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  1. 1
    Peer Reviewed

    How can we calculate the "E" in "CEA"?

    Bollinger LA

    AIDS. 2008 Jul; 22 Suppl 1:S51-7.

    Because full funding for HIV/AIDS prevention interventions is unlikely to occur in the near future, it is essential that the resources available are spent in the most effective way possible. This paper presents a matrix of effectiveness coefficients for HIV/AIDS-related prevention interventions that can be used as an integral part of the coordinated strategic planning process currently underway by the World Bank and UNAIDS, as the interventions in the matrix are harmonized with the interventions in that process. Coefficients for four types of sexual behavior change (condom use, partner reduction, sexually transmitted infection treatment-seeking behavior, age at first sex) across three different risk groups (high, medium, low) are presented, along with their interquartile ranges. Results indicate that: (1) impacts seem greater when an intervention includes interpersonal contact, rather than targeting a more general audience; (2) although significant impacts are observed in the columns measuring changing condom use, other impacts are lower, and sometimes are actually (measured) zero; and (3) additional studies have evaluations of the number of sexual partners and have found a greater impact than previous studies. Although progress has been made in increasing the number of evaluation studies that can be utilized in this impact matrix, particularly in the area of youth interventions, there are still empty cells in which no studies report impacts. Finally, it is important to note that issues such as quality differences and synergies between programmes could have an effect on the impacts calculated for a particular strategic plan.
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  2. 2

    Research on sexual behaviour that transmits HIV: the GPA / WHO collaborative surveys -- preliminary findings.

    Carael M; Cleland J; Deheneffe JC; Adeokun L

    In: Sexual behaviour and networking: anthropological and socio-cultural studies on the transmission of HIV, edited by Tim Dyson. Liege, Belgium, Editions Derouaux-Ordina, [1992]. 65-87.

    6 national surveys were conducted over the period 1988-90 in the Central African Republic, Cote d'Ivoire, Lesotho, Togo, Kenya, and Rwanda in collaboration with the WHO Global Program on AIDS. The surveys include questions on sexual behavior; preliminary findings are reported in this paper. The authors point out the limitations of the survey approach and acknowledge the need for complementary anthropological research. At the aggregate level, however, the researchers found a higher degree of sexual activity in urban compared with rural areas; younger age cohorts may be having more premarital and extramarital sex than did older cohorts during the same stage of their lives; and that the rate of casual sex is higher for men, with the incidence positively related to urban residence and educational level. The surveys also suggest that in some societies a large number of men have casual/commercial sex with a relatively small group of women, while small groups of older men in other societies have sex with larger groups of younger women. These differences may be associated with the decline of polygyny in much of East and southern Africa compared with its relative persistence in West Africa.
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  3. 3

    Some health-related aspects of fertility.

    World Health Organization [WHO]

    [Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 22 p. (IESA/P/ICP. 1984/EG.I/8)

    The World Health Organization (WHO) has been studying several national surveys with regard to certain health related aspects of fertility. The primary purpose of these studies was to stimulate the use of data by the national health authorities for an improved care system for maternal and child health, including family planning. Some preliminary results are reported in this discussion, in particular those relating to contraception, the reproductive health of adolescents, infertility and subfecundity, and breastfeeding. The national surveys concerned are those of Bangladesh, Indonesia, the Republic of Korea, the Philippines, and Sri Lanka. The methods of analysis were simple and traditional, except for 2 points: some of the data had to be obtained by additional tabulation of the raw data tapes and/or the recode tapes since the standard tabulations of the First Country Reports did not include the needed information; and Correspondence Analysis was used in an effort to stimulate and facilitate the use of the findings for improvements of national health programs. Methods of contraception vary widely, from 1 country to another and by age, parity, and socioeconomic grouping. The younger women tend to choose more effective modern methods, such as oral contraception (OC); the older women, i.e., those over age 35, tend to seek sterilization, if available. It is evident that the historical development of family planning methods has greatly influenced the current "mix" of methods and so has the current supply situation and the capacity of the health care system (particularly in regard to IUD insertions and sterilizations. Use of contraception among adolescents to postpone the 1st birth was practically unknown. The risk of complications at pregnancy and childbirth, including maternal and infant death, is known to be particularly high for young mothers, and the results clearly showed that the infant mortality rate is highest for the youngest mothers. All the women who suffer from infertility do not recognize their condition, but the limited data still point to the need to consider the health needs of women who suffer from unwanted fecundity impairments. This may require medical intervention to cure infections or the offer of relevant sexual counseling. Some infecundity may require the improvement of nutritional and personal hygienic levels before meaningful achievements are made. The prevalence of breastfeeding has declined in some population groups, and the consequences can be expected to be deleterious and to involve serious increases in specific morbidity and mortality.
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