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Management of childhood diarrhea by healthcare professionals in low income countries: An integrative review.
International Journal of Nursing Studies. 2017 Jan; 66:82-92.Background The significant drop in child mortality due to diarrhea has been primarily attributed to the use of oral rehydration solutions, continuous feeding and zinc supplementation. Nevertheless uptake of these interventions have been slow in developing countries and many children suffering from diarrhea are not receiving adequate care according to the World Health Organization recommended guidelines for the clinical management of childhood diarrhea. Objectives The aim of this integrative review is to appraise healthcare professionals’ management of childhood diarrhea in low-income countries. Design Whittemore and Knafl integrative review method was used, in conjunction with the Reporting of Observational Studies in Epidemiology (STROBE) checklist for reporting observational cohort, case control and cross sectional studies. Method A comprehensive search performed from December 2014 to April 2015 used five databases and focused on observational studies of healthcare professional's management of childhood diarrhea in low-income countries. Results A total of 21 studies were included in the review. Eight studies used a survey design while three used some type of simulated client survey referring to a fictitious case of a child with diarrhea. Retrospective chart reviews were used in one study. Only one study used direct observation of the healthcare professionals during practice and the remaining eight used a combination of research designs. Studies were completed in South East Asia (n = 13), Sub-Saharan Africa (n = 6) and South America (n = 2). Conclusion Studies report that healthcare providers have adequate knowledge of the etiology of diarrhea and the severe signs of dehydration associated with diarrhea. More importantly, regardless of geographical settings and year of study publication, inconsistencies were noted in healthcare professionals’ physical examination, prescription of oral rehydration solutions, antibiotics and other medications as well as education provided to the primary caregivers. Factors other than knowledge about diarrhea were shown to significantly influence prescriptive behaviors of healthcare professionals. This review demonstrates that “knowledge is not enough” to ensure the appropriate use of oral rehydration solutions, zinc and antibiotics by healthcare professionals in the management of childhood diarrhea.
Geneva, Switzerland, WHO, 2016.  p.Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. These guidelines provide updated treatment recommendations for common infections caused by C. trachomatis based on the most recent evidence; they form one of several modules of guidelines for specific STIs. It is strongly recommended that countries take updated global guidance into account as they establish standardized national protocols, adapting this guidance to the local epidemiological situation and antimicrobial susceptibility data. The objectives of these guidelines are: to provide evidence-based guidance on treatment of infection with C. trachomatis; and to support countries to update their national guidelines for treatment of chlamydial infection.
Geneva, Switzerland, WHO, 2016.  p.Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. These guidelines provide updated treatment recommendations for treatment of Treponema pallidum (syphilis) based on the most recent evidence. They form one of several modules of guidelines for specific STIs. It is strongly recommended that countries take updated global guidance into account as they establish standardized national protocols and adapt it to the local epidemiological situation and antimicrobial susceptibility data. The objectives of these guidelines are: to provide evidence-based guidance on treatment of infection with Treponema pallidum; and to support countries to update their national guidelines for treatment of Treponema pallidum.
Geneva, Switzerland, WHO, 2016.  p.Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. There is an urgent need to update treatment recommendations for gonococcal infections to respond to changing antimicrobial resistance (AMR) patterns of N. gonorrhoeae. High-level resistance to previously recommended quinolones is widespread and decreased susceptibility to the extended-spectrum (third-generation) cephalosporins, another recommended first-line treatment in the 2003 guidelines, is increasing and several countries have reported treatment failures. These guidelines for the treatment of common infections caused by N. gonorrhoeae form one of several modules of guidelines for specific STIs. It is strongly recommended that countries take updated global guidance into account as they establish standardized national protocols, adapting this guidance to the local epidemiological situation and antimicrobial susceptibility data. The objectives of these guidelines are: to provide evidence-based guidance on treatment of infection with N. gonorrhoeae; and to support countries to update their national guidelines for treatment of gonococcal infection.
Targeted Spontaneous Reporting: Assessing Opportunities to Conduct Routine Pharmacovigilance for Antiretroviral Treatment on an International Scale.
Drug Safety. 2016 Jun 9; 1-18.Introduction: Targeted spontaneous reporting (TSR) is a pharmacovigilance method that can enhance reporting of adverse drug reactions related to antiretroviral therapy (ART). Minimal data exist on the needs or capacity of facilities to conduct TSR. Objectives: Using data from the International epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium, the present study had two objectives: (1) to develop a list of facility characteristics that could constitute key assets in the conduct of TSR; (2) to use this list as a starting point to describe the existing capacity of IeDEA-participating facilities to conduct pharmacovigilance through TSR. Methods: We generated our facility characteristics list using an iterative approach, through a review of relevant World Health Organization (WHO) and Uppsala Monitoring Centre documents focused on pharmacovigilance activities related to HIV and ART and consultation with expert stakeholders. IeDEA facility data were drawn from a 2009/2010 IeDEA site assessment that included reported characteristics of adult and pediatric HIV care programs, including outreach, staffing, laboratory capacity, adverse event monitoring, and non-HIV care. Results: A total of 137 facilities were included: East Africa (43); Asia–Pacific (28); West Africa (21); Southern Africa (19); Central Africa (12); Caribbean, Central, and South America (7); and North America (7). Key facility characteristics were grouped as follows: outcome ascertainment and follow-up; laboratory monitoring; documentation—sources and management of data; and human resources. Facility characteristics ranged by facility and region. The majority of facilities reported that patients were assigned a unique identification number (n = 114; 83.2 %) and most sites recorded adverse drug reactions (n = 101; 73.7 %), while 82 facilities (59.9 %) reported having an electronic database on site. Conclusion: We found minimal information is available about facility characteristics that may contribute to pharmacovigilance activities. Our findings, therefore, are a first step that can potentially assist implementers and facility staff to identify opportunities and leverage their existing capacities to incorporate TSR into their routine clinical programs.
Journal of the College of Physicians and Surgeons Pakistan. 2014 Jul; 24(7):493-7.OBJECTIVE: To evaluate the efficacy of adopting WHO feeding guidelines on weight gain and case fatality rate in malnourished children. STUDY DESIGN: Cross-sectional, observational study. PLACE AND DURATION OF STUDY: Department of Pediatrics, Dow University of Health Sciences, Karachi, from 2009 to 2010. METHODOLOGY: Patients above 6 months and less than 5 years of age with severe malnutrition were included during the study period, acute complications were treated and nutritional rehabilitation by WHO feeding formulae was done. Demographic details, clinical features, reasons for weight gain and risk factors of mortality were analyzed. RESULTS: A total of 131 children were included. Mean age of children was 22 +/- 18 months. There were 78% marasmic, 4% kwashiorkor and marasmic kwashiorkor 18% children. Resolution of edema took 8 +/- 4 days, dermatosis cleared in 11 +/- 3 days. Mean hospital stay was 10 +/- 8 days. Case fatality rate was 13%. Mean weight gain was 5.25 +/- 4.57 g/kg/day. Weight gain of > 5 gm/kg/day was associated with hospital stay of more than 7 days, acceptability and palatability of feed by the children and mothers and early clearance of infections. CONCLUSION: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however, adequate healthcare services are available at the therapeutic feeding centers.
BMC Public Health. 2013; 13 Suppl 3:S17.BACKGROUND: Current WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea. METHODS: We conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/specialized ingredients versus home-available ingredients. We used all available outcome data to conduct random-effects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately. RESULTS: Evidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactose-containing liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-to-moderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these analyses to studies where both intervention and control diets were lactose-free, weight gain in children with acute diarrhea was shown to be greater among those fed with a home-available diet. CONCLUSIONS: Among children in low- and middle-income countries, where the dual burden of diarrhea and malnutrition is greatest and where access to proprietary formulas and specialized ingredients is limited, the use of locally available age-appropriate foods should be promoted for the majority of acute diarrhea cases. Lactose intolerance is an important complication in some cases, but even among those children for whom lactose avoidance may be necessary, nutritionally complete diets comprised of locally available ingredients can be used at least as effectively as commercial preparations or specialized ingredients. These same conclusions may also apply to the dietary management of children with persistent diarrhea, but the evidence remains limited.
Geneva, Switzerland, WHO, 2010. 152 p.Consistent and correct use of condoms is vital to achieve the level of protection required to prevent unintended pregnancy and the transmission of HIV and other STIs. Another vital factor is the quality of the product. If condoms leak or break, they cannot offer adequate protection. In many programmes attention tends to be focused on the condom user and the promotion of condoms. Often, inadequate attention is paid to ensuring, as a key component of a comprehensive condom programming strategy, that a quality product is manufactured, purchased, stored, distributed and handled properly. The male latex condom is an important medical device, and its manufacture needs to be regulated and controlled as such.This document describes a technically sound, systematic process to support the manufacture, prequalification, procurement and distribution of a quality product that can meet the needs of different populations in a broad spectrum of challenging environmental conditions. It is intended primarily for any policy-maker, manager or procurement officer who has the responsibility for procuring, supplying and promoting natural latex male condoms.
Efavirenz conceptions and regimen management in a prospective cohort of women on antiretroviral therapy.
Infectious Diseases In Obstetrics and Gynecology. 2012; 2012:723096.Use of the antiretroviral drug efavirenz (EFV) is not recommended by the WHO or South African HIV treatment guidelines during the first trimester of pregnancy due to potential fetal teratogenicity; there is little evidence of how clinicians manage EFV-related fertility concerns. Women on antiretroviral therapy (ART) were enrolled into a prospective cohort in four public clinics in Johannesburg, South Africa. Fertility intentions, ART regimens, and pregnancy testing were routinely assessed during visits. Women reporting that they were trying to conceive while on EFV were referred for regimen changes. Kaplan-Meier estimators were used to assess incidence across ART regimens. From the 822 women with followup visits between August 2009-March 2011, 170 pregnancies were detected during study followup, including 56 EFV conceptions. Pregnancy incidence rates were comparable across EFV, nevirapine, and lopinavir/ritonavir person-years (95% 100/users (P=0.25)); incidence rates on EFV were 18.6 Confidence Interval: 14.2-24.2). Treatment substitution from EFV was made for 57 women, due to pregnancy intentions or actual pregnancy; however, regimen changes were not systematically applied across women. High rates of pregnancy on EFV and inconsistencies in treatment management suggest that clearer guidelines are needed regarding how to manage fertility-related issues in. women on EFV-based regimens.
Communities of practice: The missing link for knowledge management on implementation issues in low-income countries?
Tropical Medicine and International Health. 2011 Aug; 16(8):1007-1014. [The implementation of policies remains a huge challenge in many low-income countries. Several factors play a role in this, but improper management of existing knowledge is no doubt a major issue. In this article, we argue that new platforms should be created that gather all stakeholders who hold pieces of relevant knowledge for successful policies. To build our case, we capitalize on our experience in our domain of practice, health care financing in sub-Saharan Africa. We recently adopted a community of practice strategy in the region. More in general, we consider these platforms as the way forward for knowledge management of implementation issues.
Clinics In Perinatology. 2010 Dec; 37(4):765-76, viii.The World Health Organization's Strategic Approaches to the Prevention of HIV Infection in Infants includes 4 components: primary prevention of HIV-1 infection; prevention of unintended pregnancies among HIV-1-infected women; prevention of transmission of HIV-1 infection from mothers to children; and provision of ongoing support, care, and treatment to HIV-1-infected women and their families. This review focuses on antiretrovirals for secondary prevention of HIV-1 infection-prevention of HIV-1 transmission from an HIV-1-infected woman to her child. Antiretroviral strategies to prevent the mother-to-child transmission of HIV-1 in nonbreastfeeding populations comprise antiretroviral treatment of HIV-1-infected pregnant women needing antiretrovirals for their own health, antiretroviral prophylaxis for HIV-1-infected pregnant women not yet meeting criteria for treatment, and antiretroviral prophylaxis for infants of HIV-1-infected mothers. The review primarily addresses antiretroviral strategies for nonbreastfeeding, HIV-1-infected women and their infants in resource-rich settings, such as the United States. Antiretroviral strategies to prevent antepartum, intrapartum, and early postnatal transmission in resource-poor settings are also addressed, albeit more briefly. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Evidence behind the WHO guidelines: Hospital Care for Children: what is the aetiology and treatment of chronic diarrhoea in children with HIV?
Journal of Tropical Pediatrics. 2009 Dec; 55(6):349-55.This clinical review aims to address the issue of appropriate treatment for chronic diarrhea in children with HIV and evaluates the scientific evidence behind WHO's recommendations for this matter. It finds that highly active antiretroviral therapy (HAART) substantially reduces diarrhea, increases the effectiveness of antimicrobial agents, and improves weight gain.
Coordination, management and utilization of foreign assistance for HIV / AIDS prevention in Vietnam. Assessment report.
Ha Noi, Vietnam, CCRD, 2006 Oct. 82 p. (CCRD Assesssment Report)International assistance for HIV / AIDS prevention and control in Vietnam has significantly contributed to combating this epidemic. However, while current resources have not yet fully met the needs, the management and utilization of resources still had many limitations which affect the effectiveness of foreign assistance and investments. The independent assessment was prepared for the Conference on “the Coordination of Foreign Assistance for HIV / AIDS Prevention and Control”. Analytical assessment and comments on the management and coordination of foreign aid were made on the basis of Government’s official procedures and regulations on those issues. This research was carried out in October, 2006.
Handbook of supply management at first-level health care facilities. 1st version for country adaptation.
Geneva, Switzerland, WHO, 2006. 73 p. (WHO/HIV/2006.03)All first-level health care facilities, namely primary health care clinics and outpatient departments based in district hospitals, use medicines and related supplies. It takes a team effort to manage these supplies, involving all health care facility staff: doctors, nurses, health workers and storekeepers. This is especially true in small facilities with only one or two health workers. Each staff member should know how to manage all supplies at the health care facility correctly. Each staff member has an important role. The Handbook of Supply Management at First-Level Health Care Facilities describes all major medicines and supply management tasks, known as the standard procedures of medicines supply management at first-level health care facilities. Each chapter covers one major task, explains how the task fits into the process of maintaining a consistent supply of medicines, and recommends which standard procedures to use. Annexes at the back of the handbook contain various checklists and examples of forms which can be introduced as needed at your health care facility. This handbook is part of a package used in an integrated training and capacity-building course targeted at first-level health care facilities. It can be used in conjunction with the existing Integrated Management of Adult and Adolescent Illness (IMAI) strategy developed by WHO. It can also be used for basic training activities independent of IMAI training courses. (excerpt)
European Journal of Public Health. 2007 Oct; 17(5):409.In public health teaching, tuberculosis (TB) has been a traditional example of how disease occurrence is determined by the triad agent, environment, host. And it has since long been standard textbook knowledge that there are strong socioeconomic determinants behind all three components: The agent is more prevalent and is spread more easily in conditions of crowding and poor hygienic conditions, and under these conditions several host factors are also more prevalent, such as malnutrition and alcoholism. In recent years another dimension has been added to the socioeconomic patterning of TB: An already very solid mass of research has highlighted the social and economic aspects of care and follow-up of patients with TB. A recent example of this research is the paper by Wang et al. in this issue of the journal, on differences in both patient's delay and doctor's delay in the diagnosis of TB, when comparing residents and non-residents (rural immigrants) in Shanghai. (excerpt)
Washington, D.C., World Bank, Global HIV / AIDS Program, 2006 Aug. 11 p.AIDS has wide consequences for development, and presents enormous challenges to businesses in the worst hit countries. The epidemic affects workers, managers and markets by increasing costs and reducing productivity. The International Finance Corporation (IFC), the private sector arm of the World Bank Group, works with client companies to mitigate the effects of the epidemic on their operations through its IFC Against AIDS program. The program works with companies in Africa and India, and efforts are underway to raise awareness among clients in China and assess program conditions in Russia. (author's)
Washington, D.C., World Bank, Global HIV / AIDS Program, 2005 Dec. 5 p.Many countries are working to expand access to antiretroviral (ARV) drugs for millions of people with HIV/AIDS. Uninterrupted and timely supplies of safe, effective and affordable ARV drugs are needed. They must be dispensed correctly by health workers, and consistently taken by patients. A partnership between the World Bank and World Health Organization (WHO), in collaboration with the Global Fund for AIDS, TB and Malaria (GFATM), UNICEF, UNAIDS, and the American and French Governments is helping countries build capacity to procure and manage HIV/AIDS drugs and related supplies. This effort has helped support an increase in the number of people on ARV treatment in low- and middle income countries, from 400,000 at the end of 2003, to about one million in June 2005. (author's)
IAP Guidelines 2006 on hospital based management of severely malnourished children (adapted from the WHO guidelines).
Indian Pediatrics. 2007 Jun 17; 44(6):443-461.Malnutrition in children is widely prevalent in India. It is estimated that 57 million children are underweight (moderate and severe). More than 50% of deaths in 0-4 years are associated with malnutrition. The median case fatality rate is approximately 23.5% in severe malnutrition, reaching 50% in edematous malnutrition. There is a need for standardized protocol-based management to improve the outcome of severely malnourished children. In 2006, Indian Academy of Pediatrics undertook the task of developing guidelines for the management of severely malnourished children based on adaptation from the WHO guidelines. We summarize below the revised consensus recommendations (and wherever relevant the rationale) of the group. (excerpt)
Indian Pediatrics. 2007 Jun 17; 44(6):413-416.Over 10 million children under five years of age die each year and 22% of these deaths occur in India. This proportion is substantially higher than for other countries, the next highest being Nigeria which accounts for 8%. Since India carries the main burden of child deaths globally, India's performance in improving child survival will define whether the Millennium Development Goal 4 will be achieved by 2015 (i.e., global child deaths reduced by two-thirds). Diarrhea and pneumonia account for approximately half the child deaths in India, and malnutrition is thought to contribute to 61% of diarrheal deaths and 53% of pneumonia deaths. In fact, some of the first studies to demonstrate the importance of this synergism between malnutrition and infection emanated from India. Part of the explanation for the important underlying role of malnutrition in child deaths is that most nutritional deficiencies, including vitamin A and zinc, impair immune function and other host defences leading to a cycle of longer lasting and more severe infections and ever-worsening nutritional status. Thus inadequate intake, infection and poor nutritional status are intimately linked. (excerpt)
CMAJ: Canadian Medical Association Journal. 2007 Jan 30; 176(3):311-312.Due to the mismanagement and theft of earlier grants, the Global Fund to Fight Malaria, Tuberculosis and HIV/AIDS (GF) has rejected grant applications from a number of African countries, including some that are among the worst hit by HIV/AIDS. Affected countries, including Kenya, Uganda, Togo, Zimbabwe, Namibia and Tanzania, say the grant freeze will badly affect their HIV/AIDS control programs. Since its inception in 2001, the GF has helped provide antiretroviral treatment to 600 000 HIV/AIDS patients; the new financing over 5 years will support about 200 000. The GF, a partnership among governments, civil society, the private sector and affected communities to support health-related initiatives, was unable to provide figures on how many people will be affected by the new rules. GF guidelines stipulate that a country can appeal a grant decision when the same proposal has been rejected in 2 consecutive rounds, and only when the appeal is based on a significant and obvious error made by the technical review panel. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2005.  p.Contraceptives, drugs, and medical supplies required for reproductive health services in developing regions cost US$1.84 billion in 2000, will cost $2.34 billion in 2005, and will rise in cost to $3.43 billion by 2015. Annual costs will be 86 per cent higher, in constant dollars, in 2015 than in 2000 (Figure 1). These estimates cover contraceptives for family planning, condoms for protection against HIV and other sexually transmitted infections, and drugs and medical supplies for safe deliveries and other reproductive health services. Drugs and medical supplies make up over half the total cost, contraceptives around one-third, and condoms for protection the remaining one-eighth or so. The estimates are detailed in this report, which attempts to assess the overall costs of reproductive health commodities, which UNFPA has traditionally had a major role in helping provide for developing regions. These commodities are essential to achieve the goal of providing universal access to reproductive health care, as mandated in 1994 by the International Conference on Population and Development. The report is not intended to specify the quantities and cost of commodities needed in particular countries but rather tries to arrive at estimates of global requirements. Nevertheless, the calculations are based on detailed consideration of regional and even country data where they are available. The report assesses the number of cases in developing regions of each relevant reproductive health condition, projects these numbers over 15 years, determines the commodities required as part of appropriate treatment, estimates the proportion of cases that do receive such treatment, specifies how coverage should rise in the future, and calculates the commodity costs for all the cases to be covered. (excerpt)
WHO training course for TB consultants: RPM Plus drug management sessions in Sondalo, Italy, September 28 - October 1, 2006: trip report.
Arlington, Virginia, Management Sciences for Health, Center for Pharmaceutical Management, Rational Pharmaceutical Management Plus, 2006 Oct 18. 26 p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ACI-323)WHO, Stop-TB Partners, and NGOs that support country programs for DOTS implementation and expansion require capable consultants in assessing the capacity of countries to manage TB pharmaceuticals in their programs, developing interventions, and providing direct technical assistance to improve availability and accessibility of quality TB medicines. Beginning in 2001, RPM Plus, in addition to its own formal courses on pharmaceutical management for tuberculosis, has contributed modules and facilitated sessions on specific aspects of pharmaceutical management to the WHO Courses for TB Consultants in Sondalo. The WHO TB Course for TB Consultants was developed and initiated in 2001 by the WHO Collaborating Centre for Tuberculosis and Lung Diseases, the S. Maugeri Foundation, the Morelli Hospital, and TB CTA. The main goal of the course is to increase the pool of international level TB consultants. As of December 2005, over 150 international TB consultants have participated in the training, a majority ofwhom have already been employed in consultancy activities by the WHO and international donors. In 2006 fiscal year RPM Plus received funds from USAID to continue supporting the Sondalo Course, which allowed RPM Plus to facilitate sessions on pharmaceutical management for TB at four courses in May, June, July, and October of 2006. RPM Plus Senior Program Associate, Edgar Barillas, traveled to Sondalo from September 28 to October 1 to facilitate the TB pharmaceutical management session at the WHO course for TB Consultants in Sondalo, Italy. (excerpt)
London, England, Overseas Development Institute, 2005 Apr.  p. (Working Paper No. 244)The Research and Policy in Development (RAPID) programme at the Overseas Development Institute (ODI) has been working since 1999 to promote development policy-making processes that are evidence-based and focused on the needs of the poor. One of the key dimensions of the RAPID programme at ODI is 'knowledge and learning systems in development agencies'. This study synthesises existing research on knowledge and learning in the development sector, and draws out eight key questions for examining related strategies and systems in development agencies. Together, these questions make up a comprehensive Knowledge Strategies Framework, which bears close resemblance to the framework used by the ODI to assess complex processes of change within the development and humanitarian sector. The dimensions of this new Knowledge Strategies Framework are mapped out as Organisational knowledge, Organisational links, Organisational contexts, and External factors. The study then presents the analysis of data collected on current knowledge and learning practices in 13 selected case study organisations1. This data was gathered via desk based reviews, interviews, consultations with agency staff and focus groups. The Knowledge Strategies Framework is used to analyse and synthesise these findings, to formulate the recommendations of the study, and to suggest key next steps. (excerpt)
A healthy partnership -- a case study of the MOH contract to KHANA for disbursement of World Bank funds for HIV / AIDS in Cambodia.
[Brighton, England], International HIV / AIDS Alliance, 2005 Mar. 12 p.In 1998, the Cambodian Ministry of Health was experiencing difficulties in disbursing World Bank funds earmarked for local NGOs/CBOs, and in 1999, contracted Khana to manage the disbursement process. Given the scarcity of documented successful government-NGO/CBO disbursement initiatives, the Alliance commissioned a case study of this mechanism of making World Bank funds more accessible to civil society organisations. This report of the case study outlines the background and context to adopting the disbursement mechanism, explains the selection of the disbursing agency and the process of contract negotiation, details the nature and quantity of the disbursement, and identifies the strengths, weaknesses and lessons learned from this model. (excerpt)
Notes from the Field. 2001 Jul; (6): p..International Planned Parenthood Federation, Western Hemisphere Region staff visited Belize in June 2001 to work with the Belize Family Life Association (BFLA) on sustainability and management aspects of its strategic plan for sexual and reproductive health care. The slogan they developed was Efficient Services with a Human Face." IPPF/WHR Senior Program Advisors Lucella and Humberto were in Belize in June 2001 to work with IPPF/WHR's affiliate there, the Belize Family Life Association (BFLA), on the sustainability and management aspects of its strategic plan. BFLA recently received a grant from the Summit Foundation to construct a new headquarters that will allow for expanded services. (excerpt)