative, nonproliferation, and safety infrastructure required for the capability desired? If so, what are the next stepsmore » for a country in preparation for a future nuclear program? And if not, what collaboration efforts are possible with the United States or others? This report provides information on the capabilities and interests of 13 countries in the region in nuclear energy programs in light of safety, nonproliferation and security concerns. It also provides information useful for determining potential for offering technical collaboration, financial aid, and/or political support.« less

  1. Development of a computer program data base of a navigation aid environment for simulated IFR flight and landing studies

    NASA Technical Reports Server (NTRS)

    Bergeron, H. P.; Haynie, A. T.; Mcdede, J. B.

    1980-01-01

    A general aviation single pilot instrument flight rule simulation capability was developed. Problems experienced by single pilots flying in IFR conditions were investigated. The simulation required a three dimensional spatial navaid environment of a flight navigational area. A computer simulation of all the navigational aids plus 12 selected airports located in the Washington/Norfolk area was developed. All programmed locations in the list were referenced to a Cartesian coordinate system with the origin located at a specified airport's reference point. All navigational aids with their associated frequencies, call letters, locations, and orientations plus runways and true headings are included in the data base. The simulation included a TV displayed out-the-window visual scene of country and suburban terrain and a scaled model runway complex. Any of the programmed runways, with all its associated navaids, can be referenced to a runway on the airport in this visual scene. This allows a simulation of a full mission scenario including breakout and landing.

  2. Exploring the Potential Health Impact and Cost-Effectiveness of AIDS Vaccine within a Comprehensive HIV/AIDS Response in Low- and Middle-Income Countries

    PubMed Central

    Harmon, Thomas M.; Fisher, Kevin A.; McGlynn, Margaret G.; Stover, John; Warren, Mitchell J.; Teng, Yu; Näveke, Arne

    2016-01-01

    Background The Investment Framework Enhanced (IFE) proposed in 2013 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) explored how maximizing existing interventions and adding emerging prevention options, including a vaccine, could further reduce new HIV infections and AIDS-related deaths in low- and middle-income countries (LMICs). This article describes additional modeling which looks more closely at the potential health impact and cost-effectiveness of AIDS vaccination in LMICs as part of UNAIDS IFE. Methods An epidemiological model was used to explore the potential impact of AIDS vaccination in LMICs in combination with other interventions through 2070. Assumptions were based on perspectives from research, vaccination and public health experts, as well as observations from other HIV/AIDS interventions and vaccination programs. Sensitivity analyses varied vaccine efficacy, duration of protection, coverage, and cost. Results If UNAIDS IFE goals were fully achieved, new annual HIV infections in LMICs would decline from 2.0 million in 2014 to 550,000 in 2070. A 70% efficacious vaccine introduced in 2027 with three doses, strong uptake and five years of protection would reduce annual new infections by 44% over the first decade, by 65% the first 25 years and by 78% to 122,000 in 2070. Vaccine impact would be much greater if the assumptions in UNAIDS IFE were not fully achieved. An AIDS vaccine would be cost-effective within a wide range of scenarios. Interpretation Even a modestly effective vaccine could contribute strongly to a sustainable response to HIV/AIDS and be cost-effective, even with optimistic assumptions about other interventions. Higher efficacy would provide even greater impact and cost-effectiveness, and would support broader access. Vaccine efficacy and cost per regimen are critical in achieving cost-effectiveness, with cost per regimen being particularly critical in low-income countries and at lower efficacy levels. PMID:26731116

  3. Hotline in Egypt marks change in government attitude to AIDS.

    PubMed

    1995-10-01

    The first 24-hour AIDS hotline in the Arab world will open in Cairo, Egypt, in October 1995. The opening of the new service marks a change in attitude on the part of the Egyptian government, which has maintained a discreet AIDS control program in the past. Approval from religious leaders was necessary for the new program to begin; the United Nations Children's Fund (UNICEF) played a prominent role in negotiations. The "Counsel and Hot Line Centre," which will be based in Imbala district, will employ 19 people, including two doctors and two psychologists. The Centre was funded with US$300,000 from the Ford Foundation. Currently, 478 persons with HIV infections and 110 people with AIDS have been reported. The ministry estimates that there are 5000-7000 persons with HIV infections in Egypt. Although these figures were greeted with suspicion by organizations outside of Egypt, subsequent testing has indicated low prevalence rates for this country, despite high tourism and a large population of migrant workers.

  4. Building nursing and midwifery leadership capacity in the Pacific.

    PubMed

    Rumsey, M; Catling, C; Thiessen, J; Neill, A

    2017-03-01

    The Australian Award Fellowship Program aimed to strengthen nursing and midwifery leadership and capacity in developing countries in the Pacific. It is necessary to build an optimal global health workforce, and leadership and mentorship are central to this need. This is especially important in small island states such as the Pacific who have limited capacity and resources. This health system strengthening program addressed quality improvement in education, through the mentorship of potential nursing and midwifery leaders in the South Pacific Region. Program participants between 2013 and 2015 were interviewed. Data were audio-taped, transcribed and analysed thematically using an inductive process. Thirty-four nurses and midwives from 12 countries participated. There were four main themes arising from the data which were: having a country-wide objective, learning how to be a leader, negotiating barriers and having effective mentorship. Our study showed that participants deemed their mentorship from country leaders highly valuable in relation to completing their projects, networking and role modelling. Similar projects are described. The limitation of this study was its small size. There is a need to continue to build the momentum of the program and Fellows in each country in order to build regional networks. The Program has provided beneficial leadership education and mentorship for nurses and midwives from Pacific countries. It has provided a platform to develop quality improvement projects in line with national priorities. Global aid programs and the recipients of the program would benefit from comparable health strengthening approaches to nursing and midwifery in similar developing countries. © 2016 International Council of Nurses.

  5. Mapping an HIV/STD prevention curriculum for Zambian in-school settings.

    PubMed

    Mpofu, Elias; Lawrence, Frank; Ngoma, Mary Shilalukey; Siziya, Seter; Malungo, Jacob R S

    2008-04-01

    HIV/AIDS poses grave risk to human development in sub-Saharan Africa. Evidence-based interventions that are rooted in local culture could help efforts to prevent threats to human development from HIV/AIDS. We used concept mapping (Concept System, 2006 ) to construct the components and content of a locally developed HIV/AIDS curriculum for use by secondary schools in Lusaka, Zambia. Participants were school counsellors (n = 14), youth health program officers (n = 7), and regular education teachers (n = 3) from the education, health, and youth development agencies in Lusaka, Zambia (males = 11; females = 13; mean age 38; SD = 15 years). Concept mapping yielded six statement clusters defining preliminary components of a locally grounded in-school HIV/AIDS prevention curriculum and the content items that define these components: (1) life skills education (18 items), (2) sexuality and reproductive health (10 items), (3) treatment, care and support (13 items), (4) counselling (12 items), (5) basic facts about HIV/AIDS (11 items), and (6) dissemination of information about HIV/AIDS (11 items). Zambian locally constructed constructs for an HIV/STD prevention curriculum overlap those promoted by public health programs in the country and internationally.

  6. HIV among women in developing countries.

    PubMed

    Decarlo, P

    1999-01-01

    In South Africa, a pregnant woman infected with HIV took zidovudine to protect her fetus, but the child later developed HIV because the woman was not told about breast milk transmission. Women in developing countries have been hit hard by the AIDS epidemic because social inequalities that make it impossible for them to negotiate for safer sex or even to choose their sexual partners. In most developing countries, the only treatment women have access to is the zidovudine that is available only during their participation in clinical trials on prenatal transmission. Activists have expressed concern over programs that attempt to save the lives of babies with no regard for their mothers or other women. Women with HIV need access to health care, to information, and to counselors who can help them make choices. Women must be able to assess whether to risk breast feeding or attempt costly bottle feeding, which may lead to higher levels of infant mortality from bacteria in contaminated water. Women must also be educated so that they can protect their sexual health. In some settings, the topics of sex and sexuality still must be introduced into public discourse. Strong prevention programs are reducing HIV-infection rates among young women in parts of Tanzania, among pregnant women and prostitutes in Dakar, among prostitutes in Thailand and Nepal, and among street children in Brazil. Effective programs must consider AIDS a social issue and address education, equality, and information access.

  7. Involvement of the US Department of Defense in Civilian Assistance, Part I: a quantitative description of the projects funded by the Overseas Humanitarian, Disaster, and Civic Aid Program.

    PubMed

    Bourdeaux, Margaret Ellis; Lawry, Lynn; Bonventre, Eugene V; Burkle, Frederick M

    2010-03-01

    To review the history and goals of the US Department of Defense's largest civilian assistance program, the Overseas Humanitarian, Disaster and Civic Aid Program and to describe the number, geographic regions, years, key words, countries, and types of projects carried out under this program since 2001. Using the program's central database, we reviewed all approved projects since 2001 and tabulated them by year, combatant command, country, and key word. We also reviewed the project descriptions of projects funded between January 1, 2006, and February 9, 2008, and examined how their activities varied by combatant command and year. Of the 5395 projects in the database, 2097 were funded. Projects took place in more than 90 countries, with Southern, Pacific, and Africa Command hosting the greatest number. The most common types of projects were school, health, disaster response, and water infrastructure construction, and disaster-response training. The "global war on terror" was the key word most frequently tagged to project descriptions. Project descriptions lacked stated goals as well as implementation and coordination strategies with potential partners, and did not report outcome or impact indicators. The geographic reach of the program is vast and projects take place in a wide variety of public sectors. Yet their security and civilian assistance value remains unclear given the lack of stated project goals, implementation strategies, or measures of effectiveness. To facilitate transparency and policy discussion, we recommend project proposals include hypotheses as to how they will enhance US security, their relevance to the public sector they address, and outcome and impact indicators that can assess their value and effectiveness.

  8. Risk Perception of HIV/AIDS and Low Self-Control Trait: Explaining Preventative Behaviors Among Iranian University Students

    PubMed Central

    Esmaeilzadeh, Safooreh; Allahverdipour, Hamid; Fathi, Behrouz; Shirzadi, Shayesteh

    2016-01-01

    Background: In spite of developed countries there are progressive trend about HIV/AIDS and its’ aspects of transmission in the low socio-economic societies. The aim of this was to explain the youth's behavior in adopting HIV/AIDS related preventive behaviors in a sample of Iranian university students by emphasizing on fear appeals approaches alongside examining the role of self-control trait for explaining adoption on danger or fear control processes based on Extended Parallel Process Model (EPPM). Methods: A sample of 156 randomly selected university students in Jolfa, Iran was recruited in a predictive cross-sectional study by application of a researcher-designed questionnaire through self-report data collection manner. Sexual high risk behaviors, the EPPM variables, self-control trait, and general self-efficacy were measured as theoretical framework. Results: Findings indicated that 31.3% of participants were in the fear control process versus 68.7% in danger control about HIV/AIDS and also the presence of multi-sex partners and amphetamine consumption amongst the participants. Low self-control trait and low perceived susceptibility significantly were related to having a history of multi-sex partners while high level of self-efficacy significantly increased the probability of condom use. Conclusion: Findings of the study were indicative of the protective role of high level of self-control, perceived susceptibility and self-efficacy factors on youth's high-risk behaviors and their preventative skills as well. PMID:26573026

  9. What have we learned on costs and financing of routine immunization from the comprehensive multi-year plans in GAVI eligible countries?

    PubMed

    Brenzel, Logan

    2015-05-07

    Immunization is one of the most cost-effective health interventions, but as countries introduce new vaccines and scale-up immunization coverage, costs will likely increase. This paper updates estimates of immunization costs and financing based on information from comprehensive multi-year plans (cMYPs) from GAVI-eligible countries during a period when countries planned to introduce a range of new vaccines (2008-2016). The analysis database included information from baseline and 5-year projection years for each country cMYP, resulting in a total sample size of 243 observations. Two-thirds were from African countries. Cost data included personnel, vaccine, injection, transport, training, maintenance, cold chain and other capital investments. Financing from government and external sources was evaluated. All estimates were converted to 2010 US Dollars. Statistical analysis was performed using STATA, and results were population-weighted. Results pertain to country planning estimates. Average annual routine immunization cost was $62 million. Vaccines continued to be the major cost driver (51%) followed by immunization-specific personnel costs (22%). Non-vaccine delivery costs accounted for almost half of routine program costs (44%). Routine delivery cost per dose averaged $0.61 and the delivery cost per infant was $10. The cost per DTP3 vaccinated child was $27. Routine program costs increased with each new vaccine introduced. Costs accounted for 5% of government health expenditures. Governments accounted for 67% of financing. Total and average costs of routine immunization programs are rising as coverage rates increase and new vaccines are introduced. The cost of delivering vaccines is nearly equivalent to the cost of vaccines. Governments are financing greater proportions of the immunization program but there may be limits in resource scarce countries. Price reductions for new vaccines will help reduce costs and the burden of financing. Strategies to improve efficiency in service delivery should be pursued. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. E-Learning and Development: Lessons from Multi-Disciplinary Capacity Strengthening

    ERIC Educational Resources Information Center

    Babu, Suresh Chandra

    2014-01-01

    This paper documents the experience and lessons from implementing an e-learning program aimed at creating multidisciplinary research capacity. It presents a case study of bringing together a multidisciplinary group of professionals on-line to learn the skills needed to be a successful researcher in the context of HIV/AIDS and food security…

  11. Psychometric characteristics of process evaluation measures for a school-based childhood obesity prevention study: Louisiana Health

    USDA-ARS?s Scientific Manuscript database

    Process evaluations of large-scale school based programs are necessary to aid in the interpretation of the outcome data. The Louisiana Health (LA Health) study is a multi-component childhood obesity prevention study for middle school children. The Physical Education (PEQ), Intervention (IQ), and F...

  12. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases

    PubMed Central

    Hongoh, Valerie; Michel, Pascal; Gosselin, Pierre; Samoura, Karim; Ravel, André; Campagna, Céline; Cissé, Hassane Djibrilla; Waaub, Jean-Philippe

    2016-01-01

    The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration. PMID:27077875

  13. Financial Scandals and Student Loans

    ERIC Educational Resources Information Center

    Eisenberg, Meyer; Franke, Ann H.

    2007-01-01

    The investigations of student-loan programs around the country echo previous scandals in the financial world involving stock offerings and mutual funds. The relationships between lenders and financial-aid officers seem to raise the same questions about impropriety, conflict of interest, and possible fraud. Indeed, lessons from Wall Street can…

  14. Zena's Hope.

    ERIC Educational Resources Information Center

    Hartrich, Catherine

    2000-01-01

    Describes Frontiers of Justice as a program that acquaints educators with third world countries. Narrates one educator's trip to Ghana, where ethnic conflict, lack of education, and AIDS are prevalent. States that food distribution has been linked with education especially for girls; asserts that if girls are educated they will educate their…

  15. Educating for Sustainability in Developing Countries: The Need for Environmental Education Support.

    ERIC Educational Resources Information Center

    Hale, Monica

    1993-01-01

    The Earth Summit in Rio de Janeiro emphasized the need for both the developing and developed world to work toward sustainable development. This paper reviews environmental education, sustainable development, and environmental strategies for aid donors to integrate into their programs. (Author/MDH)

  16. Program characteristics of home-delivered meals programs for persons with HIV and AIDS.

    PubMed

    Balsam, A; Grant, N; Rogers, B L

    1996-02-01

    The nutritional status of persons with HIV and AIDS [PWAs] is constantly challenged throughout the progression of the illness. Home-delivered meals programs for PWAs are rapidly developing across the country to address this problem among the growing population of people with HIV infection and AIDS. This study examined client socio-demographic characteristics (sex, age, ethnicity), types of services offered by these programs, organizational and financial criteria, and characteristics of survey respondents. Data for this study was obtained from 15 of the 17 known home-delivered meals programs for PWAs in the United States through an original, cross-sectional survey instrument conducted by telephone interview between March 1994 and May 1994. Results from this study show an increase in the number of minority populations who participate in these programs (36% African-American and 12% Hispanic vs. 51% Caucasian), as well as women (17.2%) and children (7%). Geographic location was an important determinant for program eligibility. The number of meals served weekly varied greatly (from 510 to 12,600 per week). Other significant services included nutrition counselling, newsletters, and holiday-basket programs. Enhancing service-delivery systems was one of the more prevalent "high-priority" concerns cited, especially with regard to food quality and safety. These results show that these programs are catering increasingly to minority populations, women and children, and that they are expanding their services to meet the growing needs of their client populations. These findings suggest that there is a greater need for meals and other home-based services for persons living with HIV and AIDS.

  17. SADC establishes a regional action plan.

    PubMed

    Klouda, T

    1997-02-01

    The regional meeting held on AIDS strategy in Lilongwe, Malawi, in December, 1996, made important advances. The 12 countries of the SADC (Southern Africa Development Community) joined the European Union to institute a regional action plan for the reduction of susceptibility of people to HIV because of social, cultural, and environmental factors; the vulnerability of people with HIV infection to social and other difficulties; and the vulnerability of institutions because of the foregoing impacts. At the conference the issues explored were employment, mining, medical drugs, education, and tourism. An employment charter was seen as crucial for the success of AIDS and workplace activities. Facilitation of travel across borders was important for the reduction of susceptibility to HIV infection. Enhancement of regional policies for essential drugs was vital for drugs for the treatment of AIDS. The clarification of the regional role was critical for regional support of national action (strengthening technical and institutional capacities) and for regional joint action such as studies on research, harmonization of data collection on HIV/AIDS; organization of training; development of information and education on HIV/AIDS; facilitation of manufacturing of drugs and condoms; and the development of a regional information and education program about HIV/AIDS. The conference also clarified HIV/AIDS programs in relation to other health and socioeconomic problems.

  18. HIV prevention in Africa: programs and populations served by non-governmental organizations.

    PubMed

    Benotsch, Eric G; Stevenson, L Yvonne; Sitzler, Cheryl A; Kelly, Jeffrey A; Makhaye, Gethwana; Mathey, Eric Dodji; Somlai, Anton M; Brown, Kevin D; Amirkhanian, Yuri; Fernandez, M Isabel; Opgenorth, Karen M

    2004-08-01

    The AIDS epidemic in Africa remains an urgent health crisis. Non-governmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services and assistance to persons living with AIDS. African NGOs are conducting numerous HIV prevention programs with several at-risk populations, yet their efforts have only rarely been systematically documented. To address this gap in the literature, the authors surveyed one NGO in each of 29 African countries regarding their HIV prevention activities and populations served. This report provides details concerning HIV prevention activities across the continent and describes in detail innovative programs from Togo and South Africa. NGOs in the present sample operate with modest budgets and small staff sizes, yet conduct programs that reach large segments of their communities. NGOs were most likely to report community-level interventions such as peer-education or community outreach. Faced with an epidemic where the main transmission occurs via heterosexual activity, African NGOs were most likely to direct their attention to the general public and to youth. NGOs in Africa are struggling to implement sustainable, cost-effective programs with few resources. Strengthening the infrastructure and capacity of these key agencies is crucial to fighting the AIDS epidemic in Africa.

  19. Efforts to secure universal access to HIV/AIDS treatment: a comparison of BRICS countries.

    PubMed

    Sun, Jing; Boing, Alexandra Crispim; Silveira, Marysabel P T; Bertoldi, Andréa D; Ziganshina, Liliya E; Khaziakhmetova, Veronica N; Khamidulina, Rashida M; Chokshi, Maulik R; McGee, Shelley; Suleman, Fatima

    2014-02-01

    This article illustrates how the BRICS countries have been building their focused leadership, making important high level commitment and national policy changes, and improving their health systems, in addressing the HIV/AIDS epidemics in respective settings. Specific aspects are focused on efforts of creating public provisions to secure universal access to ARVs from the aspects of active responsive system and national program, health system strengthening, fostering local production of ARVs, supply chain management, and information system strengthening. Challenges in each BRICS country are analyzed respectively. The most important contributors to the success of response to HIV/AIDS include: creating legal basis for healthcare as a fundamental human right; political commitment to necessary funding for universal access and concrete actions to secure equal quality care; comprehensive system to secure demands that all people in need are capable of accessing prevention, treatment and care; active community involvement; decentralization of the management system considering the local settings; integration of treatment and prevention; taking horizontal approach to strengthen health systems; fully use of the TRIPS flexibility; and regular monitoring and evaluation to serve evidence based decision making. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  20. Agroforestry In-Service Training. A Training Aid for Asia & the Pacific Islands (Honiara, Solomon Islands, South Pacific, October 23-29, 1983). Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-16.

    ERIC Educational Resources Information Center

    Fillion, Jacob; Weeks, Julius

    The Forestry/Natural Resources Sector in the Office of Training and Program Support of the Peace Corps conducted an agroforestry inservice training workshop in Honiara, Solomon Islands, in 1983. Participants included Peace Corps volunteers and their host country national counterparts from six countries of the Pacific Islands and Asia (Western…

  1. Disaster Risk Transfer for Developing Countries

    NASA Astrophysics Data System (ADS)

    Linneroothbayer, J.; Mechler, R.; Pflug, G.; Hochrainer, S.

    2005-12-01

    Financing disaster recovery often diverts resources from development, which can have long-term effects on economic growth and the poor in developing countries. Moreover, post-disaster assistance, while important for humanitarian reasons, has failed to meet the needs of developing countries in reducing their exposure to disaster risks and assuring sufficient funds to governments and individuals for financing the recovery process. The authors argue that part of disaster aid should be refocused from post-disaster to pre-disaster assistance including financial disaster risk management. Such assistance is now possible with new modeling techniques for estimating and pricing risks of natural disasters coupled with the advent of novel insurance instruments for transferring catastrophe risk to the global financial markets. The authors illustrate the potential for risk transfer in developing countries using the IIASA CATSIM model, which shows the potential impacts of disasters on economic growth in selected developing countries and the pros and cons of financial risk management to reduce those adverse impacts. The authors conclude by summarizing the advantages of investing in risk-transfer instruments (coupled with preventive measures) as an alternative to traditional post-disaster donor assistance. Donor-supported risk-transfer programs would not only leverage limited disaster aid budgets, but would also free recipient countries from depending on the vagaries of post-disaster assistance. Both the donors and the recipients stand to gain, especially since the instruments can be designed to encourage preventive measures. Precedents already exist for imaginative risk-transfer programs in highly exposed developing countries, including national insurance systems, micro-insurance schemes like weather derivatives and novel instruments (e.g., catastrophe bonds) to provide insurance cover for public sector risks.

  2. Levels of Spending and Resource Allocation to HIV Programs and Services in Latin America and the Caribbean

    PubMed Central

    Arán-Matero, Daniel; Amico, Peter; Arán-Fernandez, Christian; Gobet, Benjamin; Izazola-Licea, José Antonio; Avila-Figueroa, Carlos

    2011-01-01

    Background An estimated 1.86 million people are living with HIV in Latin America and the Caribbean (LAC). The region is comprised of mainly middle-income countries with steady economic growth while simultaneously there are enormous social inequalities and several concentrated AIDS epidemics. This paper describes HIV spending patterns in LAC countries including analysis of the levels and patterns of domestic HIV spending from both public and international sources. Methods and Findings We conducted an extensive analysis of the most recently available data from LAC countries using the National AIDS Spending Assessment tool. The LAC countries spent a total of US$ 1.59 billion on HIV programs and services during the latest reported year. Countries providing detailed information on spending showed that high percentages are allocated to treatment and care (75.1%) and prevention (15.0%). Domestic sources accounted for 93.6 percent of overall spending and 79 percent of domestic funds were directed to treatment and care. International funds represented 5.4 percent of total HIV funding in the region, but they supplied the majority of the effort to reach most-at-risk-populations (MARPs). However, prevalence rates among men who have sex with men (MSM) still reached over 25 percent in some countries. Conclusions Although countries in the region have increasingly sustained their response from domestic sources, still there are future challenges: 1) The growing number of new HIV infections and more people-living-with-HIV (PLWH) eligible to receive antiretroviral treatment (ART); 2) Increasing ART coverage along with high prices of antiretroviral drugs; and 3) The funding for prevention activities among MARPs rely almost exclusively on external donors. These threats call for strengthened actions by civil society and governments to protect and advance gains against HIV in LAC. PMID:21799839

  3. National HIV/AIDS mortality, prevalence, and incidence rates are associated with the Human Development Index.

    PubMed

    Lou, Li-Xia; Chen, Yi; Yu, Chao-Hui; Li, You-Ming; Ye, Juan

    2014-10-01

    HIV/AIDS is a worldwide threat to human health with mortality, prevalence, and incidence rates varying widely. We evaluated the association between the global HIV/AIDS epidemic and national socioeconomic development. We obtained global age-standardized HIV/AIDS mortality, prevalence, and incidence rates from World Health Statistics Report of the World Health Organization. The human development indexes (HDIs) of 141 countries were obtained from a Human Development Report. Countries were divided into 4 groups according to the HDI distribution. We explored the association between HIV/AIDS epidemic and HDI information using Spearman correlation analysis, regression analysis, and the Kruskal-Wallis test. HIV/AIDS mortality, prevalence, and incidence rates were inversely correlated with national HDI (r = -0.675, -0.519, and -0.398, respectively; P < .001), as well as the 4 indicators of HDI (ie, life expectancy at birth, mean years of schooling, expected years of schooling, and gross national income per capita). Low HDI countries had higher HIV/AIDS mortality, prevalence, and incidence rates than that of medium, high, and very high HDI countries. Quantile regression results indicated that HDI had a greater negative effect on the HIV/AIDS epidemic in countries with more severe HIV/AIDS epidemic. Less-developed countries are likely to have more severe HIV/AIDS epidemic. There is a need to pay more attention to HIV/AIDS control in less-developed countries, where lower socioeconomic status might have accelerated the HIV/AIDS epidemic more rapidly. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. HIV / AIDS, STDs and the workplace.

    PubMed

    Jackson, H

    1995-01-01

    Even though the workplace is ideal for promoting HIV/STD (sexually transmitted disease) prevention to benefit workers and employers, many workplaces are not convinced that they should be involved in HIV/AIDS and STD education, prevention, and support. They do not realize that time and money spent on health programs save them money. Perhaps they do not feel obligated to protect the health of their employees. The AIDS epidemic adversely affects society and the economy at both the macro and micro level. AIDS tends to strike the productive age group, thereby seriously affecting the workplace. In many Sub-Saharan African countries, at least 20% of the urban workforce may be infected with HIV. Persons living with HIV include top management, skilled professionals, general hands, and farm laborers. HIV/AIDS costs for formal employment are assumed through reduced productivity; increased costs of occupational benefits and social security measures; loss of skilled labor, professionals, and managerial expertise as well as the experience among workers; increased costs of training and recruitment; and low morale from stigmatization, discrimination, and subsequent industrial relation problems. Needed are comprehensive HIV/AIDS and STD workplace programs that ensure the rights of persons with HIV and compassionate treatment of these persons. Trade union or other labor representatives, management, and appropriate government departments should work together and build on existing health legislation and policy to bring about effective negotiation and policy development concerning AIDS and employment. Training of peer educators, support services (counseling, STD referral and/or treatment), community action, management commitment, monitoring and evaluation, and supportive workplace conditions make for effective comprehensive workplace programs. Successful programs operate in fishing villages in Tanzania, tea plantations in India, the University of Papua New Guinea, and Ugandan army camps.

  5. Getting to Know Nature: Evaluating the Effects of the Get to Know Program on Children's Connectedness with Nature

    ERIC Educational Resources Information Center

    Bruni, Coral M.; Winter, Patricia L.; Schultz, P. Wesley; Omoto, Allen M.; Tabanico, Jennifer J.

    2017-01-01

    People in industrialized countries may be losing their connection with nature. The Get to Know Program (Get to Know) is a multi-faceted program aimed at encouraging direct connection with nature through a variety of activities (observations of wildlife, hiking, creative arts, and special events), specifically among youth. Three studies assessed…

  6. Vulnerable to HIV / AIDS. Migration.

    PubMed

    Fernandez, I

    1998-01-01

    This special report discusses the impact of globalization, patterns of migration in Southeast Asia, gender issues in migration, the links between migration and HIV/AIDS, and spatial mobility and social networks. Migrants are particularly marginalized in countries that blame migrants for transmission of infectious and communicable diseases and other social ills. Effective control of HIV/AIDS among migrant and native populations requires a multisectoral approach. Programs should critically review the privatization of health care services and challenge economic models that polarize the rich and the poor, men and women, North and South, and migrant and native. Programs should recognize the equality between locals and migrants in receipt of health services. Countermeasures should have input from migrants in order to reduce the conditions that increase vulnerability to HIV/AIDS. Gender-oriented research is needed to understand women's role in migration. Rapid assessment has obscured the human dimension of migrants' vulnerability to HIV. Condom promotion is not enough. Migration is a major consequence of globalization, which holds the promise, real or imagined, of prosperity for all. Mass migration can be fueled by explosive regional developments. In Southeast Asia, migration has been part of the process of economic development. The potential to emigrate increases with greater per capita income. "Tiger" economies have been labor importers. Safe sex is not practiced in many Asian countries because risk is not taken seriously. Migrants tend to be used as economic tools, without consideration of social adjustment and sex behavior among singles.

  7. How was the UNAIDS drug access initiative implemented in Chile?

    PubMed Central

    Brousselle, Astrid; Champagne, François

    2012-01-01

    In 1997, UNAIDS decided to implement Drug Access Initiatives (DAI) in four different pilot-countries. We studied the implementation of the DAI in Chile as part of the evaluation program conducted by the ‘Agence Nationale de Recherche sur le SIDA’ (ANRS/France). The objective was to understand how the politico-organizational dynamic influenced the implementation process of the DAI. Approximately 50 semi-directed interviews and observation activities were conducted with the actors who participated in the implementation of the DAI or who played a role in the HIV/AIDS context. The program theory models were established and their evolution analyzed. This article offers an original analysis of an international HIV/AIDS drug access program that was put in place at a time when such programs were seen as a priority by international and governmental institutions. It also offers some insights for the creation of international projects that will be locally implemented. PMID:23230344

  8. World Bank oil-pipeline project designed to prevent HIV transmission.

    PubMed

    Kigotho, A W

    1997-11-29

    A World Bank-funded oil pipeline project, in Chad and Cameroon, is the first large-scale construction project in sub-Saharan Africa to incorporate an HIV/AIDS prevention component. The project entails the development of oil fields in southern Chad and construction of 1100 km of pipeline to port facilities on Cameroon's Atlantic coast. 3000 construction workers from the two countries will be employed between 1998 and 2001, including about 600 truck drivers. In some areas along the pipeline route, 50% of the prostitutes (who are frequented by truck drivers) are HIV-infected. The HIV/AIDS intervention aims to prevent HIV and sexually transmitted diseases (STDs) among project workers through social marketing of condoms, treatment of STDs in prostitutes along the route, and health education to modify high-risk behaviors. The program is considered a test case for African governments and donors interested in whether the integration of a health component in major construction projects can avoid AIDS epidemics in affected countries.

  9. The effects of HIV/AIDS on economic growth and human capitals: a panel study evidence from Asian countries.

    PubMed

    Roy, Shongkour

    2014-01-01

    Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) affects economic growths by reducing the human capitals are among the most poorly understood aspect of the AIDS epidemic. This article analyzes the effects of the prevalence of HIV and full-blown AIDS on a country's human capitals and economic growths. Using a fixed effect model for panel data 1990-2010 from the Asia, I explored the dynamic relationships among HIV/AIDS, economic growths, and human capitals within countries over time. The econometric effects concerned that HIV/AIDS plays an important role in the field of economic growths and it is measured as a change in real gross domestic product (GDP) per capita and human capitals. The modeling results for the Asian countries indicates HIV/AIDS prevalence that has a hurtful effect on GDP per capita by reducing human capitals within countries over time.

  10. Education and Modernization: A Method for Establishing The Relationship.

    ERIC Educational Resources Information Center

    Schubert, Jane G.

    The Agency for International Development (AID) participant training program was examined to determine its impact on developing countries. One hundred and thirty-four senior officials in Ghana and Thailand provided 492 reports on: (1) indicators of participant achievements; (2) impact-producing characteristics; and (3) contributions attributed to…

  11. Industrial Training for the Developing World

    ERIC Educational Resources Information Center

    Bell, W. L.

    1974-01-01

    Outlining the nature of the two operations of the Council for Technical Education and Training for Overseas Countries (TETOC), the article describes the scope of Great Britain's industrial training work in the Seychelles and the Sudan within the two years since its establishment as part of Britain's aid program. (MW)

  12. LISPA (Library and Information Center Staff Planning Advisor): A Microcomputer-Based System.

    ERIC Educational Resources Information Center

    Devadason, F. J.; Vespry, H. A.

    1996-01-01

    Describes LISPA (Library and Information Center Staff Planning Advisor), a set of programs based on Ranganathan's staff plan model. LISPA particularly aids in planning for library staff requirements, both professional and paraprofessional, in developing countries where automated systems for other library operations are not yet available.…

  13. Bribery and Its Ethical Implications for Aid Workers in the Developing World.

    PubMed

    Remer, J Scott

    2017-02-01

    Bribery is a complicated, multi-dimensional issue. Upon first glance, most westerners would immediately condemn it as an underhanded, unfair means of gaining an advantage in a competitive or legal situation, and so it is in virtually every case in the westernized world. However, the issue becomes much more complicated in the international context, particularly in developing nations, where giving and accepting bribes is often normal and expected. This paper serves to inform ethical decision-making in situations where the "right choice" is unclear with regards to bribery, primarily for individuals performing aid work in foreign countries with corrupt officials and police officers. In such contexts, a simple offering of food, money, or a small trinket may make the difference between a person being able to accomplish meaningful, life-changing work for the local populace or having that work significantly slowed at best and being thrown out of the country, robbed, or imprisoned in worse cases. The larger scale bribery issues in international business and the laws pertaining to them are also discussed.

  14. Financing of HIV/AIDS programme scale-up in low-income and middle-income countries, 2009-31.

    PubMed

    Hecht, Robert; Stover, John; Bollinger, Lori; Muhib, Farzana; Case, Kelsey; de Ferranti, David

    2010-10-09

    As the global HIV/AIDS pandemic nears the end of its third decade, the challenges of efficient mobilisation of funds and management of resources are increasingly prominent. The aids2031 project modelled long-term funding needs for HIV/AIDS in developing countries with a range of scenarios and substantial variation in costs: ranging from US$397 to $722 billion globally between 2009 and 2031, depending on policy choices adopted by governments and donors. We examine what these figures mean for individual developing countries, and estimate the proportion of HIV/AIDS funding that they and donors will provide. Scenarios for expanded HIV/AIDS prevention, treatment, and mitigation were analysed for 15 representative countries. We suggest that countries will move in increasingly divergent directions over the next 20 years; middle-income countries with a low burden of HIV/AIDS will gradually be able to take on the modest costs of their HIV/AIDS response, whereas low-income countries with a high burden of disease will remain reliant upon external support for their rapidly expanding costs. A small but important group of middle-income countries with a high prevalence of HIV/AIDS (eg, South Africa) form a third category, in which rapid scale-up in the short term, matched by outside funds, could be phased down within 10 years assuming strategic investments are made for prevention and efficiency gains are made in treatment. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. From innovation to implementation: the long and winding road.

    PubMed

    Galavotti, Christine; Kuhlmann, Anne K Sebert; Kraft, Joan Marie; Harford, Nicola; Petraglia, Joseph

    2008-06-01

    Building on theory and past research, in early 2000 scientists in the Division of Reproductive Health developed a prevention innovation for CDC's Global AIDS Program for use in countries severely affected by the HIV/AIDS epidemic. This innovative program model is called MARCH: Modeling and Reinforcement to Combat HIV/AIDS (Galavotti et al. Am J Public Health 91:1602-1607, 2001). MARCH promotes behavioral changes that reduce the risk of HIV infection and creates normative environments that sustain these changes through two key program components: entertainment-education using mass media, particularly long-running radio serial dramas, and reinforcement activities at the community level. Using the framework developed by Wandersman et al. (Am J Commun Psychol, 41(3-4), 2008), we describe the key elements of the MARCH prevention innovation and outline how we support its adaptation and implementation. We focus on the following questions: How do we get from an innovative model to effective program implementation in the field? How do we support implementation with fidelity when adaptation is required? And, once implemented, can we demonstrate fidelity of the adaptation to the original program model? Because our program model requires local adaptation for every instance of implementation, we suggest a potential enhancement to the Interactive Systems Framework-support for adaptation of the innovation-as part of the Prevention Support System. In this paper we describe how we supported adaptation of the radio serial drama component for unique contexts in several African countries. We focus attention on the tools and trainings we developed to build innovation specific capacity for implementation, including capacities for adaptation. We then present results of a qualitative analysis of scripts from the MARCH radio serial drama in Zimbabwe to assess the adapted program's fidelity to the original design of the innovation. Finally, we discuss lessons learned and explore implications for the field.

  16. A scoring system for selection of essential drugs.

    PubMed

    Mathur, V S; Chaudhury, R R; Fraser, H S

    1988-03-01

    A scoring system is presented for selection of essential drugs, using criteria of efficacy, safety, cost of a course of therapy, compliance, multiple usage and storage, ease of administration and local availability. Such a system allows for different weighting of factors whose relative importance varies from country to country and would help in choosing the most appropriate and cost-effective drugs for use in developing countries. The importance of such factors as cost and compliance has been illustrated with suitable examples. This approach could also be used for individual patient decisions with the aid of a computer program.

  17. Renewed UN drive against AIDS.

    PubMed

    McGregor, A

    1994-12-17

    After a 1-day meeting of agency directors on December 12 in New York, UN Secretary-General Boutros Boutros-Ghali announced the appointment of Dr. Peter Piot as director of a renewed UN program against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), provisionally entitled "UN Joint and Co-sponsored Programme on AIDS." The 6 UN agencies already involved (UNICEF, UNDP, UNESCO, UN Population Fund, the World Bank, and WHO) will be more tightly coordinated; the World Health Organization (WHO) will remain in charge. Dr. Piot, a 45-year-old Belgian physician and co-discoverer of the Ebola virus (1976), assisted and effectively succeeds Dr. Michael Merson, the director of the World Health Organizations's global program on AIDS. While professor of microbiology at the Institute of Tropical Medicine in Antwerp, Dr. Piot launched a series of collaborative projects in Africa, including "Project SIDA" in Kinshasa in 1984. The new program will not be fully operational until 1996. The World Bank is expected to provide additional money. Dr. Merson's predecessor, Dr. Jonathan Mann (now director of the International Center at the Harvard School Of Public Health) expressed hopefulness about the new leadership and concern that what has been learned about AIDS in the last decade will be applied in the new program. A transition team has been working on a provisional program blueprint that provides for a resident coordinator and the full integration of local staff in each country. Additional emphasis will be given to education. An estimated 17 million people are infected with HIV, 3 million more since June of last year. 20-40 million are expected to be infected by 1999.

  18. PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean

    PubMed Central

    Vogus, Abigail; Graff, Kylie

    2015-01-01

    The US President’s Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country’s readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor support for targeted capacity building and long-term monitoring and evaluation efforts. PMID:26085023

  19. Population: fiction and fact.

    PubMed

    1979-09-01

    This article was written to refute some common misunderstandings regarding worldwide population levels and worldwide nutrition levels. The world food supply is able to keep pace with high population growth levels. Worl food production currently meets world need; the problem is a distribution system which allocates food only to those who can pay rather than to those who need it. In many developing countries, the best agricultural lands are reserved for commercial crops rather than for subsistence crops. The U.S. food aid program does not help the most needy nations generally. The rate of world population growth is already slowing down. The desire for large families in developing countries is very often a realistic reaction to the prevailing economic system. Family planning programs will succeed. They will succeed even better in countries where general development planning is undertaken concurrently with family planning. Environmental problems are attributable to the consumption explosion in the rich countries rather than to the population explosion in the poor countries.

  20. Why some family planning program fail.

    PubMed

    1976-04-01

    40 experts representing Nepal, Malaysia, Thailand, Singapore, Korea, and the Philippines participated in a 3-day workshop in Manila in March 1976 for the purpose of discussing and proposing ways of dealing with the financial problems confronting the population programs of the individual countries. The Inter-Governmental Coordinating Committee for Southeast Asia Family/Population Planning sponsored the workshop. The recommendations made at the meeting were: 1) standardization of financing reporting procedures by the region's country programs on family planning; 2) closer coordination between donor agencies and policy-making bodies of country programs in the disbursement of funds; 3) frequent exchanges of experiences, ideas, technicaL knowledge, and other matters pertaining to the financial management of such programs; and 4) inclusion of applicable financial management topics in the training of clinical staffs and those involved in follow-up operations. Additionally, a proposal was made that national population organizations or committees develop research and evaluation units. Workshop discussion sessions focused on financial planning and management, accounting and disbursement of funds, use and control of foreign aid, cost of effectiveness and benefit analysis, and financial reporting.

  1. [Children and bankers in Bangladesh].

    PubMed

    Hartmann, B

    1991-06-01

    This critique of the World Bank's role in developing country population programs begins with a description of a 1987 case in which an 80-year- old Bangladeshi man was persuaded to undergo vasectomy and then robbed of his incentive payment by the health agent. For over 20 years, the World Bank has pressured 3rd World governments to implement population control programs. Although there are divergent opinions within the World Bank, the most dominant is the neomalthusian view that the poor through their high fertility help perpetuate their own poverty. This view hides the real source of poverty in the Third World: the unequal distribution of resources within these countries and between the developed and developing countries. The World Bank has always been blind to the inequalities, and has associated with the elites of developing countries who monopolize the resources of their countries and thereby impede authentic development. Furthermore, the emphasis on population control distorts social policy and hinders the implementation of safe and voluntary family planning services. In many countries the World Bank has required governments to give greater priority to population control than to basic health services. It has pressured them to relax contraceptive prescription norms and has promoted the more effective methods without regard to proper use or side effects. In Bangladesh the World Bank has sponsored sterilization programs that rely on coercion and incentives. In that country of enormous inequities, 10% of landowners control over 50% of lands, while nearly half the population is landless and chronically underemployed. Political power is concentrated in the military government, which annually receives over 1.5 billion dollars in external aid. External aid primarily benefits the wealthy. 3/4 of the population are undernourished and less than 1/3 are literate or have access to basic health care. The poor of Bangladesh, as in many other countries, feel that their only source of security is to have many children, a significant proportion of whom will not survive. In rural Bangladesh, where chronic hunger and unemployment are rife, the incentives and the pressures of family planning and health workers were sufficient to persuade many persons to undergo sterilization. Payment of commissions to workers to promote sterilization has discouraged them from supplying adequate information about sterilization for fear of losing clients. Population from other donors and wide publicity about the abuses in the sterilization program and the high rates of regret among women undergoing sterilization only for the incentives have led to some modifications, but the World Bank has continued to exert pressure on the Bangladeshi government to develop fertility-control programs. The damaging effects of World Bank population programs can also be seen in Indonesia, Nepal, and other developing countries.

  2. Assessing the impact of harm reduction programs on law enforcement in Southeast Asia: a description of a regional research methodology.

    PubMed

    Thomson, Nick; Moore, Tim; Crofts, Nick

    2012-07-09

    For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers.In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness.While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR.

  3. Assessing the impact of harm reduction programs on law enforcement in Southeast Asia: a description of a regional research methodology

    PubMed Central

    2012-01-01

    For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers. In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness. While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR. PMID:22769050

  4. Usage of Thin-Client/Server Architecture in Computer Aided Education

    ERIC Educational Resources Information Center

    Cimen, Caghan; Kavurucu, Yusuf; Aydin, Halit

    2014-01-01

    With the advances of technology, thin-client/server architecture has become popular in multi-user/single network environments. Thin-client is a user terminal in which the user can login to a domain and run programs by connecting to a remote server. Recent developments in network and hardware technologies (cloud computing, virtualization, etc.)…

  5. [The HIV/AIDS pandemic: African women at the heart of the control program or the difficulties with regard to gender].

    PubMed

    Moulin, B; Louis, J P

    1999-01-01

    The AIDS pandemia in developing countries forces forth the question of women's rights in Africa and underscores their extreme physical and sociocultural vulnerability. Experience gained during a program designed to reduce mother-to-child transmission of HIV in the Ivory Coast highlights the socially imposed and therefore intricate nature of differences between men and women and of the resulting relationships. Defending a woman's right to know her serologic status empowers her in the fight for emancipation but can also make her more fragile by undermining support from medical staff and family environment. To prevent the risk of outcasting, exclusion, and fragilization, gender must be given greater emphasis in planning future programs. Careful consideration must be devoted to the special sociocultural factors that affect women in Africa.

  6. Trans-National Scale-Up of Services in Global Health

    PubMed Central

    Shahin, Ilan; Sohal, Raman; Ginther, John; Hayden, Leigh; MacDonald, John A.; Mossman, Kathryn; Parikh, Himanshu; McGahan, Anita; Mitchell, Will; Bhattacharyya, Onil

    2014-01-01

    Background Scaling up innovative healthcare programs offers a means to improve access, quality, and health equity across multiple health areas. Despite large numbers of promising projects, little is known about successful efforts to scale up. This study examines trans-national scale, whereby a program operates in two or more countries. Trans-national scale is a distinct measure that reflects opportunities to replicate healthcare programs in multiple countries, thereby providing services to broader populations. Methods Based on the Center for Health Market Innovations (CHMI) database of nearly 1200 health programs, the study contrasts 116 programs that have achieved trans-national scale with 1,068 single-country programs. Data was collected on the programs' health focus, service activity, legal status, and funding sources, as well as the programs' locations (rural v. urban emphasis), and founding year; differences are reported with statistical significance. Findings This analysis examines 116 programs that have achieved trans-national scale (TNS) across multiple disease areas and activity types. Compared to 1,068 single-country programs, we find that trans-nationally scaled programs are more donor-reliant; more likely to focus on targeted health needs such as HIV/AIDS, TB, malaria, or family planning rather than provide more comprehensive general care; and more likely to engage in activities that support healthcare services rather than provide direct clinical care. Conclusion This work, based on a large data set of health programs, reports on trans-national scale with comparison to single-country programs. The work is a step towards understanding when programs are able to replicate their services as they attempt to expand health services for the poor across countries and health areas. A subset of these programs should be the subject of case studies to understand factors that affect the scaling process, particularly seeking to identify mechanisms that lead to improved health outcomes. PMID:25375328

  7. Self-efficacy of first aid for home accidents among parents with 0- to 4-year-old children at a metropolitan community health center in Taiwan.

    PubMed

    Wei, Yu-Li; Chen, Li-Li; Li, Tsai-Chung; Ma, Wei-Fen; Peng, Niang-Huei; Huang, Li-Chi

    2013-03-01

    Although accidental injury is the main factor involved in the death of young children in many countries, few studies have focused on parents' competence with regard to self-efficacy of first aid for their children following injuries occurring at home. The purpose of this cross-sectional study was to investigate parental self-sufficiency of first aid for home accidents in children aged 0-4 years. The study is a cross-sectional designed. Data from 445 parents recruited were collected by purposive sampling at eight metropolitan community health centers in central Taiwan. Measurements were taken from a self-developed questionnaire that included 37 questions. Logistic regression analysis was applied to explore the associations between factors and parents' self-efficacy of first aid at home accident. Our findings show that parents' overall rate of knowledge of first aid was 72%. The mean score for 100% certainty in parents' self-efficacy of first aid was 26.6%. The lowest scores for self-efficacy were with regard to choking and cardiopulmonary resuscitation (CPR). There was a significantly positive correlation between parents' knowledge and self-efficacy of first aid (p<0.01), and thus knowledge of first aid is a predictor of parents' self-efficacy. Knowledge of first aid is also a partly mediator between participants' attending first aid program, participants' first aid information obtained from health personnel and self-efficacy of first aid. Our findings suggest that medical services should provide first aid resources to help manage accidental injuries involving children, particularly information on how to deal with choking and CPR. With an appropriate program provided by health professionals, parents' self-efficacy of first aid for home accidents will be positively enhanced. Copyright © 2013. Published by Elsevier Ltd.

  8. The reach and impact of social marketing and reproductive health communication campaigns in Zambia

    PubMed Central

    Van Rossem, Ronan; Meekers, Dominique

    2007-01-01

    Background Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact on condom use. Methods This paper assesses the reach of selected radio and television programs about family planning and HIV/AIDS and of communications about the socially marketed Maximum condoms in Zambia, as well as their impact on condom use, using data from the 2001–2002 Zambia Demographic and Health Survey. To control for self-selection and endogeneity, we use a two-stage regression model to estimate the effect of program exposure on the behavioural outcomes. Results Those who were exposed to radio and television programs about family planning and HIV/AIDS were more likely to have ever used a condom (OR = 1.16 for men and 1.06 for women). Men highly exposed to Maximum condoms social marketing communication were more likely than those with low exposure to the program to have ever used a condom (OR = 1.48), and to have used a condom at their last sexual intercourse (OR = 1.23). Conclusion Findings suggest that the reproductive health and social marketing campaigns in Zambia reached a large portion of the population and had a significant impact on condom use. The results suggest that future reproductive health communication campaigns that invest in radio programming may be more effective than those investing in television programming, and that future campaigns should seek to increase their impact among women, perhaps by focusing on the specific constrains that prevent females from using condoms. PMID:18088437

  9. Getting to know nature: evaluating the effects of the Get to Know Program on children's connectedness with nature

    Treesearch

    Coral M. Bruni; Patricia L. Winter; P. Wesley Schultz; Allen M. Omoto; Jennifer J. Tabanico

    2017-01-01

    People in industrialized countries may be losing their connection with nature. The Get to Know Program (Get to Know) is a multi-faceted program aimed at encouraging direct connection with nature through a variety of activities (observations of wildlife, hiking, creative arts, and special events), specifically among youth. Three studies assessed the effects of three Get...

  10. The effectiveness of simulated robots for supporting the learning of introductory programming: a multi-case case study

    NASA Astrophysics Data System (ADS)

    Major, Louis; Kyriacou, Theocharis; Brereton, Pearl

    2014-07-01

    This work investigates the effectiveness of simulated robots as tools to support the learning of programming. After the completion of a systematic review and exploratory research, a multi-case case study was undertaken. A simulator, named Kebot, was developed and used to run four 10-hour programming workshops. Twenty-three student participants (aged 16-18) in addition to 23 pre-service, and 3 in-service, teachers took part. The effectiveness of this intervention was determined by considering opinions, attitudes, and motivation as well as by analysing students' programming performance. Pre- and post-questionnaires, in- and post-workshop exercises, and interviews were used. Participants enjoyed learning using the simulator and believed the approach to be valuable and engaging. The performance of students indicates that the simulator aids learning as most completed tasks to a satisfactory standard. Evidence suggests robot simulators can offer an effective means of introducing programming. Recommendations to support the development of other simulators are provided.

  11. Poverty's threat.

    PubMed

    1988-03-01

    In the debate on the Report of the World Commission on Environment and Development, chaired by Mrs. Gro Harlem Brundtland, Prime Minister of Norway, delegates to the UN General Assembly asserted that problems generated by the impact of poverty on the environment could not be solved by restricting aid to developing countries unless those countries promised to cease damaging their environment. Rather, most delegates agreed, aid should include the resources which would enable those countries to achieve "sustainable development," i.e., development that does not destroy the environment and deplete natural resources. The United States countered with the opinion that what is needed is not a UN organized "sustainable development program," but rather a grassroots "sustainable development movement" in all countries. Several delegates pointed out that it was the affluent countries which played a large part in the destruction of the environment. The Present of the Maldives, Maumoon Abdul Gayoom, pointed out, for example, that the greenhouse effect, generated by the burning of fossil fuels, would raise the sea level 2 meters, virtually submerging his country. Mrs. Brundtland pointed out that it was not morally acceptable to suggest that the poor remain poor to protect the environment. Governments at all levels, she said, must include environmental concerns in their decision making in all sectors of governmental functioning, e.g., finance, industry, energy, and agriculture.

  12. Voluntary Medical Male Circumcision: A Framework Analysis of Policy and Program Implementation in Eastern and Southern Africa

    PubMed Central

    Dickson, Kim E.; Tran, Nhan T.; Samuelson, Julia L.; Njeuhmeli, Emmanuel; Cherutich, Peter; Dick, Bruce; Farley, Tim; Ryan, Caroline; Hankins, Catherine A.

    2011-01-01

    Background Following confirmation of the effectiveness of voluntary medical male circumcision (VMMC) for HIV prevention, the World Health Organization and the Joint United Nations Programme on HIV/AIDS issued recommendations in 2007. Less than 5 y later, priority countries are at different stages of program scale-up. This paper analyzes the progress towards the scale-up of VMMC programs. It analyzes the adoption of VMMC as an additional HIV prevention strategy and explores the factors may have expedited or hindered the adoption of policies and initial program implementation in priority countries to date. Methods and Findings VMMCs performed in priority countries between 2008 and 2010 were recorded and used to classify countries into five adopter categories according to the Diffusion of Innovations framework. The main predictors of VMMC program adoption were determined and factors influencing subsequent scale-up explored. By the end of 2010, over 550,000 VMMCs had been performed, representing approximately 3% of the target coverage level in priority countries. The “early adopter” countries developed national VMMC policies and initiated VMMC program implementation soon after the release of the WHO recommendations. However, based on modeling using the Decision Makers' Program Planning Tool (DMPPT), only Kenya appears to be on track towards achievement of the DMPPT-estimated 80% coverage goal by 2015, having already achieved 61.5% of the DMPPT target. None of the other countries appear to be on track to achieve their targets. Potential predicators of early adoption of male circumcision programs include having a VMMC focal person, establishing a national policy, having an operational strategy, and the establishment of a pilot program. Conclusions Early adoption of VMMC policies did not necessarily result in rapid program scale-up. A key lesson is the importance of not only being ready to adopt a new intervention but also ensuring that factors critical to supporting and accelerating scale-up are incorporated into the program. The most successful program had country ownership and sustained leadership to translate research into a national policy and program. Please see later in the article for the Editors' Summary PMID:22140368

  13. Country watch: Venezuela.

    PubMed

    Koch, R

    1996-01-01

    Since 1990, ACCSI has worked to safeguard the rights of people living with HIV/AIDS in Venezuela. The Pan American Health Organization (PAHO) had recognized ACCSI's program by 1992, enabling the nongovernmental organization (NGO) to establish fixed office hours during which it can receive clients. ACCSI does not distinguish between people living with HIV/AIDS and others, but considers it important to regulate AIDS as a public health issue within the context of human rights and ethics. Almost all of the Legal Office's initial cases were related to discrimination in the workplace, health centers, and educational institutions, but the ACCSI now also addresses family problems related to adoption, insurance, and inheritance, among others. To cope with the increase in service caseload, services have been extended through collaboration with specialized organizations concerned with human rights, women, children, prisons, and indigenous people. ACCSI influences governmental policy-making through its participation in the National AIDS Program. Moreover, ACCSI's networking activities ensure that the topic of HIV/AIDS and human rights is now always included in seminars and conferences in Venezuela, even when they are concerned with sexually transmitted diseases or other medical issues. Almost every time the press report upon AIDS, they consult the NGO. Everyday more people in Venezuela are standing up for their rights and denouncing discrimination against people infected with HIV.

  14. Assessment of A. I. D. environmental programs: Energy conservation in Pakistan. Technical report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Church, P.; Kumar, K.; Sowers, F.

    1993-09-01

    This report highlights a model of environmental management that appears to work in the current political and economic context of Pakistan. The model focuses on energy conservation. This evaluation examines how the U.S. Agency for International Development (A.I.D.) has assisted Pakistan in using market forces to promote the adoption of energy conservation practices and technologies. The central operating hypothesis of the evaluation is that the adoption of energy conservation practices and technologies responds to market incentives. The field study concludes that the Pakistani program of energy conservation activities, set in motion with A.I.D. support, cannot easily be reversed. With changesmore » in political and economic policies toward the environment in Pakistan, greater and more sustainable impact is possible. The experience of Pakistan energy conservation program raises three issues that merit careful examination both in the contexts of Pakistan's future program implementation and in other countries: The role of program subsidies; The role of nonproject assistance; and The involvement of nongovernmental organizations.« less

  15. The AIDS scare in India could be aid-induced.

    PubMed

    Mohan, S

    1996-01-01

    Peter Piot, head of the Joint United Nations Program on HIV/AIDS (UNAIDS), told the World AIDS Conference in Vancouver that India had 3 million people infected with HIV. The Indian government, however, gave no estimate because it has no baseline data upon which a realistic projection can be made. The National AIDS Control Organization (NACO) officially questioned Dr. Piot on the basis of his estimates. Piot attributes his figure to World Health Organization estimates made in consultation with NACO at the end of 1994 that there were 1.75 million people living with HIV in India. Alarmist reports have appeared in the media based upon Dr. Piot's comments. Some health experts, however, believe that the figures are being inflated by the West to pressure India into accepting vaccine trials and other research on HIV-infected people. For now, neither the Indian government nor the country's general population seem concerned about the reported statistics.

  16. Corruption in emergency procurement.

    PubMed

    Schultz, Jessica; Søreide, Tina

    2008-12-01

    Corruption in emergency procurement reduces the resources available for life-saving operations, lowers the quality of products and services provided, and diverts aid from those who need it most.(1) It also negatively influences public support for humanitarian relief, both in the affected country and abroad. This paper aims to unpack and analyse the following question in order to mitigate risk: how and where does corruption typically occur, and what can be done? Suggested strategies reflect a multi-layered approach that stresses internal agency control mechanisms, conflict-sensitive management, and the need for common systems among operators.

  17. The "expert patient" approach for non-communicable disease management in low and middle income settings: When the reality confronts the rhetoric.

    PubMed

    Xiao, Yue

    2015-09-01

    This paper seeks to explore the relevance between the Western "expert patient" rhetoric and the reality of non-communicable diseases (NCDs) control and management in low and middle income settings from the health sociological perspective. It firstly sets up a conceptual framework of the "expert patient" or the patient self-management approach, showing the rhetoric of the initiative in the developed countries. Then by examining the situation of NCDs control and management in low income settings, the paper tries to evaluate the possibilities of implementing the "expert patient" approach in these countries. Kober and Van Damme's study on the relevance of the "expert patient" for an HIV/AIDS program in low income settings is critically studied to show the relevance of the developed countries' rhetoric of the "expert patient" approach for the reality of developing countries. In addition, the MoPoTsyo diabetes peer educator program is analyzed to show the challenges faced by the low income countries in implementing patient self-management programs. Finally, applications of the expert patient approach in China are discussed as well, to remind us of the possible difficulties in introducing it into rural settings.

  18. Population and economics.

    PubMed

    Wright, W

    1995-06-01

    The first world consists of the developed industrial countries, the second consists of rapidly developing countries, and the third of less developed, largely pre-industrial countries. The economies of most developed countries in recent years have been relatively stagnant. Most people in the developed world therefore assume that the bottom of the business cycle has arrived and that an upturn will soon be forthcoming. With the exception of the USA and Chile, which have been moderately prosperous in the last few years, the bottom has persisted for a very long time. Indeed, the developed world is not caught in a conventional business cycle, but in something quite new and different. The first world is struggling to stay at the top of countries worldwide both economically and politically, but the second world is rapidly catching up. Populations in these latter countries are both better educated and willing to work harder per unit of capital compared to people in the first world. Marketplace forces and the communication highway are increasingly bring about a scenario in which the first and second worlds will be economic peers. Faced with increased competition from the second world and a larger number of countries capable of providing foreign aid to the third world, it should be clear that the first world will turn inward and reduce its annual aid contributions to less developed countries. It is, however, in the first world's interest to promote family planning toward the goal of reduced population growth. Developed countries should insist that a substantial fraction of whatever foreign aid is provided goes toward reducing the rate of population growth. The first priority should be to make contraceptives available and promote their use worldwide. Efforts should then be taken to empower women through educational and other programs. This approach will slow population growth and improve the economic productivity of both men and women. The Third World should also seriously address its own population problems, and stop looking to the day when their enormous populations will overwhelm the first world.

  19. National Security Education Act of 1991: Summary and Analysis. CRS Report for Congress.

    ERIC Educational Resources Information Center

    Riddle, Wayne Clifton

    This report analyzes and summarizes the National Security Education Act of 1991 (NSEA) which authorizes a new program of aid for foreign language and area studies. The report discusses the legislation's aim to increase future national security through enhanced foreign language abilities and knowledge of other countries, the NSEA's authorized…

  20. Failing to Fulfill Tasks of Social Justice Weakens Country.

    ERIC Educational Resources Information Center

    USA Today, 1981

    1981-01-01

    Presents excerpts from an interview with Walter Mondale in which the former vice president expressed fears that the United States will be weakened by current policies of removing government from the tasks of social justice. Topics discussed include social security cuts, reduction of student loans, and elimination of the legal aid program. (DB)

  1. States Hurt as Stimulus Loses Steam

    ERIC Educational Resources Information Center

    Cavanagh, Sean; Hollingsworth, Heather

    2011-01-01

    States are finally arriving at the "funding cliff"--the point where about $100 billion in federal economic-stimulus aid for education runs out. The loss seems certain to compound severe budget woes and could mean thousands of school layoffs and the elimination of popular programs and services in districts across the country. The bulk of…

  2. A Cross-National CAI Tool To Support Learning Operations Decision-Making and Market Analysis.

    ERIC Educational Resources Information Center

    Mockler, Robert J.; Afanasiev, Mikhail Y.; Dologite, Dorothy G.

    1999-01-01

    Describes bicultural (United States and Russia) development of a computer-aided instruction (CAI) tool to learn management decision-making using information systems technologies. The program has been used with undergraduate and graduate students in both countries; it integrates free and controlled market concepts and combines traditional computer…

  3. From "Rebel" to "Returnee:" Daily Life and Reintegration for Young Soldiers in Northern Uganda

    ERIC Educational Resources Information Center

    Annan, Jeannie; Brier, Moriah; Aryemo, Filder

    2009-01-01

    In war's aftermath, many young soldiers attempt to reintegrate and reestablish their lives. Disarmament, Demobilization, and Reintegration (DDR) programs are a priority intervention for youth in postconflict countries; yet there is little evidence to suggest what aids reintegration. This research uses qualitative methodology to describe the issues…

  4. Language Coordinators Resource Kit. Section Ten: Picture Bank.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    The guide is one section of a resource kit designed to assist Peace Corps language instruction coordinators in countries around the world in understanding the principles underlying second language learning and teaching and in organizing instructional programs. This section contains a collection of pictures that can be used as visual aids in…

  5. To what extent could performance-based schemes help increase the effectiveness of prevention of mother-to-child transmission of HIV (PMTCT) programs in resource-limited settings? a summary of the published evidence

    PubMed Central

    2010-01-01

    Background In resource-limited settings, HIV/AIDS remains a serious threat to the social and physical well-being of women of childbearing age, pregnant women, mothers and infants. Discussion In sub-Saharan African countries with high prevalence rates, pediatric HIV/AIDS acquired through mother-to-child transmission (MTCT) can in largely be prevented by using well-established biomedical interventions. Logistical and socio-cultural barriers continue, however, to undermine the successful prevention of MTCT (PMTCT). In this paper, we review reports on maternal, neonatal and child health, as well as HIV care and treatment services that look at program incentives. Summary These studies suggest that comprehensive PMTCT strategies aiming to maximize health-worker motivation in developing countries must involve a mix of both financial and non-financial incentives. The establishment of robust ethical and regulatory standards in public-sector HIV care centers could reduce barriers to PMTCT service provision in sub-Saharan Africa and help them in achieving universal PMTCT targets. PMID:21080926

  6. Resource needs and gap analysis in achieving universal access to HIV/AIDS services: a data envelopment analysis of 45 countries.

    PubMed

    Zeng, Wu; Shepard, Donald S; Avila-Figueroa, Carlos; Ahn, Haksoon

    2016-06-01

    -To manage the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic, international donors have pledged unprecedented commitments for needed services. The Joint United Nations Programme on HIV/AIDS (UNAIDS) projected that low- and middle-income countries needed $25 billion to meet the 2010 HIV/AIDS goal of universal access to AIDS prevention and care, using the resource needs model (RNM). -Drawing from the results from its sister study, which used a data envelopment analysis (DEA) and a Tobit model to evaluate and adjust the technical efficiency of 61 countries in delivering HIV/AIDS services from 2002 to 2007, this study extended the DEA and developed an approach to estimate resource needs and decompose the performance gap into efficiency gap and resource gap. In the DEA, we considered national HIV/AIDS spending as the input and volume of voluntary counseling and testing (VCT), prevention of mother to child transmission (PMTCT) and antiretroviral treatment (ART) as the outputs. An input-oriented DEA model was constructed to project resource needs in achieving 2010 HIV/AIDS goal for 45 countries using the data in 2006, assuming that all study countries maximized efficiency. -The DEA approach demonstrated the potential to include efficiency of national HIV/AIDS programmes in resource needs estimation, using macro-level data. Under maximal efficiency, the annual projected resource needs for the 45 countries was $6.3 billion, ∼47% of their UNAIDS estimate of $13.5 billion. Given study countries' spending of $3.9 billion, improving efficiency could narrow the gap from $9.6 to $2.4 billion. The results suggest that along with continued financial commitment to HIV/AIDS, improving the efficiency of HIV/AIDS programmes would accelerate the pace to reach 2010 HIV/AIDS goals. The DEA approach provides a supplement to the AIDS RNM to inform policy making. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Building multi-country collaboration on watershed ...

    EPA Pesticide Factsheets

    Community-based watershed resilience programs that bridge public health and environmental outcomes often require cross-boundary, multi-country collaboration. The CRESSIDA project, led by the Regional Environmental Center for Central and Eastern Europe (REC) and supported by the US Environmental Protection Agency (EPA), forwards a resilience-focused approach for Western Balkan communities in the Drini and Drina river watersheds with the goal of safeguarding public health and the environment. The initial phases of this project give a contextualized example of how to advance resilience-driven environmental health goals in Western Balkan communities, and experience within the region has garnered several theme areas that require focus in order to promote a holistic watershed management program. In this paper, using CRESSIDA as a case study, we show (1) how watershed projects designed with resilience-driven environmental health goals can work in context, (2) provide data surrounding contextualized problems with resilience and suggest tools and strategies for the implementation of projects to address these problems, and (3) explore how cross-boundary foci are central to the success of these approaches in watersheds that comprise several countries. Published in the journal, Reviews on Environmental Health.

  8. Religion and women's health in Ghana: insights into HIV/AIDs preventive and protective behavior.

    PubMed

    Takyi, Baffour K

    2003-03-01

    Since the late 1970s when the first cases of HIV/AIDS were identified in Africa, there has been an upsurge of research on the epidemic. Although religious involvement may be germane to AIDS protective and risk behavior, few of these studies deal with religion and AIDS. This article contributes to the discourse on religion and health in Africa by analysing the interrelationship between religion and AIDS behavior in Ghana, a West African country at the early stages of the AIDS epidemic, and one where religious activities are more pronounced. We explore whether a woman's knowledge of HIV/AIDS is associated with her religious affiliation, and whether religious affiliation influences AIDS preventive (protective) attitudes. Findings from our analysis of Ghanaian data indicate that religious affiliation has a significant effect on knowledge of AIDS. However, we did not find religious affiliation to be associated with changes in specific protective behavior, particularly the use of condoms. The limitations and implications of the study are discussed, promising directions for further research on religion and AIDS protective and risk behaviors are also discussed, and the design and development of culturally sensitive programs to help in the ongoing AIDS prevention efforts in the region are proposed.

  9. An audit of school oral health education program in a developing country

    PubMed Central

    Lawal, Folake B.; Taiwo, Juliana O.

    2014-01-01

    Objective: The increasing prevalence of oral diseases in children in developing countries is a major public health concern and creates the need to review various preventive strategies put in place on oral health promotion. In the absence of formal national programs, tertiary health institutions have adopted low-budget school oral education programs targeted at improving oral health awareness and behavioral changes in school children. The aim of this study was to review the school oral health education programs conducted by the Community Dentistry Unit of a tertiary hospital in a major city in Nigeria. Materials and Methods: An evaluation of the school oral health education programs conducted in the city over a 5-year period was done. Data collected included: venue of the program, the number of students and teachers educated in each school, screening and referrals, adequacy of teaching aids, desire for revisit, and barriers noted in its conduct. Results: A total of 104 oral health education programs were conducted during this period involving 16,248 participants. The majority (80%) of the schools visited were primary schools and 54% were privately owned. Over half of the programs was conducted on assembly grounds, 21% in classrooms, and 13% in school halls. Challenges encountered included: lack of audiovisual aids, transportation problems, inadequacy of screening tools, and insufficient promotional materials. All the schools visited requested for (subsequent) regular visitation. Conclusion: The study showed the feasibility of low-budget oral health education and willingness of schools to benefit from such programs. There are barriers to effective communication, which can be mitigated in order to achieve an optimal school oral health education program in a low resource setting. PMID:25452928

  10. An audit of school oral health education program in a developing country.

    PubMed

    Lawal, Folake B; Taiwo, Juliana O

    2014-11-01

    The increasing prevalence of oral diseases in children in developing countries is a major public health concern and creates the need to review various preventive strategies put in place on oral health promotion. In the absence of formal national programs, tertiary health institutions have adopted low-budget school oral education programs targeted at improving oral health awareness and behavioral changes in school children. The aim of this study was to review the school oral health education programs conducted by the Community Dentistry Unit of a tertiary hospital in a major city in Nigeria. An evaluation of the school oral health education programs conducted in the city over a 5-year period was done. Data collected included: venue of the program, the number of students and teachers educated in each school, screening and referrals, adequacy of teaching aids, desire for revisit, and barriers noted in its conduct. A total of 104 oral health education programs were conducted during this period involving 16,248 participants. The majority (80%) of the schools visited were primary schools and 54% were privately owned. Over half of the programs was conducted on assembly grounds, 21% in classrooms, and 13% in school halls. Challenges encountered included: lack of audiovisual aids, transportation problems, inadequacy of screening tools, and insufficient promotional materials. All the schools visited requested for (subsequent) regular visitation. The study showed the feasibility of low-budget oral health education and willingness of schools to benefit from such programs. There are barriers to effective communication, which can be mitigated in order to achieve an optimal school oral health education program in a low resource setting.

  11. [Asymmetry in international relations, industrial property rights and anti-HIV medication].

    PubMed

    Costa-Couto, Maria Helena; Nascimento, Alvaro César

    2008-01-01

    This paper analyzes the asymmetry in the international relations as refers to the recognition of industrial property rights in the pharmaceutical industry. It focuses on the impact of such relations upon the access to ARV medication, an issue of worldwide interest due to its connection with the development of the nations. Clashing interests and the position taken by some countries in their patent laws point to a scenario less favorable for the access of peripheral countries to anti-HIV/AIDS medication. On the other hand, it seems that the success of the Brazilian STD/AIDS program in negotiating ARV prices will open new possibilities. The solution may be the internal strengthening of the National States and the active role played by the Agencies of the United Nations System in defense of the collective human interests.

  12. Lessons from the history of the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic among Spanish drug injectors.

    PubMed

    De La Fuente, L; Bravo, M J; Barrio, G; Parras, F; Suárez, M; Rodés, A; Noguer, I

    2003-12-15

    In Spain, approximately 10 years passed between the time when human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) harm-reduction programs should have been developed with sufficient coverage to have an optimum impact on public health (before the HIV/AIDS epidemic's explosion in 1984) and the date of their actual implementation. This delay yielded an enormous cost for the country. The introduction of the virus in drug injector networks during a period of widespread diffusion of heroin injection and the lack of political awareness of the growing problem were 2 important factors that contributed to the important diffusion of the HIV infection among Spanish injection drug users. Lessons can be learned that may be of great interest in countries or territories facing similar challenges now and in the future.

  13. JOICFP included in GII mission to Ghana. Global Issues Initiative.

    PubMed

    1996-03-01

    Among countries in West Africa, Ghana is the main focus of the Global Issues Initiative (GII) on Population and AIDS and one of twelve priority countries selected for official development assistance (ODA) under the program. A ten-member project formulation mission sent to Ghana by the Ministry of Foreign Affairs (MOFA) of Japan was in the country during January 10-18. This mission was the first of its kind to be sent to Africa. It was led by the director of the Third Project Formulation Study Division, Project Formulation Study Department, Japan International Cooperation Agency (JICA), and included representatives of MOFA, JICA, and the Ministry of Health and Welfare, and an observer from UNAIDS. The mission's chief objective was to explore possibilities for Japanese cooperation in the areas of population, child health, and HIV/AIDS in line with the Mid-Term Health Strategy (MTHS) formulated in 1995 by the government of Ghana. The mission also explored the possibility of collaboration with major donors, international organizations, international agencies, and NGOs. The mission met with representatives of NGOs from population, women, AIDS, and health-related areas on January 13, who were then briefed upon Japan's Grant Assistance for Grassroots Project for local NGOs. Views were exchanged upon NGO activities.

  14. A Multi-Metric Assessment on the Impact of I Can Learn[R] (ICL) Multimedia on Actual and Perceived Student Achievement in Developmental Mathematics

    ERIC Educational Resources Information Center

    Stokes, Sandra D.

    2011-01-01

    This quasi-experimental study focused on the initiatives undertaken by a community college's Academic Skills Enhancement Program (ASEP) commonly known as the Developmental Education Department to find an alternative delivery method to aid its students in learning developmental mathematics. Moreover, this study (1) conducted a comparative…

  15. PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean.

    PubMed

    Vogus, Abigail; Graff, Kylie

    2015-06-17

    The US President's Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country's readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor support for targeted capacity building and long-term monitoring and evaluation efforts. © Vogus et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/

  16. Does the theory-driven program affect the risky behavior of drug injecting users in a healthy city? A quasi-experimental study.

    PubMed

    Karimy, Mahmood; Abedi, Ahmad Reza; Abredari, Hamid; Taher, Mohammad; Zarei, Fatemeh; Rezaie Shahsavarloo, Zahra

    2016-01-01

    The horror of HIV/AIDS as a non-curable, grueling disease is a destructive issue for every country. Drug use, shared needles and unsafe sex are closely linked to the transmission of HIV/AIDS. Modification or changing unhealthy behavior through educational programs can lead to HIV prevention. The aim of this study was to evaluate the efficiency of theory-based education intervention on HIV prevention transmission in drug addicts. In this quasi-experimental study, 69 male drug injecting users were entered in to the theory- based educational intervention. Data were collected using a questionnaire, before and 3 months after four sessions (group discussions, lecture, film displaying and role play) of educational intervention. The findings signified that the mean scores of constructs (self-efficacy, susceptibility, severity and benefit) significantly increased after the educational intervention, and the perceived barriers decreased (p< 0.001). Also, the history of HIV testing was reported to be 9% before the intervention, while the rate increased to 88% after the intervention. The present research offers a primary founding for planning and implementing a theory based educational program to prevent HIV/AIDS transmission in drug injecting addicts. This research revealed that health educational intervention improved preventive behaviors and the knowledge of HIV/AIDS participants.

  17. A Systems Analysis View of the Vietnam War: 1965-1972. Volume 11. Economics: War Costs and Inflation

    DTIC Science & Technology

    1975-02-01

    Conflict On Great Society Programs Sep 67 4 The Cost Of Bombing North Vietnam Dec 67 8 The Bombing - Its Economic Costs Avnd Benefits To North Vietnam...current DOD program and the one for the peacetime force structure after the war. A third cost concept is reflected in the figures the Defense Department...papers will cover FY 70-71, as soon as those program budgets are ready, and will include AID, GVN, and third country costs . Total Cost . The total cost

  18. Business confidence still high in Zimbabwe.

    PubMed

    Amanor-wilks, D

    1995-12-01

    Business confidence has not been affected in Zimbabwe despite the AIDS epidemic in that country. An Australian mining company has recruited people to work at its platinum mine in Zimbabwe and also instituted an AIDS awareness program. The National Chamber of Commerce disclosed that semiskilled and unskilled workers who are the "easiest to replace" have been most affected by the epidemic. The impact of AIDS has not been as bad as had been predicted several years ago. By the end of the 1990s, however, there might be a skills shortage. The first AIDS case was detected in 1985 in Zimbabwe. By the end of 1995 a cumulative total of 38,500 cases had been reported, but the National AIDS Control Program believes that the true figure is over 100,000. The estimated number of HIV-infected people is about 1 million. The most economically productive age group (30-50) has the highest rates of infection. Transport is affected most, followed by mining and commercial farming. Infection rates among miners are estimated to be 20-30% and the rates are the highest at the mines on the major transport routes. The mining industry has not had any problems in recruiting labor, but, increasingly, deaths are AIDS-related. The growing sex industry at the mines has accelerated the spread of HIV. In addition, small mines do not have AIDS awareness programs in place. The National Employment Council runs a project for the transport industry, which seeks to intensify AIDS campaigns at truck stops. This also entails talks to drivers about AIDS; courses for police, nurses, and sex workers; and the distribution of condoms. In commercial farming, two-thirds of workers are unskilled casual laborers who live in squalid conditions that foster the spread of AIDS. At these farms there is also a growing number of orphans, whose number is estimated to rise to 60,000 by the late 1990s.

  19. [AIDS in Russia. It is still possible to stop the epidemic. Interview with Dr. A.P. Koslov].

    PubMed

    Bertrand, P

    1996-01-01

    According to A.P. Koslov, president of the Fourth International Conference on AIDS, Cancer, and Associated Diseases held in Russia in 1996, the conference represents the first high level discussion of AIDS risk management in Russia. Russia has a strong potential for development of a vaccine, having been a key player in the smallpox eradication program in the late 1950s. Conditions are difficult at present, but it is possible that Russia will be able to develop a practical vaccine for distribution in the Third World. Efforts to develop an HIV vaccine underway in different countries have been examined, and a list has been compiled of Russian institutions able to participate in HIV vaccine development. International assistance for vaccine development in Russia would help both the medical establishment in Russia, which has suffered because of the economic and social crisis, and the international community. A meeting is planned for December 1996 in St. Petersburg to organize an AIDS control organization for all of Russia. Mobilization of support for AIDS prevention activities is necessary but very difficult. If nothing is done, the epidemic in Ukraine will soon spread to Russia. But Russia and China are among the few countries where an HIV epidemic could still be prevented or stopped. The association in St. Petersburg cooperates with other former Soviet republics in AIDS control activities, although attendance at international meetings and conferences is frequently curtailed for financial reasons.

  20. WHO says Indian AIDS funds misused.

    PubMed

    1994-10-03

    Funds provided to India to promote AIDS awareness have been misused, in some instances by interstate truck drivers, targeted by studies as a potential source of spreading HIV, who use free condoms to plug leaking radiators on their trucks, a World Health Organization (WHO) report said. There has been an increasing demand for free condoms distributed by the government, but they weren't used to promote safe sex. Prostitution in Bombay has flourished into a major service industry. A study in 1993 by WHO revealed 35% of the city's prostitutes tested HIV-positive. Despite the fact that AIDS had spread throughout India, local and state governments were lagging behind in using funds to promote protection against HIV. In 1992, the World Bank loaned $84 million to India to finance its anti-AIDS program, but where a state government was actually using the money, it was either under-used or misused. According to the National AIDS Control Organization, India has 1.62 million HIV-positive cases, up by 60% since 1993. Most hospitals in India still have no blood screening facilities and many refuse to treat HIV-positive patients. Nearly 50 to 60% of blood in the country is not yet screened for HIV, the head of a non-governmental health organization said. Officials, however, balk at the thought of educating a country with the second largest population in the world, rampant illiteracy, and sexual taboos. India's socioeconomic conditions act as a major barrier to controlling AIDS and enforcing laws in regard to HIV-positive patients.

  1. Trends in AIDS Deaths, New Infections and ART Coverage in the Top 30 Countries with the Highest AIDS Mortality Burden; 1990–2013

    PubMed Central

    Granich, Reuben; Gupta, Somya; Hersh, Bradley; Williams, Brian; Montaner, Julio; Young, Benjamin; Zuniga, José M.

    2015-01-01

    Background Antiretroviral therapy (ART) prevents human immunodeficiency virus (HIV) disease progression, mortality and transmission. We assess the impact of expanded HIV treatment for the prevention of Acquired Immunodeficiency Syndrome (AIDS)-related deaths and simulate four treatment scenarios for Nigeria and South Africa. Methods For 1990–2013, we used the Joint United Nations Programme on HIV/AIDS (UNAIDS) database to examine trends in AIDS deaths, HIV incidence and prevalence, ART coverage, annual AIDS death rate, AIDS death-to-treatment and HIV infections to treatment ratios for the top 30 countries with the highest AIDS mortality burden and compare them with data from high-income countries. We projected the 1990–2020 AIDS deaths for Nigeria and South Africa using four treatment scenarios: 1) no ART; 2) maintaining current ART coverage; 3) 90% ART coverage based on 2013 World Health Organization (WHO) ART guidelines by 2020; and 4) reaching the United Nations 90-90-90 Target by 2020. Findings In 2013, there were 1.3 million (1.1 million–1.6 million) AIDS deaths in the top 30 countries representing 87% of global AIDS deaths. Eight countries accounted for 58% of the global AIDS deaths; Nigeria and South Africa accounted for 27% of global AIDS deaths. The highest death rates per 1000 people living with HIV were in Central African Republic (91), South Sudan (82), Côte d’Ivoire (75), Cameroon (72) and Chad (71), nearly 8–10 times higher than the high-income countries. ART access in 2013 has averted as estimated 1,051,354 and 422,448 deaths in South Africa and Nigeria, respectively. Increasing ART coverage in these two countries to meet the proposed UN 90-90-90 Target by 2020 could avert 2.2 and 1.2 million deaths, respectively. Interpretation Over the past decade the expansion of access to ART averted millions of deaths. Reaching the proposed UN 90-90-90 Target by 2020 will prevent additional morbidity, mortality and HIV transmission. Despite progress, high-burden countries will need to accelerate access to ART treatment to avert millions of premature AIDS deaths and new HIV infections. PMID:26147987

  2. Rehabilitation for disabling hearing loss: evaluating the need relative to provision of hearing aids in the public health care system.

    PubMed

    Hlayisi, Vera-Genevey; Ramma, Lebogang

    2018-05-20

    To determine the demand relative to supply of hearing rehabilitation through hearing aids for those with disabling hearing loss in a public health care setting in South Africa. Retrospective cross-sectional survey of medical records of all patients were seen at a public hospital (Polokwane Provincial Academic) during 2012-2014, was conducted. Audiological data from 3894 medical folders were accessed and reviewed; thereafter, results were analyzed using descriptive statistics. Of the 3894 medical folders reviewed, two-third (62%, n = 2402) were diagnosed with hearing loss, mostly bilaterally (81%). More than 30% of all patients diagnosed with hearing loss were ≤10 years old. Sensorineural (permanent) hearing loss was diagnosed most often (38%, n = 913) and 74% (n = 1778) of hearing losses diagnosed were of moderate or worse severity (i.e., disabling loss). Hearing aids were fitted to only 15% (n = 272) of those diagnosed with disabling hearing loss and most hearing aid fittings were to low-income adult patients (≥25 years old) with more severe-profound hearing losses. This study showed that the need for hearing aids to provide hearing rehabilitation far exceeds the supply. Therefore, a multi-pronged approach that includes increased budget allocation and exploring low-cost interventions for developing countries to meet the demand for hearing aids. Furthermore, study highlighted a high prevalence of hearing loss in those younger than 10 years of age, and thus highlights the need for early intervention as well as intensifying efforts to reduce preventable causes of hearing loss. Implications for Rehabilitation Audiologists need to advocate for an increase in budget allocation for hearing rehabilitation devices. Study indicates need to explore low-cost hearing devices/rehabilitation interventions for developing countries. Health professionals should consider preventative measures to reduce prevalence of preventable hearing loss.

  3. The Canadian effort to prevent and control hypertension: can other countries adopt Canadian strategies?

    PubMed

    Campbell, Norm R C; Sheldon, Tobe

    2010-07-01

    To indicate the key elements of current Canadian programs to treat and control hypertension. In the early 1990s Canada had a hypertension treatment and control rate of 13%. A Canadian strategy to prevent and control hypertension was developed and a coalition of national organizations and volunteers formed to develop increasingly extensive programs. The Canadian effort was largely based on annually updated hypertension management recommendations, an integrated and extensive hypertension knowledge translation program and an increasingly comprehensive outcomes assessment program. After the start of the annual process in 1999, there were very large increases in diagnosis and hypertension treatment coupled with dropping rates of cardiovascular disease. More recent initiatives include an extensive education program for the public and people with hypertension, a program to reduce dietary salt and a funded leadership position. The treatment and control rate increased to 66% when last assessed (2007-2009). The study describes important aspects of the Canadian hypertension management programs to aid those wishing to develop similar programs. Many of the programs could be fully or partially implemented by other countries.

  4. Do Sector Wide Approaches for health aid delivery lead to 'donor-flight'? A comparison of 46 low-income countries.

    PubMed

    Sweeney, Rohan; Mortimer, Duncan; Johnston, David W

    2014-03-01

    Sector Wide Approaches (SWAp) emerged during the 1990s as a new policy mechanism for aid delivery. Eschewing many features of traditional project-based aid, SWAps give greater control of aid allocation to recipient countries. Some critics have questioned whether reducing a donor's level of influence over aid allocation might lead to a decrease in donor contributions. While some qualitative evaluations have described the level of fund pooling and donor participation in SWAps, no previous study has empirically examined this potential 'donor-flight' response to health SWAp implementation. This paper utilises a uniquely compiled dataset of 46 low-income countries over 1990-2009 and a variety of panel data regression models to estimate the impact of health SWAp implementation on levels of health aid. Results suggest that amongst 16 especially poor low-income countries, SWAp implementation is associated with significant decreases in health aid levels compared with non-implementers. This suggests donors are not indifferent to how their contributions are allocated by recipients, and that low-income countries considering a SWAp may need to weigh the benefits of greater control of aid allocations against the possibility of reduced aid income. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Satellite image maps of Pakistan

    USGS Publications Warehouse

    ,

    1997-01-01

    Georeferenced Landsat satellite image maps of Pakistan are now being made available for purchase from the U.S. Geological Survey (USGS). The first maps to be released are a series of Multi-Spectral Scanner (MSS) color image maps compiled from Landsat scenes taken before 1979. The Pakistan image maps were originally developed by USGS as an aid for geologic and general terrain mapping in support of the Coal Resource Exploration and Development Program in Pakistan (COALREAP). COALREAP, a cooperative program between the USGS, the United States Agency for International Development, and the Geological Survey of Pakistan, was in effect from 1985 through 1994. The Pakistan MSS image maps (bands 1, 2, and 4) are available as a full-country mosaic of 72 Landsat scenes at a scale of 1:2,000,000, and in 7 regional sheets covering various portions of the entire country at a scale of 1:500,000. The scenes used to compile the maps were selected from imagery available at the Eros Data Center (EDC), Sioux Falls, S. Dak. Where possible, preference was given to cloud-free and snow-free scenes that displayed similar stages of seasonal vegetation development. The data for the MSS scenes were resampled from the original 80-meter resolution to 50-meter picture elements (pixels) and digitally transformed to a geometrically corrected Lambert conformal conic projection. The cubic convolution algorithm was used during rotation and resampling. The 50-meter pixel size allows for such data to be imaged at a scale of 1:250,000 without degradation; for cost and convenience considerations, however, the maps were printed at 1:500,000 scale. The seven regional sheets have been named according to the main province or area covered. The 50-meter data were averaged to 150-meter pixels to generate the country image on a single sheet at 1:2,000,000 scale

  6. The Virtual Silk Highway -- Connectivity for Central Asia and the Caucasus

    NASA Astrophysics Data System (ADS)

    Frese, Hans

    2007-04-01

    This presentation focuses on Internet for research and education communities in the countries along the Great Silk Road, eight republics of the Former Soviet Union (Kazakhstan, Uzbekistan, Kyrgyzstan, Tajikistan, Turkmenistan, Azerbaijan, Armenia, Georgia) and Afghanistan. When the Internet became a standard science tool in the nineties, connectivity to this area was limited to analog telephone lines. The TAE fiber was installed from Istanbul via Tashkent to Shanghai, but it was based on international ISDN telephone calls at 10 per minute, unaffordable to communities with salaries of 300 per month. Satellites offered connectivity on short notice at better prices but funding by the communities was out of the question. Aid programs stepped in, connecting individual institutes across the area to the outside world. ISPs catered to those who could afford it, such as universities selling MBA courses, but Internet for research and education was lacking. In 2001, the NATO Science Programme added to its grants to institutes a multi-year program of providing a shared satellite service for international connectivity to all the countries above. National connectivity and solving the ``last mile problem'' was also funded, provided that a National Research and Education Network (NREN) organization was created in the country. SILK-1 ran 2002-6 for 3.5m providing 30Mbps west->east and 6Mbps east->west. QOS was implemented for video and audio conferencing. Co-funding by NRENs and others was established, but sustainability is still outstanding. Only recently, affordable fiber (<1k/month for 1 Mbps) is offered in parts of the area, so the RFP of SILK-2 in 2006 was issued in a technology-neutral way. No fiber bids were received, but a cheaper satellite service providing a total of 120/30Mbps for 3.5m in 2007-8. With fiber initiatives under way, it is hoped that part of SILK-2 can switch to fiber in 2009.

  7. Landmine research: technology solutions looking for problems

    NASA Astrophysics Data System (ADS)

    Trevelyan, James P.

    2004-09-01

    The global landmine problem came to the attention of researchers in the mid 1990's and by 1997 several advanced and expensive sensor research programs had started. Yet, by the end of 2003, there is little sign of a major advance in the technology available to humanitarian demining programs. Given the motivation and dedication of researchers, public goodwill to support such programs, and substantial research resources devoted to the problem, it is worth asking why these programs do not seem to have had an impact on demining costs or casualty rates. Perhaps there are factors that have been overlooked. This paper reviews several research programs to gain a deeper understanding of the problem. A possible explanation is that researchers have accepted mistaken ideas on the nature of the landmine problems that need to be solved. The paper provides several examples where the realities of minefield conditions are quite different to what researchers have been led to believe. Another explanation may lie in the political and economic realities that drive the worldwide effort to eliminate landmines. Most of the resources devoted to landmine clearance programs come from humanitarian aid budgets: landmine affected countries often contribute only a small proportion because they have different priorities based on realistic risk-based assessment of needs and political views of local people. Some aid projects have been driven by the need to find a market for demining technologies rather than by user needs. Finally, there is a common misperception that costs in less developed countries are intrinsically low, reflecting low rates paid for almost all classes of skilled labour. When actual productivity is taken into account, real costs can be higher than industrialized countries. The costs of implementing technological solutions (even using simple technologies) are often significantly under-estimated. Some political decisions may have discouraged thorough investigation of cost-effective alternatives to landmine clearance.

  8. Long-term care survey reveals challenges. Facilities grapple with five broad issues, including changes in leadership and AIDS.

    PubMed

    Westhoff, L J; Schaefer, J C

    1993-05-01

    The Catholic Health Association's 1992 survey of Catholic long-term care (LTC) facilities identified five broad issues LTC facilities face in the 1990s: leadership, system affiliation, community programs, resident issues, and care of persons with AIDS. The transition to lay leadership presents new challenges to the relationship between LTC facilities and their sponsors. Despite the dominance of religious sponsors, an increasing number of laypersons are serving as healthcare administrators both in long-term and acute care. Thirty percent of respondents reported being affiliated with a multi-institutional system. This percentage has changed little in the past few years, although the number of facilities that are system members continues to increase at the fastest rate of any type of LTC facility. Only 27 percent of survey respondents said they provide educational or informational programs for persons in their communities. Thirty-nine percent of system-affiliated LTC facilities reported offering such programs. One encouraging finding shows that 80 percent of facilities have written policies for living wills, 64 percent for designated proxy, and 86 percent for durable power of attorney for healthcare. LTC providers are struggling to determine their role in caring for persons with HIV and AIDS. Only 3.6 percent of respondents care for residents with AIDS. A major problem LTC administrators face is a fear of potential infection of staff or residents.

  9. Impact of Community-Based HIV/AIDS Treatment on Household Incomes in Uganda

    PubMed Central

    Feulefack, Joseph F.; Luckert, Martin K.; Mohapatra, Sandeep; Cash, Sean B.; Alibhai, Arif; Kipp, Walter

    2013-01-01

    Though health benefits to households in developing countries from antiretroviral treatment (ART) programs are widely reported in the literature, specific estimates regarding impacts of treatments on household incomes are rare. This type of information is important to governments and donors, as it is an indication of returns to their ART investments, and to better understand the role of HIV/AIDS in development. The objective of this study is to estimate the impact of a community-based ART program on household incomes in a previously underserved rural region of Uganda. A community-based ART program, based largely on labor contributions from community volunteers, was implemented and evaluated. All households with HIV/AIDS patients enrolled in the treatment programme (n = 134 households) were surveyed five times; once at the beginning of the treatment and every three months thereafter for a period of one year. Data were collected on household income from cash earnings and value of own production. The analysis, using ordinary least squares and quantile regressions, identifies the impact of the ART program on household incomes over the first year of the treatment, while controlling for heterogeneity in household characteristics and temporal changes. As a result of the treatment, health conditions of virtually all patients improved, and household incomes increased by approximately 30% to 40%, regardless of household income quantile. These increases in income, however, varied significantly depending on socio-demographic and socio-economic control variables. Overall, results show large and significant impacts of the ART program on household incomes, suggesting large returns to public investments in ART, and that treating HIV/AIDS is an important precondition for development. Moreover, development programs that invest in human capital and build wealth are important complements that can increase the returns to ART programs. PMID:23840347

  10. Third world debt Problem

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Munroe, T.

    The author examines key elements in the debt situation of a small number of developing countries which owe $600 billion to a small number of large banks in 10 industrialized countries. Most of the debt resides in Latin America. Shrinkage of the debt will also slow economic growth in these countries. Three solutions include purchase of the debt by an international agency, indexation of loan rates to inflation, and the preferred approach in which debtor countries slow their borrowing and adopt internal austerity programs that reduce trade deficits through reduced inflation and enhanced exports. Each of these approaches is amore » band-aid solution. The fundamental long-term solution is one where the world economy grows at a healthy rate with moderate inflation.« less

  11. Parents Ask about Title I = Los padres preguntan del Titulo I.

    ERIC Educational Resources Information Center

    RMC Research Corp., Portsmouth, NH.

    Title I, the largest federal aid program for elementary, middle, and high schools, is introduced in this publication, which includes both English and Spanish versions. Through Title I, the Federal government gives money to school districts around the country based on the number of low-income families in each district. Each district uses Title I…

  12. ADULT EDUCATION TECHNIQUES IN DEVELOPING COUNTRIES, A GREEK CASE STUDY. PROBLEMS OF DEVELOPMENT SERIES.

    ERIC Educational Resources Information Center

    FOURRE, PIERRE; AND OTHERS

    AIDED BY THE ORGANIZATION FOR ECONOMIC COOPERATION AND DEVELOPMENT AND THE ORGANIZATION FOR EUROPEAN ECONOMIC COOPERATION, GREECE HAS ESTABLISHED A NETWORK OF ADULT EDUCATION CENTERS OUTSIDE TOWNS, TO MEET THE PROBLEMS OF ILLITERACY AND LOW EDUCATION LEVEL. THE CENTER PROVIDES FOR ACADEMIC AND LIBRARY PROGRAMS, SIX TO SEVEN MONTHS, AND RECREATION…

  13. Dissecting the African Digital Divide: Diffusing E-Learning in Sub-Saharan Africa

    ERIC Educational Resources Information Center

    Beaudoin, Michael F.

    2007-01-01

    Many countries identified with the developing world, such as those in sub-Saharan Africa, have been recipients of aid programs over the past five decades totaling billions of dollars and aimed at fostering social and economic development to achieve global parity with the industrialized world. Much of this activity has been focused on building…

  14. Multi-step prediction for influenza outbreak by an adjusted long short-term memory.

    PubMed

    Zhang, J; Nawata, K

    2018-05-01

    Influenza results in approximately 3-5 million annual cases of severe illness and 250 000-500 000 deaths. We urgently need an accurate multi-step-ahead time-series forecasting model to help hospitals to perform dynamical assignments of beds to influenza patients for the annually varied influenza season, and aid pharmaceutical companies to formulate a flexible plan of manufacturing vaccine for the yearly different influenza vaccine. In this study, we utilised four different multi-step prediction algorithms in the long short-term memory (LSTM). The result showed that implementing multiple single-output prediction in a six-layer LSTM structure achieved the best accuracy. The mean absolute percentage errors from two- to 13-step-ahead prediction for the US influenza-like illness rates were all <15%, averagely 12.930%. To the best of our knowledge, it is the first time that LSTM has been applied and refined to perform multi-step-ahead prediction for influenza outbreaks. Hopefully, this modelling methodology can be applied in other countries and therefore help prevent and control influenza worldwide.

  15. Behavior change communication and mobile populations: the evaluation of a cross-border HIV/AIDS communication strategy amongst migrants from Swaziland.

    PubMed

    Silvestre, Eva; Weiner, Renay; Hutchinson, Paul

    2016-01-01

    This study investigates the effect of being exposed to the Soul City Southern Africa Regional OneLove campaign, a behavior change communication program, on sexual behavior and condom use among a mobile population in Swaziland. Data for this study come from a nationally representative sample of 845 individuals who reported traveling to neighboring countries for at least two weeks at any time in the previous two years. Respondents were asked about exposure to the campaign through television, radio, booklets, posters, and advertisements both in Swaziland and in the other countries where they had traveled in the previous two years. Odds ratios were used to estimate the relationships between the HIV/AIDS outcomes of interest and program exposure for the full sample as well as separately for males and females. The program had no effect on reducing known risky behaviors such as having multiple sexual partners. However, men exposed in Swaziland only (AOR = 3.4, CI 1.2-9.4) and in Swaziland and another country (AOR = 2.8, CI 1.0-7.7) were more likely to report using a condom at last sex. In the full sample, those exposed in Swaziland were more likely to report using a condom at last sex (AOR = 2.6, CI 1.3-5.3) and a condom at last sex with a regular partner (AOR = 2.3, CI 1.1-4.8). Men who reported multiple sexual partnerships and who were exposed in Swaziland and another country were nine times as likely to report condom at last sex than men with no exposure. Respondents exposed in Swaziland and another country were more likely to have been tested for HIV; this was true for the total population (AOR = 2.9, CI 1.1-7.9) and for men separately (AOR = 3.3, CI 1.1-10.1). These findings provide support for more regional HIV prevention programs in Southern Africa as a way to increase positive behaviors among mobile populations.

  16. KSC-2012-1853

    NASA Image and Video Library

    2012-02-17

    International Cooperation: NASA international cooperation provides opportunities for utilization of space by NASA partners worldwide. Cooperative programs allow each participating country to contribute its special talents and facilities to a common goal. International cooperation is a cornerstone of NASA’s space program today with multi-national crews living and working aboard the International Space Station. Poster designed by Kennedy Space Center Graphics Department/Greg Lee. Credit: NASA

  17. 115-year-old society knows how to reach young scientists: ASM Young Ambassador Program.

    PubMed

    Karczewska-Golec, Joanna

    2015-12-25

    With around 40,000 members in more than 150 countries, American Society for Microbiology (ASM) faces the challenge of meeting very diverse needs of its increasingly international members base. The newly launched ASM Young Ambassador Program seeks to aid the Society in this effort. Equipped with ASM conceptual support and financing, Young Ambassadors (YAs) design and pursue country-tailored approaches to strengthen the Society's ties with local microbiological communities. In a trans-national setting, the active presence of YAs at important scientific events, such as 16th European Congress on Biotechnology, forges new interactions between ASM and sister societies. The paper presents an overview of the Young Ambassadors-driven initiatives at both global and country levels, and explores the topic of how early-career scientists can contribute to science diplomacy and international relations. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Astronomy for a Better World: IAU OAD Task Force-1 Programs for Advancing Astronomy Education and Research in Universities in Developing Countries

    NASA Astrophysics Data System (ADS)

    Guinan, Edward; Kolenberg, Katrien

    2015-03-01

    We discuss the IAU Commission 46 and Office for Astronomy Development (OAD) programs that support advancing Astronomy education and research primarily in universities in developing countries. The bulk of these operational activities will be coordinated through the OAD's newly installed Task Force 1. We outline current (and future) IAU/OAD Task Force-1 programs that promote the development of University-level Astronomy at both undergraduate and graduate levels. Among current programs discussed are the past and future expanded activities of the International School for Young Astronomers (ISYA) and the Teaching Astronomy for Development (TAD) programs. The primary role of the ISYA program is the organization of a three week School for students for typically M.Sc. and Ph.D students. The ISYA is a very successful program that will now be offered more frequently through the generous support of the Kavli Foundation. The IAU/TAD program provides aid and resources for the development of teaching, education and research in Astronomy. The TAD program is dedicated to assist countries that have little or no astronomical activity, but that wish to develop or enhance Astronomy education. Over the last ten years, the ISYA and TAD programs have supported programs in Africa, Asia, Central America and the Caribbean, the Middle East, South East and West Asia, and South America. Several examples are given. Several new programs being considered by OAD Task Force-1 are also discussed. Other possible programs being considered are the introduction of modular Astronomy courses into the university curricula (or improve present courses) as well as providing access to ``remote learning`` courses and Virtual Astronomy labs in developing countries. Another possible new program would support visits of astronomers from technically advanced countries to spend their sabbatical leaves teaching and advising University Astronomy programs in developing countries. Suggestions for new Task Force -1 programs are also welcomed. Useful information about the participation of IAU members and volunteers in these programs will be discussed and practical information will be provided.

  19. Healthy public policy in poor countries: tackling macro-economic policies.

    PubMed

    Mohindra, K S

    2007-06-01

    Large segments of the population in poor countries continue to suffer from a high level of unmet health needs, requiring macro-level, broad-based interventions. Healthy public policy, a key health promotion strategy, aims to put health on the agenda of policy makers across sectors and levels of government. Macro-economic policy in developing countries has thus far not adequately captured the attention of health promotion researchers. This paper argues that healthy public policy should not only be an objective in rich countries, but also in poor countries. This paper takes up this issue by reviewing the main macro-economic aid programs offered by international financial institutions as a response to economic crises and unmanageable debt burdens. Although health promotion researchers were largely absent during a key debate on structural adjustment programs and health during the 1980s and 1990s, the international macro-economic policy tool currently in play offers a new opportunity to participate in assessing these policies, ensuring new forms of macro-economic policy interventions do not simply reproduce patterns of (neoliberal) economics-dominated development policy.

  20. A fundamental shift in the approach to international health by WHO, UNICEF, and the World Bank: instances of the practice of "intellectual fascism" and totalitarianism in some Asian countries.

    PubMed

    Banerji, D

    1999-01-01

    Navarro has used the term "intellectual fascism" to depict the intellectual situation in the McCarthy era. Intellectual fascism is now more malignant in the poor countries of the world. The Indian Subcontinent, China, and some other Asian countries provide the context. The struggles of the working class culminated in the Alma-Ata Declaration of self-reliance in health by the peoples of the world. To protect their commercial and political interests, retribution from the rich countries was sharp and swift, they "invented" Selective Primary Health Care and used WHO, UNICEF, the World Bank, and other agencies to let loose on poor countries a barrage of "international initiatives" as global programs on immunization, AIDS, and tuberculosis. These programs were astonishingly defective in concept, design, and implementation. The agencies refused to take note of such criticisms when they were published by others. They have been fascistic, ahistorical, grossly unscientific, and Goebbelsian propagandists. The conscience keepers of public health have mostly kept quiet.

  1. Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries12

    PubMed Central

    Kim, Sunny S.; Rogers, Beatrice L.; Coates, Jennifer; Gilligan, Daniel O.; Sarriot, Eric

    2013-01-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, “Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries,” provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs. PMID:24038245

  2. Building evidence for sustainability of food and nutrition intervention programs in developing countries.

    PubMed

    Kim, Sunny S; Rogers, Beatrice L; Coates, Jennifer; Gilligan, Daniel O; Sarriot, Eric

    2013-09-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, "Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries," provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs.

  3. What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys.

    PubMed

    Sia, Drissa; Onadja, Yentéma; Hajizadeh, Mohammad; Heymann, S Jody; Brewer, Timothy F; Nandi, Arijit

    2016-11-03

    Women are disproportionally affected by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa (SSA). The determinants of gender inequality in HIV/AIDS may vary across countries and require country-specific interventions to address them. This study aimed to identify the socio-demographic and behavioral characteristics underlying gender inequalities in HIV/AIDS in 21 SSA countries. We applied an extension of the Blinder-Oaxaca decomposition approach to data from Demographic and Health Surveys and AIDS Indicator Surveys to quantify the differences in HIV/AIDS prevalence between women and men attributable to socio-demographic factors, sexual behaviours, and awareness of HIV/AIDS. We decomposed gender inequalities into two components: the percentage attributable to different levels of the risk factors between women and men (the "composition effect") and the percentage attributable to risk factors having differential effects on HIV/AIDS prevalence in women and men (the "response effect"). Descriptive analyses showed that the difference between women and men in HIV/AIDS prevalence varied from a low of 0.68 % (P = 0.008) in Liberia to a high of 11.5 % (P < 0.001) in Swaziland. The decomposition analysis showed that 84 % (P < 0.001) and 92 % (P < 0.001) of the higher prevalence of HIV/AIDS among women in Uganda and Ghana, respectively, was explained by the different distributions of HIV/AIDS risk factors, particularly age at first sex between women and men. In the majority of countries, however, observed gender inequalities in HIV/AIDS were chiefly explained by differences in the responses to risk factors; the differential effects of age, marital status and occupation on prevalence of HIV/AIDS for women and men were among the significant contributors to this component. In Cameroon, Guinea, Malawi and Swaziland, a combination of the composition and response effects explained gender inequalities in HIV/AIDS prevalence. The factors that explain gender inequality in HIV/AIDS in SSA vary by country, suggesting that country-specific interventions are needed. Unmeasured factors also contributed substantially to the difference in HIV/AIDS prevalence between women and men, highlighting the need for further study.

  4. Application of nutrient intake values (NIVs).

    PubMed

    Vorster, Hester H; Murphy, Suzanne P; Allen, Lindsay H; King, Janet C

    2007-03-01

    The process of applying nutrient intake values (NIVs) for dietary assessment, planning, and implementing programs is discussed in this paper. In addition to assessing, monitoring, and evaluating nutritional situations, applications include planning food policies, strategies, and programs for promotion of optimal nutrition and preventing and treating malnutrition (both over- and undernutrition). Other applications include nutrition education, food and nutrient legislation, marketing and labeling, research, product development, food procurement and trade (import and export), food aid, and therapeutic (clinical) nutrition. Specific examples of how NIVs are used to develop food labels, fortification policies, and food-based dietary guidelines are described. Applications in both developed and developing countries are also described. In summary, NIVs are the scientific backbone of all aspects of nutrition policy in countries and regions worldwide.

  5. Improving rates of cotrimoxazole prophylaxis in resource-limited settings: implementation of a quality improvement approach.

    PubMed

    Bardfield, J; Agins, B; Palumbo, M; Wei, A L; Morris, J; Marston, B

    2014-12-01

    To demonstrate the effectiveness of quality improvement methods to monitor and improve administration of cotrimoxazole (CTX) prophylaxis to improve health outcomes among adults living with HIV/AIDS in low resource countries. Program evaluation. HIV/AIDS health care facilities in Uganda, Mozambique, Namibia and Haiti. Performance measures based on national guidelines are developed in each country. These may include CD4 monitoring, ART adherence and uptake of CTX prophylaxis. CTX prophylaxis is routinely selected, because it has been shown to reduce HIV-related morbidity and mortality. Patient records are sampled using a standard statistical table to achieve a minimum confidence interval of 90% with a spread of ±8% in participating clinics. If an electronic medical record is available, all patients are reviewed. Routine review of performance measures, usually every 6 months, is conducted to identify gaps in care. Improvement interventions are developed and implemented at health facilities, informed by performance results, and local/national public health priorities. Median clinic rates of CTX prophylaxis. Median performance rates of CTX prophylaxis generally improved for adult HIV+ patients between 2006 and 2013 across countries, with median clinic rates higher than baseline at follow-up in 16 of 18 groups of clinics implementing CTX -focused improvement projects. Quality management offers a data-driven method to improve the quality of HIV care in low resource countries. Application of improvement principles has been shown to be effective to increase the rates of CTX prophylaxis in national HIV programs in multiple countries. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  6. Country watch: India.

    PubMed

    Bhende, A A

    1996-01-01

    An acquired immunodeficiency syndrome (AIDS) education program sponsored by World Vision of India was effective in reaching low-income adolescent girls in Bombay. During the preparatory phase, household surveys, interviews, and focus group discussions were conducted to gain insight into the daily lives, interests, sexual activities, and health problems of female adolescents. These activities identified a need for support and cooperation of the parents of these girls and the broader community, services such as child care for younger siblings to facilitate attendance, promotion of self-confidence and self-expression, and discussion of AIDS within the broader context of women's status and rights. The curriculum covered topics such as being a woman, puberty, sexuality, sexual exploitation and harassment, the human immune system, and protection against AIDS and other sexually transmitted diseases. These messages were communicated through lectures, videos, plays, puppet shows, quizzes, story telling, role plays, and group discussions. The course was supplemented by a community awareness program involving community leaders, mothers of adolescent females, young men, and adolescent boys. A total of 76 girls (average age, 14 years) attended the 7-session course. A follow-up survey indicated that knowledge about AIDS, menstruation, and reproduction increased significantly over baseline; 62% of participants reported they had talked to others about AIDS since the course. World Vision has since expanded its Women and AIDS project to male and female adolescents and adults in 21 slums and two industrial complexes in Bombay.

  7. Recommendations for the Improved Effectiveness and Reporting of Telemedicine Programs in Developing Countries: Results of a Systematic Literature Review.

    PubMed

    Khanal, Sumesh; Burgon, Joseph; Leonard, Saoirse; Griffiths, Matthew; Eddowes, Lucy A

    2015-11-01

    A lack of decisive evidence on the impact of telemedicine on financial and clinical outcomes has not prohibited significant investment in developing countries. Understanding characteristics that facilitate effective telemedicine programs is required to allow telemedicine to be used to its full potential. This systematic review aimed to identify organizational, technological, and financial features of successful telemedicine programs providing direct clinical care in developing countries. Databases were searched, and the results were reviewed systematically according to predefined inclusion/exclusion criteria. Information on location(s), measure of success, and organizational, technological, and financial characteristics were extracted. This review was impeded by inadequate program reporting, and so a concise checklist was developed to aid improved reporting, enabling future reviews to identify key characteristics of effective programs. This systematic review identified 46 articles reporting 36 programs that fulfilled the inclusion/exclusion criteria. Programs were distributed globally, including regional, national, and international programs. Technological modalities included synchronous technology, real-time teleconsultations, and asynchronous technology. Program integration with existing systems and twinning of international institutions were identified as factors enabling program success. Other factors included simple and easy-to-use technology, ability to reduce the burden on healthcare professionals, and technology able to maintain functionality in challenging environmental circumstances. Reports describing effectiveness and costs were limited. This systematic review identified key factors associated with telemedicine program success. However, inconsistencies in reporting represent an obstacle to establishment of successful programs in developing countries by limiting the application of previous experiences. Adhering to the guidelines suggested here may allow more quantitative assessments of effectiveness and impact for future programs.

  8. [AIDS in the Congo].

    PubMed

    Ekundzola, J R

    1990-10-01

    In the Congo, the first cases of AIDS were discovered in 1983 a Scientific Committee to Diagnose and Fight AIDS was established by the Ministry of HEALTH whose aim was to officially recognize AIDS in the Congo by: 1) evaluating the national situation, and 2) implementing a prevention program. In 1986 the Government purchased 2 ELISA diagnostic machines and established a blood bank. In 1987 the Government signed an agreement with the World Health Organization (WHO) to implement a short- term plan of action and the National Program Against AIDS was established and implemented with a national policy to prevent and control AIDS. In 1987 a National Symposium on AIDS took place and an IEC strategy developed. In 1988 the Triennial Plan Against AIDS was established for 1989-1991 with WHO to informal and educate people on AIDS, to prevent the HIV transmission through blood, to survey the progress of the epidemic and to treat those infected with HIV. In November 1988 the National Scientific Committee became the Scientific Commission of the national Committee Against AIDS presided over by the Minister of Health and Social Affairs with representation from all other sectors in the country. AIDS in the Congo is transmitted by HIV-1 through sex and blood (10-20%). Women and men alike have been affected representing all strata in society, however those affected are mostly from the urban areas. The seroprevalence in the urban areas is 5%, with 1% in the rural. 20% of those infected had blood transfusions 4-6 years before getting the HIV virus. Between 1983-1989 1940 cases of AIDS were reported to WHO; most of these were in the age group 20-4-. A KAP on AIDS was done showing that more than 90% of the population had head about AIDS: 65% knew about AIDS and 30% were using condoms. (author's modified).

  9. A multi-disciplinary approach to implementation science: the NIH-PEPFAR PMTCT implementation science alliance.

    PubMed

    Sturke, Rachel; Harmston, Christine; Simonds, R J; Mofenson, Lynne M; Siberry, George K; Watts, D Heather; McIntyre, James; Anand, Nalini; Guay, Laura; Castor, Delivette; Brouwers, Pim; Nagel, Joan D

    2014-11-01

    In resource-limited countries, interventions to prevent mother-to-child HIV transmission (PMTCT) have not yet realized their full potential health impact, illustrating the common gap between the scientific proof of an intervention's efficacy and effectiveness and its successful implementation at scale into routine health services. For PMTCT, this gap results, in part, from inadequate adaptation of PMTCT interventions to the realities of the implementation environment, including client and health care worker behaviors and preferences, health care policies and systems, and infrastructure and resource constraints. Elimination of mother-to-child HIV transmission can only be achieved through understanding of key implementation barriers and successful adaptation of scientifically proven interventions to the local environment. Central to such efforts is implementation science (IS), which aims to investigate and address major bottlenecks that impede effective implementation and to test new approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions. Advancing IS will require deliberate and strategic efforts to facilitate collaboration, communication, and relationship-building among researchers, implementers, and policy-makers. To speed the translation of effective PMTCT interventions into practice and advance IS more broadly, the US National Institutes of Health, in collaboration with the President's Emergency Plan for AIDS Relief launched the National Institutes of Health/President's Emergency Plan for AIDS Relief PMTCT IS Alliance, comprised of IS researchers, PMTCT program implementers, and policy-makers as an innovative platform for interaction and coordination.

  10. AIDS in Nicaragua: epidemiological, political, and sociocultural perspectives.

    PubMed

    Low, N; Egger, M; Gorter, A; Sandiford, P; González, A; Pauw, J; Ferrie, J; Smith, G D

    1993-01-01

    The AIDS epidemic in Nicaragua is several years behind that in the United States and neighboring countries of Central and South America. A combination of events, including the isolation caused by the war of the U.S.-backed Contra army against the Sandinista government, the complete economic embargo imposed on Nicaragua by the United States in 1985, self-sufficiency for blood products, and a low rate of recreational injectable-drug use, have contributed to this situation. Since the Sandinistas were defeated in the general election of 1990, people have returned to Nicaragua from areas where HIV is more prevalent, such as Honduras and the United States. It is probable that many HIV-infected persons have now entered the country. Because of the high rates of sexually transmitted diseases and cultural factors such as "machismo," HIV is likely to spread rapidly by heterosexual transmission, unless effective, culturally appropriate education and sexually transmitted disease prevention programs are implemented now.

  11. A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study.

    PubMed

    Gilmartin-Thomas, Julia Fiona-Maree; Smith, Felicity; Wolfe, Rory; Jani, Yogini

    2017-07-01

    No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. Prospective observational. Ten Greater London care homes. Nurses and carers administering medications. Between October 2014 and June 2015, a pharmacist researcher directly observed solid, orally administered medications in tablet or capsule form at ten purposively sampled care homes (five only used original medication packaging and five used both multi-compartment compliance aids and original medication packaging). The medication administration error rate was calculated as the number of observed doses administered (or omitted) in error according to medication administration records, compared to the opportunities for error (total number of observed doses plus omitted doses). Over 108.4h, 41 different staff (35 nurses, 6 carers) were observed to administer medications to 823 residents during 90 medication administration rounds. A total of 2452 medication doses were observed (1385 from original medication packaging, 1067 from multi-compartment compliance aids). One hundred and seventy eight medication administration errors were identified from 2493 opportunities for error (7.1% overall medication administration error rate). A greater medication administration error rate was seen for original medication packaging than multi-compartment compliance aids (9.3% and 3.1% respectively, risk ratio (RR)=3.9, 95% confidence interval (CI) 2.4 to 6.1, p<0.001). Similar differences existed when comparing medication administration error rates between original medication packaging (from original medication packaging-only care homes) and multi-compartment compliance aids (RR=2.3, 95%CI 1.1 to 4.9, p=0.03), and between original medication packaging and multi-compartment compliance aids within care homes that used a combination of both medication administration systems (RR=4.3, 95%CI 2.7 to 6.8, p<0.001). A significant difference in error rate was not observed between use of a single or combination medication administration system (p=0.44). The significant difference in, and high overall, medication administration error rate between original medication packaging and multi-compartment compliance aids supports the use of the latter in care homes, as well as local investigation of tablet and capsule impact on medication administration errors and staff training to prevent errors occurring. As a significant difference in error rate was not observed between use of a single or combination medication administration system, common practice of using both multi-compartment compliance aids (for most medications) and original packaging (for medications with stability issues) is supported. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts.

    PubMed

    Althoff, Keri N; Rebeiro, Peter F; Hanna, David B; Padgett, Denis; Horberg, Michael A; Grinsztejn, Beatriz; Abraham, Alison G; Hogg, Robert; Gill, M John; Wolff, Marcelo J; Mayor, Angel; Rachlis, Anita; Williams, Carolyn; Sterling, Timothy R; Kitahata, Mari M; Buchacz, Kate; Thorne, Jennifer E; Cesar, Carina; Cordero, Fernando M; Rourke, Sean B; Sierra-Madero, Juan; Pape, Jean W; Cahn, Pedro; McGowan, Catherine

    2016-01-01

    Maps are powerful tools for visualization of differences in health indicators by geographical region, but multi-country maps of HIV indicators do not exist, perhaps due to lack of consistent data across countries. Our objective was to create maps of four HIV indicators in North, Central, and South American countries. Using data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and the Caribbean, Central, and South America network for HIV epidemiology (CCASAnet), we mapped median CD4 at presentation for HIV clinical care, proportion retained in HIV primary care, proportion prescribed antiretroviral therapy (ART), and the proportion with suppressed plasma HIV viral load (VL) from 2010 to 2012 for North, Central, and South America. The 15 Canadian and US clinical cohorts and 7 clinical cohorts in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru represented approximately 2-7% of persons known to be living with HIV in these countries. Study populations were selected for each indicator: median CD4 at presentation for care was estimated among 14,811 adults; retention was estimated among 87,979 adults; ART use was estimated among 84,757 adults; and suppressed VL was estimated among 51,118 adults. Only three US states and the District of Columbia had a median CD4 at presentation >350 cells/mm(3). Haiti, Mexico, and several states had >85% retention in care; lower (50-74%) retention in care was observed in the US West, South, and Mid-Atlantic, and in Argentina, Brazil, and Peru. ART use was highest (90%) in Mexico. The percentages of patients with suppressed VL in the US South and Northeast were lower than in most of Central and South America. These maps provide visualization of gaps in the quality of HIV care and allow for comparison between and within countries as well as monitoring policy and programme goals within geographical boundaries.

  13. A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts

    PubMed Central

    Althoff, Keri N; Rebeiro, Peter F; Hanna, David B; Padgett, Denis; Horberg, Michael A; Grinsztejn, Beatriz; Abraham, Alison G; Hogg, Robert; Gill, M John; Wolff, Marcelo J; Mayor, Angel; Rachlis, Anita; Williams, Carolyn; Sterling, Timothy R; Kitahata, Mari M; Buchacz, Kate; Thorne, Jennifer E; Cesar, Carina; Cordero, Fernando M; Rourke, Sean B; Sierra-Madero, Juan; Pape, Jean W; Cahn, Pedro; McGowan, Catherine

    2016-01-01

    Introduction Maps are powerful tools for visualization of differences in health indicators by geographical region, but multi-country maps of HIV indicators do not exist, perhaps due to lack of consistent data across countries. Our objective was to create maps of four HIV indicators in North, Central, and South American countries. Methods Using data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and the Caribbean, Central, and South America network for HIV epidemiology (CCASAnet), we mapped median CD4 at presentation for HIV clinical care, proportion retained in HIV primary care, proportion prescribed antiretroviral therapy (ART), and the proportion with suppressed plasma HIV viral load (VL) from 2010 to 2012 for North, Central, and South America. The 15 Canadian and US clinical cohorts and 7 clinical cohorts in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru represented approximately 2–7% of persons known to be living with HIV in these countries. Results Study populations were selected for each indicator: median CD4 at presentation for care was estimated among 14,811 adults; retention was estimated among 87,979 adults; ART use was estimated among 84,757 adults; and suppressed VL was estimated among 51,118 adults. Only three US states and the District of Columbia had a median CD4 at presentation >350 cells/mm3. Haiti, Mexico, and several states had >85% retention in care; lower (50–74%) retention in care was observed in the US West, South, and Mid-Atlantic, and in Argentina, Brazil, and Peru. ART use was highest (90%) in Mexico. The percentages of patients with suppressed VL in the US South and Northeast were lower than in most of Central and South America. Conclusions These maps provide visualization of gaps in the quality of HIV care and allow for comparison between and within countries as well as monitoring policy and programme goals within geographical boundaries. PMID:27049052

  14. Drivers of inequality in Millennium Development Goal progress: a statistical analysis.

    PubMed

    Stuckler, David; Basu, Sanjay; McKee, Martin

    2010-03-02

    Many low- and middle-income countries are not on track to reach the public health targets set out in the Millennium Development Goals (MDGs). We evaluated whether differential progress towards health MDGs was associated with economic development, public health funding (both overall and as percentage of available domestic funds), or health system infrastructure. We also examined the impact of joint epidemics of HIV/AIDS and noncommunicable diseases (NCDs), which may limit the ability of households to address child mortality and increase risks of infectious diseases. We calculated each country's distance from its MDG goals for HIV/AIDS, tuberculosis, and infant and child mortality targets for the year 2005 using the United Nations MDG database for 227 countries from 1990 to the present. We studied the association of economic development (gross domestic product [GDP] per capita in purchasing-power-parity), the relative priority placed on health (health spending as a percentage of GDP), real health spending (health system expenditures in purchasing-power-parity), HIV/AIDS burden (prevalence rates among ages 15-49 y), and NCD burden (age-standardised chronic disease mortality rates), with measures of distance from attainment of health MDGs. To avoid spurious correlations that may exist simply because countries with high disease burdens would be expected to have low MDG progress, and to adjust for potential confounding arising from differences in countries' initial disease burdens, we analysed the variations in rates of change in MDG progress versus expected rates for each country. While economic development, health priority, health spending, and health infrastructure did not explain more than one-fifth of the differences in progress to health MDGs among countries, burdens of HIV and NCDs explained more than half of between-country inequalities in child mortality progress (R(2)-infant mortality = 0.57, R(2)-under 5 mortality = 0.54). HIV/AIDS and NCD burdens were also the strongest correlates of unequal progress towards tuberculosis goals (R(2) = 0.57), with NCDs having an effect independent of HIV/AIDS, consistent with micro-level studies of the influence of tobacco and diabetes on tuberculosis risks. Even after correcting for health system variables, initial child mortality, and tuberculosis diseases, we found that lower burdens of HIV/AIDS and NCDs were associated with much greater progress towards attainment of child mortality and tuberculosis MDGs than were gains in GDP. An estimated 1% lower HIV prevalence or 10% lower mortality rate from NCDs would have a similar impact on progress towards the tuberculosis MDG as an 80% or greater rise in GDP, corresponding to at least a decade of economic growth in low-income countries. Unequal progress in health MDGs in low-income countries appears significantly related to burdens of HIV and NCDs in a population, after correcting for potentially confounding socioeconomic, disease burden, political, and health system variables. The common separation between NCDs, child mortality, and infectious syndromes among development programs may obscure interrelationships of illness affecting those living in poor households--whether economic (e.g., as money spent on tobacco is lost from child health expenditures) or biological (e.g., as diabetes or HIV enhance the risk of tuberculosis).

  15. Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis

    PubMed Central

    Lee, Hwa-Young; Kang, Minah

    2015-01-01

    This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country. PMID:26617451

  16. Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis.

    PubMed

    Lee, Hwa-Young; Yang, Bong-Min; Kang, Minah

    2015-11-01

    This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country.

  17. Enhancing NGO capacity in HIV / AIDS materials development: experiences from Nepal.

    PubMed

    Frey, M; Pyakuryal, N

    1995-07-01

    With the goal of improving the communication skills of Nepali nongovernmental organizations (NGO) involved in HIV/AIDS prevention programs and activities, Save the Children, US (SC/US) invited 12 leading NGOs in HIV/AIDS prevention to attend an information, education, and communication (IEC) workshop at the end of 1993 addressing the principles of materials development and how the groups could coordinate their activities and improve the quality of materials developed. The Nepal NGO HIV/AIDS IEC Coordination Committee resulted. 17 organizations now comprise the committee which has reviewed and commented upon 60 draft educational materials developed by member organizations and other NGOs working in more remote areas of the country. The committee has proved to be a good forum for improving materials development and distribution in Nepal and for providing technical assistance to the NGO community. NGO communication skills have increased markedly. The group has also facilitated the transfer of technical skills, coordination, and resource allocation.

  18. Supporting women's empowerment in Djibouti.

    PubMed

    Rasul, Z

    1999-01-01

    This article reports on the work carried out by the UN Population Fund (UNFPA) in the small island of Djibouti, Africa. The republic's population has been plagued with problems of high levels of unemployment, poverty, malnutrition, an almost non-existent family reproductive health care service, 100% prevalence rate of female genital mutilation and low literacy rate, especially for women. In addition, refugees from Ethiopia and Eritrea have settled in the country increasing the risks of sexually transmitted diseases (STDs), HIV/AIDS, prostitution, and other social ills. In 1983, UNFPA started funding family planning and later reproductive health projects aimed at assuring access to services for a majority of Djiboutan women. The first country population program of assistance was started in 1992. This would help the government with health care for its population and to conduct a population census. In addition, the Fund has paid for training of doctors, midwives, and traditional birth assistants in the country and for rehabilitating maternity clinics and information centers. Moreover, it has supported agencies concerned with educating people on STDs, HIV/AIDS, safe motherhood and reproductive health for men and women, and other important issues.

  19. Myths about AIDS in Cambodia.

    PubMed

    Nariddh, M C

    1994-08-01

    HIV has been reported in the capital city of Cambodia, Phnom Penh, as well as in the northwestern provinces of Banteay Meanchey, Battambang, Pursat, and Kompong Chhnang. Unofficial reports indicate the presence of HIV in three northeastern provinces. According to World Health Organization data, 382 people were infected with HIV in Cambodia as of March 1994, but the national AIDS program estimates that 2000-4000 Cambodians may be HIV-seropositive. Small surveys in 1992 identified HIV infection rates to be 4.5% among patients of sexually transmitted disease (STD) clinics and 9.2% among prostitutes. A seroprevalence rate of 4.3% was found in 1993 among clients of STD clinics and others requesting HIV testing. These rather marked levels of infection exist in Cambodia even though HIV was first identified in the country as recently as 1991 among screened blood from volunteer donors. By December 1993, the rate of positive results from blood donors had increased to 1.97%.; the rate of infection among blood donors is expected to double to approximately 4% in 1994. People in Cambodia variously believe that AIDS is nonexistent, AIDS is a problem of other countries, can be transmitted by mosquitoes, healthy people do not have AIDS, a cure exists for AIDS, AIDS can be contracted only from prostitutes, AIDS is the most severe state of syphilis, and AIDS is only a propaganda ploy of condom producers to market their products. It is therefore proving extremely difficult to convince people that AIDS is a truly threatening disease against which they should protect themselves, especially when symptoms are rarely present during the early stage of infection. Health education campaigns, videos, posters, and accurate reporting in the media will, however, help change minds and hopefully induce HIV-preventive behaviors. Of interest, the article notes that virtually every prostitute in Cambodia has at least two-three STDs.

  20. The impact of HIV-associated anaemia on the incidence of red blood cell transfusion: implications for blood services in HIV-endemic countries.

    PubMed

    van den Berg, Karin; Murphy, Edward L; Pretorius, Lelanie; Louw, Vernon J

    2014-12-01

    Cytopaenias, especially anaemia, are common in the HIV-infected population. The causes of HIV related cytopaenias are multi-factorial and often overlapping. In addition, many of the drugs used in the management of HIV-positive individuals are myelosuppresive and can both cause and exacerbate anaemia. Even though blood and blood products are still the cornerstone in the management of severe cytopaenias, how HIV may affect blood utilisation is not well understood. The impact of HIV/AIDS on blood collections has been well documented. As the threat posed by HIV on the safety of the blood supply became clearer, South Africa introduced progressively more stringent donor selection criteria, based on the HIV risk profile of the donor cohort from which the blood collected. The implementation of new testing technology in 2008 which significantly improved the safety of the blood supply enabled the removal of what was perceived by many as a racially based donor risk model. However, this new technology had a significant and sustained impact on the cost of blood and blood products in South Africa. In contrast, it would appear little is known of how HIV influences the utilisation of blood and blood products. Considering the high prevalence of HIV among hospitalised patients and the significant risk for anaemia among this group, there would be an expectation that the transfusion requirements of an HIV-infected patient would be higher than that of an HIV-negative patient. However, very little published data is available on this topic which emphasises the need for further large-scale studies to evaluate the impact of HIV/AIDS on the utilisation of blood and blood products and how the large-scale roll-out of ARV programs may in future play a role in determining the country's blood needs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Social responsibility, international development, and institutional commitment: lessons from the Boston University experience.

    PubMed

    Babich, Lauren P; Bicknell, William J; Culpepper, Larry; Jack, Brian W

    2008-02-01

    Boston University (BU) has a long history of a strong social mission and commitment to service. In August 2003, BU made an institutional commitment to work with the country of Lesotho to tackle the human capital implications of the HIV/AIDS epidemic. Surrounded by South Africa, and with a population of two million, Lesotho, a stable democracy, suffers the world's third-highest adult HIV prevalence rate of about 24%. The initiation of the program required a substantial initial institutional investment without any promise of payback. This allowed BU to begin work in Lesotho while searching for additional funds. The government of Lesotho and BU agreed to focus on preserving the lives of Lesotho's citizens, building the capacity of the country's workforce, and maximizing the efficiency of Lesotho's existing systems and resources. Initial activities were modest, beginning with workshops on problem solving, then the launch of a primary care clinic that offered HIV/AIDS treatment services at the nation's only teacher training college. With support from the W.K. Kellogg Foundation, the main focus is now on strengthening district-level primary care services, including the initiation of a family medicine residency training program in cooperation with the University of the Free State in Bloemfontein. The initial commitment has developed into a mutual partnership, with benefits to country and university alike. By combining the expertise from various schools and departments to focus on a single country, a university can significantly advance international development, strengthen its service mission, enrich teaching, and provide new opportunities for research.

  2. Family planning and the controversial contraceptives.

    PubMed

    Dias Saxena, F

    1995-01-01

    India was one of the first countries in the world to launch a national family planning program in an apparent effort to help women gain access to birth control measures and reduce population growth. Family planning acquired a different meaning and emphasis in the 1960s, however, when a clause in the US PL480 wheat import policy demanded that India speed its implementation of birth control measures if the country wanted food aid. Women in India were therefore expected to consume contraceptives with dangerous and unknown side effects in order to quality the country for food aid. Women rejected this stipulation. By the 1980s, it was acknowledged that family planning programs in India had failed to produce a decline in the birth rate and that no sign of change was on the horizon despite the investment of substantial funds to that end, the input of expert assistance, and the establishment of appropriate infrastructure in the country. Experts and policy makers blamed women for having misused the pill and sought alternative methods which would not require user compliance. Norplant and norethisterone enanthate (Net-en) were subsequently developed. Policymakers, experts, and the press have now been clamoring for the right to conduct Norplant trials despite reported side effects. The drug's ability to prevent pregnancy is more important for family planning experts. The author notes that the emphasis has been upon contraceptive methods for women instead of men because men were not expected to take responsibility for family planning. She also notes that feminists are opposed to Norplant and Net-en, and hopes that the government withdraws them from the market.

  3. Building a Stronger System for Tracking Nutrition-Sensitive Spending: A Methodology and Estimate of Global Spending for Nutrition-Sensitive Foreign Aid.

    PubMed

    Ickes, Scott B; Trichler, Rachel B; Parks, Bradley C

    2015-12-01

    There is growing awareness that the necessary solutions for improving nutrition outcomes are multisectorial. As such, investments are increasingly directed toward "nutrition-sensitive" approaches that not only address an underlying or basic determinant of nutrition but also seek to achieve an explicit nutrition goal or outcome. Understanding how and where official development assistance (ODA) for nutrition is invested remains an important but complex challenge, as development projects components vary in their application to nutrition outcomes. Currently, no systematic method exists for tracking nutrition-sensitive ODA. To develop a methodology for classifying and tracking nutrition-sensitive ODA and to produce estimates of the amount of nutrition-sensitive aid received by countries with a high burden of undernutrition. We analyzed all financial flows reported to the Organization for Economic Co-Operation and Development's Development Assistance Committee Creditor Reporting Service in 2010 to estimate these investments. We assessed the relationships between national stunting prevalence, stunting burden, under-5 mortality, and the amount of nutrition-specific and nutrition-sensitive ODA. We estimate that, in 2010, a total of $379·4 million (M) US dollars (USD) was committed to nutrition-specific projects and programs of which 25 designated beneficiaries (countries and regions) accounted for nearly 85% ($320 M). A total of $1.79 billion (B) was committed to nutrition-sensitive spending, of which the top 25 countries/regions accounted for $1.4 B (82%). Nine categories of development activities accounted for 75% of nutrition-sensitive spending, led by Reproductive Health Care (30·4%), Food Aid/Food Security Programs (14·1%), Emergency Food Aid (13·2%), and Basic Health Care (5·0%). Multivariate linear regression models indicate that the amount of nutrition-sensitive (P = .001) and total nutrition ODA was significantly predicted by stunting prevalence (P = .001). The size of the total population of stunted children significantly predicted the amount of nutrition-specific ODA (P < .001). The recipient profile of nutrition-specific and nutrition-sensitive ODA is related but distinct. Nutrition indicators are associated with the level of nutrition-related ODA commitments to recipient countries. A reliable estimate of nutrition spending is critical for effective planning by both donors and recipients and key for success, as the global development community recommits to a new round of goals to address the interrelated causes of undernutrition in low-income countries. © The Author(s) 2015.

  4. Country watch. Tanzania / Uganda / Zaire.

    PubMed

    Senturias, E N

    1994-01-01

    A participatory action research program was implemented in Tanzania, Uganda, and Zaire to sensitize and encourage church leaders and members to more actively participate in HIV/AIDS prevention and care. Communities had a major role in the process, even defining research questions. The program effectively helped sensitize individuals at the community and international levels, with its effects ongoing even though the program has officially ended. Collective community consciousness was raised on the need to address the epidemic, while identifying important issues to confront. Focus group discussions and the conference generated open and frank discussions on condom use, culture, and sexual behavior.

  5. Guidelines for Analysis of Communicable Disease Control Planning in Developing Countries. Volume 1: Communicable Diseases Control Planning. International Health Planning Methods Series.

    ERIC Educational Resources Information Center

    Chin, James

    Intended to assist Agency for International Development (AID) officers, advisors, and health officials in incorporating health planning into national plans for economic development, this first of ten manuals in the International Health Planning Methods Series deals with planning and evaluation of communicable disease control programs. The first…

  6. A Practical Guide to Management of Common Pests in Schools. Integrated Pest Management.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Public Health, Springfield.

    This 3-part manual is designed to assist school officials understand the principles of Integrated Pest Management and aid them in implementing those principles into a comprehensive pest control program in their facilities. Developed for Illinois, this guide can be applied in part or in total to other areas of the country. Part 1 explains what an…

  7. Counselors, Education and Mousetraps: An Action Plan for the Junior High School Counselor.

    ERIC Educational Resources Information Center

    Oakes, Jack E.

    This paper describes a plan for career education which is being adopted by the California Career Education Task Force with the intent of aiding the State Department of Education. The plan will be useful to many educators throughout the country. Part One of this paper deals with counselor effectiveness. Guidance and counseling program modes as well…

  8. Marine Fisheries Case Studies. Appropriate Technologies for Development. Case Study No. 1.

    ERIC Educational Resources Information Center

    Chakroff, Marilyn; DuBois, Random

    This guide was developed to aid Peace Corps volunteers interested in programming marine fisheries projects. Although these projects are not new to the Peace Corps, new staff members may not be aware of the history of marine fisheries efforts in their country. Chapter 1 discusses all past marine fisheries projects initiated by the Peace Corps in…

  9. More a plowshare than a sword: the legacy of US Cold War agricultural diplomacy.

    PubMed

    McGlade, Jacqueline

    2009-01-01

    Recently, agriculture has assumed an elevated role in world diplomacy due to pressing issues like international poverty relief, changing environmental conditions, farm trade imbalances, rising food prices, and the diversion of crops into bio-fuel production. Consequently, agricultural interests and production have become increasingly entwined with the politics of national protectionism and identity, domestic security, and the preservation of trading advantage in developed and developing countries alike. This study examines the current impasse in world agricultural negotiations as an outgrowth of US foreign aid and trade policymaking as it evolved during the Cold War. In particular, it chronicles the historic shift in US foreign policy away from "give-away" food aid and surplus sales and toward the championing of global agricultural redevelopment under such programs as the Marshall Plan and PL 480, the Food for Peace program. As more a plowshare than a sword, the American Cold War push for worldwide agricultural modernization led many countries to experience new levels of food self-efficiency and export capabilities. Along with production parity, however, has come escalating levels of trade competition and national protectionism, which challenges again the achievement of world agricultural stability and prosperity.

  10. Does the theory-driven program affect the risky behavior of drug injecting users in a healthy city? A quasi-experimental study

    PubMed Central

    Karimy, Mahmood; Abedi, Ahmad Reza; Abredari, Hamid; Taher, Mohammad; Zarei, Fatemeh; Rezaie Shahsavarloo, Zahra

    2016-01-01

    Background: The horror of HIV/AIDS as a non-curable, grueling disease is a destructive issue for every country. Drug use, shared needles and unsafe sex are closely linked to the transmission of HIV/AIDS. Modification or changing unhealthy behavior through educational programs can lead to HIV prevention. The aim of this study was to evaluate the efficiency of theory-based education intervention on HIV prevention transmission in drug addicts. Methods: In this quasi-experimental study, 69 male drug injecting users were entered in to the theory- based educational intervention. Data were collected using a questionnaire, before and 3 months after four sessions (group discussions, lecture, film displaying and role play) of educational intervention. Results: The findings signified that the mean scores of constructs (self-efficacy, susceptibility, severity and benefit) significantly increased after the educational intervention, and the perceived barriers decreased (p< 0.001). Also, the history of HIV testing was reported to be 9% before the intervention, while the rate increased to 88% after the intervention. Conclusion: The present research offers a primary founding for planning and implementing a theory based educational program to prevent HIV/AIDS transmission in drug injecting addicts. This research revealed that health educational intervention improved preventive behaviors and the knowledge of HIV/AIDS participants. PMID:27390684

  11. Setting the Stage: Current State of Affairs and Major Challenges

    PubMed Central

    Reynolds, Steven J.; Quinn, Thomas C.

    2010-01-01

    The global human immunodeficiency virus (HIV) pandemic reached staggering proportions over the past 2 decades, particularly in areas of sub-Saharan Africa and other developing countries. Tremendous increases in donor resources over the past decade have allowed for a rapid scale-up of antiretroviral treatment and greater access to basic care and prevention programs in countries worst affected by HIV infection and AIDS. These programs have had a tremendous impact on the lives of millions of individuals and have also created optimism and hope where previously there was despair. Major challenges remain in combating the current HIV pandemic with regard to access to treatment; efficiency, quality, and sustainability of current programs; and the scale-up of evidence-based, effective prevention strategies. The global health community and political leaders will need to overcome these challenges if a long-term effective response to the HIV pandemic is to be achieved. PMID:20397959

  12. Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships.

    PubMed

    Matovu, Joseph K B; Wanyenze, Rhoda K; Mawemuko, Susan; Wamuyu-Maina, Gakenia; Bazeyo, William; Olico-Okui; Serwadda, David

    2011-02-24

    Around the world, health professionals and program managers are leading and managing public and private health organizations with little or no formal management and leadership training and experience. To describe an innovative 2-year, long-term apprenticeship Fellowship training program implemented by Makerere University School of Public Health (MakSPH) to strengthen capacity for leadership and management of HIV/AIDS programs in Uganda. IMPLEMENTATION PROCESS: The program, which began in 2002, is a 2-year, full-time, non-degree Fellowship. It is open to Ugandan nationals with postgraduate training in health-related disciplines. Enrolled Fellows are attached to host institutions implementing HIV/AIDS programs and placed under the supervision of host institution and academic mentors. Fellows spend 75% of their apprenticeship at the host institutions while the remaining 25% is dedicated to didactic short courses conducted at MakSPH to enhance their knowledge base. Overall, 77 Fellows have been enrolled since 2002. Of the 57 Fellows who were admitted between 2002 and 2008, 94.7% (54) completed the Fellowship successfully and 50 (92.3%) are employed in senior leadership and management positions in Uganda and internationally. Eighty-eight percent of those employed (44/54) work in institutions registered in Uganda, indicating a high level of in-country retention. Nineteen of the 20 Fellows who were admitted between 2009 and 2010 are still undergoing training. A total of 67 institutions have hosted Fellows since 2002. The host institutions have benefited through staff training and technical expertise from the Fellows as well as through grant support to Fellows to develop and implement innovative pilot projects. The success of the program hinges on support from mentors, stakeholder involvement, and the hands-on approach employed in training. The Fellowship Program offers a unique opportunity for hands-on training in HIV/AIDS program leadership and management for both Fellows and host institutions. © 2011 Joseph K.B. Matovu et al.

  13. Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships

    PubMed Central

    Matovu, Joseph K.B.; Wanyenze, Rhoda K.; Mawemuko, Susan; Wamuyu-Maina, Gakenia; Bazeyo, William; Olico-Okui; Serwadda, David

    2011-01-01

    Background Around the world, health professionals and program managers are leading and managing public and private health organizations with little or no formal management and leadership training and experience. Objective To describe an innovative 2-year, long-term apprenticeship Fellowship training program implemented by Makerere University School of Public Health (MakSPH) to strengthen capacity for leadership and management of HIV/AIDS programs in Uganda. Implementation process The program, which began in 2002, is a 2-year, full-time, non-degree Fellowship. It is open to Ugandan nationals with postgraduate training in health-related disciplines. Enrolled Fellows are attached to host institutions implementing HIV/AIDS programs and placed under the supervision of host institution and academic mentors. Fellows spend 75% of their apprenticeship at the host institutions while the remaining 25% is dedicated to didactic short courses conducted at MakSPH to enhance their knowledge base. Achievements Overall, 77 Fellows have been enrolled since 2002. Of the 57 Fellows who were admitted between 2002 and 2008, 94.7% (54) completed the Fellowship successfully and 50 (92.3%) are employed in senior leadership and management positions in Uganda and internationally. Eighty-eight percent of those employed (44/54) work in institutions registered in Uganda, indicating a high level of in-country retention. Nineteen of the 20 Fellows who were admitted between 2009 and 2010 are still undergoing training. A total of 67 institutions have hosted Fellows since 2002. The host institutions have benefited through staff training and technical expertise from the Fellows as well as through grant support to Fellows to develop and implement innovative pilot projects. The success of the program hinges on support from mentors, stakeholder involvement, and the hands-on approach employed in training. Conclusion The Fellowship Program offers a unique opportunity for hands-on training in HIV/AIDS program leadership and management for both Fellows and host institutions. PMID:21364774

  14. An investigation of constraint-based component-modeling for knowledge representation in computer-aided conceptual design

    NASA Technical Reports Server (NTRS)

    Kolb, Mark A.

    1990-01-01

    Originally, computer programs for engineering design focused on detailed geometric design. Later, computer programs for algorithmically performing the preliminary design of specific well-defined classes of objects became commonplace. However, due to the need for extreme flexibility, it appears unlikely that conventional programming techniques will prove fruitful in developing computer aids for engineering conceptual design. The use of symbolic processing techniques, such as object-oriented programming and constraint propagation, facilitate such flexibility. Object-oriented programming allows programs to be organized around the objects and behavior to be simulated, rather than around fixed sequences of function- and subroutine-calls. Constraint propagation allows declarative statements to be understood as designating multi-directional mathematical relationships among all the variables of an equation, rather than as unidirectional assignments to the variable on the left-hand side of the equation, as in conventional computer programs. The research has concentrated on applying these two techniques to the development of a general-purpose computer aid for engineering conceptual design. Object-oriented programming techniques are utilized to implement a user-extensible database of design components. The mathematical relationships which model both geometry and physics of these components are managed via constraint propagation. In addition, to this component-based hierarchy, special-purpose data structures are provided for describing component interactions and supporting state-dependent parameters. In order to investigate the utility of this approach, a number of sample design problems from the field of aerospace engineering were implemented using the prototype design tool, Rubber Airplane. The additional level of organizational structure obtained by representing design knowledge in terms of components is observed to provide greater convenience to the program user, and to result in a database of engineering information which is easier both to maintain and to extend.

  15. Automated quantitative muscle biopsy analysis system

    NASA Technical Reports Server (NTRS)

    Castleman, Kenneth R. (Inventor)

    1980-01-01

    An automated system to aid the diagnosis of neuromuscular diseases by producing fiber size histograms utilizing histochemically stained muscle biopsy tissue. Televised images of the microscopic fibers are processed electronically by a multi-microprocessor computer, which isolates, measures, and classifies the fibers and displays the fiber size distribution. The architecture of the multi-microprocessor computer, which is iterated to any required degree of complexity, features a series of individual microprocessors P.sub.n each receiving data from a shared memory M.sub.n-1 and outputing processed data to a separate shared memory M.sub.n+1 under control of a program stored in dedicated memory M.sub.n.

  16. Reducing Threshold of Multi Quantum Wells InGaN Laser Diode by Using InGaN/GaN Waveguide

    NASA Astrophysics Data System (ADS)

    Abdullah, Rafid A.; Ibrahim, Kamarulazizi

    2010-07-01

    ISE TCAD (Integrated System Engineering Technology Computer Aided Design) software simulation program has been utilized to help study the effect of using InGaN/GaN as a waveguide instead of conventional GaN waveguide for multi quantum wells violet InGaN laser diode (LD). Simulation results indicate that the threshold of the LD has been reduced by using InGaN/GaN waveguide where InGaN/GaN waveguide increases the optical confinement factor which leads to increase the confinement carriers at the active region of the LD.

  17. Autonomous aircraft initiative study

    NASA Technical Reports Server (NTRS)

    Hewett, Marle D.

    1991-01-01

    The results of a consulting effort to aid NASA Ames-Dryden in defining a new initiative in aircraft automation are described. The initiative described is a multi-year, multi-center technology development and flight demonstration program. The initiative features the further development of technologies in aircraft automation already being pursued at multiple NASA centers and Department of Defense (DoD) research and Development (R and D) facilities. The proposed initiative involves the development of technologies in intelligent systems, guidance, control, software development, airborne computing, navigation, communications, sensors, unmanned vehicles, and air traffic control. It involves the integration and implementation of these technologies to the extent necessary to conduct selected and incremental flight demonstrations.

  18. Expert meeting on Child Growth and Micronutrient Deficiencies--New Initiatives for Developing Countries to Achieve Millennium Development Goals: executive summary report.

    PubMed

    Usfar, Avita A; Achadi, Endang L; Martorell, Reynaldo; Hadi, Hamam; Thaha, Razak; Jus'at, Idrus; Atmarita; Martianto, Drajat; Ridwan, Hardinsyah; Soekirman

    2009-01-01

    Undernutrition in early childhood has long-term physical and intellectual consequences. Improving child growth should start before the age of two years and be an integrated effort between all sectors, covering all aspects such as diet and nutrient intake, disease reduction, optimum child care, and improved environmental sanitation. To discuss these issues, the Indonesian Danone Institute Foundation organized an expert meeting on Child Growth and Micronutrient Deficiencies: New Initiatives for Developing Countries to Achieve Millennium Development Goals. The objective of the meeting was to have a retrospective view on child growth: lessons learned from programs to overcome under-nutrition in the developed countries and to relate the situation to the Indonesian context, as well as to discuss implications for future programs. Recommendations derived from the meeting include focus intervention on the window of opportunity group, re-activation of the Integrated Health Post at the village level, improvement of infant and young child feeding, expand food fortification intervention programs, strengthen supplementation programs with multi-micronutrient, and strengthening public and private partnership on food related programs.

  19. Implementing Laboratory Quality Management Systems in Mozambique: The Becton Dickinson-US President's Emergency Plan for AIDS Relief Public-Private Partnership Initiative.

    PubMed

    Skaggs, Beth; Pinto, Isabel; Masamha, Jessina; Turgeon, David; Gudo, Eduardo Samo

    2016-04-15

    Mozambique's ministry of health (MOH) recognized the need to establish a national laboratory quality assurance (NLQA) program to improve the reliability and accuracy of laboratory testing. The Becton Dickinson-US President's Emergency Plan for AIDS Relief Public-Private Partnership (PPP) was used to garner MOH commitment and train a cadre of local auditors and managers to support sustainability and country ownership of a NLQA program. From January 2011 to April 2012, the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist and the Strengthening Laboratory Management Towards Accreditation (SLMTA) curriculum were used in 6 MOH laboratories. PPP volunteers provided training and mentorship to build the capacity of local auditors and program managers to promote institutionalization and sustainability of the program within the MOH. SLIPTA was launched in 6 MOH laboratories, and final audits demonstrated improvements across the 13 quality system essentials, compared with baseline. Training and mentorship of MOH staff by PPP volunteers resulted in 18 qualified auditors and 28 managers/quality officers capacitated to manage the improvement process in their laboratories. SLIPTA helps laboratories improve the quality and reliability of their service even in the absence of full accreditation. Local capacity building ensures sustainability by creating country buy-in, reducing costs of audits, and institutionalizing program management. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  20. International nuclear fuel cycle fact book. Revision 4

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Harmon, K.M.; Lakey, L.T.; Leigh, I.W.

    This Fact Book has been compiled in an effort to provide (1) an overview of worldwide nuclear power and fuel cycle programs and (2) current data concerning fuel cycle and waste management facilities, R and D programs, and key personnel in countries other than the United States. Additional information on each country's program is available in the International Source Book: Nuclear Fuel Cycle Research and Development, PNL-2478, Rev. 2. The Fact Book is organized as follows: (1) Overview section - summary tables which indicate national involvement in nuclear reactor, fuel cycle, and waste management development activities; (2) national summaries -more » a section for each country which summarizes nuclear policy, describes organizational relationships and provides addresses, names of key personnel, and facilities information; (3) international agencies - a section for each of the international agencies which has significant fuel cycle involvement; (4) energy supply and demand - summary tables, including nuclear power projections; (5) fuel cycle - summary tables; and (6) travel aids - international dialing instructions, international standard time chart, passport and visa requirements, and currency exchange rate.« less

  1. International Nuclear Fuel Cycle Fact Book. Revision 5

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Harmon, K.M.; Lakey, L.T.; Leigh, I.W.

    This Fact Book has been compiled in an effort to provide: (1) an overview of worldwide nuclear power and fuel cycle programs; and (2) current data concerning fuel cycle and waste management facilities, R and D programs, and key personnel in countries other than the United States. Additional information on each country's program is available in the International Source Book: Nuclear Fuel Cycle Research and Development, PNL-2478, Rev. 2. The Fact Book is organized as follows: (1) Overview section - summary tables which indicate national involvement in nuclear reactor, fuel cycle, and waste management development activities; (2) national summaries -more » a section for each country which summarizes nuclear policy, describes organizational relationships and provides addresses, names of key personnel, and facilities information; (3) international agencies - a section for each of the international agencies which has significant fuel cycle involvement; (4) energy supply and demand - summary tables, including nuclear power projections; (5) fuel cycle - summary tables; and (6) travel aids international dialing instructions, international standard time chart, passport and visa requirements, and currency exchange rate.« less

  2. Modeling Costs and Impacts of Introducing Early Infant Male Circumcision for Long-Term Sustainability of the Voluntary Medical Male Circumcision Program.

    PubMed

    Njeuhmeli, Emmanuel; Stegman, Peter; Kripke, Katharine; Mugurungi, Owen; Ncube, Gertrude; Xaba, Sinokuthemba; Hatzold, Karin; Christensen, Alice; Stover, John

    2016-01-01

    Voluntary medical male circumcision (VMMC) has been shown to be an effective prevention strategy against HIV infection in males [1-3]. Since 2007, the President's Emergency Plan for AIDS Relief (PEPFAR) has supported VMMC programs in 14 priority countries in Africa. Today several of these countries are preparing to transition their VMMC programs from a scale-up and expansion phase to a maintenance phase. As they do so, they must consider the best approaches to sustain high levels of male circumcision in the population. The two alternatives under consideration are circumcising adolescents 10-14 years old over the long term or integrating early infant male circumcision (EIMC) into maternal and child health programs. The paper presents an analysis, using the Decision Makers Program Planning Tool, Version 2.0 (DMPPT 2.0), of the estimated cost and impact of introducing EIMC into existing VMMC programs in several countries in eastern and southern Africa. Limited cost data exist for the implementation of EIMC, but preliminary studies, such as the one detailed in Mangenah, et al. [4-5], suggest that the cost of EIMC may be less than that of adolescent and adult male circumcision. If this is the case, then adding EIMC to the VMMC program will increase the number of circumcisions that need to be performed but will not increase the total cost of the program over the long term. In addition, we found that a delayed or slow start-up of EIMC would not substantially reduce the impact of adding it to the program or increase cumulative long-term costs, which should make introduction of EIMC more feasible and attractive to countries contemplating such a program innovation.

  3. Development and Implementation of the DHAPP Military eHealth Information Network System.

    PubMed

    Kratz, Mary; Thomas, Anne; Hora, Ricardo; Vera, Delphis; Lutz, Mickey; Johnson, Mark D

    2017-01-01

    As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. HIV / AIDS and tourism.

    PubMed

    Forsythe, S

    1999-01-01

    Since it tends to be significantly affected by HIV/AIDS, the tourism sector is a likely target for HIV/AIDS interventions in many countries. The tourist industry is at particular risk from the pandemic because of the mobility of the work force, the presence of sex tourists, and the heavy reliance of many countries upon tourism revenues. Indeed, tourism is one of the largest and fastest growing industries in many countries. Some people have speculated that potential tourists' fear of AIDS could discourage them from visiting certain countries, while others have even suggested that tourism should be discouraged because the industry contributes to the spread of HIV/AIDS. When traveling, tourists often take risks that they would not take at home. They tend to drink more, use drugs more, and be generally more adventurous while on holiday. Such adventures often include taking sexual risks. When tourists have sex with prostitutes, hotel staff, and others in the local population, a bridge can be created for HIV to cross back and forth between the tourist's home country and the tourist destination. The author reviews selected studies on the relationship between HIV/AIDS and tourism. Overall, the existing literature offers no definitive evidence that AIDS has had any lasting impact upon the tourism industry anywhere in the world. Rather, promoting a healthy tourism industry and HIV/AIDS prevention are likely complementary in many ways.

  5. What are today's priorities in research?

    PubMed

    1994-01-01

    The World Health Organization (WHO) Global Programme on AIDS has identified priority areas of HIV/AIDS-related research. Vaccine trials are need to evaluate their effectiveness and their accessibility and availability (supply and price) to developing countries with the greatest need. The pharmaceutical industry and national governments should work to develop microbicidal agents for use in the vagina. Research on the care of people with AIDS is needed to document the best way to provide their care in developing countries and to improve their quality of life. Another research priority is the resurgence of tuberculosis (TB): its association with HIV infection, and management of TB in areas where the HIV prevalence is high. WHO would like to see research establishing simplified case management regimes for the control and management of sexually transmitted diseases (STDs), STD case management that can be integrated into primary health care systems or at the primary health care level, simple and inexpensive diagnostic tests (particularly for women, who often are asymptomatic), and integration of STD management into family planning programs. More research needs to conducted on the availability and use of female condoms, so women can enhance their capability of protecting themselves. WHO would like more HIV/AIDS-related behavior research in the following areas: descriptive research, economic impact, community support, women's empowerment, and behavior change. HIV/AIDS-related researchers should ask themselves 3 fundamental questions: Does it work? What is the best way to do it? What does it cost?

  6. Financing the response to AIDS: some fiscal and macroeconomic considerations.

    PubMed

    Haacker, Markus

    2008-07-01

    This article examines the international response to AIDS from a fiscal perspective: first the financing of the international response to AIDS, especially the role of external financing, and second, a more comprehensive perspective on the costs of the national response to AIDS relevant for fiscal policy. The second half of the article focuses on the effectiveness of the response to AIDS. We find that there is little basis for concerns about macroeconomic constraints to scaling up, in light of the moderate scale of AIDS-related aid flows relative to overall aid. Regarding sectoral constraints, the picture is more differentiated. Many countries with high prevalence rates have also achieved high rates of access to treatment, but most of these are middle-income countries. Our econometric analysis credits external aid as a key factor that has enabled higher-prevalence countries to cope with the additional demands for health services. At the same time, gross domestic product per capita and health sector capacities are important determinants of access to treatment.

  7. STD / AIDS prevention: new challenges for family planning programs.

    PubMed

    Williamson, N; Townsend, S

    1991-12-01

    Family planning (FP) professionals and programs are increasingly called upon to respond to increasing rates of sexually transmitted diseases (STD) and AIDS. While structural and ideological readjustment to meet these demands may seem problematic for some programs, the AIDS epidemic allows the opportunity for programs to expand into preventive health activities. Dr. Nancy Williamson, Director of Family Health International's Division of Program Evaluation and 1 of the authors of the World Health Organization's guidelines on family planning and AIDS, responds to questions most frequently posed by FP providers considering the need for and process of FP program restructuring. She holds that programmatic expansion for the prevention of HIV infection enhances the capability to provide good contraceptive services. FP programs are not expected to abandon their central missions of preventing unwanted pregnancies, but to engage in both the prevention of STD infection and unwanted pregnancies where possible. Sharing responsible sex behavior and the condom as common means of prevention, these 2 missions are far from mutually exclusive. The AIDS epidemic has impacted upon FP programs in a number of ways. Increased demand for condoms has been observed in countries with high levels of HIV seropositivity, greater concern has been placed upon counseling and sterile procedures, view have been altered to accept this dual role of contraception, and universal precautions for the protection of both client and workers from infection are of greater importance. Promoting the consistent use of condoms for the prevention of STDs has proved more challenging than promoting for contraceptive uses. Gaining the legitimacy of condoms among married couples while they are also promoted among high-risk groups also remains difficult. On other issues, promoting the routine use of 2 temporary methods is not recommended, questions must be posed to determine clients' risk status for infection, counseling and services should be provided to those HIV+, and alternative funding sources may need to be sought for FP program expansion. Arguments for and against such expansion are discussed. Most of sub-Saharan Africa, the Caribbean, and Thailand are in most serious need of programmatic changes, India and most of Central and South American need some changes, and other areas would benefit from minor changes. Dr. Williamson finally considers how programs should be modified, changes made thus far by programs, and suggests what programs may do to enhance their capability to provide contraceptive services.

  8. Are country reputations for good and bad leadership on AIDS deserved? An exploratory quantitative analysis.

    PubMed

    Nattrass, Nicoli

    2008-12-01

    Some countries (e.g. Brazil) have good reputations on AIDS policy, whereas others, (notably South Africa) have been criticized for inadequate leadership. Cross-country regression analysis reveals that these 'poster children' for AIDS leadership have indeed performed better or worse than expected given their economic and institutional constraints and the demographic and health challenges facing them. Regressions were run on HAART coverage (number on highly active antiretroviral therapy as percentage of total need) and MTCTP coverage (pregnant HIV+ women accessing mother-to-child-transmission prevention services as percentage of total need). Brazil, Cambodia, Thailand and Uganda (all of whom have established reputations for good leadership on AIDS performed consistently better than expected-as did Burkina-Faso, Suriname, Paraguay Costa Rica, Mali and Namibia. South Africa, which has the worst reputation for AIDS leadership, performed significantly below expectations-as did Uruguay and Trinidad and Tobago. The paper thus confirms much of the conventional wisdom on AIDS leadership at country level and suggests new areas for research.

  9. Imported tropical neuroinfections: practice skills and knowledge among nurses and nursing students.

    PubMed

    Rajoo, Maheswaari; Sulicova, Andrea; Mroskova, Slavka; Supinova, Maria; Plackova, Anna; Bystra, Martina; Baranova, Lenka; Grezdova, Iveta; Santova, Tatiana; Janakova, Maria; Simova, Zuzana; Cinova, Jana; Cibrikova, Silvia; Decsiova, Zuzana; Lengyelova, Anna; Hlinovska, Jana; Rovna, Silvia; Igazova, Maria; Nadova, Monika; Rakova, Jana; Lehotska, Maria; Moraucikova, Eva; Mizenkova, Ludmila; Novotna, Zuzana; Paukova, Luba; Semjonova, Alexandra; Schlosserova, Alena; Vicanova, Michaela; Balkova, Hilda; Banasova, Vlasta; Horanska, Valeria; Hudakova, Pavlina; Hudakova, Anna; Majernikova, Ludmila; Poliakova, Nikoleta; Suchanova, Renata; Tirpakova, Libusa; Perinova, Nadezda; Vatehova, Drahormira; Komanicky, Dusan; Koudelkova, Vlasta; Capska, Jana; Maskalikova, Tatiana; Hulkova, Vlasta; Treslova, Marie

    2013-09-01

    Tropical neuroinfections are still cause of substantial mortality in travelers. Therefore, good knowledge of early symptoms is very important for nurses acting as first contact persons. Nurse's practical skills and knowledge of signs and early recognition of tropical neuroinfections, providing first aid and quick action has been studied among graduates of two Tropical Nursing PhD programs (in EU-Countries vs. tropical country) using a standardized questionnaire. Statistical package EPI info was used to determine potential differences between both groups of graduates. Acceptable knowledge on early symptoms and signs of cerebral malaria and meningococcal meningitis in returning travelers was found among 121 graduates of two PhD programs who were included in the study. Of these, 99 questionnaires were filled in Slovakia, Czech Republic and Germany and another 22 were filled in Malaysia, as a part of the Tropical Nursing PhD Study Programs. Nursing students and recent graduates in two PhD programs demonstrated acceptable, although not large-scaled, knowledge of early signs and symptoms of tropical neuroinfections.

  10. The role of professional education in building capacity for health promotion in the global South: a case study from Norway.

    PubMed

    Mittelmark, Maurice B

    2003-01-01

    The capacity to train public health professionals is far from sufficient to meet urgent global needs. Foreign aid programs hold much promise to deal with this challenge. A case study from Norway illustrates the possibilities. Since the early 1960s, Norwegian universities have offered English-taught masters and doctoral degree programs, with sufficient financial support that all Third World students have the resources to complete training, regardless of their personal financial circumstances. This facet of the program is its main distinguishing factor, compared to many educational opportunities that are available in other countries. Since the first visiting students were awarded degrees in 1968, almost 10,000 students have participated at more than 25 Norwegian institutions, including many offering public health training. Many eligible applicants have been turned away due to lack of resources, indicating a level of interest that cannot be met with existing resources. Similar programs in more countries could help alleviate the need.

  11. [Women with AIDS: disclosing risk stories].

    PubMed

    Vermelho, L L; Barbosa, R H; Nogueira, S A

    1999-01-01

    This study approaches the social and cultural profile concerning risk for HIV infection in women, describing some epidemiological variables and disclosing reports of risk situations, the meaning of living with AIDS, and support received. A semi-structured questionnaire was used to interview 25 women from the University Hospital of the Federal University of Rio de Janeiro, prior to the availability of multi-drug treatment. The majority reported limited schooling, were housewives or engaged in under-skilled occupations, and had family incomes lower than average for users of this public teaching hospital. The view of AIDS as "someone else's disease" was prevalent, and STDs were perceived as male infections, although several women reported episodes of STDs prior to HIV. They had received their diagnosis and initial medical care only after their partners' and/or children's illness or death. The study points to preventive strategies reinforcing these silent women's bargaining power, acting on men as potential active participants in reproductive health programs that incorporate STD/AIDS issues.

  12. NREL Kicks Off Next Phase of Advanced Computer-Aided Battery Engineering |

    Science.gov Websites

    lithium-ion (Li-ion) batteries, known as a multi-scale multi-domain (GH-MSMD) model framework, was News | NREL Kicks Off Next Phase of Advanced Computer-Aided Battery Engineering NREL Kicks Off Next Phase of Advanced Computer-Aided Battery Engineering March 16, 2016 NREL researcher looks across

  13. Social Security privatization in Latin America.

    PubMed

    Kritzer, B E

    2000-01-01

    The new, partially privatized social security system adopted by Chile in 1981 has attracted attention in many parts of the world. Since then, a number of Latin American countries have implemented the Chilean model, with some variations: either with a single- or multi-tier system, or with a period of transition to take care of those in the labor force at the time of the change. The single-tier version consists of a privatized program with individual accounts in pension fund management companies. Multi-tier systems have a privatized component and retain some form of public program. This article describes each of the new programs in Latin America, their background, and similarities and differences among them. Much more information is available for Chile than for the other countries (in part because Chile has the oldest system), enough to be able to evaluate what, in most cases, is the most accurate information. That is often not the case for the other countries, especially when dealing with subjects such as transition costs and net rates of return (rates of return minus administrative fees). No country has copied the Chilean system exactly. Bolivia, El Salvador, and Mexico have closed their public systems and set up mandatory individual accounts. Argentina has a mixed public/private system with three tiers. In Colombia and Peru, workers have a choice between the public and private programs. Uruguay created a two-tier mixed system. Costa Rica has a voluntary program for individual accounts as a supplement to the pay-as-you-go program and has just passed a law setting up mandatory accounts containing employer contributions for severance pay. All of the countries continue to face unresolved issues, including: High rates of noncompliance--the percentage of enrollees who do not actively and regularly contribute to their accounts--which could lead to low benefits and greater costs to the governments that offer a guaranteed minimum benefit; Proportionately lower benefits for women and lower earners than for men and higher earners; A minimum required rate of return among the pension fund management companies (in most of these countries) that has resulted in similarity among the companies and the consequent lack of meaningful choice; and High administrative fees in most of these countries, which reduce the individual's effective rate of return. To what extent these issues can be mitigated or resolved in the future is not yet clear. In general, a definitive assessment of the Chilean model and its Latin American variations will not be possible until a cohort of retirees has spent most of its career under the new system.

  14. Building Capacity for Data-Driven Decision Making in African HIV Testing Programs: Field Perspectives on Data Use Workshops.

    PubMed

    Courtenay-Quirk, Cari; Spindler, Hilary; Leidich, Aimee; Bachanas, Pam

    2016-12-01

    Strategic, high quality HIV testing services (HTS) delivery is an essential step towards reaching the end of AIDS by 2030. We conducted HTS Data Use workshops in five African countries to increase data use for strategic program decision-making. Feedback was collected on the extent to which workshop skills and tools were applied in practice and to identify future capacity-building needs. We later conducted six semistructured phone interviews with workshop planning teams and sent a web-based survey to 92 past participants. The HTS Data Use workshops provided accessible tools that were readily learned by most respondents. While most respondents reported increased confidence in interpreting data and frequency of using such tools over time, planning team representatives indicated ongoing needs for more automated tools that can function across data systems. To achieve ambitious global HIV/AIDS targets, national decision makers may continue to seek tools and skill-building opportunities to monitor programs and identify opportunities to refine strategies.

  15. Drug companies cut HIV drug prices in the developing world.

    PubMed

    Yamey, G

    2000-05-20

    The UN has reported that five multinational pharmaceutical companies would cut down HIV drug prices in the developing world. One of these drug companies is GlaxoWellcome, which has promised to reduce the price of zidovudine and lamivudine to US$2 in the poorest nations, a fifth of its price in the US. Although Peter Piot, director of the UN Program on HIV/AIDS, welcomed the companies' promises, he warned that price cuts alone will not curb the epidemic. He stated that this initiative is only one critical factor in what must become a much broader and more urgent effort to help people living with HIV/AIDS. Moreover, health and development agencies expressed concern that AIDS drugs will still be unaffordable for the vast majority of those in need in developing countries. In addition, poor countries lack the infrastructure to deliver these drugs safely and effectively. During the time of the UN announcement, US President Bill Clinton also signed an executive order allowing sub-Saharan Africa to adopt legal measures to obtain cheap HIV drugs. Meanwhile, South Africa's reaction to the offer to cut antiretroviral drug prices has been lukewarm.

  16. Family Economic Strengthening and Parenting Stress Among Caregivers of AIDS-Orphaned Children: Results from a Cluster Randomized Clinical Trial in Uganda.

    PubMed

    Nabunya, Proscovia; Ssewamala, Fred M; Ilic, Vilma

    2014-09-01

    This study examines the impact of a family economic strengthening intervention on parenting stress among caregivers of AIDS-orphaned children in Uganda. The study uses data from a 4-year (2008-2012) NIMH randomized clinical trial for AIDS-orphaned children known as Suubi-Maka (N=346 dyads). Child-caregiver dyads from 10 comparable primary schools were randomly assigned to either the control group (n=167 dyads) receiving usual care for school-going orphaned children (such as food aid and scholastic materials) or the treatment group (n=179 dyads) receiving a family economic strengthening intervention (focused on a matched savings account), financial planning and management workshops over and above the usual care. Interviews were conducted at baseline, 12 months and 24 months follow-up. This study uses data from baseline and 24 months post-intervention. We use multivariate regression methods, controlling for socioeconomic characteristics. At 24 months, caregivers in the treatment group reported significantly lower levels of parenting stress compared to caregivers in the control group. Findings from this study point to the potential of a family economic strengthening intervention to improve caregiver's psychosocial wellbeing and that of their families. We conclude that programs and policies aimed at improving the psychosocial wellbeing of families caring for AIDS-orphaned children may consider incorporating economic strengthening components in their programming to help support these kinds of families, caregivers of AIDS-orphaned children especially those residing in developing countries.

  17. Social Determinants of Infectious Diseases in South Asia

    PubMed Central

    Bishwajit, Ghose; Ide, Seydou; Ghosh, Sharmistha

    2014-01-01

    South Asian countries have developed infectious disease control programs such as routine immunization, vaccination, and the provision of essential drugs which are operating nationwide in cooperation with many local and foreign NGOs. Most South Asian countries have a relatively low prevalence of HIV/AIDS until now, but issues like poverty, food insecurity, illiteracy, poor sanitation, and social stigma around AIDS are widespread and are creating formidable challenges to prevention of further spread of this epidemic. Besides that, resurgence of tuberculosis along with the emergence of the drug resistant (MDR-TB and XDRTB) strains and the coepidemic of TB and HIV are posing ever-growing threats to the underdeveloped healthcare infrastructure. The countries are undergoing an epidemiological transition where the disease burden is gradually shifting to noncommunicable diseases, but the infectious diseases still account for almost half of the total disease burden. Despite this huge burden of infectious diseases in South Asia, which is second only to Africa, there is yet any study on the social determinants of infectious diseases in a local context. This paper examines various issues surrounding the social determinants of infectious diseases in South Asian countries with a special reference to HIV and tuberculosis. And, by doing so, it attempts to provide a framework for formulating more efficient prevention and intervention strategies for the future. PMID:27350969

  18. Developing effective chronic disease interventions in Africa: insights from Ghana and Cameroon

    PubMed Central

    2010-01-01

    Background Africa faces an urgent but 'neglected epidemic' of chronic disease. In some countries stroke, hypertension, diabetes and cancers cause a greater number of adult medical admissions and deaths compared to communicable diseases such as HIV/AIDS or tuberculosis. Experts propose a three-pronged solution consisting of epidemiological surveillance, primary prevention and secondary prevention. In addition, interventions must be implemented through 'multifaceted multi-institutional' strategies that make efficient use of limited economic and human resources. Epidemiological surveillance has been prioritised over primary and secondary prevention. We discuss the challenge of developing effective primary and secondary prevention to tackle Africa's chronic disease epidemic through in-depth case studies of Ghanaian and Cameroonian responses. Methods A review of chronic disease research, interventions and policy in Ghana and Cameroon instructed by an applied psychology conceptual framework. Data included published research and grey literature, health policy initiatives and reports, and available information on lay community responses to chronic diseases. Results There are fundamental differences between Ghana and Cameroon in terms of 'multi-institutional and multi-faceted responses' to chronic diseases. Ghana does not have a chronic disease policy but has a national health insurance policy that covers drug treatment of some chronic diseases, a culture of patient advocacy for a broad range of chronic conditions and mass media involvement in chronic disease education. Cameroon has a policy on diabetes and hypertension, has established diabetes clinics across the country and provided training to health workers to improve treatment and education, but lacks community and media engagement. In both countries churches provide public education on major chronic diseases. Neither country has conducted systematic evaluation of the impact of interventions on health outcomes and cost-effectiveness. Conclusions Both Ghana and Cameroon require a comprehensive and integrative approach to chronic disease intervention that combines structural, community and individual strategies. We outline research and practice gaps and best practice models within and outside Africa that can instruct the development of future interventions. PMID:20403170

  19. Homemaking Handbook for Village Workers in Many Countries. Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Reprint No. R-39.

    ERIC Educational Resources Information Center

    Extension Service (USDA), Washington, DC.

    This handbook, designed as a guide for the village level worker, can also serve as a teaching aid and text for teachers of village workers. It is intended for use by personnel in home economics extension, community development, home economics classroom teaching, health education, and other programs involving home and family life. Section I…

  20. Collaborative Evaluation and Market Research Converge: An Innovative Model Agricultural Development Program Evaluation in Southern Sudan

    ERIC Educational Resources Information Center

    O'Sullivan, John M.; O'Sullivan, Rita

    2012-01-01

    In June and July 2006 a team of outside experts arrived in Yei, Southern Sudan through an AID project to provide support to a local agricultural development project. The team brought evaluation, agricultural marketing and financial management expertise to the in-country partners looking at steps to rebuild the economy of the war ravaged region. A…

  1. HIV/AIDS health care challenges for cross-country migrants in low- and middle-income countries: a scoping review

    PubMed Central

    Suphanchaimat, Rapeepong; Sommanustweechai, Angkana; Khitdee, Chiraporn; Thaichinda, Chompoonut; Kantamaturapoj, Kanang; Leelahavarong, Pattara; Jumriangrit, Pensom; Topothai, Thitikorn; Wisaijohn, Thunthita; Putthasri, Weerasak

    2014-01-01

    Introduction HIV/AIDS has been one of the world’s most important health challenges in recent history. The global solidarity in responding to HIV/AIDS through the provision of antiretroviral therapy (ART) and encouraging early screening has been proved successful in saving lives of infected populations in past decades. However, there remain several challenges, one of which is how HIV/AIDS policies keep pace with the growing speed and diversity of migration flows. This study therefore aimed to examine the nature and the extent of HIV/AIDS health services, barriers to care, and epidemic burdens among cross-country migrants in low-and middle-income countries. Methods A scoping review was undertaken by gathering evidence from electronic databases and gray literature from the websites of relevant international initiatives. The articles were reviewed according to the defined themes: epidemic burdens of HIV/AIDS, barriers to health services and HIV/AIDS risks, and the operational management of the current health systems for HIV/AIDS. Results Of the 437 articles selected for an initial screening, 35 were read in full and mapped with the defined research questions. A high HIV/AIDS infection rate was a major concern among cross-country migrants in many regions, in particular sub-Saharan Africa. Despite a large number of studies reported in Africa, fewer studies were found in Asia and Latin America. Barriers of access to HIV/AIDS services comprised inadequate management of guidelines and referral systems, discriminatory attitudes, language differences, unstable legal status, and financial hardship. Though health systems management varied across countries, international partners consistently played a critical role in providing support for HIV/AIDS services to uninsured migrants and refugees. Conclusion It was evident that HIV/AIDS health care problems for migrants were a major concern in many developing nations. However, there was little evidence suggesting if the current health systems effectively addressed those problems or if such management would sustainably function if support from global partners was withdrawn. More in-depth studies were recommended to further explore those knowledge gaps. PMID:24600250

  2. Developing a program for enhancing youth HIV treatment adherence and risk reduction.

    PubMed

    Fongkaew, Warunee; Udomkhamsuk, Warawan; Viseskul, Nongkran; Guptaruk, Marisa

    2017-12-01

    Youth living with HIV face difficult and challenging situations that decrease their adherence to antiretroviral medications. In this study, we developed a pilot program to enhance HIV treatment adherence and risk reduction among youth living with HIV based on collaboration with a community hospital involving a multi-disciplinary healthcare team. Participants were 25 youth living with HIV/AIDS, 18 caregivers, and 12 healthcare providers. The action research process comprised a preliminary stage and four phases of assessment, planning, implementation, and evaluation. This program used "edutainment", participatory learning, and multi-disciplinary collaboration to improve HIV treatment adherence and HIV risk behavior knowledge, motivation, and behavior. Education aimed to improve knowledge of antiretroviral drugs and HIV risk-taking behaviors. Motivation was directed at reframing beliefs and increasing positive attitudes of youth toward treatment adherence and raising awareness about safer sex behaviors. The behavioral skills focused on medication management in daily life activities, problem-solving, refusal and negotiation, and condom use. Findings provided preliminary evidence that the program was practical in a clinical context in a community hospital. © 2017 John Wiley & Sons Australia, Ltd.

  3. Asia needs political commitment to fight AIDS.

    PubMed

    1997-06-02

    Delegates from China, Cambodia, Indonesia, Malaysia, Burma, Thailand, and Vietnam to a Joint UN Program on HIV/AIDS (UNAIDS) workshop in Bangkok urged their governments to give priority to the prevention of HIV and AIDS. There are already approximately 3 million people infected with HIV in Asia. Their numbers should increase by 1-2 million by the year 2000. However, devoid of any prevention measures, 2-5 million more people could instead become infected over the same period. Thailand, where many people have adopted condom use and the patronage of brothels and prostitutes has declined, was noted as a success story at the workshop in preventing the further spread of HIV. The level of risky sexual behavior in Thailand has declined to such an extent that HIV case projections made in 1991 for the year 2000 have been revised to a lower number. An estimated more than 100,000 people are infected with HIV in Indonesia, a country in which the epidemic may grow to 2.5 million cases by 2000 unless successful prevention programs are implemented.

  4. Strange but common bedfellows: the relationship between humanitarians and the military in developing psychosocial interventions for civilian populations affected by armed conflict.

    PubMed

    Kienzler, Hanna; Pedersen, Duncan

    2012-07-01

    This essay analyses how the relationships between Cold War and post-Cold War politics, military psychiatry, humanitarian aid and mental health interventions in war and post-war contexts have transformed over time. It focuses on the restrictions imposed on humanitarian interventions and aid during the Cold War; the politics leading to the transfer of the PTSD diagnosis and its treatment from the military to civilian populations; humanitarian intervention campaigns in the post-Cold War era; and the development of psychosocial intervention programs and standards of care for civilian populations affected by armed conflict. Viewing these developments in their broader historical, political and social contexts reveals the politics behind mental health interventions conducted in countries and populations affected by warfare. In such militarized contexts, the work of NGOs providing assistance to people suffering from trauma-related health problems is far from neutral as it depends on the support of the military and plays an important role in the shaping of international politics and humanitarian aid programs.

  5. Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors.

    PubMed

    Qiao, Shan; Zhang, Yao; Li, Xiaoming; Menon, J Anitha

    2018-01-01

    It was estimated that 1.2 million people live with HIV/AIDS in Zambia by 2015. Zambia has developed and implemented diverse programs to reduce the prevalence in the country. HIV-testing is a critical step in HIV treatment and prevention, especially among all the key populations. However, there is no systematic review so far to demonstrate the trend of HIV-testing studies in Zambia since 1990s or synthesis the key factors that associated with HIV-testing practices in the country. Therefore, this study conducted a systematic review to search all English literature published prior to November 2016 in six electronic databases and retrieved 32 articles that meet our inclusion criteria. The results indicated that higher education was a common facilitator of HIV testing, while misconception of HIV testing and the fear of negative consequences were the major barriers for using the testing services. Other factors, such as demographic characteristics, marital dynamics, partner relationship, and relationship with the health care services, also greatly affects the participants' decision making. The findings indicated that 1) individualized strategies and comprehensive services are needed for diverse key population; 2) capacity building for healthcare providers is critical for effectively implementing the task-shifting strategy; 3) HIV testing services need to adapt to the social context of Zambia where HIV-related stigma and discrimination is still persistent and overwhelming; and 4) family-based education and intervention should involving improving gender equity.

  6. Implications of prioritizing HIV cure: new momentum to overcome old challenges in HIV.

    PubMed

    Tucker, Joseph D; Gilbertson, Adam; Lo, Ying-Ru; Vitória, Marco

    2016-03-03

    Curing HIV is a new strategic priority for several major AIDS organizations. In step with this new priority, HIV cure research and related programs are advancing in low, middle, and high-income country settings. This HIV cure momentum may influence existing HIV programs and research priorities. Despite the early stage of ongoing HIV cure efforts, these changes have directly influenced HIV research funding priorities, pilot programs, and HIV messaging. The building momentum to cure HIV infection may synergize with strategic priorities to better identify adults and infants with very early HIV infection. Although HIV cure represents a new goal, many existing programs and research techniques can be repurposed towards an HIV cure. HIV messages focused on engaging communities towards an HIV cure need to be careful to promote ARV adherence and retention within the HIV continuum of care. An increased emphasis within the AIDS field on finding an HIV cure has several important implications. Strengthening connections between HIV cure research and other areas of HIV research may help to catalyze research and facilitate implementation in the future.

  7. Drivers of Inequality in Millennium Development Goal Progress: A Statistical Analysis

    PubMed Central

    Stuckler, David; Basu, Sanjay; McKee, Martin

    2010-01-01

    Background Many low- and middle-income countries are not on track to reach the public health targets set out in the Millennium Development Goals (MDGs). We evaluated whether differential progress towards health MDGs was associated with economic development, public health funding (both overall and as percentage of available domestic funds), or health system infrastructure. We also examined the impact of joint epidemics of HIV/AIDS and noncommunicable diseases (NCDs), which may limit the ability of households to address child mortality and increase risks of infectious diseases. Methods and Findings We calculated each country's distance from its MDG goals for HIV/AIDS, tuberculosis, and infant and child mortality targets for the year 2005 using the United Nations MDG database for 227 countries from 1990 to the present. We studied the association of economic development (gross domestic product [GDP] per capita in purchasing-power-parity), the relative priority placed on health (health spending as a percentage of GDP), real health spending (health system expenditures in purchasing-power-parity), HIV/AIDS burden (prevalence rates among ages 15–49 y), and NCD burden (age-standardised chronic disease mortality rates), with measures of distance from attainment of health MDGs. To avoid spurious correlations that may exist simply because countries with high disease burdens would be expected to have low MDG progress, and to adjust for potential confounding arising from differences in countries' initial disease burdens, we analysed the variations in rates of change in MDG progress versus expected rates for each country. While economic development, health priority, health spending, and health infrastructure did not explain more than one-fifth of the differences in progress to health MDGs among countries, burdens of HIV and NCDs explained more than half of between-country inequalities in child mortality progress (R 2-infant mortality  = 0.57, R 2-under 5 mortality  = 0.54). HIV/AIDS and NCD burdens were also the strongest correlates of unequal progress towards tuberculosis goals (R 2 = 0.57), with NCDs having an effect independent of HIV/AIDS, consistent with micro-level studies of the influence of tobacco and diabetes on tuberculosis risks. Even after correcting for health system variables, initial child mortality, and tuberculosis diseases, we found that lower burdens of HIV/AIDS and NCDs were associated with much greater progress towards attainment of child mortality and tuberculosis MDGs than were gains in GDP. An estimated 1% lower HIV prevalence or 10% lower mortality rate from NCDs would have a similar impact on progress towards the tuberculosis MDG as an 80% or greater rise in GDP, corresponding to at least a decade of economic growth in low-income countries. Conclusions Unequal progress in health MDGs in low-income countries appears significantly related to burdens of HIV and NCDs in a population, after correcting for potentially confounding socioeconomic, disease burden, political, and health system variables. The common separation between NCDs, child mortality, and infectious syndromes among development programs may obscure interrelationships of illness affecting those living in poor households—whether economic (e.g., as money spent on tobacco is lost from child health expenditures) or biological (e.g., as diabetes or HIV enhance the risk of tuberculosis). Please see later in the article for the Editors' Summary PMID:20209000

  8. CAI System with Multi-Media Text Through Web Browser for NC Lathe Programming

    NASA Astrophysics Data System (ADS)

    Mizugaki, Yoshio; Kikkawa, Koichi; Mizui, Masahiko; Kamijo, Keisuke

    A new Computer Aided Instruction (CAI) system for NC lathe programming has been developed with use of multi-media texts including movies, animations, pictures, sound and texts through Web browser. Although many CAI systems developed previously for NC programming consist of text-based instructions, it is difficult for beginners to learn NC programming with use of them. In the developed CAI system, multi-media texts are adopted for the help of users' understanding, and it is available through Web browser anytime and anywhere. Also the error log is automatically recorded for the future references. According to the NC programming coded by a user, the movement of the NC lathe is animated and shown in the monitor screen in front of the user. If its movement causes the collision between a cutting tool and the lathe, some sound and the caution remark are generated. If the user makes mistakes some times at a certain stage in learning NC, the corresponding suggestion is shown in the form of movies, animations, and so forth. By using the multimedia texts, users' attention is kept concentrated during a training course. In this paper, the configuration of the CAI system is explained and the actual procedures for users to learn the NC programming are also explained too. Some beginners tested this CAI system and their results are illustrated and discussed from the viewpoint of the efficiency and usefulness of this CAI system. A brief conclusion is also mentioned.

  9. The International Monetary Fund's effects on global health: before and after the 2008 financial crisis.

    PubMed

    Stuckler, David; Basu, Sanjay

    2009-01-01

    In April 2009, the G20 countries committed US $750 billion to the International Monetary Fund (IMF), which has assumed a central role in global economic management. The IMF provides loans to financially ailing countries, but with strict conditions, typically involving a mix of privatization, liberalization, and fiscal austerity programs. These loan conditions have been extremely controversial. In principle, they are designed to help countries balance their books. In practice, they often translate into reductions in social spending, including spending on public health and health care delivery. As more countries are being exposed to IMF policies, there is a need to establish what we know and do not know about the IMF's effects on global health. This article introduces a series in which contributors review the evidence on the relationship between the IMF and public health and discuss potential ways to improve the Fund's effects on health. While more evidence is needed for some regions, there is sufficient evidence to indicate that IMF programs have been significantly associated with weakened health care systems, reduced effectiveness of health-focused development aid, and impeded efforts to control tobacco, infectious diseases, and child and maternal mortality. Reforms are urgently needed to prevent the current wave of IMF programs from further undermining public health in financially ailing countries and limiting progress toward the health Millennium Development Goals.

  10. Global update: Malaysia.

    PubMed

    1993-01-01

    Malaysia produces more condoms than any other country in the world, yet it has one of the lowest per capita condom usage rates. The official number of HIV-infected persons and of persons with AIDS in Malaysia is 5140 and 72, respectively. People working in AIDS prevention efforts believe the actual number of HIV-infected people is closer to 50,000 and climbing. People working in AIDS prevention efforts believe the actual number of HIV-infected people is closer to 50,000 and climbing. Public health officials report that AIDS is spreading rapidly through Malaysia's relatively large population of IV drug users. The Ministry of Health wants to introduce comprehensive and pragmatic efforts to stem the AIDS epidemic. They include sex education in schools, ways to prevent IV drug users from sharing needles, promotion of condoms among high risk groups, and screening to monitor HIV transmission. Islamic and Catholic groups oppose these program and policy measures, however. The new director of the Ministry's AIDS prevention unit announced during a meeting of health officials that a return to the teaching of Islam and adoption of Islamic values are the means to deal with AIDS. He suggested that boys and girls be separated, television be rigorously censored, and that Muslim scholars not be limited to mosques to do their teaching. The government has greatly increased the 1993 AIDS budget with all of the funds dedicated to blood screening, nongovernmental organizations (NGOs), and health education. The deputy health minister noted that the NGOs are supposed to address the more sensitive issues. The government does not allow any of the funds to directly go to condom promotion or programs for IV drug users, however.

  11. [Population, development and AIDS "that is all we needed].

    PubMed

    Assoga, L N

    1990-10-01

    Sub-Saharan Africa (SSA) has been undergoing a devastating economic recession forcing the need for structural adjustment programs (SAP's) to correct many of the economic imbalances, but the effects of SAP's have been to destroy rather than to adjust, making the situation worse than ever. Budgets for social welfare expenditures have been depleted and entire families cannot plan a day ahead. The last thing SSA needed was AIDS to add to the region's poverty and misery. The transmission of AIDS has been facilitated by 2 movements: 1) urbanization and 2) spatial migration from the rural areas to the urban. Some other routes that facilitate the transmission of AIDS in SSA are: 1) returning migrants or people with long-term jobs from countries such as Burkina Faso returning to the Ivory Coast; 2) the truck drivers on the highways; 3) prostitution such as in the Ivory Coast with the rich coffee or cocoa planters; 4) multiple sex partners; 5) wars of liberation such as in Angola; and 6) vertical transmission between mother and child. The SAP's have further increased the transmission of AIDS because of the poverty of the region. For example, some of the immediate effects of SAP's have been intensification of migration for economic reasons, destruction of the traditional family and the growth of urban prostitution. Demographic effects of AIDS has been the increase in mortality. It is important that future surveys on AIDS in SSA should be the responsibility of African researchers to ensure that they do not also become "prophets of apocalypse" as have many researchers from the West. These African led surveys and outcomes should become the basis of an AIDS IEC program.

  12. Sea Ventures Development Phase, October 1, 1975 - September 30, 1978.

    ERIC Educational Resources Information Center

    Sea Ventures, Highlands, NJ.

    A detailed profile of the largest fresh-air education program in the country for disadvantaged youth -- Sea Ventures -- is provided in this document. Created entirely through the effort of volunteers, Sea Ventures provides learning opportunities that go beyond occupying youngsters. This multi-racial/lingual juvenile delinquency prevention program…

  13. 77 FR 34964 - Notice of Issuance of Final Determination Concerning Toshiba E-Studio Multi-Function Peripherals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-12

    ... in part of materials from another country or instrumentality, it has been substantially transformed... the combining of parts or materials constitutes a substantial transformation, the determinative issue... States), the programming of a foreign PROM (Programmable Read-Only Memory chip) in the United States...

  14. Training a New Generation of Biostatisticians: A Successful Consortium Model

    ERIC Educational Resources Information Center

    Simpson, Judy M.; Ryan, Philip; Carlin, John B.; Gurrin, Lyle; Marschner, Ian

    2009-01-01

    In response to the worldwide shortage of biostatisticians, Australia has established a national consortium of eight universities to develop and deliver a Masters program in biostatistics. This article describes our successful innovative multi-institutional training model, which may be of value to other countries. We first present the issues…

  15. HIV research productivity and structural factors associated with HIV research output in European Union countries: a bibliometric analysis.

    PubMed

    Uusküla, A; Toompere, K; Laisaar, K T; Rosenthal, M; Pürjer, M L; Knellwolf, A; Läärä, E; Des Jarlais, D C

    2015-02-03

    To assess HIV/AIDS research productivity in the 27 countries of the European Union (EU), and the structural level factors associated with levels of HIV/AIDS research productivity. A bibliometric analysis was conducted with systematic search methods used to locate HIV/AIDS research publications (period of 1 January 2002 to 31 December 2011; search databases: MEDLINE (Ovid, PubMed), EMBASE, ISI-Thomson Web of Science; no language restrictions). The publication rate (number of HIV/AIDS research publications per million population in 10 years) and the rate of articles published in HIV/AIDS journals and selected journals with moderate to very high (IF ≥3) 5-year impact factors were used as markers for HIV research productivity. A negative binomial regression model was fitted to assess the impact of structural level factors (sociodemographic, health, HIV prevalence and research/development indicators) associated with the variation in HIV research productivity. The total numbers of HIV/AIDS research publications in 2002-2011 by country ranged from 7 to 9128 (median 319). The median publication rate (per million population in 10 years) was 45 (range 5-150) for all publications. Across all countries, 16% of the HIV/AIDS research was published in HIV/AIDS journals and 7% in selected journals with IF ≥3. Indicators describing economic (gross domestic product), demographic (size of the population) and epidemiological (HIV prevalence) conditions as well as overall scientific activity (total research output) in a country were positively associated with HIV research productivity. HIV research productivity varies noticeably across EU countries, and this variation is associated with recognisable structural factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Use of antiretroviral therapy in resource-limited countries in 2006: distribution and uptake of first- and second-line regimens.

    PubMed

    Renaud-Théry, Françoise; Nguimfack, Boniface Dongmo; Vitoria, Marco; Lee, Evan; Graaff, Peter; Samb, Badara; Perriëns, Joseph

    2007-07-01

    To address the information gap on current use of antiretroviral drugs (ARTs) in developing countries. The AIDS Medicines and Diagnostics Service of the World Health Organization (WHO) carried out a multi-country survey in early 2006. Questionnaires covered the use of first- and second-line regimens in adults and children, and the rates of switching from first-line to second-line regimen. Weighted percentages of use of ARTs across the cohort of adults and children were calculated and correlated with 2006 WHO guidelines. A second analysis compared demand for ARTs with rates of production of active pharmaceutical ingredients. Twenty-three countries (96%) returned the questionnaires, representing 53% of relevant patients in developing countries as of June 2006, and comprising 92% adults and 8% children receiving ARTs. Response rates were highest for questions regarding first-line use and lowest for those regarding pediatric regimens. The distribution of first-line: second-line use was 96%: 4% among adults and 99%: 1% among children. For adults, 95% of those receiving first-line treatment, but only 25% of those receiving second-line treatment, were on regimens consistent with those preferred by the WHO. Among first-line users, the most common regimen (61%) was stavudine+lamivudine+nevirapine. Among second-line users, abacavir+didanosine+lopinavir/ritonavir was the most common regimen (24%). Among children, compliance with WHO guidelines was high among the respondents, with zidovudine+lamivudine+nevirapine reported as the main option. Estimates of first-year switching rate were highly variable, ranging from 1% to 15%, with only ten responses. Comparison of supply and demand showed that the stated production capacity for active pharmaceutical ingredients is sufficient to meet current demands for ARTs. This survey has provided valuable information on the uptake of ARTs in developing countries and will help forecast future demand. Reporting for second-line and pediatric antiretroviral therapy should improve as national programs gain more experience. The current availability of active pharmaceutical ingredients appears to be sufficient to meet current demand. Further work is needed for an understanding of switching rates.

  17. Call for a Computer-Aided Cancer Detection and Classification Research Initiative in Oman.

    PubMed

    Mirzal, Andri; Chaudhry, Shafique Ahmad

    2016-01-01

    Cancer is a major health problem in Oman. It is reported that cancer incidence in Oman is the second highest after Saudi Arabia among Gulf Cooperation Council countries. Based on GLOBOCAN estimates, Oman is predicted to face an almost two-fold increase in cancer incidence in the period 2008-2020. However, cancer research in Oman is still in its infancy. This is due to the fact that medical institutions and infrastructure that play central roles in data collection and analysis are relatively new developments in Oman. We believe the country requires an organized plan and efforts to promote local cancer research. In this paper, we discuss current research progress in cancer diagnosis using machine learning techniques to optimize computer aided cancer detection and classification (CAD). We specifically discuss CAD using two major medical data, i.e., medical imaging and microarray gene expression profiling, because medical imaging like mammography, MRI, and PET have been widely used in Oman for assisting radiologists in early cancer diagnosis and microarray data have been proven to be a reliable source for differential diagnosis. We also discuss future cancer research directions and benefits to Oman economy for entering the cancer research and treatment business as it is a multi-billion dollar industry worldwide.

  18. Hands-On Universe: A Global Program for Education and Public Outreach in Astronomy

    NASA Astrophysics Data System (ADS)

    Boër, M.; Thiébaut, C.; Pack, H.; Pennypaker, C.; Isaac, M.; Melchior, A.-L.; Faye, S.; Ebisuzaki, T.

    Hands-On Universe (HOU) is an educational program that enables students to investigate the Universe while applying tools and concepts from science, math, and technology. Using the Internet, HOU participants around the world request observations from an automated telescope, download images from a large image archive, and analyze them with the aid of user-friendly image processing software. This program is now in many countries, including the USA, France, Germany, Sweden, Japan, and Australia. A network of telescopes has been established, many of them remotely operated. Students in the classroom are able to make night observations during the day, using a telescope in another country. An archive of images taken on large telescopes is also accessible, as well as resources for teachers. Students deal with real research projects, e.g., the search for asteroids, which resulted in the discovery of a Kuiper Belt object by high-school students. Not only does Hands-On Universe give the general public access to professional astronomy, it also demonstrates the use of a complex automated system, data processing techniques, and automation. Using telescopes located in many countries over the globe, a powerful and genuine cooperation between teachers and children from various countries is promoted, with a clear educational goal.

  19. The MAGIC-5 CAD for nodule detection in low dose and thin slice lung CTs

    NASA Astrophysics Data System (ADS)

    Cerello, Piergiorgio; MAGIC-5 Collaboration

    2010-11-01

    Lung cancer is the leading cause of cancer-related mortality in developed countries. Only 10-15% of all men and women diagnosed with lung cancer live 5 years after the diagnosis. However, the 5-year survival rate for patients diagnosed in the early asymptomatic stage of the disease can reach 70%. Early-stage lung cancers can be diagnosed by detecting non-calcified small pulmonary nodules with computed tomography (CT). Computer-aided detection (CAD) could support radiologists in the analysis of the large amount of noisy images generated in screening programs, where low-dose and thin-slice settings are used. The MAGIC-5 project, funded by the Istituto Nazionale di Fisica Nucleare (INFN, Italy) and Ministero dell'Università e della Ricerca (MUR, Italy), developed a multi-method approach based on three CAD algorithms to be used in parallel with a merging of their results: the Channeler Ant Model (CAM), based on Virtual Ant Colonies, the Dot-Enhancement/Pleura Surface Normals/VBNA (DE-PSN-VBNA), and the Region Growing Volume Plateau (RGVP). Preliminary results show quite good performances, to be improved with the refining of the single algorithm and the added value of the results merging.

  20. The epidemic of HIV/AIDS in developing countries; the current scenario in Pakistan.

    PubMed

    Yousaf, Muhammad Z; Zia, Sadia; Babar, Masroor E; Ashfaq, Usman A

    2011-08-12

    HIV (Human Immunodeficiency virus) causes (acquired immunodeficiency syndrome) AIDS, in which the immune system of body totally fails to develop any defense against the foreign invaders. Infection with HIV occurs by transfer of blood, semen, and breast milk. HIV/AIDS is a global problem and it results nearly 25 million deaths worldwide. Developing countries like Pakistan have issues regarding Public Health. Currently, epidemic of HIV/AIDS is established in Pakistan and there is a threat of an expanded HIV/AIDS outbreak in the country. The major reason is that population is engaging in high-risk practices, low awareness about HIV/AIDS, and treacherous blood transfusion practices. A supplementary threat to Pakistan is India because both sharing a border and India is facing a rapidly growing HIV/AIDS epidemic. Local NGOs, National and International organizations are warning that in near future Pakistan may experiences bad situation regarding HIV/AIDS.In the present article we focused current situation of surveillance of HIV/AIDS, its virology, genotype, diagnostics, high-risk groups, reasons of vulnerability in Pakistani population, and the role of different national and international organizations in this situation.

  1. The social network of international health aid.

    PubMed

    Han, Lu; Koenig-Archibugi, Mathias; Opsahl, Tore

    2018-06-01

    International development assistance for health generates an emergent social network in which policy makers in recipient countries are connected to numerous bilateral and multilateral aid agencies and to other aid recipients. Ties in this global network are channels for the transmission of knowledge, norms and influence in addition to material resources, and policy makers in centrally situated governments receive information faster and are exposed to a more diverse range of sources and perspectives. Since diversity of perspectives improves problem-solving capacity, the structural position of aid-receiving governments in the health aid network can affect the health outcomes that those governments are able to attain. We apply a recently developed Social Network Analysis measure to health aid data for 1990-2010 to investigate the relationship between country centrality in the health aid network and improvements in child health. A generalized method of moments (GMM) analysis indicates that, controlling for the volume of health aid and other factors, higher centrality in the health aid network is associated with better child survival rates in a sample of 110 low and middle income countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa

    PubMed Central

    Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N.

    2016-01-01

    After the launch of the US President's Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of the US Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sectors to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs. PMID:27025696

  3. Can community carers cope?

    PubMed

    1989-07-01

    Acquired immunodeficiency syndrome (AIDS) leads to severe social, psychological, and financial consequences for affected families and communities. In response to this stress, service organizations in both developed and developing countries are providing support both to People with AIDS (PWAs) and to their caregivers. In New York, for example, Gay Men's Health Crisis volunteers visit PWAs in hospitals, assist PWAs after discharge with daily chores such as shopping and getting to medical appointments, and provide psychological support through peer and group counseling. The 1st self-help group in Africa, Uganda's AIDS Service Organization (TASO), was established by the widow of an AIDS victim in response to the abandonment of many PWAs by their families. TASO helps families with the practical and financial burdens of caring for AIDS patients, seeks to overcome the fears and misconceptions surrounding the disease, operates a center where those infected with the AIDS virus can gather, and offers income-generating opportunities to PWAs. In the Kagera region of Tanzania, where at least 4000 children have been orphaned by AIDS, villages have allocated community funds for the needs of these children. Other voluntary organizations have focused on providing legal advice to PWAs who have faced discrimination in the workplace or in housing. The World Health Organization's Global Program on AIDS has reiterated its commitment to work with community-based organizations.

  4. Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

    PubMed Central

    Arora, Monika; Chauhan, Kavita; John, Shoba; Mukhopadhyay, Alok

    2011-01-01

    Major noncommunicable diseases (NCDs) share common behavioral risk factors and deep-rooted social determinants. India needs to address its growing NCD burden through health promoting partnerships, policies, and programs. High-level political commitment, inter-sectoral coordination, and community mobilization are important in developing a successful, national, multi-sectoral program for the prevention and control of NCDs. The World Health Organization's “Action Plan for a Global Strategy for Prevention and Control of NCDs” calls for a comprehensive plan involving a whole-of-Government approach. Inter-sectoral coordination will need to start at the planning stage and continue to the implementation, evaluation of interventions, and enactment of public policies. An efficient multi-sectoral mechanism is also crucial at the stage of monitoring, evaluating enforcement of policies, and analyzing impact of multi-sectoral initiatives on reducing NCD burden in the country. This paper presents a critical appraisal of social determinants influencing NCDs, in the Indian context, and how multi-sectoral action can effectively address such challenges through mainstreaming health promotion into national health and development programs. India, with its wide socio-cultural, economic, and geographical diversities, poses several unique challenges in addressing NCDs. On the other hand, the jurisdiction States have over health, presents multiple opportunities to address health from the local perspective, while working on the national framework around multi-sectoral aspects of NCDs. PMID:22628911

  5. The Multi-Country Evaluation of the Integrated Management of Childhood Illness Strategy: Lessons for the Evaluation of Public Health Interventions

    PubMed Central

    Bryce, Jennifer; Victora, Cesar G.; Habicht, Jean-Pierre; Vaughan, J. Patrick; Black, Robert E.

    2004-01-01

    The Multi-Country Evaluation of the Integrated Management of Childhood Illness (IMCI) includes studies of the effectiveness, cost, and impact of the IMCI strategy in Bangladesh, Brazil, Peru, Tanzania, and Uganda. Seven questions were addressed when the evaluation was designed: who would be in charge, through what mechanisms IMCI could affect child health, whether the focus would be efficacy or effectiveness, what indicators would be measured, what types of inference would be made, how costs would be incorporated, and what elements would constitute the plan of analysis. We describe how these questions were answered, the challenges encountered in implementing the evaluation, and the 5 study designs. The methodological insights gained can improve future evaluations of public health programs. PMID:14998804

  6. Healthcare team training programs aimed at improving depression management in primary care: A systematic review.

    PubMed

    Vöhringer, Paul A; Castro, Ariel; Martínez, Pablo; Tala, Álvaro; Medina, Simón; Rojas, Graciela

    2016-08-01

    Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. A comparative study of two communication models in HIV/AIDS coverage in selected Nigerian newspapers.

    PubMed

    Okidu, Onjefu

    2013-01-30

    The current overriding thought in HIV/AIDS communication in developing countries is the need for a shift from the cognitive model, which emphasises the decision-making of the individual, to the activity model, which emphasises the context of the individual. In spite of the acknowledged media shift from the cognitive to the activity model in some developing countries, some HIV/AIDS communication scholars have felt otherwise. It was against this background that this study examined the content of some selected Nigerian newspapers to ascertain the attention paid to HIV/AIDS cognitive and activity information. Generally, the study found that Nigerian newspapers had shifted from the cognitive to the activity model of communication in their coverage of HIV/AIDS issues. The findings of the study seem inconsistent with the theoretical argument of some scholars that insufficient attention has been paid by mass media in developing countries to the activity model of HIV/AIDS communication. It is suggested that future research replicate the study for Nigerian and other developing countries' mass media.

  8. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    PubMed Central

    2011-01-01

    Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater accessibility because of multiple, complex, and interrelated barriers to HIV/AIDS service utilisation at the service delivery level. Factors external to, as well as within, the health sector are key to understanding the access deficit in the FSU where low or concentrated HIV/AIDS epidemics are prevalent. Funders of HIV/AIDS programmes need to consider how best to tackle key structural and systemic drivers of access including prohibitionist legislation on drugs use, limited transparency and low staff salaries within the health sector. PMID:21752236

  9. IMF, World Bank programs hinder AIDS prevention.

    PubMed

    Denoon, D J

    1995-07-10

    International Monetary Fund (IMF) and World Bank structural adjustment programs (SAPs) imposed on developing nations in the 1980s inadvertently helped set the stage for the AIDS epidemic. These programs continue to hinder efforts to prevent HIV transmission. SAPs resulted in the following phenomena which place populations at risk of HIV infection: increased rural-urban migration of cheap labor sparked by a shift to an export-oriented economy, the development of transportation infrastructures in the 1980s to support the changed economy, increased migration and urbanization, and reduced government spending upon health and social services necessitated by the SAPs. For HIV transmission in developing countries to be substantially reduced, the SAP economic policies which may have promoted disease must be modified. An alternative development strategy must satisfy basic human needs such as food, housing, and transport; shift emphasis from the production of a small number of primary commodities for export to diversified agricultural production; support marginal producers and subsistence farmers; emphasize human resource development; end the top-down approach favored by the IMF and World Bank in favor of a truly cooperative development policy; alter the charters of the IMF and World Bank to permit the cancellation or restructuring of debt; and require AIDS Impact Reports of the IMF and World Bank.

  10. Migration, Aid and Trade: Policy Coherence for Development. Policy Brief No. 28

    ERIC Educational Resources Information Center

    Dayton-Johnson, Jeff; Katseli, Louka T.

    2006-01-01

    Many Organisation for Economic Cooperation and Development (OECD) countries recruit internationally skilled workers for their health, education, or public administration sectors and the subsequent emigration of such workers can cause critical shortages in developing countries, even as these countries receive substantial aid from those same OECD…

  11. Laboratory Innovation Towards Quality Program Sustainability.

    PubMed

    Abimiku, Alash'le; Timperi, Ralph; Blattner, William

    2016-08-01

    Laboratory innovation significantly affects program sustainability of HIV programs in low and middle income countries (LMICs) far beyond its immediate sphere of impact. Innovation in rapid development of diagnostic technologies, improved quality management systems, strengthened laboratory management, affordable external quality assurance and accreditation schemes, and building local capacity have reduced costs, brought quality improvement to point-of-care testing, increased access to testing services, reduced treatment and prevention costs and opened the door to the real possibility of ending the AIDS epidemic. However, for effectively implemented laboratory innovation to contribute to HIV quality program sustainability, it must be implemented within the overall context of the national strategic plan and HIV treatment programs. The high quality of HIV rapid diagnostic test was a breakthrough that made it possible for more persons to learn their HIV status, receive counseling, and if infected to receive treatment. Likewise, the use of dried blood spots made the shipment of samples easier for the assessment of different variables of HIV infection-molecular diagnosis, CD4+ cell counts, HIV antibodies, drug resistance surveillance, and even antiretroviral drug level measurements. Such advancement is critical for to reaching the UNAIDS target of 90-90-90 and for bringing the AIDS epidemic to an end, especially in LMICs.

  12. ARISTOTLE (All Risk Integrated System TOwards The hoListic Early-warning)

    NASA Astrophysics Data System (ADS)

    Michelini, Alberto; Wotawa, Gerhard; Arnold-Arias, Delia

    2017-04-01

    The Emergency Response Coordination Centre (ERCC) is the EU coordination office for humanitarian aid and civil protection operations of DG ECHO (EU Humanitarian Aid and Civil Protection). ERCC needs rapidly authoritative multi-hazard scientific expertise and analysis on 24*7 basis since, when a disaster strikes, every minute counts for saving lives and immediate, coordinated and pre-planned response is essential. The EU is committed to providing disaster response in a timely and efficient manner and to ensure European assistance meets the real needs in the population affected, whether in Europe or beyond. The ARISTOTLE consortium was awarded the European Commission's DG ECHO "Pilot project in the area of Early Warning System for natural disasters" (OJ 2015 S/154-283349). The tender articulates the needs and expectations of DG ECHO in respect of the provision of multi-hazard advice to the Emergency Response & Coordination Centre in Brussels. Specifically, the tender aims to fill the gap in knowledge that exists in the: • first 3 hours immediately after an event that has the potential to require a country to call on international help • provision of longer term advice following an emergency • provision of advice when a potential hazardous event is starting to form; this will usually be restricted to severe weather and flooding events and when possible to volcanic events. The ARISTOTLE Consortium was awarded the tender and the project effectively started on February 1st, 2016, for a duration of 2 years. ARISTOTLE (aristotle.ingv.it) is a multi-hazard partnership created by combining expertise from of total of 5 hazard groups [4 main hazard groups plus a sub-hazard - Severe Weather, Floods, Volcanos (only for ashes and gases hazard deriving from eruptions), Earthquakes and the related Tsunamis as a sub-hazard given its peculiarities and potential huge impact]. Each Hazard Group brings together experts from the particular hazard domain to deliver a 'collective analysis' which is then fed into the partnership multi-hazard discussions. The hazards are very different and have very diverse timelines for phenomenological occurrence (Figure 1). The ARISTOTLE consortium includes 15 partner institutions (11 from EU Countries; 2 from non-EU countries and 2 European organizations) operating in the Meteorological and Geophysical domains. The project coordination is shared among INGV and ZAMG for the geophysical and meteorological communities, respectively. Primary target of the tender project is the prototyping and the implementation of a scalable system (in terms of number of partners and hazards) capable of providing to ERCC the "desiderata" above. To this end, the activities of the project have been focusing on the establishment of a multi-hazard operational board (MHOB) that is assigned the 24*7 operational duty regulated by a "Standard Operating Protocol". The presentation will illustrate the different modes of operation envisaged and the status and the solutions found by the project consortium to respond to the ERCC requirements.

  13. White Paper Report of the RAD-AID Conference on International Radiology for Developing Countries: identifying challenges, opportunities, and strategies for imaging services in the developing world.

    PubMed

    Mollura, Daniel J; Azene, Ezana M; Starikovsky, Anna; Thelwell, Aduke; Iosifescu, Sarah; Kimble, Cary; Polin, Ann; Garra, Brian S; DeStigter, Kristen K; Short, Brad; Johnson, Benjamin; Welch, Christian; Walker, Ivy; White, David M; Javadi, Mehrbod S; Lungren, Matthew P; Zaheer, Atif; Goldberg, Barry B; Lewin, Jonathan S

    2010-07-01

    The RAD-AID Conference on International Radiology for Developing Countries was an assembly of individuals and organizations interested in improving access to medical imaging services in developing countries where the availability of radiology has been inadequate for both patient care and public health programs. The purpose of the meeting was to discuss data, experiences, and models pertaining to radiology in the developing world and to evaluate potential opportunities for future collaboration. Conference participants included radiologists, technologists, faculty members of academic medical institutions, and leadership of nongovernmental organizations involved in international health care and social entrepreneurship. Four main themes from the conference are presented in this white paper as important factors for the implementation and optimization of radiology in the developing world: (1) ensuring the economic sustainability of radiologic services through financial and administrative training support of health care personnel; (2) designing, testing, and deploying clinical strategies adapted for regions with limited resources; (3) structuring and improving the role of American radiology residents interested in global health service projects; and (4) implementing information technology models to support digital imaging in the developing world. Published by Elsevier Inc.

  14. Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya.

    PubMed

    Cole, Donald C; Levin, Carol; Loechl, Cornelia; Thiele, Graham; Grant, Frederick; Girard, Aimee Webb; Sindi, Kirimi; Low, Jan

    2016-06-01

    Multi-sectoral programs that involve stakeholders in agriculture, nutrition and health care are essential for responding to nutrition problems such as vitamin A deficiency among pregnant and lactating women and their infants in many poor areas of lower income countries. Yet planning such multi-sectoral programs and designing appropriate evaluations, to respond to different disciplinary cultures of evidence, remain a challenge. We describe the context, program development process, and evaluation design of the Mama SASHA project (Sweetpotato Action for Security and Health in Africa) which promoted production and consumption of a bio-fortified, orange-fleshed sweetpotato (OFSP). In planning the program we drew upon information from needs assessments, stakeholder consultations, and a first round of the implementation evaluation of a pilot project. The multi-disciplinary team worked with partner organizations to develop a program theory of change and an impact pathway which identified aspects of the program that would be monitored and established evaluation methods. Responding to the growing demand for greater rigour in impact evaluations, we carried out quasi-experimental allocation by health facility catchment area, repeat village surveys for assessment of change in intervention and control areas, and longitudinal tracking of individual mother-child pairs. Mid-course corrections in program implementation were informed by program monitoring, regular feedback from implementers and partners' meetings. To assess economic efficiency and provide evidence for scaling we collected data on resources used and project expenses. Managing the multi-sectoral program and the mixed methods evaluation involved bargaining and trade-offs that were deemed essential to respond to the array of stakeholders, program funders and disciplines involved. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya

    PubMed Central

    Cole, Donald C.; Levin, Carol; Loechl, Cornelia; Thiele, Graham; Grant, Frederick; Girard, Aimee Webb; Sindi, Kirimi; Low, Jan

    2016-01-01

    Multi-sectoral programs that involve stakeholders in agriculture, nutrition and health care are essential for responding to nutrition problems such as vitamin A deficiency among pregnant and lactating women and their infants in many poor areas of lower income countries. Yet planning such multi-sectoral programs and designing appropriate evaluations, to respond to different disciplinary cultures of evidence, remain a challenge. We describe the context, program development process, and evaluation design of the Mama SASHA project (Sweetpotato Action for Security and Health in Africa) which promoted production and consumption of a bio-fortified, orange-fleshed sweetpotato (OFSP). In planning the program we drew upon information from needs assessments, stakeholder consultations, and a first round of the implementation evaluation of a pilot project. The multi-disciplinary team worked with partner organizations to develop a program theory of change and an impact pathway which identified aspects of the program that would be monitored and established evaluation methods. Responding to the growing demand for greater rigour in impact evaluations, we carried out quasi-experimental allocation by health facility catchment area, repeat village surveys for assessment of change in intervention and control areas, and longitudinal tracking of individual mother-child pairs. Mid-course corrections in program implementation were informed by program monitoring, regular feedback from implementers and partners’ meetings. To assess economic efficiency and provide evidence for scaling we collected data on resources used and project expenses. Managing the multi-sectoral program and the mixed methods evaluation involved bargaining and trade-offs that were deemed essential to respond to the array of stakeholders, program funders and disciplines involved. PMID:27003730

  16. The impact of HIV/AIDS on human development in African countries.

    PubMed

    Boutayeb, Abdesslam

    2009-11-18

    In the present paper, we consider the impact of HIV/AIDS on human development in African countries, showing that, beyond health issues, this disease should and must be seen as a global development concern, affecting all components of human development. Consequently, we stress the necessity of multidisciplinary approaches that model, estimate and predict the real impact of HIV/AIDS on human development of African countries in order to optimise the strategies proposed by national countries, international institutions and their partners. In our search strategy, we relied on secondary information, mainly through National Human Development Reports of some African countries and regular publications released by the United Nations (UN), United Nations Development Programme (UNDP), World Health Organization (WHO) and the World Bank. We restricted ourselves to reports dealing explicitly with the impact of HIV/AIDS on human development in African countries. HIV/AIDS is affecting the global human development of African countries through its devastating impact on health and demographic indicators such as life expectancy at birth, healthcare assistance, age and sex distribution, economic indicators like income, work force, and economic growth, education and knowledge acquisition and other indicators like governance, gender inequality and human rights. On the basis of the national reports reviewed, it appears clearly that HIV/AIDS is no longer a crisis only for the healthcare sector, but presents a challenge to all sectors. Consequently, HIV/AIDS is a development question and should be viewed as such. The disease is impeding development by imposing a steady decline in the key indicators of human development and hence reversing the social and economic gains that African countries are striving to attain. Being at the same time a cause and consequence of poverty and underdevelopment, it constitutes a challenge to human security and human development by diminishing the chances of alleviating poverty and hunger, achieving universal primary education, promoting gender equality, reducing child and maternal mortality, and ensuring environmental sustainability.

  17. The History of the HIV/AIDS Epidemic in Africa.

    PubMed

    Kagaayi, Joseph; Serwadda, David

    2016-08-01

    HIV testing of African immigrants in Belgium showed that HIV existed among Africans by 1983. However, the epidemic was recognized much later in most parts of sub-Saharan Africa (SSA) due to stigma and perceived fear of possible negative consequences to the countries' economies. This delay had devastating mortality, morbidity, and social consequences. In countries where earlier recognition occurred, political leadership was vital in mounting a response. The response involved establishment of AIDS control programs and research on the HIV epidemiology and candidate preventive interventions. Over time, the number of effective interventions has grown; the game changer being triple antiretroviral therapy (ART). ART has led to a rapid decline in HIV-related morbidity and mortality in addition to prevention of onward HIV transmission. Other effective interventions include safe male circumcision, pre-exposure prophylaxis, and post-exposure prophylaxis. However, since none of these is sufficient by itself, delivering a combination package of these interventions is important for ending the HIV epidemic as a public health threat.

  18. Computer Aided Battery Engineering Consortium

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pesaran, Ahmad

    A multi-national lab collaborative team was assembled that includes experts from academia and industry to enhance recently developed Computer-Aided Battery Engineering for Electric Drive Vehicles (CAEBAT)-II battery crush modeling tools and to develop microstructure models for electrode design - both computationally efficient. Task 1. The new Multi-Scale Multi-Domain model framework (GH-MSMD) provides 100x to 1,000x computation speed-up in battery electrochemical/thermal simulation while retaining modularity of particles and electrode-, cell-, and pack-level domains. The increased speed enables direct use of the full model in parameter identification. Task 2. Mechanical-electrochemical-thermal (MECT) models for mechanical abuse simulation were simultaneously coupled, enabling simultaneous modelingmore » of electrochemical reactions during the short circuit, when necessary. The interactions between mechanical failure and battery cell performance were studied, and the flexibility of the model for various batteries structures and loading conditions was improved. Model validation is ongoing to compare with test data from Sandia National Laboratories. The ABDT tool was established in ANSYS. Task 3. Microstructural modeling was conducted to enhance next-generation electrode designs. This 3- year project will validate models for a variety of electrodes, complementing Advanced Battery Research programs. Prototype tools have been developed for electrochemical simulation and geometric reconstruction.« less

  19. Early impact of a national multi-faceted road safety intervention program in Mexico: results of a time-series analysis.

    PubMed

    Chandran, Aruna; Pérez-Núñez, Ricardo; Bachani, Abdulgafoor M; Híjar, Martha; Salinas-Rodríguez, Aarón; Hyder, Adnan A

    2014-01-01

    In January 2008, a national multifaceted road safety intervention program (IMESEVI) funded by the Bloomberg Philanthropies was launched in Mexico. Two years later in 2010, IMESEVI was refocused as part of a 10-country international consortium demonstration project (IMESEVI/RS10). We evaluate the initial effects of each phase of the road safety intervention project on numbers of RT crashes, injuries and deaths in Mexico and in the two main target cities of Guadalajara-Zapopan and León. An interrupted time series analysis using autoregressive integrated moving average (ARIMA) modeling was performed using monthly data of rates of RT crashes and injuries (police data), as well as deaths (mortality system data) from 1999-2011 with dummy variables representing each intervention phase. In the period following the first intervention phase at the country level and in the city of León, the rate of RT crashes decreased significantly (p<0.05). Notably, following the second intervention phase although there was no reduction at the country level, there has been a decrease in the RT crash rate in both Guadalajara-Zapopan (p = 0.029) and in León (p = 0.029). There were no significant differences in the RT injury or death rates following either intervention phase in either city. These initial results suggest that a multi-faceted road safety intervention program appears to be effective in reducing road crashes in a middle-income country setting. Further analysis is needed to differentiate the effects of various interventions, and to determine what other economic and political factors might have affected this change.

  20. Early Impact of a National Multi-Faceted Road Safety Intervention Program in Mexico: Results of a Time-Series Analysis

    PubMed Central

    Chandran, Aruna; Pérez-Núñez, Ricardo; Bachani, Abdulgafoor M.; Híjar, Martha; Salinas-Rodríguez, Aarón; Hyder, Adnan A.

    2014-01-01

    Background In January 2008, a national multifaceted road safety intervention program (IMESEVI) funded by the Bloomberg Philanthropies was launched in Mexico. Two years later in 2010, IMESEVI was refocused as part of a 10-country international consortium demonstration project (IMESEVI/RS10). We evaluate the initial effects of each phase of the road safety intervention project on numbers of RT crashes, injuries and deaths in Mexico and in the two main target cities of Guadalajara-Zapopan and León. Methods An interrupted time series analysis using autoregressive integrated moving average (ARIMA) modeling was performed using monthly data of rates of RT crashes and injuries (police data), as well as deaths (mortality system data) from 1999–2011 with dummy variables representing each intervention phase. Results In the period following the first intervention phase at the country level and in the city of León, the rate of RT crashes decreased significantly (p<0.05). Notably, following the second intervention phase although there was no reduction at the country level, there has been a decrease in the RT crash rate in both Guadalajara-Zapopan (p = 0.029) and in León (p = 0.029). There were no significant differences in the RT injury or death rates following either intervention phase in either city. Conclusion These initial results suggest that a multi-faceted road safety intervention program appears to be effective in reducing road crashes in a middle-income country setting. Further analysis is needed to differentiate the effects of various interventions, and to determine what other economic and political factors might have affected this change. PMID:24498114

  1. Pakistan/USAID to start CSM project.

    PubMed

    1984-01-01

    Pakistan, with the assistance of funds for the US Agency for International Development (USAID), is about to start its novel approach to contraceptive social marketing (CSM). This new effort suggests a marked policy shift on the part of the Pakistan government toward intensifying its family planning activities. The program will be government-operated and supported by AID over the next 5 years with $20 million, more than double the cost of similar CSM projects elswhere. Distribution of a condom on a pilot project basis is expected to begin by December 1984. Sales of a low-dose oral contraceptive (OC) could begin in test market areas by mid-1985, with national launching of both products tentatively scheduled for January 1986. The Pakistan/USAID agreement represents the 1st time since the formation of India's Nirodh project in the late 1960s that a CSM program is being established without the involvement of either an international social marketing contractor or a country's family planning association. The Pakistan CSM program will be managed by a policy board composed of representatives from the government's Ministries of Planning, Health and Education; a resident advisor from USAID; and a local company responsible for product marketing and distribution. The approach has received a skeptical response among international social marketing experts about the program's chances for success. Their doubts extend to 2 other aspects of the proposed design: an official of the Ministry of Planning's Population and Welfare Division expects the CSM program to generate sufficient revenues to cover all operating costs following the 5-year subsidy period, while also providing attractive profit margins for the marketing/distribution company; and the government prohibits mass media advertising of contraceptives. According to AID, the issue of mass media contraceptive advertising has not yet been resolved, and a national survey will be conducted to determine what communication needs are required for product promotion. In addition, AID's agreement requires a yearly review by the Pakistan government of its marketing strategies. The Pakistan government hopes that its new emphasis on family planning can slow the country's annual rate of population growth from 1983's 2.9% figure to 2.6% by 1988.

  2. Factors associated with parent-child communication about HIV/AIDS in the United States and Kenya: a cross-cultural comparison.

    PubMed

    Poulsen, Melissa N; Miller, Kim S; Lin, Carol; Fasula, Amy; Vandenhoudt, Hilde; Wyckoff, Sarah C; Ochura, Juliet; Obong'o, Christopher O; Forehand, Rex

    2010-10-01

    This study explored parent-child communication about HIV/AIDS among two populations disproportionately affected by HIV. Similar computer-assisted surveys were completed by parents of pre-teens, including 1,115 African American parents of 9-12-year-old children in southeastern US and 403 parents of 10-12-year-old children in Nyanza Province, Kenya. Multivariate analyses identified factors associated with parental report of ever talking to their child about HIV/AIDS. Twenty-nine percent of US parents and 40% in Kenya had never talked to their pre-teen about HIV/AIDS. In both countries, communication was more likely if parents perceived their child to be ready to learn about sex topics, had gotten information to educate their child about sex, and had greater sexual communication responsiveness (skill, comfort, and confidence communicating about sexuality). Programs are needed that help parents assess children's readiness to learn about sexual issues; access accurate information about adolescent sexual risks; and acquire the responsiveness needed to discuss sexual issues, including HIV/AIDS.

  3. Funding AIDS programmes in the era of shared responsibility: an analysis of domestic spending in 12 low-income and middle-income countries.

    PubMed

    Resch, Stephen; Ryckman, Theresa; Hecht, Robert

    2015-01-01

    As the incomes of many AIDS-burdened countries grow and donors' budgets for helping to fight the disease tighten, national governments and external funding partners increasingly face the following question: what is the capacity of countries that are highly affected by AIDS to finance their responses from domestic sources, and how might this affect the level of donor support? In this study, we attempt to answer this question. We propose metrics to estimate domestic AIDS financing, using methods related to national prioritisation of health spending, disease burden, and economic growth. We apply these metrics to 12 countries in sub-Saharan Africa with a high prevalence of HIV/AIDS, generating scenarios of possible future domestic expenditure. We compare the results with total AIDS financing requirements to calculate the size of the resulting funding gaps and implications for donors. Nearly all 12 countries studied fall short of the proposed expenditure benchmarks. If they met these benchmarks fully, domestic spending on AIDS would increase by 2·5 times, from US$2·1 billion to $5·1 billion annually, covering 64% of estimated future funding requirements and leaving a gap of around a third of the total $7·9 billion needed. Although upper-middle-income countries, such as Botswana, Namibia, and South Africa, would become financially self-reliant, lower-income countries, such as Mozambique and Ethiopia, would remain heavily dependent on donor funds. The proposed metrics could be useful to stimulate further analysis and discussion around domestic spending on AIDS and corresponding donor contributions, and to structure financial agreements between recipient country governments and donors. Coupled with improved resource tracking, such metrics could enhance transparency and accountability for efficient use of money and maximise the effect of available funding to prevent HIV infections and save lives. US Centers for Disease Control and Prevention. Copyright © 2015 Hecht et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.

  4. Scientific approaches to AIDS prevention and control in China.

    PubMed

    Teng, T; Shao, Y

    2011-04-01

    The HIV epidemic in China started among intravenous drug users in the late 1980s. The second wave of the epidemic was caused by an outbreak in the paid plasma donors in central China in the mid-1990s. Sexually transmitted HIV cases have steadily increased and comprised more than half the reported HIV/AIDS infections since 2007. In the last 5 years, there has been a sharp increase of HIV infection in men who have sex with men. The HIV epidemic in China has expanded from high-risk groups to the general population and from rural regions to urban areas. This brief article discusses the history of HIV epidemics in China and the challenges facing the current AIDS control efforts in the country. It explains that only scientific approaches can sustain the national AIDS control programs and introduce the type of research needed to address those challenges. The selected research areas include molecular epidemiology, drug resistance surveillance, and the Chinese HIV vaccine research.

  5. The impact of HIV / AIDS on Kenya's commercial sector.

    PubMed

    Forsythe, S; Roberts, M

    1995-02-01

    AIDSCAP is undertaking a project designed to encourage Kenya's private sector to participate in HIV/AIDS prevention efforts. Part of that project involves estimating the impact of HIV/AIDS on Kenya's commercial sector. AIDSCAP and Kenyan researcher estimates are based upon financial data from a sugar estate, a transportation company, a wood processing plant, a textile factory, and a light manufacturing company, a small sample representing the diversity of industries in the country. Most are medium-sized companies with 1200-2200 employees. Preliminary results suggest that absenteeism, training costs, and HIV-related health care will cause the greatest losses to Kenyan businesses. Projections show that the HIV/AIDS epidemic could increase labor costs for some Kenyan businesses by 17% by the year 2005. Despite increasing labor costs, however, the epidemic may not cause a significant drop in profits for larger, capital-intensive Kenyan businesses. Some companies could still find their profits cut by 15-25% within the next 10 years. Study findings and implications for workplace prevention programs are discussed.

  6. Defining and refining international donor support for combating the AIDS pandemic.

    PubMed

    Attaran, A; Sachs, J

    2001-01-06

    The international aid effort against AIDS is greatly incommensurate with the severity of the epidemic. Drawing on the data that international aid donors self-reported to the Organization for Economic Cooperation and Development (OECD), we find that, between 1996 and 1998, finance from all rich countries to sub-Saharan Africa for projects designated as AIDS control averaged US $69 million annually, and, assuming a safe margin for under-reporting and misreporting, we estimate that total donor spending on HIV/AIDS control was perhaps twice that at most. Since the late 1980s, aid levels have dropped relative to the prevalence of HIV infection, and stood recently at about $3 per HIV-infected person. Lack of finance is now the primary constraint on progress against AIDS, notwithstanding the widespread belief that a lack of interest from the goveements of poor countries is limiting. We argue that to produce a meaningful response to the pandemic, international assistance must be based on grants, not loans, for the poorest countries; be increased within the next 3 years to a minimum of $7.5 billion or more; be directed toward funding projects which are proposed and desired by the affected countries themselves, and which are judged as having epidemiological merit against the pandemic by a panel of independent scientific experts; and fund concurrent needs, including prevention, drug treatment (such as highly active antiretroviral therapy), and blocking mother-to-child HIV transmission. An effort of this scope and scale will both radically alter the prospects for intervention against AIDS in poor countries, and together with comparable efforts to control other infectious diseases, is easily afforded by the OECD donor economies, whose aggregate national income recently surpassed $21 trillion annually.

  7. Acceptance of HIV in Cote d'Ivoire earns praise.

    PubMed

    1996-04-22

    The first known case of AIDS in Cote d'Ivoire was diagnosed in 1985. After that, the number of people identified as having AIDS grew rapidly, but the social stigmatization of people with HIV and AIDS caused the discussion of HIV/AIDS to remain taboo for years. Even health workers only mentioned the virus within the privacy of their clinics. The government of Cote d'Ivoire finally decided in 1994 to acknowledge the existence of an HIV epidemic in the country and launched an anti-AIDS campaign supported by social workers and nongovernmental organizations. These actions have earned international support for the authorities of Cote d'Ivoire. As a result of the campaign, growing numbers of people have been taking care of infected relatives, while some people with AIDS have publicly declared their HIV-positive serostatus. An HIV laboratory, the first of its kind in West Africa, will be established in Cote d'Ivoire, and the UN Program Against AIDS will base its regional office for West Africa in the city. Peter Piot, the program's executive director, has stated that the UN chose Abidjan because of the Cote d'Ivoire's new honest approach toward fighting HIV and AIDS. Cote d'Ivoire, a member of the UN AIDS Coordination Committee, plans to host an International Conference on AIDS in 1997. The US Centers for Disease Control also plan to finance the creation of a virological laboratory in Abidjan to determine how the virus is reproduced in humans with the goal of developing a vaccine against it; to identify how HIV is transmitted, how it kills, and how to prevent its propagation; and to serve as a training center for young Ivoirian virologists. Construction began upon the Abidjan Virology Laboratory in late March 1996. The laboratory is expected to cost 400 million CFA francs (almost $850,000) and should start operating in July 1997.

  8. Population success.

    PubMed

    1982-01-01

    "The commitment to population programs is now widespread," says Rafael Salas, Executive Director of the UNFPA, in its report "State of World Population." About 80% of the total population of the developing world live in countries which consider their fertility levels too high and would like them reduced. An important impetus came from the World Conference of 1974. The Plan of Action from the conference projected population growth rates in developing countries of 2.0% by 1985. Today it looks as though this projection will be realized. While in 1969, for example, only 26 developing countries had programs aimed at lowering or maintaining fertility levels, by 1980 there were 59. The International Population Conference, recently announced by the UN for 1984, will, it is hoped, help sustain that momentum. Cuba is the country which has shown the greatest decline in birth rate so far. The birth rate fell 47% between 1965-1970 and 1975-1980. Next came China with a 34% decline in the same period. After these came a group of countries--each with populations of over 10 million--with declines of between 15 and 25%: Chile, Colombia, India, Indonesia, the Republic of Korea, Malaysia and Thailand. Though birth rates have been dropping significantly the decline in mortality rates over recent years has been less than was hoped for. The 1974 conference set 74 years as the target for the world's average expectation of life, to be reached by the year 2000. But the UN now predicts that the developing countries will have only reached 63 or 64 years by then. High infant and child mortality rates, particularly in Africa, are among the major causes. The report identifies the status of women as an important determinant of family size. Evidence from the UNFPA-sponsored World Fertility Survey shows that in general the fertility of women decreases as their income increases. It also indicates that women who have been educated and who work outside the home are likely to have smaller families. Access to contraceptives is, of course, a major influence on fertility decline. According to UNFPA some of the Latin American countries have the highest contraceptive use among developing countries. The countries of Asia come next and contraceptives are least used in sub-Saharan Africa where birth rates of 45/1000 are still common. The money for population programs, says the report, has come largely from developing countries themselves. A survey of 15 countries showed them to have contributed 67% out of their own budgets--the rest having come from external aid. And in programs aided by UNFPA the local input has been even higher. During 1979-1981 the developing countries themselves budgeted $4.6 for each dollar budgeted by UNFPA. The report also highlights some of the emerging problems for the next 2 decades--and which will be high on the agenda of the 1984 conference. These include "uncontrolled urban growth" in developing countries as well as an important change in overall population age structure as more and more old people survive. Aging populations are of particular concern to the developed countries but, as the report points out, even countries like China--which has achieved a steep drop in fertility and mortality--will face the problems of an aging population by the year 2000. full text

  9. AIDS and National Security

    DTIC Science & Technology

    2003-04-07

    prevention and education programs. This increase in migrant workers is transforming local HIV epidemics and spreading the virus throughout the country.41...consumers, represents a huge, untapped market that would otherwise be promising for U.S. trade growth, but for the instability in the region, fueled...in states that are suffering from increasing HIV infection rates than waiting until those states fail and we suffer loss of trade or we are forced to

  10. The Impact of Resource Wealth On Economic Growth, Governance, and Conflict in Afghanistan

    DTIC Science & Technology

    2013-09-01

    charged with developing the mining sector . While analysis of aid programs in the country shows flaws in governance and monetary policies, there are...indications that the incentives induced by the emerging mining sector have triggered a shift toward a future-oriented development strategy amongst...the realization of the country’s economic potential has positively affected government institutions charged with developing the mining sector . While

  11. HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries.

    PubMed

    Marseille, Elliot; Dandona, Lalit; Marshall, Nell; Gaist, Paul; Bautista-Arredondo, Sergio; Rollins, Brandi; Bertozzi, Stefano M; Coovadia, Jerry; Saba, Joseph; Lioznov, Dmitry; Du Plessis, Jo-Ann; Krupitsky, Evgeny; Stanley, Nicci; Over, Mead; Peryshkina, Alena; Kumar, S G Prem; Muyingo, Sowedi; Pitter, Christian; Lundberg, Mattias; Kahn, James G

    2007-07-12

    Economic theory and limited empirical data suggest that costs per unit of HIV prevention program output (unit costs) will initially decrease as small programs expand. Unit costs may then reach a nadir and start to increase if expansion continues beyond the economically optimal size. Information on the relationship between scale and unit costs is critical to project the cost of global HIV prevention efforts and to allocate prevention resources efficiently. The "Prevent AIDS: Network for Cost-Effectiveness Analysis" (PANCEA) project collected 2003 and 2004 cost and output data from 206 HIV prevention programs of six types in five countries. The association between scale and efficiency for each intervention type was examined for each country. Our team characterized the direction, shape, and strength of this association by fitting bivariate regression lines to scatter plots of output levels and unit costs. We chose the regression forms with the highest explanatory power (R2). Efficiency increased with scale, across all countries and interventions. This association varied within intervention and within country, in terms of the range in scale and efficiency, the best fitting regression form, and the slope of the regression. The fraction of variation in efficiency explained by scale ranged from 26-96%. Doubling in scale resulted in reductions in unit costs averaging 34.2% (ranging from 2.4% to 58.0%). Two regression trends, in India, suggested an inflection point beyond which unit costs increased. Unit costs decrease with scale across a wide range of service types and volumes. These country and intervention-specific findings can inform projections of the global cost of scaling up HIV prevention efforts.

  12. Advancing MEMS Technology Usage through the MUMPS (Multi-User MEMS Processes) Program

    NASA Technical Reports Server (NTRS)

    Koester, D. A.; Markus, K. W.; Dhuler, V.; Mahadevan, R.; Cowen, A.

    1995-01-01

    In order to help provide access to advanced micro-electro-mechanical systems (MEMS) technologies and lower the barriers for both industry and academia, the Microelectronic Center of North Carolina (MCNC) and ARPA have developed a program which provides users with access to both MEMS processes and advanced electronic integration techniques. The four distinct aspects of this program, the multi-user MEMS processes (MUMP's), the consolidated micro-mechanical element library, smart MEMS, and the MEMS technology network are described in this paper. MUMP's is an ARPA-supported program created to provide inexpensive access to MEMS technology in a multi-user environment. It is both a proof-of-concept and educational tool that aids in the development of MEMS in the domestic community. MUMP's technologies currently include a 3-layer poly-silicon surface micromachining process and LIGA (lithography, electroforming, and injection molding) processes that provide reasonable design flexibility within set guidelines. The consolidated micromechanical element library (CaMEL) is a library of active and passive MEMS structures that can be downloaded by the MEMS community via the internet. Smart MEMS is the development of advanced electronics integration techniques for MEMS through the application of flip chip technology. The MEMS technology network (TechNet) is a menu of standard substrates and MEMS fabrication processes that can be purchased and combined to create unique process flows. TechNet provides the MEMS community greater flexibility and enhanced technology accessibility.

  13. The Potential Impact of Preventive HIV Vaccines in China: Results and Benefits of a Multi-Province Modeling Collaboration

    PubMed Central

    Harmon, Thomas; Guo, Wei; Stover, John; Wu, Zunyou; Kaufman, Joan; Schneider, Kammerle; Liu, Li; Feng, Liao; Schwartländer, Bernard

    2015-01-01

    China’s commitment to implementing established and emerging HIV/AIDS prevention and control strategies has led to substantial gains in terms of access to antiretroviral treatment and prevention services, but the evolving and multifaceted HIV/AIDS epidemic in China highlights the challenges of maintaining that response. This study presents modeling results exploring the potential impact of HIV vaccines in the Chinese context at varying efficacy and coverage rates, while further exploring the potential implications of vaccination programs aimed at reaching populations at highest risk of HIV infection. A preventive HIV vaccine would add a powerful tool to China’s response, even if not 100% efficacious or available to the full population. PMID:26344945

  14. The global polio eradication initiative Stop Transmission of Polio (STOP) program - 1999-2013.

    PubMed

    2013-06-21

    In 1988, the Global Polio Eradication Initiative (GPEI) was established through a partnership between the World Health Organization (WHO), Rotary International, CDC, and the United Nations Children's Fund (UNICEF). By 2012, the annual incidence of polio had decreased by >99%, compared with 1988, and the number of countries in which wild poliovirus (WPV) circulation has never been interrupted was reduced to three: Afghanistan, Nigeria, and Pakistan. However, because of the persistence of endemic WPV transmission and recurring outbreaks in polio-free countries after the original polio eradication target date of 2000, the World Health Assembly in 2012 declared the completion of polio eradication a programmatic emergency. A key component of GPEI is the Stop Transmission of Polio (STOP) program, which was developed and initiated by CDC with WHO in 1999 to mobilize additional human resources and technical assistance for countries affected by WPV transmission. During 1999-2013, 1,563 volunteers were identified, trained, and deployed for 2,221 assignments in 69 countries. The number of volunteers increased from 90-120 per year during 1999-2011 to 287 in 2012 and 378 in 2013, and the number of volunteer person-months in the field per year increased from 273 in 1999 to 1,456 in 2012. The STOP program has aided GPEI by strengthening the capacity of country-level immunization programs and by allowing a large cohort of volunteers to gain valuable field experience that prepares them well for subsequent work as staff members of WHO, UNICEF, and other public health agencies.

  15. Power lifting: people meeting the population challenge.

    PubMed

    Dillon, L

    1994-12-01

    Whereas population pressures are usually associated with developing countries, developed countries like the US also suffer from population-associated problems. For example, in some US cities the infant mortality rate is worse than in the developing world. US policy-makers have found it useful to apply some of the programs used successfully in the developing world to problems at home. Efforts to increase the availability of health care services and education have led to the creation of the Healthy Start program in Baltimore, Maryland, which uses community residents to motivate their peers and provides counseling on family planning, education, and employment. In Oregon, an AIDS-prevention program, which makes condoms more accessible to teenagers, has been transplanted from Zaire. Chattanooga, Tennessee, has used techniques from Brazil to design public transportation systems and improve air quality. In communities across the country, activists are working to instill power in local residents as they seek ways to improve the environment and promote economic health. Modeled on an initiative in Bangladesh, community-run loan programs allow the development of microenterprises which help people develop self-employment opportunities. When women take part in these activities and become successfully employed, their children are given what is usually their first example of parental employment and a reason to hope for a better future.

  16. Regional meeting on behavioral interventions for STD and AIDS prevention.

    PubMed

    1991-01-01

    The abstract of the regional meeting on behavioral interventions for sexually transmitted disease (STD) and AIDS prevention held in Jamaica in 1990, and sponsored by the Pan American Health Organization (PAHO)/WHO, is provided. The conference objectives were to assess existing STD intervention programs in the Americas, to improve coordination of health approaches, to evaluate knowledge and the implication for prevention interventions, to develop evaluation procedures on program effectiveness, and to provide guidelines and regional strategies for prevention and control of STD/HIV. In the inaugural session the idea that further spread of AIDS is minimized through both HIV and STD prevention programs was introduced. Effective strategies for AIDS prevention can be adapted for STD prevention. The new sexual candor has positively affected public understanding and comprehensive research, and applies to the discussion of all STDs. Coordination of STD and AIDS activity makes more efficient use of resources, and can be adapted to specific country needs. Coordination involved information sharing on effective prevention strategies, joint planning and provision of services such as serological testing and counseling, and integration of administration, personnel, and infrastructure for HIV/AIDS and STD prevention. Primary prevention and longterm change are desired. Coordination also involves joint efforts with other health care activities such as maternal and child health. Plenary session 1 was devoted to expert opinion on specific STDs, their physical and mental impact, and their economic and environmental impact. The day 2 plenary session reported on the increases in HIV and STD prevalence, and the various opportunities and needs for intervention. Target audiences were identified as those at high risk and teens and children as anticipatory risks. Religious opinions, societal norms, and public opinion were obstacles to program support. Other sessions dealt with condom promotion, the role and training of health workers, and counseling and partner notification. The final day's discussion focused on methods and materials approaches: general public, STD service, outreach, youth, and women. The findings of the last plenary session focused on funding and staffing shortages and lack of coordinated national programs. The Kingston Declaration, which proposes a plan for action for governments, community groups, nongovernment organizations, and others, was agreed upon. Basic components of any program should be accessibility, targeted risk groups, cultural sensitivity, and local design.

  17. Review of Multi-Criteria Decision Aid for Integrated Sustainability Assessment of Urban Water Systems - MCEARD

    EPA Science Inventory

    Integrated sustainability assessment is part of a new paradigm for urban water decision making. Multi-criteria decision aid (MCDA) is an integrative framework used in urban water sustainability assessment, which has a particular focus on utilising stakeholder participation. Here ...

  18. A National Satellite-Based System for Providing Continuing Education to Engineers.

    ERIC Educational Resources Information Center

    Georgia Inst. of Tech., Atlanta.

    This document proposes, and indicates initial reaction to, a multi-point satellite-based delivery system which will permit expansion of current programs and services of the Association for Media-based Continuing Education for Engineers, Inc. (AMCEE) consortium to a much larger aggregated audience of practicing engineers throughout the country. It…

  19. Human development and South East Asian countries: Special emphasis on India.

    PubMed

    Sharma, Kalpa

    2013-08-31

    'Development' is to improve the quality of people's lives by creating an environment for them to engage in a wide range of activities, to be healthy and well nourished, to be knowledgeable and to be able to participate in the community life. The Human Development Index (HDI) is a multi-dimensional index of development as it is the combination of three development indices- health index, education index and income index. This article attempts to compare the HDI and its components between various South East Asian countries. Secondary data is used. India's position on the HDI scale is equivalent to the South East Asian average and rank 134 out of more than 190 countries. In South East Asia, India stood fifth in HDI, behind Sri Lanka, Thailand, Maldives and Indonesia. Country has launched several schemes and programs to improve the health indicators, to provide elementary education to every child and to alleviate poverty. India's HDI value has improved with time but still country has a long way to go in achieving an acceptable HDI. Need is to strengthen the existing schemes and programs.

  20. Human development and South East Asian countries: Special emphasis on India

    PubMed Central

    Sharma, Kalpa

    2013-01-01

    ‘Development’ is to improve the quality of people's lives by creating an environment for them to engage in a wide range of activities, to be healthy and well nourished, to be knowledgeable and to be able to participate in the community life. The Human Development Index (HDI) is a multi-dimensional index of development as it is the combination of three development indices- health index, education index and income index. This article attempts to compare the HDI and its components between various South East Asian countries. Secondary data is used. India's position on the HDI scale is equivalent to the South East Asian average and rank 134 out of more than 190 countries. In South East Asia, India stood fifth in HDI, behind Sri Lanka, Thailand, Maldives and Indonesia. Country has launched several schemes and programs to improve the health indicators, to provide elementary education to every child and to alleviate poverty. India's HDI value has improved with time but still country has a long way to go in achieving an acceptable HDI. Need is to strengthen the existing schemes and programs. PMID:24251281

  1. University of Wyoming, College of Engineering, undergraduate design projects to aid Wyoming persons with disabilities.

    PubMed

    Barrett, Steven F; Laurin, Kathy M; Bloom, Janet K Chidester

    2003-01-01

    In Spring 2002 the University of Wyoming received NSF funding from the Division of Bioengineering and Environmental Systems to provide a meaningful design experience for University of Wyoming, College of Engineering students that will directly aid individuals with disabilities within the state of Wyoming. Other universities have participated in this very worthwhile program [1, 2, 3]. To achieve the program purpose, the following objectives were established: Provide engineering students multi-disciplinary, meaningful, community service design projects, Provide persons with disabilities assistive devices to empower them to achieve the maximum individual growth and development and afford them the opportunity to participate in all aspects of life as they choose, Provide engineering students education and awareness on the special needs and challenges of persons with disabilities, and Provide undergraduate engineering students exposure to the biomedical field of engineering. To accomplish these objectives the College of Engineering partnered with three organizations that provide education and service related to disability. Specifically, the college has joined with the Wyoming Institute for Disabilities (WIND) assistive technology program, Wyoming New Options in Technology (WYNOT) and their Sports and Outdoor Assistive Recreation (SOAR) project along with the university's Special Education program. In this paper we will describe how the program was created, developed, and its current status.

  2. Public-private partnerships to build human capacity in low income countries: findings from the Pfizer program

    PubMed Central

    Vian, Taryn; Richards, Sarah C; McCoy, Kelly; Connelly, Patrick; Feeley, Frank

    2007-01-01

    Background The ability of health organizations in developing countries to expand access to quality services depends in large part on organizational and human capacity. Capacity building includes professional development of staff, as well as efforts to create working environments conducive to high levels of performance. The current study evaluated an approach to public-private partnership where corporate volunteers give technical assistance to improve organizational and staff performance. From 2003 to 2005, the Pfizer Global Health Fellows program sent 72 employees to work with organizations in 19 countries. This evaluation was designed to assess program impact. Methods The researchers administered a survey to 60 Fellows and 48 Pfizer Supervisors. In addition, the team conducted over 100 interviews with partner organization staff and other key informants during site visits in Uganda, Kenya, Ghana, South Africa and India, the five countries where 60% of Fellows were placed. Results Over three-quarters of Fellowships appear to have imparted skills or enhanced operations of NGOs in HIV/AIDS and other health programs. Overall, 79% of Fellows reported meeting all or most technical assistance goals. Partner organization staff reported that the Fellows provided training to clinical and research personnel; strengthened laboratory, pharmacy, financial control, and human resource management systems; and helped expand Partner organization networks. Local staff also reported the Program changed their work habits and attitudes. The evaluation identified problems in defining goals of Fellowships and matching Organizations with Fellows. Capacity building success also appears related to size and sophistication of partner organization. Conclusion Public expectations have grown regarding the role corporations should play in improving health systems in developing countries. Corporate philanthropy programs based on "donations" of personnel can help build the organizational and human capacity of frontline agencies delivering health services. More attention is needed to measure and compare outcomes of international volunteering programs, and to identify appropriate strategies for expansion. PMID:17335578

  3. Multi-stage learning aids applied to hands-on software training.

    PubMed

    Rother, Kristian; Rother, Magdalena; Pleus, Alexandra; Upmeier zu Belzen, Annette

    2010-11-01

    Delivering hands-on tutorials on bioinformatics software and web applications is a challenging didactic scenario. The main reason is that trainees have heterogeneous backgrounds, different previous knowledge and vary in learning speed. In this article, we demonstrate how multi-stage learning aids can be used to allow all trainees to progress at a similar speed. In this technique, the trainees can utilize cards with hints and answers to guide themselves self-dependently through a complex task. We have successfully conducted a tutorial for the molecular viewer PyMOL using two sets of learning aid cards. The trainees responded positively, were able to complete the task, and the trainer had spare time to respond to individual questions. This encourages us to conclude that multi-stage learning aids overcome many disadvantages of established forms of hands-on software training.

  4. Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries

    PubMed Central

    2011-01-01

    Background Implementing a primary care clinical research study in several countries can make it possible to recruit sufficient patients in a short period of time that allows important clinical questions to be answered. Large multi-country studies in primary care are unusual and are typically associated with challenges requiring innovative solutions. We conducted a multi-country study and through this paper, we share reflections on the challenges we faced and some of the solutions we developed with a special focus on the study set up, structure and development of Primary Care Networks (PCNs). Method GRACE-01 was a multi-European country, investigator-driven prospective observational study implemented by 14 Primary Care Networks (PCNs) within 13 European Countries. General Practitioners (GPs) recruited consecutive patients with an acute cough. GPs completed a case report form (CRF) and the patient completed a daily symptom diary. After study completion, the coordinating team discussed the phases of the study and identified challenges and solutions that they considered might be interesting and helpful to researchers setting up a comparable study. Results The main challenges fell within three domains as follows: i) selecting, setting up and maintaining PCNs; ii) designing local context-appropriate data collection tools and efficient data management systems; and iii) gaining commitment and trust from all involved and maintaining enthusiasm. The main solutions for each domain were: i) appointing key individuals (National Network Facilitator and Coordinator) with clearly defined tasks, involving PCNs early in the development of study materials and procedures. ii) rigorous back translations of all study materials and the use of information systems to closely monitor each PCNs progress; iii) providing strong central leadership with high level commitment to the value of the study, frequent multi-method communication, establishing a coherent ethos, celebrating achievements, incorporating social events and prizes within meetings, and providing a framework for exploitation of local data. Conclusions Many challenges associated with multi-country primary care research can be overcome by engendering strong, effective communication, commitment and involvement of all local researchers. The practical solutions identified and the lessons learned in implementing the GRACE-01 study may assist in establishing other international primary care clinical research platforms. Trial registration ClinicalTrials.gov Identifier: NCT00353951 PMID:21794112

  5. Condom use increasing.

    PubMed

    Finger, W R

    1998-01-01

    Condom use is central to the prevention of AIDS among people at risk for contracting HIV. As such, condom use is increasing dramatically even though many men say that they do not like using them. Condom sales through social marketing campaigns have increased dramatically in some countries, where tens of millions of condoms are sold annually. For example, during the period 1991-96, annual social marketing sales increased about five-fold in Ethiopia to 21 million, and nine-fold in Brazil to 27 million. These sales reflect the success of condom social marketing campaigns in making condoms accessible and largely affordable. There is also a greater general awareness of AIDS than there used to be, and communication campaigns have shown that condoms are an effective solution. More condoms still need to be used in the ongoing struggle against HIV/AIDS. The author discusses the factors which affect the limited acceptance of condoms, condom use outside of marriage, social marketing, and family planning programs.

  6. Social security reform in Central and Eastern Europe: variations on a Latin American theme.

    PubMed

    Kritzer, B E

    After Chile reformed its social security system in 1981, several other Latin American countries and certain Central and Eastern European (CEE) countries implemented the Chilean model, with some variations: either a single- or multitier system, or with a period of transition to take care of those in the labor force at the time of the change. The single-tier version consists of individual accounts in pension fund management companies. Multi-tier systems retain some form of public program and add mandatory individual accounts. Most of the CEE countries did not want to incur the high transition costs associated with the Chilean model. The switch to a market economy had already strained their economies. Also, the countries' desire to adopt the European Union's Euro as their currency--a move that required a specific debt ceiling--limited the amount of additional debt they could incur. This article describes the CEE reforms and makes some comparisons with the Latin American experience. Most of the CEE countries have chosen a mixed system and have restructured the pay-as-you-go (PAYGO) tier, while the Latin American countries have both single- and multi-tier systems. Some CEE countries have set up notional defined contribution (NDC) schemes for the PAYGO tier in which each insured person has a hypothetical account made up of all contributions during his or her working life. Survivors and disability programs in CEE have remained in the public tier, but in most of the Latin American programs the insured must purchase a separate insurance policy. Issues common to both regions include: Administrative costs are high and competition is keen, which has led to consolidation and mergers among the companies and a large market share controlled by a few companies. Benefits are proportionately lower for women than for men. A large, informal sector is not covered by social security. This sector is apparently much larger in Latin America than in the CEE countries. Issues that are unique to some of the CEE countries include: Individual accounts in Hungary and Poland have proved more attractive than originally anticipated. As a result, contributions to the public PAYGO system in Hungary and Poland fell short of expectations. In several countries, laws setting up the programs were enacted without all the details of providing benefits. For example, in some countries laws must now be drawn up for establishment of annuities because they do not yet exist. Setting up a coherent pension policy has been difficult in some countries because of frequent and significant changes in government. This situation has affected the progress of reform in various stages of development. In general, a definitive assessment of individual accounts in these countries will not be possible until a cohort of retirees has spent most of its career under the new system.

  7. A randomized controlled trial of a resilience-based intervention on psychosocial well-being of children affected by HIV/AIDS: Effects at 6- and 12-month follow-up.

    PubMed

    Li, Xiaoming; Harrison, Sayward E; Fairchild, Amanda J; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2017-10-01

    Global literature suggests that resilience-based interventions may yield improvements in psychosocial well-being for vulnerable children, but limited data are available regarding the efficacy of such interventions among children affected by parental HIV/AIDS. To evaluate initial efficacy of a multi-level resilience-based intervention among children affected by parental HIV/AIDS in China in improving children's psychosocial well-being and resilience-related outcomes. Seven hundred-ninety children, 6-17 years of age, were recruited from rural China. Children were either AIDS orphans or were living with one or two parents infected with HIV/AIDS. Children and primary caregivers were randomly assigned to participate in a 4-arm trial to evaluate the Child-Caregiver-Advocacy Resilience (ChildCARE) intervention. This resilience-based psychosocial intervention provides programming at three levels (child, caregiver, community). Survey data were collected at baseline, 6-months, and 12-months in order to examine efficacy of the child-only and child + caregiver arms in improving children's psychological resilience. Intervention groups displayed improvements in several resilience-related outcomes at 6- and 12-month follow-ups, including self-reported coping, hopefulness, emotional regulation, and self-control. The child-only intervention arm showed some fading of intervention effects by 12-months. Preliminary findings suggest that the ChildCARE intervention is efficacious in promoting psychosocial well-being of children affected by parental HIV/AIDS in rural China. Targeting both children and caregivers for psychosocial intervention may be effective in improving children's resilience. Additional evaluation and modifications, including the inclusion of booster sessions, should be considered to further strengthen the program. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Egypt boosts family planning.

    PubMed

    1977-10-27

    A $4 million Agency for International Development (AID) agreement was signed in Cairo September 30 which will help the Egyptian government increase family planning services. The project is in response to a request for up to $17 million of AID funds for family planning programs during the next 3 years. The funds will pay for: contract advisors to provide short-term in-country training of physicians, architectural and engineering services to renovate a hospital for family planning and obstetrics/gynecology training, and a field training site for family planning service providers. Some Egyptians will receive training in specialized areas in the U.S. and other countries. More than $1.5 million of the $4 million will finance local costs of goods and services required. In addition, it is anticipated that U.S.-owned local currencies will be obligated for direct support of U.S. technical personnel. Over the 3-year life of the project the $17 million from AID plus $664,000 of U.S.-owned local currency will cover 44% of the total costs of selected Egyptian family planning activities. The Egyptian government will contribute at least $18.4 million and the U.N. Fund for Population Activities and the International Bank for Reconstruction and Development will contribute $4.3 million.

  9. [Berlin Declaration on Tuberculosis: High Level Follow-Up of High Priority Countries for TB Control in the WHO-EURO Region 'Double Trouble or Double Success? Bringing Together Diseases and Programs' - a symposium report].

    PubMed

    Castell, S; Hauer, B; Manissero, D; Ulrichs, T; Zaleskis, R; Loddenkemper, R

    2010-07-01

    The global tuberculosis (TB) situation has deteriorated dramatically since the beginning of the 1990s. In 2007, the WHO identified 18 countries of the WHO European Region as 'high priority countries' and introduced a plan for these countries to improve the situation. To further promote solutions a WHO European Ministerial Forum 'All against Tuberculosis' took place in Berlin in 2007 and resulted in the 'Berlin Declaration' which was commonly endorsed. In October 2009 a meeting was organized by the German Ministry of Health under the title "Berlin Declaration on Tuberculosis: High Level Follow-Up of High Priority Countries for TB Control in the WHO-EURO Region 'Double Trouble or Double Success? Bringing together Diseases and Programs'". This article summarizes the symposium. Besides reporting on the recent epidemiological situation of the WHO-EURO Region (with partly dramatically developments) presentations on psychosocial issues, the role of the EU and the 'Global Fund to Fight AIDS, Tuberculosis and Malaria', the importance of new tools for the fight against tuberculosis and the need for further political commitment were given. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  10. HIV spreading among women and children in Asia and Eastern Europe.

    PubMed

    1996-12-16

    This December 16, 1996, article gives some statistics published in "HIV/AIDS: The Global Epidemic," recently released by the United Nations Agency on AIDS (UNAIDS). 25% of all deaths (6.4 million total) due to acquired immunodeficiency syndrome (AIDS) occurred within the last year. 3.1 million persons were infected with human immunodeficiency virus (HIV) in 1996; the total number of HIV/AIDS cases is 22.6 million. About 90% of HIV/AIDS cases live in developing countries. Most of the newly infected adults (2.7 million total) are younger than 25; 50% are women. In 1996, 400,000 children were infected with HIV; the total number of cases in children is 830,000. Drug abuse and sexually transmitted diseases (STDs) are responsible for the rapid spread of HIV in central and eastern Europe. In Nikolayev (Ukraine), the proportion of HIV cases among injecting drug users rose from 1.7% in January 1995 to 56.5% 11 months later. In Kaliningrad (Russia), the number of reported cases increased from 21 to 387 since January 1996. These countries do not have the infrastructure to provide programs. Figures cited from the Chinese Academy of Preventive Medicine show that the number of cases of HIV in China rose from 10,000 at the end of 1993 to 100,000 by the end of 1995. In Vietnam, HIV rates among prostitutes increased from 9% in 1992 to 38% in 1994. Sub-Saharan Africa has 14 million cases (63% of the world total). Refugees in Rwanda and Burundi come from areas where over 20% of pregnant women, and 50% of those with other STDs, have HIV. In South Africa's Free State, HIV rates among pregnant women grew from 1/25 to greater than 1/10, in 2 years. In El Salvador, according to one study of female sex workers, the HIV rate among 15- to 19-year-olds was 3.1%, as opposed to 2.2% overall. Dr. Peter Piot, of UNAIDS, urges promotion of safe sex programs for women and development of a vaccine.

  11. A fresh injection of interest for vaccines.

    PubMed

    1998-02-01

    In recent years, HIV/AIDS funding has gone largely to prevention measures, drug therapy for people who are already infected with HIV, and basic related science. HIV/AIDS vaccine development has been of only low priority, and almost no effort is targeted toward vaccines appropriate for use in developing countries. A vaccine, however, is theoretically the only way to end the epidemic. An attempt was made at the Abidjan AIDS Conference to reinvigorate the AIDS vaccine research program, but because the potential market for such a vaccine is in the poorer developing countries, it will be difficult to convince the pharmaceutical industry to renew investment in vaccine research. Pharmaceutical companies see no profit potential in vaccine development and marketing. The World Bank's suggestion on how to encourage the pharmaceutical industry to invest again in vaccine research is discussed. The gp120(E) vaccine is undergoing an early-stage trial in Thailand, and another trial is scheduled for later in 1998 in Uganda. However, none of the 25 possible vaccine types which have been developed in the laboratory and tested for safety on humans has gone into efficacy trials. Experts calculate that even if more intensive work were to begin now, a vaccine could not become generally available before 2005, due to the 8-year product evaluation cycle. Whether a vaccine based upon one HIV subtype will be effective against other subtypes, and the need for governments and donors to invest in the development of a vaccine are discussed.

  12. The impacts of AIDS movements on the policy responses to HIV/AIDS in Brazil and South Africa: A comparative analysis

    PubMed Central

    Nunn, Amy; Dickman, Samuel; Nattrass, Nicoli; Cornwall, Alexandra; Gruskin, Sofia

    2013-01-01

    Brazil and South Africa were among the first countries profoundly impacted by the HIV/AIDS epidemic and had similar rates of HIV infection in the early 1990s. Today, Brazil has less than 1% adult HIV prevalence, implemented treatment and prevention programmes early in the epidemic, and now has exemplary HIV/AIDS programmes. South Africa, by contrast, has HIV prevalence of 18% and was, until recently, infamous for its delayed and inappropriate response to the HIV/ AIDS epidemic. This article explores how differing relationships between AIDS movements and governments have impacted the evolving policy responses to the AIDS epidemic in both countries, including through AIDS programme finance, leadership and industrial policy related to production of generic medicines. PMID:23137055

  13. Parasites and vectors carry no passport: how to fund cross-border and regional efforts to achieve malaria elimination

    PubMed Central

    2012-01-01

    Background Tremendous progress has been made in the last ten years in reducing morbidity and mortality caused by malaria, in part because of increases in global funding for malaria control and elimination. Today, many countries are striving for malaria elimination. However, a major challenge is the neglect of cross-border and regional initiatives in malaria control and elimination. This paper seeks to better understand Global Fund support for multi-country initiatives. Methods Documents and proposals were extracted and reviewed from two main sources, the Global Fund website and Aidspan.org. Documents and reports from the Global Fund Technical Review Panel, Board, and Secretariat documents such as guidelines and proposal templates were reviewed to establish the type of policies enacted and guidance provided from the Global Fund on multi-country initiatives and applications. From reviewing this information, the researchers created 29 variables according to eight dimensions to use in a review of Round 10 applications. All Round 10 multi-country applications (for HIV, malaria and tuberculosis) and all malaria multi-country applications (6) from Rounds 1 – 10 were extracted from the Global Fund website. A blind review was conducted of Round 10 applications using the 29 variables as a framework, followed by a review of four of the six successful malaria multi-country grant applications from Rounds 1 – 10. Findings During Rounds 3 – 10 of the Global Fund, only 5.8% of grants submitted were for multi-country initiatives. Out of 83 multi-country proposals submitted, 25.3% were approved by the Technical Review Panel (TRP) for funding, compared to 44.9% of single-country applications. The majority of approved multi-country applications were for HIV (76.2%), followed by malaria (19.0%), then tuberculosis (4.8%). TRP recommendations resulted in improvements to application forms, although guidance was generally vague. The in-depth review of Round 10 multi-country proposals showed that applicants described their projects in one of two ways: a regional ‘network approach’ by which benefits are derived from economies of scale or from enhanced opportunities for mutual support and learning or the development of common policies and approaches; or a ‘cross-border’ approach for enabling activities to be more effectively delivered towards border-crossing populations or vectors. In Round 10, only those with a ‘network approach’ were recommended for funding. The Global Fund has only ever approved six malaria multi-country applications. Four approved applications stated strong arguments for a multi-country initiative, combining both ‘cross-border’ and ‘network’ approaches. Conclusion With the cancellation of Round 11 and the proposal that the Global Fund adopt a more targeted and strategic approach to funding, the time is opportune for the Global Fund to develop a clear consensus about the key factors and criteria for funding malaria specific multi-country initiatives. This study found that currently there was a lack of guidance on the key features that a successful multi-country proposal needs to be approved and that applications directed towards the ‘network’ approach were most successful in Round 10. This type of multi-country proposal may favour other diseases such as HIV, whereas the need for malaria control and elimination is different, focusing on cross-border coordination and delivery of interventions to specific groups. The Global Fund should seek to address these issues and give better guidance to countries and regions and investigate disease-specific calls for multi-country and regional applications. PMID:23057734

  14. FOREIGN AFFAIRS: Perspectives on Foreign Affairs Programs and Structures

    DTIC Science & Technology

    1996-11-01

    would end. One participant cited Egypt as a case where large amounts of aid have had negligible effect. Another participant, however, pointed out...within the country, but this has not always been the case . As one participant noted, it has not been within the Secretary of State’s power to direct...particular, Indonesia, Malaysia , Chile, Argentina, and Brazil—private sector trade and capital flows are occurring to support development. It was

  15. Health research in the developing world: a gastroenterological view from Bangladesh.

    PubMed

    Hamilton, J R

    1997-01-01

    Ill health is a serious impediment to progress in most poor countries, yet health is not a high priority on foreign aid agendas. Health research, which provides the essential base for sustainable progressive health programs, is barely visible in developing countries. For example, in Bangladesh, one finds unacceptably high morbidity and mortality rates among infants and children, health programs that are struggling and a rudimentary health research establishment; for the huge foreign donor community in that country, health programs and research do not appear to warrant major investments. Diarrheal diseases are at the top of the list of killers in many poor nations including Bangladesh. Recent advances in our understanding of diarrhea suggest that when prevention may not be possible soon, improved active treatment can evolve from an aggressive research effort centered in a developing country and linked to appropriate international partners. Global agencies such as the World Health Organization have demonstrated a declining interest in health research, as reflected in the policies of their Diarrhoeal Disease Control Programme. Major donors to the developing world, the Canadian International Development Agency for example, have had a relatively minor involvement in health and little commitment to health research. University links with the west, private enterprises and specially targeted programs are involved in developing world health research but they have not been able to foster and leave behind sustainable, high quality research programs. The problem should be attacked directly by supporting focused, relevant health research centres in regions of the world where the burden of disease continues to impede progress and where the environment is conducive to high quality research that is well integrated with care delivery programs. An instructive model of this approach is the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.

  16. Multi-Harmony: detecting functional specificity from sequence alignment

    PubMed Central

    Brandt, Bernd W.; Feenstra, K. Anton; Heringa, Jaap

    2010-01-01

    Many protein families contain sub-families with functional specialization, such as binding different ligands or being involved in different protein–protein interactions. A small number of amino acids generally determine functional specificity. The identification of these residues can aid the understanding of protein function and help finding targets for experimental analysis. Here, we present multi-Harmony, an interactive web sever for detecting sub-type-specific sites in proteins starting from a multiple sequence alignment. Combining our Sequence Harmony (SH) and multi-Relief (mR) methods in one web server allows simultaneous analysis and comparison of specificity residues; furthermore, both methods have been significantly improved and extended. SH has been extended to cope with more than two sub-groups. mR has been changed from a sampling implementation to a deterministic one, making it more consistent and user friendly. For both methods Z-scores are reported. The multi-Harmony web server produces a dynamic output page, which includes interactive connections to the Jalview and Jmol applets, thereby allowing interactive analysis of the results. Multi-Harmony is available at http://www.ibi.vu.nl/ programs/shmrwww. PMID:20525785

  17. Poverty, drug abuse fuel Caribbean AIDS outbreak.

    PubMed

    Kovaleski, S F

    1998-01-01

    Hatred and fear of homosexuals, together with a fear of losing tourism revenue, drove many high-level policymakers in the Caribbean to ignore the HIV/AIDS in its infancy. With an annual incidence rate of at least 146.6 people per 100,000, the Bahamas now has one of the highest AIDS rates in the world and the highest such rate in the English-speaking Caribbean. AIDS has become the major cause of death for men and women aged 20-44 in the Bahamas. Indeed, throughout the Caribbean, countries like the Bahamas must now cope with a growing AIDS epidemic. UN AIDS Program figures indicate that at least 310,000 people in the Caribbean have either HIV infection or AIDS, and that the prevalence rate among adults is almost 2%. This compares with an estimated 7.4% of the adult population of sub-Saharan Africa which is infected and 0.6% of adults in North America. 65% of reported AIDS cases in the region result from heterosexual intercourse. While the annual number of AIDS cases has been falling in North America over the last several years and rates in Latin America have leveled off, rates in the Caribbean are increasing sharply. Poverty, the population's lack of awareness, low levels of education, internal and international migration, crack cocaine use, promiscuity, high levels of STDs, prostitution, and tourism are also facilitating the spread of HIV in the Caribbean. Social conservatism, mainly in the English-Caribbean, about discussing sex impedes the implementation and success of HIV/AIDS prevention interventions.

  18. Assessing the challenges of multi-scope clinical research sites: an example from NIH HIV/AIDS clinical trials networks.

    PubMed

    Rosas, Scott R; Cope, Marie T; Villa, Christie; Motevalli, Mahnaz; Utech, Jill; Schouten, Jeffrey T

    2014-04-01

    Large-scale, multi-network clinical trials are seen as a means for efficient and effective utilization of resources with greater responsiveness to new discoveries. Formal structures instituted within the National Institutes of Health (NIH) HIV/AIDS Clinical Trials facilitate collaboration and coordination across networks and emphasize an integrated approach to HIV/AIDS vaccine, prevention and therapeutics clinical trials. This study examines the joint usage of clinical research sites as means of gaining efficiency, extending capacity, and adding scientific value to the networks. A semi-structured questionnaire covering eight clinical management domains was administered to 74 (62% of sites) clinical site coordinators at single- and multi-network sites to identify challenges and efficiencies related to clinical trials management activities and coordination with multi-network units. Overall, respondents at multi-network sites did not report more challenges than single-network sites, but did report unique challenges to overcome including in the areas of study prioritization, community engagement, staff education and training, and policies and procedures. The majority of multi-network sites reported that such affiliations do allow for the consolidation and cost-sharing of research functions. Suggestions for increasing the efficiency or performance of multi-network sites included streamlining standards and requirements, consolidating protocol activation methods, using a single cross-network coordinating centre, and creating common budget and payment mechanisms. The results of this assessment provide important information to consider in the design and management of multi-network configurations for the NIH HIV/AIDS Clinical Trials Networks, as well as others contemplating and promoting the concept of multi-network settings. © 2013 John Wiley & Sons Ltd.

  19. Social representation of hearing aids: cross-cultural study in India, Iran, Portugal, and the United Kingdom.

    PubMed

    Manchaiah, Vinaya; Danermark, Berth; Vinay; Ahmadi, Tayebeh; Tomé, David; Krishna, Rajalakshmi; Germundsson, Per

    2015-01-01

    The current study was aimed at understanding the social representation of hearing aids in India, Iran, Portugal, and the United Kingdom. We also compared these results to explore the cross-cultural differences and similarities among these countries. The study involved a cross-sectional design, and the data were collected from four different countries using the snowball sampling method. Data were analyzed using a content analysis to identify the most-similar categories of responses reported, a co-occurrences analysis to see which of these categories are reported commonly, and a chi-square analysis to study if there was any association between positive, neutral, and negative connotations among participants in different countries. The current study revealed four different social representations of hearing aids from India, Iran, Portugal, and the United Kingdom, and also a global index. The study results provide very useful insights into how hearing aids are represented in the society. These findings may have important implications for public education and also for manufacturers from the viewpoint of designing and marketing hearing aids in different countries.

  20. Social representation of hearing aids: cross-cultural study in India, Iran, Portugal, and the United Kingdom

    PubMed Central

    Manchaiah, Vinaya; Danermark, Berth; Vinay; Ahmadi, Tayebeh; Tomé, David; Krishna, Rajalakshmi; Germundsson, Per

    2015-01-01

    Background The current study was aimed at understanding the social representation of hearing aids in India, Iran, Portugal, and the United Kingdom. We also compared these results to explore the cross-cultural differences and similarities among these countries. Methods The study involved a cross-sectional design, and the data were collected from four different countries using the snowball sampling method. Data were analyzed using a content analysis to identify the most-similar categories of responses reported, a co-occurrences analysis to see which of these categories are reported commonly, and a chi-square analysis to study if there was any association between positive, neutral, and negative connotations among participants in different countries. Results The current study revealed four different social representations of hearing aids from India, Iran, Portugal, and the United Kingdom, and also a global index. Conclusion The study results provide very useful insights into how hearing aids are represented in the society. These findings may have important implications for public education and also for manufacturers from the viewpoint of designing and marketing hearing aids in different countries. PMID:26504376

  1. Multi-Stakeholder Aid to Education: Power in the Context of Partnership

    ERIC Educational Resources Information Center

    Menashy, Francine

    2018-01-01

    This study examines power asymmetries within the largest multi-stakeholder agency in the education sector: the Global Partnership for Education (GPE). Drawing from data collected through key informant interviews and document analyses, this research asks if the establishment of the GPE has altered power arrangements in educational aid. The study…

  2. The enter-educate approach.

    PubMed

    Piotrow, P T; Coleman, P L

    1992-03-01

    This article describes how the Population Communication Services (PCS) has seized on the "enter-educate" approach, the blending of popular entertainment with social messages, to change reproductive health behavior. The enter-educate approach spreads its message through songs, soap operas, variety shows, and other types of popular entertainment mediums. Because they entertain, enter-educate projects can capture the attention of an audience -- such as young people -- who would otherwise scorn social messages. And the use of population mediums makes it possible to reach a variety of audiences. Funded by USAID, PCS began its first enter-educate project in response to the increasing number of teenage pregnancies in Latin America. PCS developed 2 songs and videos, which featured popular teenage singers to serve as role models, to urge abstinence. The songs became instant hits. Since then, PCS has mounted more then 80 major projects in some 40 countries. Highlights of programs range from a successful multi-media family planning campaign in Turkey to humorous television ads in Brazil promoting vasectomy. Recently, PCS initiated projects to teach AIDS awareness. At the core of the enter-educate approach is the social learning theory which holds that much behavior is learned through the observation of role-models. Health professionals work alongside entertainers to produce works that have audience appeal and factual social messages. The enter-educate approach works because it is popular, pervasive, personal, persuasive, and profitable. PCS has found that enter-educate programs pay for themselves through cost sharing and cost recovery.

  3. China's health assistance to Africa: opportunism or altruism?

    PubMed

    Lin, Shuang; Gao, Liangmin; Reyes, Melissa; Cheng, Feng; Kaufman, Joan; El-Sadr, Wafaa M

    2016-12-03

    China has made substantial health commitments to Africa in the past several decades. However, while much has been written regarding China-Africa aid overall, relatively little attention has been given to China's health aid. To better understand these investments, we provide an overview of the current framework and characteristics of China's health aid to Africa. China's health assistance has been perceived by some as opportunistic, largely as a demonstration of China's engagement in "soft power" and an attempt to enhance its access to natural resources and political favors by African countries. Others have attributed altruistic intent, aiming to support the advancement of the health of populations in the African continent with a "no strings attached" approach. Our overview demonstrated that despite the magnitude of China's health assistance, many questions remain regarding the scope of this aid, its effectiveness and the governance mechanisms that guide the conceptualization and implementation of such efforts. We also identified the need for a systematic and rigorous evaluation of the various elements of China's health assistance to African countries in order to gain a deeper understanding of how priorities and allocations for health aid are determined, how such aid fits within the specific African country's health strategies and to assess the effectiveness of such aid. Insights garnered through such an assessment could help determine future priorities for investment as well as inform efforts to optimize the value of China's aid for the populations of the recipient countries.

  4. UNFPA stresses importance of reproductive health.

    PubMed

    Sadik, N

    1998-12-01

    This article summarizes statements made by Dr. Nafis Sadik on October 19, 1998, to TICAD II. The address focused on the health challenges that Africa faces. The 1998 population in Africa of 780 million will double to about 1.5 billion in about 25 years. It is likely that this growth will impede socioeconomic development. Quality of life will be reduced by high infant and maternal mortality and high levels of HIV/AIDS. Only a small minority of Africans have access to basic health and reproductive health (RH) services. There are many unwanted births. The impact of HIV/AIDS on women has been very harsh. Life expectancy in some countries has been reduced. 50% of new HIV infections are among young people, who are poorly informed about RH. Health services are not suitable for youth needs. The consequences of early marriage and childbearing are limits to education and employment. Young women face the threat of domestic violence and abuse. Teenagers can be protected against HIV/AIDS and sexually transmitted diseases by institutionalization of sex education. RH needs to stress male responsibility in sexual health and childbearing. Sexual responsibility can be a life-and-death situation. African countries are beginning to integrate population and development policies. African countries need to adopt goals to increase access to RH services and family planning. Access should increase to 20% of population by the year 2000. Integrated programs, empowerment of women in development, male responsibility, and increased literacy should be expanded. UNFPA will continue to give Africa priority through increased resources, staff, and other partnerships.

  5. Country watch: South Africa.

    PubMed

    Everett, K; Schaay, N

    1994-01-01

    Photo-comics are an ideal format for education of South African youth about acquired immunodeficiency syndrome (AIDS) given their low literacy rate and the widespread popularity of comic books. An example of the success of this strategy is "Roxy: Life, Love, and Sex in the Nineties," a comic produced as part of a school-based AIDS prevention program run by the National AIDS Research Program. The comic tells the story of an adolescent girl who learns her friend committed suicide because she was infected with the human immunodeficiency virus (HIV). Roxy learns about AIDS and discusses the risk factors with her friends. Focus group discussions were used to generate story ideas and pretesting of the comic book took place among several student groups. By July 1993, 30,000 copies of "Roxy" had been distributed to students, churches, youth groups, civic associations, and organizations working with street children. In addition, the comic was reproduced in a magazine, "Upbeat," that is popular among out-of-school youth. Qualitative evaluation through 8 student focus groups revealed that young people from various cultural backgrounds strongly identify with the themes, characters, and situations depicted in "Roxy." Of particular significance were the realistic portrayals of romantic and sexual relationships, relationships with parents, and dilemmas posed by pressures to use drugs and alcohol. The comic includes a sex education chart with concise condom use instructions.

  6. Methods and Techniques. Student Involvement in the Production of Teaching Aids.

    ERIC Educational Resources Information Center

    Fernau, C.

    1984-01-01

    Indicates that teaching materials used in industrialized countries are not appropriate and often cannot be adapted for the use in developing countries. Having students help with production of teaching aids increases their motivation for using them. (JOW)

  7. AIDS. 1st annual George H. Gallup Memorial Survey.

    PubMed

    1988-06-01

    Acquired immunodeficiency syndrome (AIDS) was selected as the subject for the 1st annual George H Gallup Memorial Survey. This survey, conducted in August 1987-April 1988 in 35 countries, measured the level of awareness of AIDS, the extent of concern about AIDS, knowledge, changes in behavior resulting form the AIDS epidemic, and attitudes toward people with AIDS. Overall, the poll's findings attest to the effectiveness of the health education efforts of governmental and nongovernmental organizations. Awareness that AIDS poses an urgent international health problem was almost universal in the 35 samples. In about half of these countries, AIDS was identified as the most important national health problem; in the remaining countries, AIDS was ranked 2nd to cancer. The proportion of respondents expressing a fear of personally contracting the AIDS virus ranged from lows of under 10% in most of Europe to a high of 45% among South African blacks. A majority of respondents in the US, Colombia, the Philippines, Brazil, Nigeria, Ecuador, El Salvador, and Chile believed that AIDS will soon spread beyond current risk groups to the general population. Despite widespread awareness of the grave threat posed by AIDS, insufficient numbers of respondents reported that they had made specific behavioral changes intended to protect themselves form HIV infection. Overall, about half of those interviewed indicated they are now more cautious in their choice of sexual partners; similarly, about half are using condoms more or for the 1st time.

  8. Pakistan needs to speed up its human immunodeficiency virus control strategy to achieve targets in fast-track acquired immune deficiency syndrome response.

    PubMed

    Waheed, Yasir; Waheed, Hasnain

    2017-05-12

    In last fifteen years remarkable success in the fight against human immunodeficiency virus (HIV) is achieved globally. The number of HIV infections has decreased and the number of people on antiretroviral therapy is increased. This all is possible by strong political commitments and heavy investments in the fight against HIV. Pakistan is among few Asian countries in which HIV cases are increasing year by year since 1990. There are 94000 cases of HIV in Pakistan and only 14000 are registered with government. The main source of HIV infection in Pakistan is the use of contaminated injection equipment among people who inject drugs (PWID). The overall prevalence of HIV among PWID in Pakistan is 27.2%. There are five cities in Pakistan in which HIV prevalence is above 40% in PWIDs. In June 2016, United Nations political declaration on acquired immune deficiency syndrome (AIDS) provided a global mandate to fast-track the AIDS response over the next five years to achieve the targets in Sustainable Development Goals. To achieve the targets in fast-track AIDS response, the global leaders showed strong commitments to invest $ 26 billion per year by 2020. Pakistan needs to speed up its HIV control program. There is a dire need to locate all HIV positive people and enroll them in the treatment program. Pakistan also needs to calculate exact number of people living with HIV, increase HIV treatment centers and increase HIV awareness. Recently, Global Fund invested handsome money in the fight against HIV. Let's hope the country will have effective HIV control strategy to achieve the HIV elimination target by 2030.

  9. Utilization and Monetization of Healthcare Data in Developing Countries.

    PubMed

    Bram, Joshua T; Warwick-Clark, Boyd; Obeysekare, Eric; Mehta, Khanjan

    2015-06-01

    In developing countries with fledgling healthcare systems, the efficient deployment of scarce resources is paramount. Comprehensive community health data and machine learning techniques can optimize the allocation of resources to areas, epidemics, or populations most in need of medical aid or services. However, reliable data collection in low-resource settings is challenging due to a wide range of contextual, business-related, communication, and technological factors. Community health workers (CHWs) are trusted community members who deliver basic health education and services to their friends and neighbors. While an increasing number of programs leverage CHWs for last mile data collection, a fundamental challenge to such programs is the lack of tangible incentives for the CHWs. This article describes potential applications of health data in developing countries and reviews the challenges to reliable data collection. Four practical CHW-centric business models that provide incentive and accountability structures to facilitate data collection are presented. Creating and strengthening the data collection infrastructure is a prerequisite for big data scientists, machine learning experts, and public health administrators to ultimately elevate and transform healthcare systems in resource-poor settings.

  10. Utilization and Monetization of Healthcare Data in Developing Countries

    PubMed Central

    Bram, Joshua T.; Warwick-Clark, Boyd; Obeysekare, Eric; Mehta, Khanjan

    2015-01-01

    Abstract In developing countries with fledgling healthcare systems, the efficient deployment of scarce resources is paramount. Comprehensive community health data and machine learning techniques can optimize the allocation of resources to areas, epidemics, or populations most in need of medical aid or services. However, reliable data collection in low-resource settings is challenging due to a wide range of contextual, business-related, communication, and technological factors. Community health workers (CHWs) are trusted community members who deliver basic health education and services to their friends and neighbors. While an increasing number of programs leverage CHWs for last mile data collection, a fundamental challenge to such programs is the lack of tangible incentives for the CHWs. This article describes potential applications of health data in developing countries and reviews the challenges to reliable data collection. Four practical CHW-centric business models that provide incentive and accountability structures to facilitate data collection are presented. Creating and strengthening the data collection infrastructure is a prerequisite for big data scientists, machine learning experts, and public health administrators to ultimately elevate and transform healthcare systems in resource-poor settings. PMID:26487984

  11. Strengthening Indonesia's health workforce through partnerships.

    PubMed

    Kurniati, A; Rosskam, E; Afzal, M M; Suryowinoto, T B; Mukti, A G

    2015-09-01

    Indonesia faces critical challenges pertaining to human resources for health (HRH). These relate to HRH policy, planning, mismatch between production and demand, quality, renumeration, and mal-distribution. This paper provides a state of the art review of the existing conditions in Indonesia, innovations to tackle the problems, results of the innovations to date, and a picture of the on-going challenges that have yet to be met. Reversing this crisis level shortage of HRH requires an inclusive approach to address the underlying challenges. In 2010 the government initiated multi-stakeholder coordination for HRH, using the Country Coordination and Facilitation approach. The process requires committed engagement and coordination of relevant stakeholders to address priority health needs. This manuscript is a formative evaluation of the program using documentary study and analysis. Consistent with Indonesia's decentralized health system, since 2011 local governments also started establishing provincial multi-stakeholder committees and working groups for HRH development. Through this multi-stakeholder approach with high level government support and leadership, Indonesia was able to carry out HRH planning by engaging 164 stakeholders. Multi-stakeholder coordination has produced positive results in Indonesia by bringing about a number of innovations in HRH development to achieve UHC, fostered partnerships, attracted international attention, and galvanized multi-stakeholder support in improving the HRH situation. This approach also has facilitated mobilizing technical and financial support from domestic and international partners for HRH development. Applying the multi-stakeholder engagement and coordination process in Indonesia has proved instrumental in advancing the country's work to achieve Universal Health Coverage and the Millennium Development Goals by 2015. Indonesia continues to face an HRH crisis but the collaborative process provides an opportunity to achieve results. Indonesia's experience indicates that irrespective of geographical or economic status, countries can benefit from multi-stakeholder coordination and engagement to increase access to health workers, strengthen health systems, as well as achieve and sustain UHC. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Effect of First Aid Education on First Aid Knowledge and Skills of Commercial Drivers in South West Nigeria.

    PubMed

    Olumide, Adesola O; Asuzu, Michael C; Kale, Oladele O

    2015-12-01

    Prompt prehospital care is essential for improving outcomes of road crash victims; however, this service is sub-optimal in developing countries because Emergency Medical Services (EMS) are not readily available. Training of lay responders in first aid has been suggested as a means of filling this gap in settings with inadequate EMS. This study was conducted to determine the effect of first aid training on the first aid knowledge and skills of commercial drivers. A before-and-after study was conducted among 128 commercial drivers (62 intervention and 66 controls) selected by multi-stage sampling. Drivers' first aid knowledge and skills were assessed at baseline, immediate, and three months post-intervention. The intervention involved a 2-day training session in first aid. Repeated measures ANOVA was used to test for differences in respondents' pre- and post-intervention scores over the three assessment points. Mean first aid knowledge scores for intervention drivers were 48.9% (SD=12.0), 57.8% (SD=11.2), and 59.2% (SD=9.0) at baseline, immediate, and three months post-intervention. Corresponding scores for the controls were 48.3% (SD=12.8), 39.2% (SD=15.3), and 46.8% (SD=15.3). Mean first aid skill scores for intervention drivers were 17.5% (SD=3.8), 80.7% (SD=8.3), and 72.3% (SD=16.8). Scores for control drivers were 16.5% (SD=4.5), 16.3% (SD=4.7), and 20.4% (SD=9.1), respectively. Repeated measures ANOVA showed significant differences in first aid knowledge and skills scores over the three phases. Independent t-test revealed significant differences in scores between the intervention and control groups post-intervention. The training led to significant improvement in first aid knowledge and skills of intervention drivers. This confirms that lay responders can be trained in provision of first aid. The slight drop in skills scores, which occurred three months post-intervention, highlights the need for periodic refresher trainings to be conducted for the drivers in order to maintain the knowledge and skills acquired.

  13. Impact of vaccination against Haemophilus influenzae type b with and without a booster dose on meningitis in four South American countries.

    PubMed

    Garcia, Salvador; Lagos, Rosanna; Muñoz, Alma; Picón, Teresa; Rosa, Raquel; Alfonso, Adriana; Abriata, Graciela; Gentile, Angela; Romanin, Viviana; Regueira, Mabel; Chiavetta, Laura; Agudelo, Clara Inés; Castañeda, Elizabeth; De la Hoz, Fernando; Higuera, Ana Betty; Arce, Patricia; Cohen, Adam L; Verani, Jennifer; Zuber, Patrick; Gabastou, Jean-Marc; Pastor, Desiree; Flannery, Brendan; Andrus, Jon

    2012-01-05

    To inform World Health Organization recommendations regarding use of Haemophilus influenzae type b (Hib) vaccines in national immunization programs, a multi-country evaluation of trends in Hib meningitis incidence and prevalence of nasopharyngeal Hib carriage was conducted in four South American countries using either a primary, three-dose immunization schedule without a booster dose or with a booster dose in the second year of life. Surveillance data suggest that high coverage of Hib conjugate vaccine sustained low incidence of Hib meningitis and low prevalence of Hib carriage whether or not a booster dose was used. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Scaling Up of Breastfeeding Promotion Programs in Low- and Middle-Income Countries: the “Breastfeeding Gear” Model12

    PubMed Central

    Pérez-Escamilla, Rafael; Curry, Leslie; Minhas, Dilpreet; Taylor, Lauren; Bradley, Elizabeth

    2012-01-01

    Breastfeeding (BF) promotion is one of the most cost-effective interventions to advance mother–child health. Evidence-based frameworks and models to promote the effective scale up and sustainability of BF programs are still lacking. A systematic review of peer-reviewed and gray literature reports was conducted to identify key barriers and facilitators for scale up of BF programs in low- and middle-income countries. The review identified BF programs located in 28 countries in Africa, Latin America and the Caribbean, and Asia. Study designs included case studies, qualitative studies, and observational quantitative studies. Only 1 randomized, controlled trial was identified. A total of 22 enabling factors and 15 barriers were mapped into a scale-up framework termed “AIDED” that was used to build the parsimonious breastfeeding gear model (BFGM). Analogous to a well-oiled engine, the BFGM indicates the need for several key “gears” to be working in synchrony and coordination. Evidence-based advocacy is needed to generate the necessary political will to enact legislation and policies to protect, promote, and support BF at the hospital and community levels. This political-policy axis in turn drives the resources needed to support workforce development, program delivery, and promotion. Research and evaluation are needed to sustain the decentralized program coordination “gear” required for goal setting and system feedback. The BFGM helps explain the different levels of performance in national BF outcomes in Mexico and Brazil. Empirical research is recommended to further test the usefulness of the AIDED framework and BFGM for global scaling up of BF programs. PMID:23153733

  15. Uganda: condoms provoke an AIDS storm.

    PubMed

    Tebere, R

    1991-03-01

    An advertisement in the Uganda weekly Topic printed in 1990 is the center of the controversy over whether promoting condom use to prevent AIDS is really promoting immorality and promiscuity. The ad states: "The bible may save your soul but this condom will save you life." Critics have called the ad blasphemy for showing a condom package alongside the Bible; claimed the condom fools people into thinking they are safe from AIDS; and blamed the practice of supplying condoms for the moral decadence that is destroying the country. In contrast the national AIDS Control Program (ACP) believes that supplying university students, who may be the group at highest risk, with condoms, is wise because they at lest know how to use them properly. A spokesman for the ACP said that the condom is one of the limited options that exist to fight the life-threatening epidemic. Present Museven changed his views to November 1990 from a policy of encouraging abstinence and monogamy, to promoting condoms. This change in government policy coincided with the report of 17,422 cases of AIDS, and the estimate that 1.3 million people in Uganda are infected with HIV.

  16. The potential for political leadership in HIV/AIDS communication campaigns in Sub-Saharan Africa.

    PubMed

    Karan, Abraar; Hartford, Emily; Coates, Thomas J

    2017-01-01

    The HIV/AIDS epidemic has become a point of important political concern for governments especially in Sub-Saharan Africa. Clinical and public health interventions to curb the epidemic can be greatly enhanced with the strategic support of political leaders. We analyzed the role of national political leadership in large-scale HIV/AIDS communications campaigns in 14 countries in Sub-Saharan Africa. We primarily reviewed grey and white literature published from 2005-2014. We further triangulated data from in-person and phone interviews with key public health figures. A number of themes emerged supporting political leaders' efforts toward HIV/AIDS program improvement, including direct involvement of public officials in campaign spearheading, the acknowledgment of personal relationship to the HIV epidemic, and public testing and disclosure of HIV status. Areas for future improvement were also identified, including the need for more directed messaging, increased transparency both nationally and internationally and the reduction of stigmatizing messaging from leaders. The political system has a large role to play within the healthcare system, particularly for HIV/AIDS. This partnership between politics and the health must continue to strengthen and be leveraged to effect major change in behaviors and attitudes across Sub-Saharan Africa.

  17. Globalization and multi-spatial trends in the coverage of protected-area conservation (1980-2000).

    PubMed

    Zimmerer, Karl S; Galt, Ryan E; Buck, Margaret V

    2004-12-01

    This study is focused on the global expansion of protected-area coverage that occurred during the 1980--2000 period. We examine the multi-scale patterning of four of the basic facets of this expansion: i) estimated increases at the world-regional and country-level scales of total protected-area coverage; ii) transboundary protected areas; iii) conservation corridor projects; and iv) type of conservation management. Geospatial patterning of protected-area designations is a reflection of the priorities of global conservation organizations and the globalization of post-Cold War political and economic arrangements. Local and national-level factors (political leadership and infrastructure) as well as international relations such as multilateral and bilateral aid combine with these globalization processes to impact the extent, type, and location of protected-area designations. We conclude that the interaction of these factors led to the creation and reinforcement of marked spatial differences (rather than tendencies toward worldwide evenness or homogenization) in the course of protected-area expansion during the 1980--2000 period.

  18. ARISTOTLE (All Risk Integrated System TOward The hoListic Early-warning): a multi-hazard expert advice system for the EU disaster response

    NASA Astrophysics Data System (ADS)

    Michelini, A.; Wotawa, G.; Arnold-Arias, D.

    2017-12-01

    ARISTOTLE (http://aristotle.ingv.it/) is a Pilot Project funded by the DG ECHO (EU Humanitarian Aid and Civil Protection) that provides expert scientific advice on natural disasters around the world that may cause a country to seek international help to the EU's Emergency Response Coordination Centre (ERCC) and, consequently, to the Union Civil Protection Mechanism Participating States. The EU is committed to providing disaster response in a timely and efficient manner and to ensure European assistance meets the real needs in the population affected, whether in Europe or beyond. When a disaster strikes, every minute counts for saving lives and rapid, coordinated and pre-planned response is essential. The ARISTOTLE consortium includes 15 partner institutions (11 from EU Countries; 2 from non-EU countries and 2 European organizations) operating in the Meteorological and Geophysical domains. The project coordination is shared among INGV and ZAMG for the geophysical and meteorological communities, respectively. ARISTOTLE harnesses operational expertise from across Europe to form a multi-hazard perspective on natural disasters related to volcanoes, earthquake (and resulting tsunami), severe weather and flooding. Each Hazard Group brings together experts from the particular hazard domain to deliver a `collective analysis' which is then fed into the partnership multi-hazard discussions. Primary target of the pilot project has been the prototyping and the implementation of a scalable system (in terms of number of partners and hazards) capable of providing to ERCC the sought advice. To this end, the activities of the project have been focusing on the establishment of a "Multi-Hazard Operational Board" that is assigned the 24*7 operational duty regulated by a "Standard Operating Protocol" and the implementation of a dedicated IT platform to assembly the resulting reports. The project has reached the point where the routine and emergency advice services are being provided and will continue until the end of the project in January 2018. The presentation will illustrate the different modes of operation envisaged and the status and the solutions found by the project consortium to respond to the ERCC requirements.

  19. Injection drug use and HIV/AIDS in China: Review of current situation, prevention and policy implications

    PubMed Central

    Qian, Han-Zhu; Schumacher, Joseph E; Chen, Huey T; Ruan, Yu-Hua

    2006-01-01

    Illicit drug abuse and HIV/AIDS have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/AIDS epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/AIDS based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/AIDS cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs; meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/AIDS problems seriously. Strengthening government leadership at both central and local levels; scaling up methadone substitution and needle exchange programs; making HIV voluntary counseling and testing available and affordable to both urban and rural drug users; and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem. PMID:16451717

  20. Stitch overlap via coloring technique enables maskless via

    NASA Astrophysics Data System (ADS)

    Civay, D.; Laffosse, E.

    2017-03-01

    Lithographic patterning limits can be a cost-barrier that delays advancement to new nodes. This paper introduces a cost-saving design method that enables a maskless via. Multi-patterning or coloring of a design is a technique that is used at advanced nodes to aid in patterning. Coloring allows designers to designate different patterns on one level to be printed with different masks. Stitch overlap via (SOV) is a coloring technique introduced herein. SOV utilizes via-aware coloring and a unique process flow to print a maskless via. Identification of qualifying design structures is achieved through a custom program. The program inputs the design level of the multipatterned layer and the via levels above and below to determine the coloring decomposition. Vias are a particularly challenging layer to print due to the dimensions required for these pillars. SOV is a methodology for identifying qualifying multi-patterned layouts and replacing them with a new design that enables a maskless via layer.

  1. Linking national and global population agendas: case studies from eight developing countries.

    PubMed

    Lee, K; Walt, G

    1995-06-01

    This comparative study of the determinants of family planning policy initiation and implementation focuses on four pairs of countries: Zambia/Zimbabwe, Algeria/Tunisia, Pakistan/Bangladesh, and Philippines/Thailand. The conclusion is drawn that global efforts had an influence on national policy makers and on putting family planning issues on the policy agenda. Global impacts were affected by national economic and social conditions and the broader political and economic relations with Western countries. The absolute level of economic development was found to be unrelated to the timing of initiation of family planning on national policy agendas. Stronger national family planning programs occurred in countries where policy makers linked economic development at whatever level with the need to limit population growth. Pakistan and Thailand in the 1960s illustrated this commitment to family planning programs, and Zambia and Algeria illustrated the lack of connection between development and population growth at the policy level and the lack of family planning on the policy agenda. Affiliation with the West during the 1960s meant early initiation of family planning in Pakistan/Bangladesh and Philippines/Thailand. Stronger commitment to program implementation occurred only in Thailand during the 1970s and Zimbabwe during the 1980s. Commitment lessened in the Philippines and Pakistan. Program implementation and national support of family planning were viewed as also dependent upon domestic factors, such as sufficient resources. Algeria/Tunisia and Zambia/Zimbabwe were countries that promoted family planning only after national political ideology shifted and anti-imperialist sentiments subsided. The impact of the international Cairo conference on these countries was minimal in terms of policy change. Most of the countries however desired greater support from donors. Even objections from the Vatican and internal domestic pressures were insufficient to prevent countries such as the Philippines and Pakistan from supporting the Cairo Plan of Action and a family planning and reproductive health agenda. Bangladesh and Pakistan are given as examples of countries where differences in the focus of foreign aid impacted on the national support for social services.

  2. The Swift Project Contamination Control Program: A Case study of Balancing Cost, Schedule and Risk

    NASA Technical Reports Server (NTRS)

    Hansen, Patricia A.; Day, Diane; Secunda, Mark

    2003-01-01

    The Swift Observatory will be launched in early 2004 to examine the dynamic process of gamma ray burst (GRB) events. The multi-wavelength Observatory will study the GRB afterglow characteristics, which will help to answer fundamental questions about both the structure and the evolution of the universe. The Swift Observatory Contamination Control Program has been developed to aid in ensuring the success of the on-orbit performance of two of the primary instruments: the Ultraviolet and Optical Telescope (UVOT) and the X-Ray Telescope (XRT). During the design phase of the Observatory, the contamination control program evolved and trade studies were performed to assess the risk of contaminating the sensitive UVOT and XRT optics during both pre-launch testing and on-orbit operations, within the constraints of the overall program cost and schedule.

  3. The Swift Project Contamination Control Program: A Case Study of Balancing Cost, Schedule and Risk

    NASA Technical Reports Server (NTRS)

    Hansen, Patricia A.; Day, Diane T.; Secunda, Mark S.; Rosecrans, Glenn P.

    2004-01-01

    The Swift Observatory will be launched in early 2004 to examine the dynamic process of gamma ray burst (GRB) events. The multi-wavelength Observatory will study the GRB afterglow characteristics, which will help to answer fundamental questions about both the structure and the evolution of the universe. The Swift Observatory Contamination Control Program has been developed to aid in ensuring the success of the on-orbit performance of two of the primary instruments: the Ultraviolet and Optical Telescope (UVOT) and the X-Ray Telescope (XRT). During the design phase of the Observatory, the contamination control program evolved and trade studies were performed to assess the risk of contaminating the sensitive UVOT and XRT optics during both pre-launch testing and on-orbit operations, within the constraints of the overall program cost and schedule.

  4. Youth mental health first aid: a description of the program and an initial evaluation

    PubMed Central

    2011-01-01

    Background Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions. Methods The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries. Results The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were maintained at follow-up. Over the first 3 years of this program, a total of 318 instructors were trained to deliver the course and these instructors have delivered courses to 10,686 people across all states and territories in Australia. The program has also spread to Canada, Singapore and England, and will spread to Hong Kong, Sweden and China in the near future. Conclusions Initial evaluation suggests that the Youth Mental Health First Aid course improves participants' knowledge, attitudes and helping behaviour. The program has spread successfully both nationally and internationally. Trial registration ACTRN12609000033246 PMID:21272345

  5. Analysing inter-relationships among water, governance, human development variables in developing countries

    NASA Astrophysics Data System (ADS)

    Dondeynaz, C.; Carmona Moreno, C.; Céspedes Lorente, J. J.

    2012-10-01

    The "Integrated Water Resources Management" principle was formally laid down at the International Conference on Water and Sustainable development in Dublin 1992. One of the main results of this conference is that improving Water and Sanitation Services (WSS), being a complex and interdisciplinary issue, passes through collaboration and coordination of different sectors (environment, health, economic activities, governance, and international cooperation). These sectors influence or are influenced by the access to WSS. The understanding of these interrelations appears as crucial for decision makers in the water sector. In this framework, the Joint Research Centre (JRC) of the European Commission (EC) has developed a new database (WatSan4Dev database) containing 42 indicators (called variables in this paper) from environmental, socio-economic, governance and financial aid flows data in developing countries. This paper describes the development of the WatSan4Dev dataset, the statistical processes needed to improve the data quality, and finally, the analysis to verify the database coherence is presented. Based on 25 relevant variables, the relationships between variables are described and organised into five factors (HDP - Human Development against Poverty, AP - Human Activity Pressure on water resources, WR - Water Resources, ODA - Official Development Aid, CEC - Country Environmental Concern). Linear regression methods are used to identify key variables having influence on water supply and sanitation. First analysis indicates that the informal urbanisation development is an important factor negatively influencing the percentage of the population having access to WSS. Health, and in particular children's health, benefits from the improvement of WSS. Irrigation is also enhancing Water Supply service thanks to multi-purpose infrastructure. Five country profiles are also created to deeper understand and synthetize the amount of information gathered. This new classification of countries is useful in identifying countries with a less advanced position and weaknesses to be tackled. The relevance of indicators gathered to represent environmental and water resources state is questioned in the discussion section. The paper concludes with the necessity to increase the reliability of current indicators and calls for further research on specific indicators, in particular on water quality at national scale, in order to better include environmental state in analysis to WSS.

  6. Shared decision making in preventive care in Switzerland: From theory to action.

    PubMed

    Selby, Kevin; Auer, Reto; Cornuz, Jacques

    2017-06-01

    Switzerland with its decentralized, liberal health system and its tradition of direct democracy may be an ideal place for shared decision making (SDM) to take root organically, rather than using top-down regulations seen in other countries. There are now multiple directives and programmes in place to encourage SDM, with the creation of several decision aids and specific training programs in the five Swiss medical schools. There has been an emphasis on preventive care, with the integration of patient preference into an organized colorectal cancer screening program, clear recommendations for prostate cancer screening, and inroads into the primary prevention of cardiovascular disease. Focusing on the experience of the University of Lausanne, we describe multiple approaches being taken to teaching SDM and the local development of decision aids, drawing on international experience but tailored to local needs. Efforts are being made to further involve patients in not only SDM, but also associated research and quality improvement projects. Copyright © 2017. Published by Elsevier GmbH.

  7. Evaluation of Computer Aided Vortex Forecast System

    NASA Technical Reports Server (NTRS)

    Rossow, Vernon J.; Olson, Lawrence E. (Technical Monitor)

    1995-01-01

    Several countries, including the United States. Canada, Germany, England and Russia, are in the process of trying to develop some sort of computer-aided system that will guide controllers at airports on the hazard posed by lift-generated vortices that trail behind subsonic transport aircraft. The emphasis on this particular subject has come about because the hazard posed by wake vortices is currently the only reason why aircraft are spaced at 3 to 6 miles apart during landing and takeoff rather than something like 2 miles. It is well known that under certain weather conditions, aircraft spacings can be safely reduced to as little as the desired 2 miles. In an effort to perhaps capitalize on such a possibility, a combined FAA and NASA program is currently underway in the United States to develop such a system. Needless to say, the problems associated with anticipating the required separation distances when weather conditions are involved is very difficult. Similarly, Canada has a corresponding program to develop a vortex forecast system of their own.

  8. NASA-UK STAP: A technology applications program to aid government and industry in Kentucky

    NASA Technical Reports Server (NTRS)

    1978-01-01

    There is a need for a well-defined partnership between universities, and the business and industrial community to promote the transfer of technology. In an effort to foster such a partnership, the Space Systems Program, administered by NASA, has established information dissemination centers in cooperation with various universities throughout the country. As a result of limited success in the transfer of technology to state and local units of government NASA felt that new stimuli and new approaches were needed in the public sector area. NASA selected the University of Kentucky, a land grant institution with a significant research dissemination and service role, as the site for the new program. An annual report of this program at the University of Kentucky is presented.

  9. Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature

    PubMed Central

    Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

    2015-01-01

    Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems. PMID:26113945

  10. Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature.

    PubMed

    Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

    2015-01-01

    Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems.

  11. A Review Of Innovative International Financing Mechanisms To Address Noncommunicable Diseases.

    PubMed

    Meghani, Ankita; Basu, Sanjay

    2015-09-01

    Noncommunicable diseases have become prevalent in low- and middle-income countries. A key question that remains unresolved is how to support the development of systems to prevent and treat noncommunicable disease through international financing mechanisms. We conducted a review of articles and grey literature published from 2000 through 2014 on innovative financing models proposed or used for other disease control efforts. We found that the greatest available evidence supported pooled funding models, where funding from multiple groups is combined for a specific investment, with such models previously deployed in vaccine and infectious disease funding areas. Robust evidence also supported the viability of international transactions taxes or levies placed on specific transactions to fund investments in drug procurement and supply, and of the front-loading of development aid through bond sales, particularly to stabilize funding and subsidize drug procurement. Far less compelling evidence was available to support diaspora bonds or debt reduction programs as mechanisms to aid low- and middle-income countries' health systems in financing noncommunicable disease prevention and care services. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Existing capacity to manage pharmaceuticals and related commodities in East Africa: an assessment with specific reference to antiretroviral therapy

    PubMed Central

    Waako, Paul J; Odoi-adome, Richard; Obua, Celestino; Owino, Erisa; Tumwikirize, Winnie; Ogwal-okeng, Jasper; Anokbonggo, Willy W; Matowe, Lloyd; Aupont, Onesky

    2009-01-01

    Background East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University, with technical assistance from the USAID supported Rational Pharmaceutical Management Plus (RPM Plus) Program of Management Sciences for Health (MSH) established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity. The initiative conducted a regional assessment to determine the existing capacity for the management of antiretroviral drugs and related commodities. Methods Heads and implementing workers of fifty HIV/AIDS programs and institutions accredited to offer antiretroviral services in Uganda, Kenya, Tanzania and Rwanda were key informants in face-to-face interviews guided by structured questionnaires. The assessment explored categories of health workers involved in the management of ARVs, their knowledge and practices in selection, quantification, distribution and use of ARVs, nature of existing training programs, training preferences and resources for capacity building. Results Inadequate human resource capacity including, inability to select, quantify and distribute ARVs and related commodities, and irrational prescribing and dispensing were some of the problems identified. A competence gap existed in all the four countries with a variety of healthcare professionals involved in the supply and distribution of ARVs. Training opportunities and resources for capacity development were limited particularly for workers in remote facilities. On-the-job training and short courses were the preferred modes of training. Conclusion There is inadequate capacity for managing medicines and related commodities in East Africa. There is an urgent need for training in aspects of pharmaceutical management to different categories of health workers. Skills building activities that do not take healthcare workers from their places of work are preferred. PMID:19272134

  13. A 30-year bibliometric analysis of research coverage on HIV and AIDS in Lesotho.

    PubMed

    Mugomeri, Eltony; Bekele, Bisrat S; Mafaesa, Mamajoin; Maibvise, Charles; Tarirai, Clemence; Aiyuk, Sunny E

    2017-03-21

    Given the well documented undesired impacts of HIV/AIDS globally, there is a need to create a statistical inventory of research output on HIV/AIDS. This need is particularly important for a country such as Lesotho, whose HIV/AIDS prevalence is one of the highest globally. Research on HIV/AIDS in sub-Saharan Africa continues to trail behind that of other regions, especially those of the developed countries. Lesotho, a sub-Saharan country, is a developing country with lower research output in this area when longitudinally compared to other countries. This study reviewed the volume and scope of the general research output on HIV/AIDS in Lesotho and assessed the coverage of the national research agenda on HIV/AIDS, making recourse to statistical principles. A bibliometric review of studies on HIV/AIDS retrieved from the SCOPUS and PubMed databases, published within the 30-year period between 1985 and 2016, was conducted. The focus of each of the studies was analysed and the studies were cross-matched with the national research agenda in accordance with bibliometric methodologies. In total, 1280 studies comprising 1181 (92.3%) journal articles, 91 (7.1%) books and 8 (0.6%) conference proceedings were retrieved. By proportion, estimation of burden of infection (40.7%) had the highest research volume, while basic (5.5%) and preventive measures (24.4%) and national planning (29.4%) had the lowest. Out of the total studies retrieved, only 516 (40.3%) matched the national research agenda. Research on maternal and child health quality of care, viral load point-of-care devices, and infant point-of-care diagnosis had hardly any publications in the high priority research category of the agenda. Notwithstanding a considerable research output on HIV/AIDS for Lesotho, there is insufficient coverage of the national research agenda in this research area. The major research gaps on general research output are in basic and preventive measures as well as national planning. There is also a need to increase targeted funding for HIV/AIDS research to appropriately address the most compelling gaps and national needs.

  14. Social change, migration and sexual health: Chilean women in Chile and Australia.

    PubMed

    Dawson, Maria Teresa; Gifford, Sandra Margaret

    2003-01-01

    Cultural beliefs, norms and values regarding sexuality and gender roles forge people's sexual behaviour and understanding of sexual health risk. Acknowledging a person's cultural background is a key challenge for the promotion of sexual health programs and strategies for the prevention of sexually transmitted diseases (STDs) and HIV/AIDS. This challenge acquires larger dimensions when health promotion programs are directed towards migrant communities. This article examines narratives about past and present life experiences of Chilean women living in Australia and Chilean women in Chile. We inquire about social changes and exposure to education women experienced in their own country and in Australia and the ways in which migrant women define and articulate their experiences in relation to sexual health prevention. In comparing these experiences, we raise a number of questions about sexual health promotion and programs, including the prevention of STDs and HIV/AIDS targeted to specific migrant communities in Australia. Very few sexual health policies and strategies in Australia take into account the impact that the social and cultural background of migrants, social changes and the 'settlement process' has on the cultural construction of gender identity of migrants in the new country. We propose that these cultural constructs are key in the formulation of migrants' beliefs and attitudes towards sexuality and sexual health. We suggest that there is a need to build effective and culturally appropriate sexual health promotion and prevention strategies that build upon the social and cultural background and the present and past life experiences of migrant women and men.

  15. Addressing HIV/AIDS challenges in Uganda: does social capital generation by NGOs matter?

    PubMed

    Muriisa, Roberts Kabeba; Jamil, Ishtiaq

    2011-01-01

    HIV/AIDS has had devastating impacts in many countries, Uganda in particular. However, Uganda is depicted as one of the most successful countries in fighting HIV/AIDS. Among others, Uganda's success story is attributed to the open general environment which allows open discussions surrounding HIV/AIDS when other countries such as South Africa and Kenya denied the existence of the disease in their countries. In addition, the success is attributed to the policy which allowed many actors to participate in the fight against the disease. The primary focus of this article is to map the process of social capital generation by NGOs and how social capital benefits enhance mitigation of HIV/AIDS challenges in Uganda. The key to social capital is nurturing relationships. In this regard, HIV/AIDS NGOs play a central role in the way individuals, groups and communities interact, and how various kinds of social relations are forged with people living with HIV/AIDS and especially for those who are HIV infected. NGOs' success in reducing the number of HIV/AIDS cases in Uganda is based on their abilities to generate social capital. This involves inclusion and building social networks and empowerment at the individual and community levels, and disseminating information to reduce social stigma as well as discrimination. We used a mixed-method strategy to collect data for this study. We used a structured questionnaire having quantitative and qualitative question sets which focused on different social capital measurement indicators. We used observations and in-depth face-to-face interviews. A major finding of the study is that the ways individuals and groups are connected and interact with each other are important mechanisms for alleviating HIV/AIDS challenges in Uganda.

  16. Improving access to malaria medicine through private-sector subsidies in seven African countries.

    PubMed

    Tougher, Sarah; Mann, Andrea G; Ye, Yazoume; Kourgueni, Idrissa A; Thomson, Rebecca; Amuasi, John H; Ren, Ruilin; Willey, Barbara A; Ansong, Daniel; Bruxvoort, Katia; Diap, Graciela; Festo, Charles; Johanes, Boniface; Kalolella, Admirabilis; Mallam, Oumarou; Mberu, Blessing; Ndiaye, Salif; Nguah, Samual Blay; Seydou, Moctar; Taylor, Mark; Wamukoya, Marilyn; Arnold, Fred; Hanson, Kara; Goodman, Catherine

    2014-09-01

    Improving access to quality-assured artemisinin combination therapies (ACTs) is an important component of malaria control in low- and middle-income countries. In 2010 the Global Fund to Fight AIDS, Tuberculosis, and Malaria launched the Affordable Medicines Facility--malaria (AMFm) program in seven African countries. The goal of the program was to decrease malaria morbidity and delay drug resistance by increasing the use of ACTs, primarily through subsidies intended to reduce costs. We collected data on price and retail markups on antimalarial medicines from 19,625 private for-profit retail outlets before and 6-15 months after the program's implementation. We found that in six of the AMFm pilot programs, prices for quality-assured ACTs decreased by US$1.28-$4.34, and absolute retail markups on these therapies decreased by US$0.31-$1.03. Prices and markups on other classes of antimalarials also changed during the evaluation period, but not to the same extent. In all but two of the pilot programs, we found evidence that prices could fall further without suppliers' losing money. Thus, concerns may be warranted that wholesalers and retailers are capturing subsidies instead of passing them on to consumers. These findings demonstrate that supranational subsidies can dramatically reduce retail prices of health commodities and that recommended retail prices communicated to a wide audience may be an effective mechanism for controlling the market power of private-sector antimalarial retailers and wholesalers. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Establishing space activities in non-space faring nations: An example of university-based strategic planning

    NASA Astrophysics Data System (ADS)

    Faure, Pauline; Cho, Mengu; Maeda, George

    2018-07-01

    In 2015, Kyushu Institute of Technology initiated the Joint Global Multi-Nation Birds Satellite (BIRDS) program. As of September 2017, young professionals from Bangladesh, Ghana, Nigeria, Thailand, Mongolia, Philippines, Malaysia, and Bhutan are being involved in BIRDS program. To help the young professionals acquiring the right tools and preparing them to successfully establish indigenous space activities, the space strategic planning project was established in February 2017. During the project, young professionals from Bangladesh, Ghana, Mongolia, and Bhutan were invited to think about the strategy their home country should be following in the next ten years to achieve their country's goals in terms of space sciences, engineering, and utilization, while respecting the country needs and constraints. In this paper, the efforts undertaken by the different young professionals are reported and the guidelines for each country space strategic planning are described. From this work, the authors aim at promoting space activities development in non-space faring nations and encouraging non-space faring nations to find their right strategy to achieve sustainable indigenous space activities despite the nation's constraints.

  18. Network Analytical Tool for Monitoring Global Food Safety Highlights China

    PubMed Central

    Nepusz, Tamás; Petróczi, Andrea; Naughton, Declan P.

    2009-01-01

    Background The Beijing Declaration on food safety and security was signed by over fifty countries with the aim of developing comprehensive programs for monitoring food safety and security on behalf of their citizens. Currently, comprehensive systems for food safety and security are absent in many countries, and the systems that are in place have been developed on different principles allowing poor opportunities for integration. Methodology/Principal Findings We have developed a user-friendly analytical tool based on network approaches for instant customized analysis of food alert patterns in the European dataset from the Rapid Alert System for Food and Feed. Data taken from alert logs between January 2003 – August 2008 were processed using network analysis to i) capture complexity, ii) analyze trends, and iii) predict possible effects of interventions by identifying patterns of reporting activities between countries. The detector and transgressor relationships are readily identifiable between countries which are ranked using i) Google's PageRank algorithm and ii) the HITS algorithm of Kleinberg. The program identifies Iran, China and Turkey as the transgressors with the largest number of alerts. However, when characterized by impact, counting the transgressor index and the number of countries involved, China predominates as a transgressor country. Conclusions/Significance This study reports the first development of a network analysis approach to inform countries on their transgressor and detector profiles as a user-friendly aid for the adoption of the Beijing Declaration. The ability to instantly access the country-specific components of the several thousand annual reports will enable each country to identify the major transgressors and detectors within its trading network. Moreover, the tool can be used to monitor trading countries for improved detector/transgressor ratios. PMID:19688088

  19. Second European multi-disciplinary conference of national strategies for Chlamydia trach. and human papillomavirus NSCP conf. in Berlin, 2013 enhanced detection, management and surveillance of sexually transmitted infections in Europe are essential!

    PubMed

    Ozolins, D; D' Elios, M M; Ripa, T; Bailey, R; Timms, P; Spiteri, G; Haar, K; Unemo, M

    2013-01-01

    There is a need for updated guidance on detection, management and surveillance of sexually transmitted infections (STIs). Chlamydia, gonorrhoea and syphilisreporting needs to be mandatory in more European countries to aid collection of data. More widespread Chlamydia screening is needed in many countries as this is the only way to reduce complications. The role of Human Papillomavirus (HPV) screening in a situation where the prevalence of HPV infection has dropped significantly was also discussed in the context of the high cost of screening, the need for a relatively complex infrastructure, particularly in developing countries, and falling vaccination costs. An integrated HPV vaccination and screening policy could be the most appropriate with vaccination at 9-13 years as recommended by WHO and a single HPV screen at 35-39 years, possibly repeated thereafter every 10 years. Female and male HPV vaccination programmes could lead to near elimination of genital warts in both females and males. Surveillance of STIsshould be intensified where needed; additional or better quality data should be collected including reasons for testing, denominator data to estimate positivity rates, diagnostic methods, concurrent STIs, sexual orientation and country of acquisition; more analytical rather than descriptive epidemiology is needed.

  20. AIDS epidemic in Malawi: shaking cultural foundations.

    PubMed

    Chirwa, I

    1993-05-01

    Many young men and women in Malawi are infected with HIV and dying from AIDS. The head of the Malawi AIDS Control Program estimates that as many as 10% of all adults in the country may be infected with HIV, with the rate being higher in urban areas. While more than 90% of the population is now aware of the existence of AIDS and its dangers, changes in behavior have not taken place and HIV continues to spread. Early campaigns attempted to generate condom use through peer educators among bar girls, truck drivers, and STD patients. Many men state, however, that they prefer to have sex without condoms because it is more exciting. Others cite alcohol consumption, ignorance of the dangers of HIV infection, and/or a fear of suggesting mistrust in a partner as reasons for not using condoms. Many women also find it difficult to negotiate condom use among reluctant men. Making condoms readily accessible and giving them a positive image may help increase their rate of use; the opposition of some religious groups must be thwarted and the distribution system needs to be improved to realize these ends. Condoms are provided to Malawi free of charge by the US Agency of International Development. Supplies are then either distributed free through health centers and bars or sold in shops. The failure of free condoms to be readily available in rural areas where 90% of the population resides, however, poses concern. Finally, training programs, counseling, anonymous HIV testing centers, and peer educators are among some of the interventions being made against AIDS in Malawi.

  1. Temporal changes in causes of death among HIV-infected patients in the HAART era in Rio de Janeiro, Brazil.

    PubMed

    Pacheco, Antonio G; Tuboi, Suely H; May, Silvia B; Moreira, Luiz F S; Ramadas, Luciana; Nunes, Estevão P; Merçon, Mônica; Faulhaber, José C; Harrison, Lee H; Schechter, Mauro

    2009-08-15

    The widespread use of highly active antiretroviral therapy (HAART) has led to marked decreases in death rates in Brazil in HIV-infected individuals. Nonetheless, there are scarce data on specific causes of death. Death rates from a cohort of HIV-infected patients in Rio de Janeiro, Brazil, were analyzed in 2-year periods, from 1997 to 2006. Poisson models and survival models accounting for competing risks were used to assess association of covariables. A standardized validated algorithm was used to ascertain specific causes of death. Of the 1538 eligible patients, 226 (14.7%) died during the study period, corresponding to a mortality rate of 3.2 per 100 person-years. The median follow-up time was 4.61 years (interquartile range = 5.63 years) and the loss to follow-up rate was 2.4 per 100 person-years. Overall, 98 (43.4%) were classified as non-AIDS-related causes. Although opportunistic infections were the leading causes of death (37.6%), deaths due to AIDS-related causes declined significantly over time (P < 0.01). In the most recent period (2005-2006), the rate of non-AIDS-related causes of deaths was higher than that of AIDS-related causes of death. In the HAART era, there has been a significant change in causes of death among HIV-infected patients in Rio de Janeiro. As access to HAART improves, integration with other public programs will become critically important for the long-term success of HIV/AIDS programs in developing countries.

  2. Costs and financing of routine immunization: Approach and selected findings of a multi-country study (EPIC).

    PubMed

    Brenzel, Logan; Young, Darwin; Walker, Damian G

    2015-05-07

    Few detailed facility-based costing studies of routine immunization (RI) programs have been conducted in recent years, with planners, managers and donors relying on older information or data from planning tools. To fill gaps and improve quality of information, a multi-country study on costing and financing of routine immunization and new vaccines (EPIC) was conducted in Benin, Ghana, Honduras, Moldova, Uganda and Zambia. This paper provides the rationale for the launch of the EPIC study, as well as outlines methods used in a Common Approach on facility sampling, data collection, cost and financial flow estimation for both the routine program and new vaccine introduction. Costing relied on an ingredients-based approach from a government perspective. Estimating incremental economic costs of new vaccine introduction in contexts with excess capacity are highlighted. The use of more disaggregated System of Health Accounts (SHA) coding to evaluate financial flows is presented. The EPIC studies resulted in a sample of 319 primary health care facilities, with 65% of facilities in rural areas. The EPIC studies found wide variation in total and unit costs within each country, as well as between countries. Costs increased with level of scale and socio-economic status of the country. Governments are financing an increasing share of total RI financing. This study provides a wealth of high quality information on total and unit costs and financing for RI, and demonstrates the value of in-depth facility approaches. The paper discusses the lessons learned from using a standardized approach, as well as proposes further areas of methodology development. The paper discusses how results can be used for resource mobilization and allocation, improved efficiency of services at the country level, and to inform policies at the global level. Efforts at routinizing cost analysis to support sustainability efforts would be beneficial. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Effect of the Prevalence of HIV/AIDS and the Life Expectancy Rate on Economic Growth in SSA Countries: Difference GMM Approach.

    PubMed

    Waziri, Salisu Ibrahim; Mohamed Nor, Norashidah; Raja Abdullah, Nik Mustapha; Adamu, Peter

    2015-09-01

    The productivity of countries around the globe is adversely affected by the health-related problems of their labour force. This study examined the effect of the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and life expectancy on the economic growth of 33 Sub-Saharan African (SSA) countries over a period of 11 years (2002-2012). The study employed a dynamic panel approach as opposed to the static traditional approach utilised in the literature. The dynamic approach became eminent because of the fact that HIV/AIDS is a dynamic variable as its prevalence today depends on the previous years. The result revealed that HIV/AIDS is negatively correlated with economic growth in the region, with a coefficient of 0.014, and significant at the 1% level. That is, a 10% increase in HIV/AIDS prevalence leads to a 0.14% decrease in the GDP of the region. Tackling HIV/AIDS is therefore imperative to the developing Sub-Saharan African region and all hands must be on deck to end the menace globally.

  4. A comparative study of two communication models in HIV/AIDS coverage in selected Nigerian newspapers

    PubMed Central

    Okidu, Onjefu

    2013-01-01

    The current overriding thought in HIV/AIDS communication in developing countries is the need for a shift from the cognitive model, which emphasises the decision-making of the individual, to the activity model, which emphasises the context of the individual. In spite of the acknowledged media shift from the cognitive to the activity model in some developing countries, some HIV/AIDS communication scholars have felt otherwise. It was against this background that this study examined the content of some selected Nigerian newspapers to ascertain the attention paid to HIV/AIDS cognitive and activity information. Generally, the study found that Nigerian newspapers had shifted from the cognitive to the activity model of communication in their coverage of HIV/AIDS issues. The findings of the study seem inconsistent with the theoretical argument of some scholars that insufficient attention has been paid by mass media in developing countries to the activity model of HIV/AIDS communication. It is suggested that future research replicate the study for Nigerian and other developing countries’ mass media. PMID:23394854

  5. Effect of the Prevalence of HIV/AIDS and the Life Expectancy Rate on Economic Growth in SSA Countries: Difference GMM Approach

    PubMed Central

    Waziri, Salisu Ibrahim; Nor, Norashidah Mohamed; Abdullah, Nik Mustapha Raja; Adamu, Peter

    2016-01-01

    The productivity of countries around the globe is adversely affected by the health-related problems of their labour force. This study examined the effect of the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and life expectancy on the economic growth of 33 Sub-Saharan African (SSA) countries over a period of 11 years (2002–2012). The study employed a dynamic panel approach as opposed to the static traditional approach utilised in the literature. The dynamic approach became eminent because of the fact that HIV/AIDS is a dynamic variable as its prevalence today depends on the previous years. The result revealed that HIV/AIDS is negatively correlated with economic growth in the region, with a coefficient of 0.014, and significant at the 1% level. That is, a 10% increase in HIV/AIDS prevalence leads to a 0.14% decrease in the GDP of the region. Tackling HIV/AIDS is therefore imperative to the developing Sub-Saharan African region and all hands must be on deck to end the menace globally. PMID:26573032

  6. Literacy and Life Skills Education for Vulnerable Youth: What Policy Makers Can Do

    ERIC Educational Resources Information Center

    Bernhardt, Anna Caroline; Yorozu, Rika; Medel-Añonuevo, Carolyn

    2014-01-01

    In countries with a high concentration of youth with low literacy levels, the policy and programming task related to education and training is particularly daunting. This note briefly presents policies and practices which have been put in place to provide vulnerable youth with literacy and life skills education. It is based on a multi-country…

  7. Multi-User Virtual Environments Fostering Collaboration in Formal Education

    ERIC Educational Resources Information Center

    Di Blas, Nicoletta; Paolini, Paolo

    2014-01-01

    This paper is about how serious games based on MUVEs in formal education can foster collaboration. More specifically, it is about a large case-study with four different programs which took place from 2002 to 2009 and involved more than 9,000 students, aged between 12 and 18, from various nations (18 European countries, Israel and the USA). These…

  8. EFFECTS OF HIV/AIDS ON MATERNITY CARE PROVIDERS IN KENYA

    PubMed Central

    Turan, Janet M.; Bukusi, Elizabeth A.; Cohen, Craig R.; Sande, John; Miller, Suellen

    2008-01-01

    Objective To explore the impact of HIV/AIDS on maternity care providers (MCP) in labor and delivery in a high HIV prevalence setting in sub-Saharan Africa. Design Qualitative one-on-one in-depth interviews with MCPs. Setting Four health facilities providing labor and delivery services (2 public hospitals, a public health center, and a small private maternity hospital) in Kisumu, Nyanza Province, Kenya. Participants Eighteen (18) MCPs, including 14 nurse/midwives, 2 physician assistants, and 2 physicians (ob/gyn specialists). Results The HIV/AIDS epidemic has had numerous adverse effects and a few positive effects on MCPs in this setting. Adverse effects include reductions in the number of health care providers, increased workload, burnout, reduced availability of services in small health facilities when workers are absent due to attending HIV/AIDS training programs, difficulties with confidentiality and unwanted disclosure, and MCPs' fears of becoming HIV infected and the resulting stigma and discrimination. Positive effects include improved infection control procedures on maternity wards and enhanced MCP knowledge and skills. Conclusion A multi-faceted package including policy, infrastructure, and training interventions is needed to support MCPs in these settings and ensure that they are able to perform their critical roles in maternal healthcare and prevention of HIV/AIDS transmission. PMID:18811779

  9. Creating opportunities through mentorship, parental involvement, and safe spaces (COMPASS) program: multi-country study protocol to protect girls from violence in humanitarian settings.

    PubMed

    Falb, Kathryn L; Tanner, Sophie; Ward, Leora; Erksine, Dorcas; Noble, Eva; Assazenew, Asham; Bakomere, Theresita; Graybill, Elizabeth; Lowry, Carmen; Mallinga, Pamela; Neiman, Amy; Poulton, Catherine; Robinette, Katie; Sommer, Marni; Stark, Lindsay

    2016-03-05

    Violence against adolescent girls in humanitarian settings is of urgent concern given their additional vulnerabilities to violence and unique health and well-being needs that have largely been overlooked by the humanitarian community. In order to understand what works to prevent violence against adolescent girls, a multi-component curriculum-based safe spaces program (Creating Opportunities through Mentorship, Parental involvement and Safe Spaces - COMPASS) will be implemented and evaluated. The objectives of this multi-country study are to understand the feasibility, acceptability and effectiveness of COMPASS programming to prevent violence against adolescent girls in diverse humanitarian settings. Two wait-listed cluster-randomized controlled trials are being implemented in conflict-affected communities in eastern Democratic Republic of Congo (N = 886 girls aged 10-14 years) and in refugee camps in western Ethiopia (N = 919 girls aged 13-19 years). The intervention consists of structured facilitated sessions delivered in safe spaces by young female mentors, caregiver discussion groups, capacity-building activities with service providers, and community engagement. In Ethiopia, the research centers on the overall impact of COMPASS compared to a wait-list group. In DRC, the research objective is to understand the incremental effectiveness of the caregiver component in addition to the other COMPASS activities as compared to a wait-list group. The primary outcome is change in sexual violence. Secondary outcomes include decreased physical and emotional abuse, reduced early marriage, improved gender norms, and positive interpersonal relationships, among others. Qualitative methodologies seek to understand girls' perceptions of safety within their communities, key challenges they face, and to identify potential pathways of change. These trials will add much needed evidence for the humanitarian community to meet the unique needs of adolescent girls and to promote their safety and well-being, as well as contributing to how multi-component empowerment programming for adolescent girls could be adapted across humanitarian settings. Clinical Trials NCT02384642 (Registered: 2/24/15) & NCT02506543 (Registered: 7/19/15).

  10. Quantifying the risk of deforestation in Latin America and the Caribbean.

    NASA Astrophysics Data System (ADS)

    Manners, Rhys; Varela-Ortega, Consuelo

    2015-04-01

    Latin American and Caribbean countries have seen considerable deforestation due to a complex web of interconnected and interdependent causes, which include agricultural expansion, infrastructure development, social demographics and governmental policies and activity. It is necessary for successful and efficient policy development to understand how variability in these causes can potentially result in increased or decreased deforestation. The purpose of this study is to develop a tool that can quantify the risk, as in the threat or pressure, of potential deforestation, whilst identifying the key indicators that contribute to this risk. This tool will take the form of a composite index that will provide spatial and temporal trends of deforestation risk across Latin America and the Caribbean. The development of the Deforestation Risk Index (DRI) was based upon work performed in the EU project ROBIN1. Indicators of deforestation included in the index were identified based upon the multi-scalar approach adopted in ROBIN- nationally from principal component analysis and econometric modelling, provincially from extensive interviews with experts and farmers (subsistence and commercial) in Amazonian regions of Bolivia and Brazil, and locally from stakeholder workshops in Bolivia, Brazil and Mexico. The identification process was supported by an extensive literature review. In total, 11 indicators were identified and grouped into four components (biophysical, economic, governance and social) capable of explaining the risk of deforestation in Latin America and Caribbean countries. The DRI was calculated for 24 Latin American and Caribbean countries in the years 2000, 2005 and 2010 using national-level data collected from open access databases (FAOStat, WorldBank and UNDP). The DRI was subjected to two weighting schemes; the first based upon the opinions of experts from ROBIN (weighted biophysical and governance components heavily), and the second developed from the results of the ROBIN stakeholder workshops (heavily weighted the governance component). The results from the DRI were categorised as; low risk, moderate risk, at risk, elevated risk, high risk and extreme risk. The DRI demonstrated that in over 60% of countries, the risk of deforestation reduced between 2000-2010 with Belize, Costa Rica, Guyana and Venezuela being notable exceptions. Countries that saw reductions in their risk did so through economic growth (per capita GDP), institutional development (governmental effectiveness and regulatory quality), as well reductions in the scale of agricultural expansion. Despite the general trend towards lower risk, Amazonian countries were still found to be subject to potential deforestation. Bolivia, Ecuador, Guyana and Suriname were estimated to have an elevated risk of deforestation, with Brazil, Colombia and Peru considered to be at risk in 2010. The DRI provides an innovative, potentially multi-scalar tool, that can be used by national policy makers to identify where policies should be developed and directed, where specific measures in international programs such as REDD/+ could be most effectively pursued, and for international policy makers to identify and to tailor development or aid packages that reduce rather than contribute to deforestation.

  11. 100 million refugees. The world stabilizes through population stability.

    PubMed

    Sakaiya, T

    1993-09-01

    Global change has come about due to shifts in the business cycle, a new undeveloped paradigm to replace the Cold War, and a stabilization of expansion and development of modern industrial society. Japan has been transfixed with its own internal domestic affairs, but will feel the consequences of the Industrial Age nearing its end. Industrialization had relied on unlimited resources from the natural environment and the belief that a free-market economy would automatically lead to orderliness and a state of economic equilibrium. Population control has been an issue that has slid over the years as a priority status. In 1800, the population in developed countries was 4 times the population in developing countries; the reverse is becoming true. Mass migration was an unusual phenomena and not the problem it is today. There is a gap between population and productive capacity. Developed countries believed in humanitarian aid for refugees and impoverished peoples, but the numbers were unanticipated. There is no shame for war or civil unrest to drive boat people and hugh numbers to another country. The notion of nation state has changed. The boat people from Cuba were a beginning example of how governments were unconcerned about the loss of population. Afghanistan in 1979 was another example of refugees fleeing civil war. Iraq bombed the Kurds until there was no choice but to leave. Turkey was required to use troops to drive the Kurds back into Iraq. To increase aid indefinitely, or to send out more refugees than it takes in, or to use military forces to kill the invading refugees are not acceptable. An international framework with consensus from developed and developing countries is needed for dealing with mass migrations. Conventions adopted would have to be recognized as in each countries self-interest; disregard of the regulations would have to reflect significant disadvantages to a nation. Several issues are discussed as key in such a global framework: assuring productivity for all by absorbing some refugees, and developing new training programs for the private sector at home, and assuring development aid (technology, capital, markets). A self perpetuating cycle of growth and expansion must be set in motion. Infrastructure development must be replaced with stable employment in the home country.

  12. Trend of HIV/AIDS Prevalence and Related Interventions Administered in Prisons of Iran -13 Years’ Experience

    PubMed Central

    SHAHBAZI, Mohammad; FARNIA, Marzieh; RAHMANI, Khaled; MORADI, Ghobad

    2014-01-01

    Abstract Background HIV/AIDS epidemic is concentrated among injecting drug users in Iran. Like many other countries with HIV/AIDS concentrated epidemic, prisons are high risk areas for spreading HIV/AIDS. The aim of this paper was to study the trend of HIV/AIDS prevalence and related interventions administered in prisons of Iran during a 13 years period Methods This cross sectional study was conducted using the data collected from the sentinel sites in all prisons in the country and it also used the data about Harm Reduction interventions which has been implemented by Iran Prisons Organization. To evaluate the correlation between the prevalence and each of administered interventions in prisons the Correlation Coefficient Test was used for the second half of the mentioned time period Results The prevalence of HIV/AIDS in prisons had increased rapidly in the early stages of epidemic, so that in 2002 the prevalence raised to 3.83%. Followed by the expansion of Methadone Maintenance Therapy and development of Triangular Clinics, HIV/AIDS prevalence in prisons declined. There was a relationship between interventions and the prevalence of HIV/AIDS. Conclusion In regions and countries where the epidemic is highly prevalent among injecting drug users and prisoners, Methadone Maintenance Therapy and development of Triangular Clinics can be utilized to control HIV/AIDS epidemic quickly. PMID:26005657

  13. We care don't we? Social workers, the profession and HIV/AIDS.

    PubMed

    Hall, Nigel

    2007-01-01

    The HIV/AIDS epidemic has impacted all levels of society from the individual to the macro-economic. The continuing spread of infection around the world means that traditional methods of care and support are put under extreme pressure and many families lose their capacity to cope. Social workers are involved in providing care, counseling and support to those affected, and in developing programmes and other interventions to prevent the spread of the disease. Prevention and behaviour change are vital, but access to treatment is an ethical imperative, particularly in developing countries where the epidemic is most prevalent. Social work is a profession uniquely situated to demonstrate leadership in multi-sectoral collaboration in responding to this pandemic. Consequently this paper briefly reviews the scale and current nature of the epidemic and then considers how social workers can help build more compassionate policies at an international level. Social workers can help to create awareness of the negative effects of poverty, tackle gender inequity, help build more effective coalitions and partnerships, and work with other concerned groups and organisations to end stigma and discrimination. Using case examples the paper considers how social workers can help develop caring strategies that improve the lives of those living with HIV and AIDS.

  14. Lessons Learned From Early Implementation of Option B+: The Elizabeth Glaser Pediatric AIDS Foundation Experience in 11 African Countries

    PubMed Central

    Mattingly, Meghan; Giphart, Anja; van de Ven, Roland; Chouraya, Caspian; Walakira, Moses; Boon, Alexandre; Mikusova, Silvia; Simonds, R. J.

    2014-01-01

    Background: “Option B+” is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. Methods: This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Results: Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Discussion: Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation. PMID:25436817

  15. Lessons learned from early implementation of option B+: the Elizabeth Glaser Pediatric AIDS Foundation experience in 11 African countries.

    PubMed

    Kieffer, Mary Pat; Mattingly, Meghan; Giphart, Anja; van de Ven, Roland; Chouraya, Caspian; Walakira, Moses; Boon, Alexandre; Mikusova, Silvia; Simonds, R J

    2014-12-01

    "Option B+" is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation.

  16. AIDS-related discrimination in Asia.

    PubMed

    Paxton, S; Gonzales, G; Uppakaew, K; Abraham, K K; Okta, S; Green, C; Nair, K S; Merati, T Parwati; Thephthien, B; Marin, M; Quesada, A

    2005-05-01

    The Asia Pacific Network of People Living with HIV/AIDS (APN+) conducted the first regional documentation of AIDS-related discrimination in Asia. This project was an action-based, peer-implemented study that aimed to develop an understanding of the nature, pattern and extent of AIDS-related discrimination in several Asian countries. Trained HIV-positive people interviewed 764 positive people in four countries (India 302; Indonesia 42; Thailand 338; the Philippines 82) using a structured questionnaire. Findings indicate that the major area of discrimination in each country is within the health sector, where over half of those surveyed experienced some form of discrimination. In all countries, the majority of people did not receive pre-test counselling before being tested for HIV. People who reported coerced testing were significantly more likely than other respondents to face subsequent AIDS-related discrimination. A considerable number of respondents were refused treatment after being diagnosed with HIV and many experienced delayed provision of treatment or health services. Breaches of confidentiality by health workers were common. Within the family and the community, women were significantly more likely to experience discrimination than men, including ridicule and harassment, physical assault and being forced to change their place of residence because of their HIV status. These findings have serious implications, particularly in light of the increasing trend in many countries to test all pregnant women in order to prevent transmission of HIV to their unborn children.

  17. How Should Global Fund Use Value-for-Money Information to Sustain its Investments in Graduating Countries?

    PubMed

    Kanpirom, Kitti; Luz, Alia Cynthia G; Chalkidou, Kalipso; Teerawattananon, Yot

    2017-02-27

    It has been debated whether the Global Fund (GF), which is supporting the implementation of programs on the prevention and control of HIV/AIDS, tuberculosis (TB) and malaria, should consider the value-for-money (VFM) for programs/interventions that they are supporting. In this paper, we critically analyze the uses of economic information for GF programs, not only to ensure accountability to their donors but also to support country governments in continuing investment in cost-effective interventions initiated by the GF despite the discontinuation of financial support after graduation. We demonstrate that VFM is not a static property of interventions and may depend on program start-up cost, economies of scales, the improvement of effectiveness and efficiency of providers once the program develops, and acceptance and adherence of the target population. Interventions that are cost-ineffective in the beginning may become cost-effective in later stages. We consider recent GF commitments towards value for money and recommend that the GF supports interventions with proven cost-effectiveness from program initiation as well as interventions that may be cost-effective afterwards. Thus, the GF and country governments should establish mechanisms to monitor cost-effectiveness of interventions invested over time. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  18. Risky sexual behaviour and human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among healthcare workers.

    PubMed

    Khamisa, Natasha; Mokgobi, Maboe

    2018-01-01

    South Africa is known to have one of the highest prevalence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) globally, with one in seven healthcare workers being HIV-positive. An HIV-positive healthcare workforce is less equipped to respond to the increasing spread of the epidemic. Assessment of the factors contributing to high HIV prevalence rates among healthcare workers is important in planning the development of human resources. This review sought to identify and understand predominant risky sexual behaviours among healthcare workers in HIV and AIDS-affected countries. This study reviewed articles focusing on sexual behaviour among healthcare workers. Major health science databases (e.g. ProQuest, Cochrane, PubMed and CINAHL) were searched for combinations of keywords including 'healthcare workers', 'risky sexual behaviour' and 'HIV and AIDS'. Articles from a range of countries met inclusion and exclusion criteria. Findings of the study revealed three main contributing factors: unprotected sex, multiple sex partners and sexual violence. Sexual violence emerged as the dominant risk factor in the majority of the studies. Most research was conducted in developed countries where the HIV infection rate is much lower than it is in developing countries. More research needs to be conducted in developing countries and appropriate strategies should be implemented to reduce sexual violence among healthcare workers. Appropriate procedures on reporting sexual violence coupled with education on HIV and AIDS as well as influencing attitudes and belief systems could assist in reducing the spread of HIV and AIDS within the healthcare workforce while minimising the effect on patient care.

  19. [A problem-posing educational methodology for the prevention of HIV / AIDS].

    PubMed

    Magana, J R; Ferreira-pinto, J B; Blair, M; Mata A

    1992-01-01

    The problem-posing methodology of Brazilian educator Paulo Freire, using the reading circle approach previously deployed in successful literacy campaigns in developing countries, is introduced for application in AIDS information programs. The basis of this educational process is the dialogue where those to be educated resolve their problems by evaluating information critically, capturing concepts by codification and decodification, and transmitting information by creating relevant educational materials. Health circles are organized with women as educators to impart knowledge about AIDS and HIV: definitions, epidemiological components (sex, age, and risk behavior), means of transmission, stages of the progression of AIDS, prevention of HIV infection, and tests for detecting HIV antibodies. The dialogue explores knowledge and feelings about AIDS and how it affects life in the community reveals personal experiences and accounts of knowing someone who was HIV-positive, and develops action plans to minimize AIDS cases in the community. The Latin population of California, mainly of Mexican origin, with low levels of education, income, and acculturation and a high incidence of AIDS, is an appropriate target of such intervention. In 1980, there were 12.3 million people of Hispanic origin in the US. In August 1990, there were 143,280 persons diagnoses with AIDS according to the Centers for Disease Control. 78,878 of these (55%) were Anglos, and 21,752 (15%) were Hispanics. Among the Anglos, the incidence was 300/million inhabitants, while among Hispanics, it was 1059/million, a 3-field higher rate.

  20. 30 CFR 75.1713-6 - First-aid training program; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false First-aid training program; minimum... § 75.1713-6 First-aid training program; minimum requirements. (a) All first-aid training programs... course of instruction similar to that outlined in “First Aid, A Bureau of Mines Instruction Manual.” (b...

  1. Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium.

    PubMed

    Ousman, Kevin; Polomano, Rosemary C; Seloilwe, Esther; Odero, Theresa; Tarimo, Edith; Mashalla, Yohana J; Voss, Joachim G; O'Malley, Gabrielle; Chapman, Susan A; Gachuno, Onesmus; Manabe, Yukari; Nakanjako, Damalie; Sewankambo, Nelson; Urassa, David; Wasserheit, Judith N; Wiebe, Douglas J; Green, Wendy; Farquhar, Carey

    2016-01-01

    HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship in Global Health capitalizes on academic partnerships between African and U.S. universities to provide interprofessional leadership training through classroom, online, and service-oriented learning in 5 countries in Africa. This fellowship program prepares health professionals to design, implement, scale-up, evaluate, and lead health programs that are population-based and focused on prevention and control of HIV and other public health issues of greatest importance to African communities and health service settings. Afya Bora nurse fellows acquire leadership attributes and competencies that are continuously and systematically tested during the entire program. This multinational training platform promotes interprofessional networks and career opportunities for nurses. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  2. Overview of the University of Pittsburgh/amfAR Training Program in HIV Prevention Research for MSM and Male-to-Female Transgender Populations in Low- and Middle-Income Countries.

    PubMed

    Stall, Ron; Egan, James E; Kinsky, Suzanne; Coulter, Robert W S; Friedman, M Reuel; Matthews, Derrick D; Klindera, Kent; Cowing, Michael

    2016-12-01

    Gay men, other men who have sex with men and transgender (GMT) populations suffer a disproportionate burden of HIV disease around the globe, which is directly attributable to the virulently homophobic environments in which many GMT people live. In addition to the direct effects of homophobia on GMT individuals, the ongoing marginalization of GMT people has meant that there is limited social capital on which effective HIV prevention and care programs can be built in many low- and middle-income countries (LMIC). Thus, meaningful responses meant to address the dire situation of GMT populations in LMIC settings must include a combination of bold and innovative approaches if efforts to end the epidemic are to have any chance of making a real difference. The HIV Scholars Program at the University of Pittsburgh's Center for LGBT Health Research is a prime example of a creative and dynamic approach to raising the expertise needed within GMT populations to respond to the global HIV/AIDS pandemic.

  3. Understanding socio-economic impacts of geohazards aided by cyber-enabled systems

    NASA Astrophysics Data System (ADS)

    Klose, C. D.; Webersik, C.

    2008-12-01

    Due to an increase in the volume of geohazards worldwide, not only are impoverished regions in less developed countries such as Haiti, vulnerable to risk but also low income regions in industrialized countries, e.g. USA, as well. This has been exemplified once again by Hurricanes Gustav, Hanna and Ike and the impact on the Caribbean countries during the summer of 2008. To date, extensive research has been conducted to improve the monitoring of human-nature coupled systems. However, there is little emphasis on improving and developing methodologies to a) interpret multi-dimensional and complex data and b) validate prediction and modeling results. This presentation tries to motivate more research initiatives to address the aforementioned issues, bringing together two academic disciplines, earth and social sciences, to research the relationship between natural and socio-economic processes. Results are presented where cyber-enabled methods based on artificial intelligence are applied to different geohazards and regions in the world. They include 1) modeling of public health risks associated with volcanic gas hazards, 2) prediction and validation of potential areas of mining-triggered earthquakes, and 3) modeling of socio-economic risks associated with tropical storms in Haiti and the Dominican Republic.

  4. Effectiveness of a multicomponent school based intervention to reduce bullying among adolescents in Chandigarh, North India: A quasi-experimental study protocol.

    PubMed

    Rana, Monica; Gupta, Madhu; Malhi, Prahbhjot; Grover, Sandeep; Kaur, Manmeet

    2018-02-05

    Bullying perpetration and victimization is associated with significant academic, psychosocial and health related problems among adolescents. There is a need to develop effective interventions to prevent bullying among adolescents, especially in low and middle income countries. This paper presents the study protocol to develop, and evaluate the effect of multi-component school based prevention program for bullying in India. Quasi-experimental study. The study will be conducted among 846 students of grade 7 th and 8 th in the intervention and control schools in Chandigarh, Union Territory, North India. A government and a private school will be selected purposively in each of the intervention and control arm. The intervention is based on socio-ecological model, and will be administered at individual, relationship (parents and teachers) and school level. The primary study outcome will be the proportion of students experiencing any kind of bullying (bullying, victimization, or both), in each study arm. The effectiveness of the intervention will be measured by performing difference in difference analysis and generalized estimating equations. Bullying is an aggressive behaviour with significant morbidities, including psychological or physical trauma, affecting individuals not only in their adolescence, but also later in their adulthood. This quasi-experimental study is expected to provide evidence on whether multi-component bullying prevention intervention program, can reduce the burden of bullying perpetration and victimization among school adolescents in India. The results of the study will add in the exiting literature on bullying intervention program, especially, from the low middle-income countries, as there are limited studies available on this topic in these countries.

  5. Space shuttle post-entry and landing analysis. Volume 1: Candidate system evaluations

    NASA Technical Reports Server (NTRS)

    Crawford, B. S.; Duiven, E. M.

    1973-01-01

    The general purpose of this study is to aid in the evaluation and design of multi-sensor navigation schemes proposed for the orbiter. The scope of the effort is limited to the post-entry, energy management, and approach and landing mission phases. One candidate system based on conventional navigation aids is illustrated including two DME (Distance Measuring Equipment) stations and ILS (Instrument Landing System) glide slope and localizer antennas. Some key elements of the system not shown are the onboard IMUs (Inertial Measurement Units), altimeters, and a computer. The latter is programmed to mix together (filter) the IMU data and the externally-derived data. A completely automatic, all-weather landing capability is required. Since no air-breathing engines will be carried on orbital flights, there will be no chance to go around and try again following a missed approach.

  6. Modeling the Impact of Uganda's Safe Male Circumcision Program: Implications for Age and Regional Targeting.

    PubMed

    Kripke, Katharine; Vazzano, Andrea; Kirungi, William; Musinguzi, Joshua; Opio, Alex; Ssempebwa, Rhobbinah; Nakawunde, Susan; Kyobutungi, Sheila; Akao, Juliet N; Magala, Fred; Mwidu, George; Castor, Delivette; Njeuhmeli, Emmanuel

    2016-01-01

    Uganda aims to provide safe male circumcision (SMC) to 80% of men ages 15-49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program's progress, and to refine the implementation approach. The Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0), was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM) to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20-34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10-19 will offer the greatest impact over a 15-year period, while focusing on men ages 15-34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed. Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda's SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10-34 as a priority group for SMC in the 2014 application to the Global Fund's new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence.

  7. Guarding against emerging epidemics: addressing HIV and AIDS among culturally and linguistically diverse communities in NSW.

    PubMed

    McMahon, Tadgh; Moreton, Renee J; Luisi, Barbara N

    2010-01-01

    In Australia, people from culturally and linguistically diverse backgrounds, largely born in low- and middle-income countries, accounted for 24% of HIV notifications in the period 2004-2008. NSW has one of the most culturally diverse communities in Australia and is also the most popular destination for both permanent and temporary migrants. Consequently people from culturally and linguistically diverse backgrounds have recently been recognised as a priority in the NSW HIV/AIDS Strategy. The National Health and Medical Research Council provides a cultural competency framework for re-orienting public health and health promotion programs to better meet the needs of these communities. It is being applied to re-orientate the HIV response in NSW. Examples of how this framework can be implemented are provided.

  8. Thailand condom campaign reduced AIDS infections by fifty percent.

    PubMed

    1996-08-12

    AIDS was first reported in Thailand in 1988 and quickly spread among the country's prostitutes, their clients, and their clients' wives until 750,000 Thais were infected by 1993. In 1990, the Thai government began to provide condoms to brothels and to educate men about the dangers of unprotected sex. As a result of this program, the number of military conscripts in the six northern provinces who were infected dropped from 13% in 1991 to 7% in 1995. Condom use with prostitutes has increased to 93%, and fewer men are visiting prostitutes. The key to this unprecedented success is the support of the Thai government and its acknowledgement that commercial sex could not be eradicated and, therefore, that the industry had to be involved in control efforts in a nonjudgmental way.

  9. A Comprehensive Response: The Role of Nonstate Actors in the Global Plan.

    PubMed

    Vitillo, Robert J; Merico, Francesca; Levine, Anna S; Buonocore, Taylor

    2017-05-01

    Nonstate actors-especially faith-based organizations, other nongovernmental organizations, groups of people living with HIV and AIDS, and private sector organizations-have been deeply committed to supporting governments reach the goals of the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan). This article highlights the role and contributions of select faith-based organizations and some private sector and philanthropic partners, as well as the work of other organizations. The success and impact of the Global Plan was in no small part a result of large-scale country-led collaboration in the provision of health care and implementation of programs. As the world grapples with meeting the ambitious United Nations Joint Programme on AIDS targets to end the AIDS epidemic by 2030-at a time when it also faces many other emerging health crises-the lessons learned from the Global Plan in harnessing the strengths of nonstate partners are the ones that should be replicated, enhanced, and taken to scale.

  10. [Healthcare: a growing role in international politics].

    PubMed

    Dixneuf, M; Rey, J L

    2004-01-01

    Since the end of the cold war the tone of international relations has clearly changed. Whereas relations were once defined strictly in terms of more or less armed confrontation, economic and social issues now play a growing role. Healthcare policies in Africa have long been influenced by the policies of countries sponsoring bilateral and even multilateral foreign aid programs. However the last ten years have witnessed an increasing interaction between international policy and healthcare policy. The two main reasons for this trend involve 1) access to drug treatment and the WTO and 2) the extension and impact of the AIDS epidemic. The problem of access to drug treatment for poor populations (fundamental right) has led to the emergence of an increasingly strong and effective civil society. Because of its social and economic effects as well as its geopolitical and security implications, AIDS has become a major factor in international relations. With regard to both these issues the place and role of the USA is demonstrative of the interaction between healthcare and international relations.

  11. Country watch: Zimbabwe.

    PubMed

    Laver, S

    1999-01-01

    Tsungirirai is a counseling and information service developed during 1994 in response to the growing problem of HIV/AIDS in the small town of Norton, southwest of Harare, Zimbabwe. The objectives of the project include identification of key leaders in the area, determination of the setting in which HIV was spreading, and community consultation in program design and implementation. Tsungirirai's initial activities included a series of workshops on participatory techniques particularly the LADA (Listening-Appraisal-Dialogue-Action) method for key leaders, community men, women, and adolescents. Workshop participants demonstrated different views concerning HIV/AIDS problems. Key leaders viewed the HIV/AIDS problem within the context of existing laws that contradict traditional mores, while the youth linked the problem of HIV to the issue of unemployment and lack of recreation. Lessons learned include the following: 1) stop talking and listen; 2) start where people are at instead of telling them what they already know; 3) let the people decide; 4) turn a dream into reality; and 5) facilitate awareness process instead of leading it.

  12. 75 FR 49432 - Impact Aid Programs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... CONTACT. Background The Impact Aid Discretionary Construction Program is authorized under section 8007(b... 2004, when the most recent Impact Aid Discretionary Construction Program regulations were issued, the... Federal Domestic Assistance Number 84.041 Impact Aid Discretionary Construction Program) List of Subjects...

  13. Lay First Responder Training in Eastern Uganda: Leveraging Transportation Infrastructure to Build an Effective Prehospital Emergency Care Training Program.

    PubMed

    Delaney, Peter G; Bamuleke, Richard; Lee, Yang Jae

    2018-01-18

    Though road traffic injuries (RTIs) are a major cause of mortality in East Africa, few countries have emergency medical services. The aim was to create a sustainable and efficient prehospital lay first responder program, creating a system with lay first responders spread through the 53 motorcycle taxi stages of Iganga Municipality. One hundred and fifty-four motorcycle taxi riders were taught a first aid curriculum in partnership with a local Red Cross first aid trainer and provided with a first aid kit following WHO guidelines for basic first aid. Pre- and post-survey tests measured first aid knowledge improvement over the course. Post-implementation incident report forms were collected from lay first responders after each patient encounter over 6 months. Follow-up interviews were conducted with 110 of 154 trainees, 9 months post-training. Improvement was measured across all five major first aid categories: bleeding control (56.9 vs. 79.7%), scene management (37.6 vs. 59.5%), airway and breathing (43.4 vs. 51.6%), recovery position (13.1 vs. 43.4%), and victim transport (88.2 vs. 94.3%). From the incident report findings, first responders treated 250 victims (82.8% RTI related) and encountered 24 deaths (9.6% of victims). Of the first aid skills, bleeding control and bandaging was used most often (55.2% of encounters). Lay first responders provided transport in 48.3% of encounters. Of 110 lay first responders surveyed, 70 of 76 who had used at least one skill felt "confident" in the care they provided. A prehospital care system composed of lay first responders can be developed leveraging existing transport organizations, offering a scalable alternative for LMICs, demonstrating usefulness in practice and measurable educational improvements in trauma skills for non-clinical lay responders.

  14. Microenterprise in health care and health education.

    PubMed Central

    Edler, A. A.

    1998-01-01

    Over the last decade, development aid has increasingly used a more collaborative model, with donors and recipients both contributing ideas, methods and goals. Though many examples of collateral aid projects exist in agriculture, business administration and banking, few have found their way into health care and health education, a typically donor-dominated model. The following case report describes a collateral project in health care education. This case report analyzes data-inducing project proposals, personal interviews and project reports obtained through standard archival research methods. The setting for this joint project was the collaboration between international nongovernmental (NGO) aid foundations and the faculty of a major sub-Saharan African Medical School's Department of Anesthesia. The initial goal of this project was to improve record keeping for all anesthetic records, both in the operating theatres and outside. Analysis of the data was performed using ethnographic methods of constant comparative analysis. The purpose of the analysis was to critically evaluate both the goals and their results in the Department of Anesthesiology. The findings of this analysis suggested that results included not only quality assurance and improvement programs in the department but also advances in the use of critical incidents as teaching tools, hospital-wide drug and equipment utilization information and the initiation of an outreach program to district hospitals throughout the country for similar projects. PMID:10604789

  15. Risk analysis. HIV / AIDS country profile: Senegal.

    PubMed

    1996-12-01

    Since the first acquired immunodeficiency syndrome (AIDS) case was confirmed in 1986, Senegal has conducted an aggressive prevention campaign. Senegal's National AIDS Committee has noted the contributions of poverty and migration to the spread of AIDS. By June 1994, 1297 AIDS cases had been reported and an estimated 500,000 people (1.4% of the population) were infected with human immunodeficiency virus (HIV)-1 and 2. The highest rate of HIV infection (14%) exists among commercial sex workers. At present, HIV/AIDS cases are concentrated in Dakar, Kaolack, the Matam region, and Ziguinchor; however, the growing importance of inter-regional trading is expected to spread HIV to the smaller towns and rural areas. Also salient is the recent devaluation by 50% of the CFA franc, which has reduced the public sector workforce and led many poor urban residents into commercial sex work. CFA devaluation has made Senegal attractive to tourists and business visitors--another factor responsible for growth of the legalized commercial sex industry. Although sex workers are instructed in condom use and tested annually for HIV, only 850 of the 2000 registered sex workers have reported for check-ups, and the majority of prostitutes are unregistered. Senegal's AIDS Plan for 1994-98 focuses on care of AIDS patients, pressures placed on family structures by HIV, and AIDS-related erosions in the status of women. Each health service region has its own local plan for AIDS/HIV and sexually transmitted diseases, supervised by a regional committee. Public education has involved outreach to religious leaders, promotion of affordable condoms, and distribution of over 75,000 leaflets to key target populations. About US $16 million of the $25,688,875-budget HIV/AIDS program for 1994-98 was pledged by external donors.

  16. [Molecular epidemiological study on HIV/AIDS under the follow-up program in Zhejiang province in 2009].

    PubMed

    Zhang, Jia-feng; Pan, Xiao-hong; Ding, Xiao-bei; Chen, Lin; Guo, Zhi-hong; Xu, Yun; Huang, Jing-jing

    2013-01-01

    To analyze the molecular epidemiological characteristics on HIV infectors/AIDS patients (HIV/AIDS) under a follow-up program in Zhejiang province in 2009. 303 cases were randomly sampled. Information on the cases was collected and followed by genomic DNA extraction. Gag gene fragments were amplified by nested PCR, followed by sequencing and bio-informatic analysis. The rate of success for sequence acquisition was 74.3% (225/303). Distributions of HIV subtypes were as follows: CRF01_AE (58.7%), CRF07_BC (13.8%), CRF08_BC (9.8%), B' (15.1%), C (1.8%), G (0.4%) and unassigned BC (unique recombinant form 0.4%). from the HIV BLAST analysis showed that the sources of strains with the highest homology involved in 10 provinces/municipalities (Liaoning, Guangxi, Yunnan, Henan, etc.) and five other countries (Thailand, Vietnam, India, South Africa and Libya). The CRF01_AE phylogenetic tree was divided into four clusters. The sequences of HIV/AIDS with homosexual transmission showed a gather in cluster 1, and mix with those infected through heterosexual contact. Circulating recombinant forms of HIV seemed to play a dominant role in Zhejiang province. Unique recombinant form and new subtype of HIV were found. People living with HIV under homosexual transmission and heterosexual transmission had a trend of interwoven with each other. Increase of both the diversity and complexity of HIV strains were also noticed in Zhejiang province.

  17. Innovative financing for HIV response in sub-Saharan Africa.

    PubMed

    Atun, Rifat; Silva, Sachin; Ncube, Mthuli; Vassall, Anna

    2016-06-01

    In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub-Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long-term fiscal obligations for countries affected by HIV/AIDS. As donor assistance for health remains constrained, novel financing mechanisms are needed to augment funding domestic sources. We explore how Innovative Financing has been used to co-finance domestic HIV/AIDS responses. Based on analysis of non-health sectors, we identify innovative financing instruments that could be used in the HIV response. We undertook a systematic review to identify innovative financing instruments used for (1) domestic HIV/AIDS financing in sub-Saharan Africa (2) international health financing and (3) financing in non-health sectors. We analyzed peer-reviewed and grey literature published between 2002 and 2014. We examined the nature and volume of funds mobilized with innovative financing, then in consultation with leading experts, identified instruments that held potential for financing the HIV response. Our analysis revealed three innovative financing instruments in use: Zimbabwe's AIDS Trust Fund (a tax/levy-based instrument), Botswana's National HIV/AIDS Prevention Support (BNAPS) International Bank for Reconstruction and Development (IBRD) Buy-Down (a debt conversion instrument), and Côte d'Ivoire's Debt2Health Debt Swap Agreement (a debt conversion instrument). Zimbabwe's AIDS Trust Fund generated US$ 52.7 million between 2008 and 2011, Botswana's IBRD Buy-Down generated US$ 20 million, and Côte d'Ivoire's Debt2Health Debt Swap Agreement generated US$ 27 million, at least half of which was to be invested in HIV/AIDS programs. Four additional categories of innovative financing instruments met our criteria for future use: (1) remittances and diaspora bonds (2) social and development impact bonds (3) sovereign wealth funds (4) risk and credit guarantees. A limited number of innovative financing instruments contributed a very modest share of funding toward domestic HIV/AIDS programs. Several innovative financing instruments successfully applied in other sectors could be used to augment domestic financing toward HIV/AIDS programmes.

  18. Innovative financing for HIV response in sub–Saharan Africa

    PubMed Central

    Atun, Rifat; Silva, Sachin; Ncube, Mthuli; Vassall, Anna

    2016-01-01

    Background In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub–Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long–term fiscal obligations for countries affected by HIV/AIDS. As donor assistance for health remains constrained, novel financing mechanisms are needed to augment funding domestic sources. We explore how Innovative Financing has been used to co–finance domestic HIV/AIDS responses. Based on analysis of non–health sectors, we identify innovative financing instruments that could be used in the HIV response. Methods We undertook a systematic review to identify innovative financing instruments used for (1) domestic HIV/AIDS financing in sub–Saharan Africa (2) international health financing and (3) financing in non–health sectors. We analyzed peer–reviewed and grey literature published between 2002 and 2014. We examined the nature and volume of funds mobilized with innovative financing, then in consultation with leading experts, identified instruments that held potential for financing the HIV response. Results Our analysis revealed three innovative financing instruments in use: Zimbabwe’s AIDS Trust Fund (a tax/levy–based instrument), Botswana’s National HIV/AIDS Prevention Support (BNAPS) International Bank for Reconstruction and Development (IBRD) Buy–Down (a debt conversion instrument), and Côte d'Ivoire's Debt2Health Debt Swap Agreement (a debt conversion instrument). Zimbabwe’s AIDS Trust Fund generated US$ 52.7 million between 2008 and 2011, Botswana’s IBRD Buy–Down generated US$ 20 million, and Côte d’Ivoire’s Debt2Health Debt Swap Agreement generated US$ 27 million, at least half of which was to be invested in HIV/AIDS programs. Four additional categories of innovative financing instruments met our criteria for future use: (1) remittances and diaspora bonds (2) social and development impact bonds (3) sovereign wealth funds (4) risk and credit guarantees. Conclusion A limited number of innovative financing instruments contributed a very modest share of funding toward domestic HIV/AIDS programs. Several innovative financing instruments successfully applied in other sectors could be used to augment domestic financing toward HIV/AIDS programmes. PMID:27231543

  19. 2015 RAD-AID Conference on International Radiology for Developing Countries: The Evolving Global Radiology Landscape.

    PubMed

    Kesselman, Andrew; Soroosh, Garshasb; Mollura, Daniel J

    2016-09-01

    Radiology in low- and middle-income (developing) countries continues to make progress. Research and international outreach projects presented at the 2015 annual RAD-AID conference emphasize important global themes, including (1) recent slowing of emerging market growth that threatens to constrain the advance of radiology, (2) increasing global noncommunicable diseases (such as cancer and cardiovascular disease) needing radiology for detection and management, (3) strategic prioritization for pediatric radiology in global public health initiatives, (4) continuous expansion of global health curricula at radiology residencies and the RAD-AID Chapter Network's participating institutions, and (5) technologic innovation for recently accelerated implementation of PACS in low-resource countries. Published by Elsevier Inc.

  20. Energy, affluence, and poverty. [United Arab Emirates

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Al-Otaiba, M.S.

    The United Arab Emirates realizes that its newly found wealth imposes upon it certain humanistic obligations towards the less-fortunate nations. Accordingly, it allocated 30 percent of its 1975 national income or $1.24 billion for aid to the developing countries. Two points discussed for bridging the gap between the rich and the poor countries involve two commitments: (1) developed or developing, wealthy countries should allocate a reasonable percentage of their GNP to aid poor nations; and (2) the industrial countries, in addition, must provide the technical expertise necessary for the construction of such projects as are appropriate to the particular conditionsmore » in each underdeveloped country. (MCW)« less

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