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Advocating the new WHO antenatal care model in a free maternity care setting in a developing country.
Tropical Doctor. 2008 Jan; 38(1):24-27.In a free maternity care setting the number of antenatal clients can be overwhelming for the obstetric staff. Using the World Health Organization (WHO) classifying form, most of the women can be triaged for the basic component of the new WHO antenatal care model. Our aim was to evaluate the risk status of pregnant women in a tertiary health institution providing free maternity care in Nigeria. We interviewed 1022 randomly selected clients using the WHO classifying form at our booking clinic over a 12-month period. The analysis was performed using the epi info statistical program. Seven hundred and sixty-five clients (74.9%) were found eligible for the basic component of the new antenatal care model. The associated risk in pregnancy increased with increasing parity. The basic component of the new WHO antenatal care model can safely be implemented in centres such as ours. (author's)
Geneva, Switzerland, World Health Organization [WHO], 2006. 93 p. (WHO/HTM/STB/2006.37)A significant scaling up of advocacy, communication and social mobilization (ACSM) will be needed to achieve the global targets for tuberculosis control as detailed in the Global Plan to Stop TB 2006--2015. In 2005, the ACSM Working Group (ACSM WG) was established as the seventh working group of the Stop TB Partnership to mobilize political, social and financial resources; to sustain and expand the global movement to eliminate TB; and to foster the development of more effective ACSM programming at country level in support of TB control. It succeeded an earlier Partnership Task Force on Advocacy and Communications. This work-plan focuses on those areas where ACSM has most to offer and where ACSM strategies can be most effectively concentrated to help address four key challenges to TB control at country level: Improving case detection and treatment adherence; Combating stigma and discrimination; Empowering people affected by TB; Mobilizing political commitment and resources for TB. (excerpt)
Valiadation of a new clinical case definition for paediatric HIV infection, Bloemfontein, South Africa [letter]
Journal of Tropical Pediatrics. 2005 Dec; 51(6):387.In 2003 a study was published, evaluating the WHO clinical case definition for paediatric HIV infection in Bloemfontein, South Africa. It was found that the WHO case definition could only detect 14.5 per cent of children who were in fact symptomatic and HIV positive on age-appropriate serology testing. Following logistic regression analysis, a new case definition was proposed, namely that HIV is suspected in a child who has at least two of the following four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. This new case definition had a sensitivity of 63.2 per cent and a specificity of 96.0 per cent. (excerpt)
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2002 Jun.  p. (UNAIDS Best Practice Collection; UNAIDS Case Study; UNAIDS/02.36E; PN-ACP-803)South Africa has begun to explore how best to involve people living with HIV/AIDS (PLWHA) in workplace responses to the HIV/AIDS epidemic. A pilot programme, the GIPA Workplace Model, has been developed over the past four years with the support of the United Nations Development Programme (UNDP) and the World Health Organization (WHO). Its aim was to place trained fieldworkers, living openly with HIV/AIDS, in selected partner organizations in different sectors so that they could set up, review or enrich workplace policies and programmes. For partner organizations, the GIPA Workplace Model has added value by: adding credibility to its HIV/AIDS programmes by giving a face to HIV and personalizing it; creating a supportive environment for people living with HIV/AIDS (PLWHA) and others to speak about HIV/AIDS and issues related to it. (excerpt)
The effect of structural characteristics on family planning program performance in Cote d'Ivoire and Nigeria. [Effet des caractéristiques structurelles sur les performances du programme de planning familial en Côte d'Ivoire et au Nigeria]
Social Science and Medicine. 2003 May; 56(10):2123-2137.This paper uses Côte d’Ivoire and Nigeria survey data on both supply and demand characteristics to examine how structural and demographic factors influence family planning provision and cost. The model, which takes into account the endogenous influence of service provision on average cost, explains provision well but poorly explains what influences service cost. We show that both size and specialization matter. In both countries, vertical (exclusive family planning) facilities provide significantly more contraception than integrated medical establishments. In the Nigeria sample, larger facilities also offer services at lower average cost. Since vertical facilities tend to be large, they at most incur no higher unit costs than integrated facilities. These results are consistent across most model specifications, and are robust to corrections for endogenous facility placement in Nigeria. Model results and cost recovery information point to the relative efficiency of the International Planned Parenthood Federation, which operates large, mostly vertically organized facilities. (author's)
WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1994; 47(3-4):98-100.Health futures is defined as a set of tools that can help explore probable, plausible, possible, and preferable futures for guiding actions whereby potential health threats could be anticipated. The World Health Organization (WHO) is promoting national futures studies for health planning and development as confirmed at the World Health Assembly in 1990. WHO began scanning the field of health futures and learning about the methods used for trend assessment and forecasting. An international consultation on health futures was convened in July 1993 and attended by 38 experts. The consultation proposed follow-up activities sharing studies and methods through international publications; establishing electronic communication to this end; developing a handbook on health futures; and cataloguing experts, institutions, and training opportunities in health futures. A variety of people presented a wide range of studies on the purposes of health futures studies, methodologies, and funding; there were 5 scenarios for health care in the United States (continued growth/high technology, hard times/governmental leadership, buyer's market, a new civilization, healing and health care). The consultation focused on 6 themes, including assessing health technology. An extensive study undertaken in the Netherlands between 1985 and 1988 identified emerging health technology: neurosciences, the use of lasers in treating ischemic heart disease, biotechnology, new vaccines, genetic testing, computer-assisted medical imaging, and home care technologies. Health resources projection was also described for China using simulation models for 3 estimates of demand for hospital beds and doctors between 1990 and 2010. Also presented was Statistics Canada's new population-health model (POHEM), which is based on an individual life-cycle theory of health. A well-institutionalized modeling system by the US Bureau of Health Professions was introduced, showing the physician-supply model for forecasting purposes in the debate over health care reform. Artificial neural networking was introduced for predicting hospital length-of-stay.
In: Child health priorities for the 1990s. Report of a seminar held June 20-22, 1991 at the Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland, edited by Kenneth Hill. Baltimore, Maryland, Johns Hopkins University, School of Hygiene and Public Health, Institute for International Programs, 1992 Oct. 309-32.An analytical model of cost-effectiveness of child survival interventions is introduced which incorporates changes in intervention costs and varying degrees of efficacy. Linear programming is used to develop estimates of the cost-effectiveness of several child mortality goals for the year 2000 set during a conference in 1988 in Talloires, France. Data for calculations were derived from the World Bank data base for the less developed countries. The attainment of the Talloires goals requires a reduction in annual mortality of 5.26 million deaths. In contrast, there are about 125 million children born in developing countries each year, of which about 14 million die, equivalent to a probability of death of about .112, or a mortality rate of 112/1000. There are significant nonlinear interactions that cannot be captured in this model. Another model, the rising cost model sets the goal at the maximum reduction in mortality from any cause. On the other hand, the rising cost, declining productivity model examines the varying effectiveness of interventions. The final model was calculated for a reasonable range of spending levels. Decreases in mortality become more and more difficult as spending and the number of interventions increase, and the marginal cost of saving another life rises substantially. When the classification of deaths into specific categories is removed, in this simulation it would cost about $1.7 billion/year to reduce total child deaths from 14.6 million to 9.4 million, somewhat higher than the results of the model with constant effectiveness. Over 83% of all spending would be in expanded programs of immunization, general medical consultations, antenatal nutrition supplements, family planning, and general antenatal and delivery care. The average cost for a fully immunized child at higher levels of coverage is estimated at about $28.
JOURNAL OF DEVELOPMENT STUDIES. 1992 Jan; 28(2):163-240.In the postwar period, foreign aid increased 4.1% a year to reach US $70 billion by 1988, and a total of US $1.4 trillion has been doled out in 3 decades with questionable results. A World Bank review of 246 projects indicated that 85% were rated acceptable with a 14.6% economic return. The topics addressed are the macroeconomic impact of aid (47 countries with more than 5% of gross domestic product from aid in 1988 and over 10% in half of them, the so-called Dutch diseases); dual gap model based on Harrod-Domar growth models (higher growth through relief of savings or foreign exchange constraint) of Rosenstein-Rodan and Chenery-Strout (the actual aid of $192 billion required for growth during 1976-88 far exceeded the original estimate) and its criticism; the savings debate (Griffin's presentation of the negative impact of aid on savings, positive impact on savings, budget constraint with aid tying, aid-savings models): the recipient fiscal response to aid inflows (the Heller-Mosley model of aid impact and government response to aid): and empirical tests of the aid-growth relationship (single equation estimation, capital output, investment, imports and the private sector). The trade theory approach to the impact of aid (Joshi and Findlay's critique of the dual gap model, dependent economy model, real exchange rate impact); counter part funds and the monetary sector; aid and income distribution; the micro-macro paradox; and suggestions for further research.
[Unpublished] 1972 Sep 20. 43 p. (COM/72/CONF.32-A/6)This paper offers some guidelines for family planning administration, communications staff, donor agency advisers, and researchers on developing a model communication research project. The target for a family planning communication project includes government and political elite, family planning administrators, the medical profession and family planning clinic staff, fuctionaries and opinion leaders, and the general public by means of mass media, full and part time family planning workers, medical personnel providing contraceptive services, and functionaries. A model for communication research should have comprehensive and extensive family planning services. This report of the Meeting of Experts on Research in Family Planning Communication covers the problems in population and family planning communication, goals and design for a model communication research project(administration, organization, and targets and the development of contraceptive services); priorities in a comprehensive model (elite education, mass communications, the use of field workers, functionaries and mobile units, and developing training and text materials for institutions with public contact); the communication research methodology; local, national, regional, and international suggestions; and some budgetary considerations. Assessing priorities in a comprehensive model is difficult. Initially, developing a contraceptive service is more important than a communication program. Priority should be given in the following order: elite education; mass media; field workers; mobile unit and functionaries; and developing training and text materials for institutions with public contact. Each country wanting to participate in such a model project should conduct some feasibility studies and fact finding in an area with about 2 million people. Once the project location has been chosen and a fact finding survey has identified the medical personnel, media structure, functionary infrastructure, and research capabilities, then a project director should be selected, one with administrative experience in developing communication programs. He/she would choose 3 deputies: one for developing contraceptive services; one for the overall communications program; and one for research and evaluation. The communication director must find out what to say, to whom, through what channels, when, and how often. The strategy should consider the audiences to be reached, the cost effectiveness of the media, and the media infrastructure.
Genus. 1976; 32(1-2):45-70.Add to my documents.
In: International Committee on the Management of Population Programmes (ICOMP). 1975 Annual Conference Report: expanding role of the population manager, Mexico City, July 14-17, 1975. (Mahati, Philippines, 1976). p. 102-108A case report of the development of family planning services in Costaguay, Latin America, is presented as a basis for class discussion under the auspices of the case development program of the International Committee for the Management of Population Programmes. The official population agency of Costaguay is NPAC which was legalized by an executive decree in February 1968 as an interinstitutional body with representatives of several cabinet ministries and an ex-officio representative from the Costaguayan Family Welfare Association. In 1972 a technical mission from the U.N. visited Costaguay to make recommendations in the field of population. The 4 operating components of the U.N. Assistance Project were: 1) clinic services, 2) information and education, 3) training, and 4) research and evaluation. In May 1974 there were about 80 family planning clinics in Costaguay, serving 30,000 users. There were 5 categories of facilities: 1) hospitals, 2) provincial health centers with afternoon shifts, 3) provincial health centers with integrated services, 4) municipal subcenters, and 5) rural clinics. A new information system was being used by May 1974 which utilized a ''daily report'' for use with a mechanical tabulator or computer.