Your search found 35 Results

  1. 1
    334624

    HIV testing, treatment and prevention. Generic tools for operational research.

    World Health Organization [WHO]; Population Council

    Geneva, Switzerland, WHO, 2009. [66] p.

    As part of efforts to obtain evidence to inform the public health approach to HIV treatment and prevention, the Population Council collaborated with the HIV / AIDS Department of the World Health Organization to develop tools, "HIV Testing, Treatment and Prevention: Generic Tools for Operational Research" for operational research on topics that have relevance to programs. The tools include this main document that is intended to serve as a basis for formulating research questions and designing an operational research project to address them. The document includes four sections: HIV testing and counseling; HIV stigma and discrimination; Adherence to antiretrovirals; and HIV prevention in the context of scaled-up access to HIV treatment.
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  2. 2
    351137
    Peer Reviewed

    The Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form.

    Zubaran C; Foresti K; Schumacher M; Thorell MR; Amoretti A; Muller L; Dennis CL

    Journal of Human Lactation. 2010 Aug; 26(3):297-303.

    The objective of this study was to translate and psychometrically assess a Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The original English version of the BSES-SF was translated to Portuguese and tested among a sample of 89 mothers in southern Brazil from the 2nd to 12th postpartum week followed by face-to-face interviews. The mean total score of the Portuguese version of the BSES-SF was 63.6 +/- 6.22. The reliability analysis of each item in the scale attained significant Cronbach's alphas of 0.63 or superior. The Cronbach's alpha generated by the entire range of 14 questions was 0.71. A factor analysis identified one factor that contributed to 20% of the variance. This study demonstrates that the original English version of the BSES-SF was successfully adapted to Portuguese. The Portuguese version of the BSES-SF constitutes a reliable research instrument for evaluating breastfeeding self-efficacy in Brazil.
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  3. 3
    326029

    Implementation process review of the "Training of Teachers Manual on Preventive Education against HIV / AIDS in the School Setting".

    Girault P

    [Paris, France], UNESCO, Internal Oversight Service, Evaluation Section, 2003 Aug. 50 p. (IOS/EVS/PI/33)

    At a recent review workshop in Uzbekistan and elsewhere concerns have been raised that the manual is too strictly focused on transferring biomedical knowledge and does not pay enough attention to reducing vulnerability to HIV/AIDS by promoting lifeskills. It is also believed that the HIV information in the manual needs to be updated, and that the inclusion of teaching of more participatory training techniques could be considered. In addition, in some countries, a strict focus on HIV/AIDS is not realistic - embedding HIV/AIDS in a wider school-health approach should be considered. Before expanding to other countries, UNESCO decided then to do a review of the progress implementation of the "Preventive Education against HIV/AIDS in the School Setting" project and a review of the manual. The particular interest of this review is to look at the way that the project was implemented and to review the manual based on the comments generated by the targeted countries. Its overall aim is to generate recommendations both on the content of the manual and the implementation process, before expanding to other countries covered by UNESCO Bangkok. (excerpt)
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  4. 4
    324656
    Peer Reviewed

    What do we know about sexual and reproductive health of adolescents in Europe?

    Avery L; Lazdane G

    European Journal of Contraception and Reproductive Health Care. 2008 Mar; 13(1):58-70.

    Acceptance of sexual and reproductive health as fundamental to the sustainable development of societies has allowed for creation of new reproductive health programmes and policies. WHO sexual and reproductive health (SRH) strategies were developed in the WHO Regional Office for Europe (2001), as well as globally (2004). Adolescent SRH is important in both strategies. Despite these commitments, adolescents remain vulnerable to poor reproductive health. The goal of this paper is to analyse the current status of SRH of adolescents in Europe. Key reproductive health indicators were chosen. Information was obtained from published studies, databases and questionnaires sent to WHO reproductive health counterparts within the health ministries in the Member States of the WHO European Region. Pregnancy rate, age at first sexual intercourse, contraceptive use at first and last intercourse, contraceptive prevalence, HIV knowledge, and STI rates vary widely according to the population considered. Gender difference and lack of information pertaining to SRH of all adolescent populations are other key findings. While the SRH of most European adolescents is good, they remain a vulnerable population. Lack of standardized reproductive indicators and age specific aggregate data make it difficult to accurately assess the situation in individual countries or perform cross country comparison. (author's)
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  5. 5
    323585
    Peer Reviewed

    Utility of the WHO ten questions screen for disability detection in a rural community -- the north Indian experience.

    Singhi P; Kumar M; Malhi P; Kumar R

    Journal of Tropical Pediatrics. 2007 Dec; 53(6):383-387.

    The utility of the WHO Ten Questions Screen (TQS) was studied in a rural community of North India. The study was done in three villages, in two phases. In phase 1, the TQS was administered to parents of children aged between 2 and 9 years, during a house-to-house survey. In phase 2, all children screened positive and a random sample of 110 screened negative were clinically evaluated in detail. The total population of the three villages was 5830 with 1763 children aged between 2 and 9 years. Seventy-six children were positive on the TQS, of these, 38 were found to have significant disability, 18 had protein energy malnutrition and 19 were found normal on clinical evaluation. All the 110 screen-negative children were normal. Significantly larger numbers of boys were positive on TQS as compared to girls [Odd Ratio (OR) 1.5]. The sensitivity of the TQS for significant disability was 100%; the positive predictive value was 50% and was higher for boys than for girls. Of the 50% children classified as false positive 23% had mild delays due to malnutrition. The estimated prevalence of disability was 16/1000. The TQS was found to be a sensitive tool for detection of significant disabilities among children 2-9 years of age. The low-positive predictive value would lead to over referrals but a large number of these children would benefit from medical attention. (author's)
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  6. 6
    322586

    Adolescents, social support and help-seeking behaviour: An international literature review and programme consultation with recommendations for action.

    Barker G

    Geneva, Switzerland, World Health Organization [WHO], Department of Child and Adolescent Health and Development, 2007. 56 p. (WHO Discussion Papers on Adolescence)

    With this brief introduction and justification, this document presents: The findings from an international literature review on the topic of adolescents and help-seeking behaviour. The results of a programme consultation with 35 adolescent health programmes (including public health sector programmes, university-based adolescent health programmes and non-government organizations (NGO) working in adolescent health) from Latin America (10), the Western Pacific region (4), Asia (20), and the Middle East (1), and the results of six key informant interviews. These results are incorporated into the literature review where relevant. The complete report from this consultation of programmes is found in Appendix 1. Recommendations for action, including a brief outline for developing a set of guidelines for the rapid assessment of social supports to promote the help-seeking of adolescents. This document is part of a WHO project to identify and define evidence-based strategies for influencing adolescent help-seeking and identify research questions and activities to promote improved help-seeking behaviour by adolescents. To achieve this objective, the consultants, with WHO guidance: (1) carried out an international literature review of the topic; (2) sent 67 questionnaires and received 35 questionnaires back from adolescent health programmes on the topic of adolescents and help-seeking in the four regions; and (3) carried out key informant interviews with nine individuals (three in Latin America, three in the Pacific region and three in South Asia). The consultants also developed short case studies of illustrative approaches in promoting help-seeking behaviour. (excerpt)
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  7. 7
    313945
    Peer Reviewed

    Quality of life of women with gynecologic cancer: Associated factors.

    Vaz AF; Pinto-Neto AM; Conde DM; Costa-Paiv L; Morais SS

    Archives of Gynecology and Obstetrics. 2007 Dec; 276(6):583-589.

    The objective was to evaluate quality of life (QOL) and identify its associated factors in a cohort of women with gynecologic cancer. A cross-sectional study was conducted, including 103 women with cervical or endometrial cancer, aged between 18 and 75 years who were receiving their entire treatment at the institution where the investigation was carried out. QOL was measured by the World Health Organization's QOL instrument-abbreviated version (WHOQOL-BREF). Clinical and sociodemographic characteristics, in addition to prevalence of cancer-related symptoms prior to radiotherapy were investigated. Bivariate analysis was performed, applying the Mann-Whitney test. Multivariate analysis was used to identify factors associated with QOL. The mean age of the participants was 56.8 plus or minus 11.6 years. The study included 67 (65%) women with cervical cancer and 36 (35%) women with endometrial cancer. Most participants were at an advanced stage (63.1%). The most common complaints were pain (49.5%) and vaginal bleeding (36.9%). The prevalence of anemia was 22.3%. On multivariate analysis, it was observed that anemia (P = 0.006) and nausea and/or vomiting (P = 0.010) determined impairment in physical domain. Pain negatively influenced physical domain (P = 0.001), overall QOL (P = 0.024), and general health (P = 0.013), while the history of surgery positively affected general health (P = 0.001). Cancer-related symptoms were factors that most interfered with QOL in women with gynecologic cancer. Therefore, more attention should be focused on identifying these symptoms, adopting measures to minimize their repercussions on QOL. (author's)
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  8. 8
    312466

    Preventing child maltreatment: a guide to taking action and generating evidence.

    Butchart A; Harvey AP; Mian M; Furniss T

    Geneva, Switzerland, World Health Organization [WHO], 2006. [98] p.

    There is thus an increased awareness of the problem of child maltreatment and growing pressure on governments to take preventive action. At the same time, the paucity of evidence for the effectiveness of interventions raises concerns that scarce resources may be wasted through investment in well-intentioned but unsystematic prevention efforts whose effectiveness is unproven and which may never be proven. For this reason, the main aim of this guide is to provide technical advice for setting up policies and programmes for child maltreatment prevention and victim services that take into full account existing evidence on the effectiveness of interventions and that use the scientific principles of the public health approach. This will encourage the implementation of scientifically testable interventions and their evaluation. It is hoped that, in this way, the guide will contribute to a geographical expansion of the evidence base to include more evaluations of interventions from low-income and middle-income countries, and a greater variety of evaluated interventions. The long-term aim is to be able to prepare evidence-based guidelines on interventions for child maltreatment. (excerpt)
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  9. 9
    306659

    Development and testing of the South African National Nutrition Guidelines for People Living with HIV / AIDS.

    Kennedy RD; MacIntyre UE

    SAJCN. South African Journal of Clinical Nutrition. 2003 Feb; 16(1):12-16.

    Malnutrition is a common consequence of HIV infection, and weight loss is used as a diagnostic criterion for HIV/AIDS. The relationship between HIV/AIDS and malnutrition and wasting is well described, with nutritional status compromised by reduced food intake, malabsorption caused by gastrointestinal involvement, increased nutritional needs as a result of fever and infection, and increased nutrient losses. Malnutrition contributes to the frequency and severity of opportunistic infections seen in HIV/AIDS and nutritional status is a major factor in survival. Failure to maintain body cell mass leads to death at 54% of ideal body weight. The effectiveness of nutrition intervention has been documented and dietary nutrition counselling is considered critical in the treatment of HIV/AIDS, especially in view of the fact that drug treatment is inaccessible to many people living with the virus in Africa. (excerpt)
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  10. 10
    302689
    Peer Reviewed

    National adult antiretroviral therapy guidelines in resource-limited countries: concordance with 2003 WHO guidelines?

    Beck EJ; Vitoria M; Mandalia S; Crowley S; Gilks CF

    AIDS. 2006 Jul 13; 20(11):1497-1502.

    The aims were to investigate the existence of national adult antiretroviral therapy (ART) guidelines in 43 World Health Organization (WHO) '3 by 5' focus countries and compare their content with the 2003 WHO ART guidelines. Questionnaires covered initiation of ART, selection of first or second-line ART, monitoring treatment response and toxicity and dissemination of national guidelines. Weighted concordance scores were created and country scores correlated with national indicators and WHO recommendations. Thirty-nine (91%) countries returned questionnaires, three of which had no national ART guidelines. Of the 36, 16 (44%) recommended to start ART based on WHO clinical staging criteria and CD4 cell count or T-lymphocyte count, 12 (33%) WHO clinical staging criteria and CD4 cell count, four (11%) only CD4 cell counts. 35 (97%) recommended a standard first-line regimen and 24 (67%) preferred stavudine + lamivudine + nevirapine; 33 (92%) recommended second-line regimens, and 24 (60%) preferred abacavir + didanosine + lopinavir/ritonavir. Thirty-one (94%) recommended CD4 cell count, possibly combined with other indicators, to monitor ART. Concordance scores were higher in countries with lower health expenditure per capita (P = 0.009) and lower GDP per capita (P < 0.03). Median concordance scores for starting ART was 100 [interquartile range (IQR), 67 to 100]; first line therapy, 70 (IQR, 60 to 80); second-line regimens, 45 (IQR, 27 to 55) and for laboratory investigations, 80 (IQR, 80 to 100). Most countries had developed national ART guidelines as part of a comprehensive national HIV program. Concordance with WHO recommendations was strong on starting first-line ART regimens and routine monitoring but lower for second-line recommendations. (author's)
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  11. 11
    275666
    Peer Reviewed

    The members' enquiry service: frequently asked questions.

    Stephen G; Brechin S; Penney G

    Journal of Family Planning and Reproductive Health Care. 2004; 30(4):253-254.

    The Clinical Effectiveness Unit (CEU) presents an illustrative response of a frequently asked question to the Members’ Enquiry Service on whether or not hormonal contraceptive use by women with a history of pregnancy-related cholestasis is safe or associated with recurrence of cholestasis. The Summaries of Product Characteristics (SPCs) for combined oral contraceptives (COCs) and progestogen-only pills (POPs) advise against use by women with a history of cholestatic jaundice or with severe pruritis in pregnancy. The World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use (WHOMEC), however, recommends that for women with pregnancy-related cholestasis the benefits of COC use outweigh the risks (WHO Category 2) and progestogen-only methods or non-hormonal methods can be used without restriction (WHO Category 1). No evidence was identified to support an increased risk of recurrence of symptoms with hormonal contraceptive use. The CEU advises that women with a history of pregnancy-related cholestasis should be informed about the unknown risk of recurrence with hormonal contraceptive use. After counselling regarding non-hormonal methods, women with a history of pregnancy-related cholestasis may choose to use hormonal methods (COCs, POPs, progestogen-only injectables, implant or intrauterine system). Women should be informed that the use of COCs and POPs in this situation is outside the product licence. (excerpt)
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  12. 12
    273985

    Working with adolescent boys: programme experiences. Consolidated findings from regional surveys in Africa, the Americas, Eastern Mediterranean, South-East Asia, and Western Pacific.

    World Health Organization [WHO]. Department of Child and Adolescent Health and Development

    Geneva, Switzerland, WHO, Department of Child and Adolescent Health and Development, 2000. [59] p. (WHO/FCH/CAH/00.10)

    The survey and this report seek to contribute to the understanding of working with adolescent boys in health and health promotion. Pursuant to this purpose, the consultants contacted programmes working in health promotion with adolescent boys in four regions of the world. These contacts did not aspire to include all of the programmes which are working with adolescent boys in these regions, nor do they necessarily represent a random sample of those programmes. Where possible, the survey included a relatively small but representative number of organizations working with adolescent boys in other regions. The organizations were identified via colleague organizations, WHO regional and local offices, the literature review, personal contacts of the survey authors and via non-governmental organizations (NGOs) working in health/health promotion. As detailed below, the survey sought to gather information in a dozen specific areas of interest by means of a questionnaire, which was translated into Spanish and Arabic. Programme staff were requested to fill out the questionnaire and return it to the consultants. (excerpt)
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  13. 13
    190506
    Peer Reviewed

    Comparison of patient evaluations of health care quality in relation to WHO measures of achievement in 12 European countries.

    Kerssens JJ; Groenewegen PP; Sixma HJ; Boerma WG; van der Eijk I

    Bulletin of the World Health Organization. 2004 Feb; 82(2):106-114.

    To gain insight into similarities and differences in patient evaluations of quality of primary care across 12 European countries and to correlate patient evaluations with WHO health system performance measures (for example, responsiveness) of these countries. Patient evaluations were derived from a series of Quote (QUality of care Through patients’ Eyes) instruments designed to measure the quality of primary care. Various research groups provided a total sample of 5133 patients from 12 countries: Belarus, Denmark, Finland, Greece, Ireland, Israel, Italy, the Netherlands, Norway, Portugal, United Kingdom, and Ukraine. Intra-class correlations of 10 Quote items were calculated to measure differences between countries. The world health report 2000 — Health systems: improving performance performance measures in the same countries were correlated with mean Quote scores. Intra–class correlation coefficients ranged from low to very high, which indicated little variation between countries in some respects (for example, primary care providers have a good understanding of patients’ problems in all countries) and large variation in other respects (for example, with respect to prescription of medication and communication between primary care providers). Most correlations between mean Quote scores per country and WHO performance measures were positive. The highest correlation (0.86) was between the primary care provider’s understanding of patients’ problems and responsiveness according to WHO. Patient evaluations of the quality of primary care showed large differences across countries and related positively to WHO’s performance measures of health care systems. (author's)
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  14. 14
    185001
    Peer Reviewed

    Treatment of tuberculosis: Is our knowledge adequate?

    Bhalla A

    Indian Journal of Medical Sciences. 2002 Feb; 56(2):73-78.

    Tuberculosis remains a global problem inspite of the excellent drugs available to cure it. According to an estimate in 1995 there were 9 million cases of tuberculosis worldwide and 3 million deaths. Tuberculosis was declared a global emergency by WHO in 1990 as it had reemerged in countries where it was supposed to be on a decline. Global explosion of HIV infection coupled with chaotic treatment of tuberculosis, the world today is threatened with untreatable epidemic of tuberculosis. Inappropriate and inadequate treatment leads to acquired drug resistance, which may result in treatment failure and spread of resistant organisms to other persons. The only way to prevent this is uniformity in the treatment of such patients both in governmental programs and private practice. In India under national tuberculosis control program 1.5 million cases are detected every year but still 1200 cases die due to it daily. The reason for this could be lack of compliance by the patients, faulty drug distribution, emergence of MDR-TB and inappropriate prescriptions of anti TB drugs due to lack of knowledge regarding the guidelines. Our study was aimed at finding out the knowledge, attitude and practice of resident doctors and consultants treating tuberculosis in two medical institutes in two different states of India. (author's)
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  15. 15
    184996
    Peer Reviewed

    Prophylactic use of cotrimoxazole against opportunistic infections in HIV-positive patients: knowledge and practices of health care providers in Cote d'Ivoire.

    Brou H; Desgrees-Du-Lou A; Souville M; Moatti JP; Msellati P

    AIDS Care. 2003 Oct; 15(5):629-637.

    We present here the results of a survey conducted in Côte d’Ivoire, Africa, among health care providers, on the knowledge of prophylactic use of cotrimoxazole to prevent opportunistic infections in HIV-infected persons. The survey was conducted in 15 health centres, involved or not in the ‘initiative of access to treatment for HIV infected people’. Between December 1999 and March 2000, 145 physicians and 297 other health care providers were interviewed. In the analysis, the health centres were divided into three groups: health centres implicated in the initiative of access to treatment for HIV-infected people with a great deal of caring for HIV-infected people, health centres implicated in this initiative but caring for few HIV-infected people, and health centres not specifically involved in the care of HIV-infected people. Six per cent of physicians and 50% of other health care providers had never heard of cotrimoxazole prophylaxis. The level of information about this prophylaxis is related to the level of HIV-related activities in the health centre. Among health care providers informed, knowledge on the exact terms of prescription of the cotrimoxazole is poor. In conclusion, it appears that the recommendations for primary cotrimoxazole prophylaxis of HIV-infected people did not reach the whole health care provider population. Most physicians are informed but not other health workers, even if the latter are often the only contact of the patient with the health centre. The only medical staff correctly informed are the physicians already strongly engaged in the care of HIV-infected people. (author's)
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  16. 16
    182569
    Peer Reviewed

    Vitamin A deficiency and increased mortality among human immunodeficiency virus-infected adults in Uganda.

    Langi P; Semba RD; Mugerwa RD; Whalen CC

    Nutrition Research. 2003 May; 23(5):595-605.

    The specific aims of the study were to determine the prevalence of vitamin A deficiency and to examine the relationship between vitamin A deficiency and mortality among human immunodeficiency virus (HIV)-infected adults in sub-Saharan Africa. A prospective cohort study was conducted at the outpatient clinic of Mulago Hospital, Kampala, Uganda, among HIV-infected adults enrolled in the placebo arms of a randomized clinical trial to prevent Mycobacterium tuberculosis infection. Of 519 subjects at enrollment, 186 (36%) had serum vitamin A concentrations consistent with deficiency (<1.05 µmol/L). During follow-up (median 17 months), the mortality among subjects with and without vitamin A deficiency at enrollment was 30% and 17%, respectively (P = 0.01). In a multivariate model adjusting for CD4+ lymphocyte count, age, sex, anergy status, body mass index, and diarrhea, vitamin A deficiency was associated with a significantly elevated risk of death [relative risk (RR) = 1.78, 95% confidence interval (CI) 1.2-2.6]. Vitamin A deficiency is common among HIV-infected adults in this sub-Saharan population and is associated with higher mortality. (author's)
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  17. 17
    182566
    Peer Reviewed

    Nutritional status of vegetarian and omnivorous adolescent girls. [Estado nutricional de adolescentes vegetarianas y omnívoras]

    Meirelles CD; da Veiga GV; Soares ED

    Nutrition Research. 2001 May; 21(5):689-702.

    This study compared the dietary and anthropometric profile of 24 ovo-lacto-vegetarian and 36 omnivorous female adolescents, between 15 and 18 years old. Weight, height and skinfolds were measured. Food frequency questionnaires and a three day food record were used for dietary assessment. Vegetarians presented subscapular, suprailiac and midaxillary skinfolds statistically higher than omnivores, but the percent body fat was not different. The vegetarian diet provided smaller amounts of energy than that of the omnivores ( p < 0.05) and only 17% of the vegetarians was able to reach the recommended allowance for protein. Regarding calcium, 83% of the vegetarians and 69% of the omnivores ate less than 2/3 of the recommended allowances and a significantly higher percentage of vegetarians presented low ingestion of iron, riboflavin, and niacin than omnivores ( p < 0.05). It was concluded that the intake of vegetarians was lower in fat and cholesterol, and less adequate in micronutrients than the omnivores ones. (author's)
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  18. 18
    180840

    Research summary. Vulnerability of street and working children to HIV / AIDS.

    Venkatachalam Y

    Vadodara, India, Centre for Operations Research and Training [CORT], 2000. [2] p.

    Street children live and work in conditions that are not conducive for healthy development. They are exposed to the street subculture such as smoking, drug, alcohol and substance abuse, gambling, engaging in sexual activities or selling sex for survival. The few studies that exist on the sexual behaviour of street children show that these children are more prone to high-risk behaviour and are sexually active at an early age. Often such relationships start as abusive. The circumstances in which they live and work increase their vulnerability also to sexual exploitation and abuse and put them at a higher risk of unintended pregnancies, sexually transmitted infections and even HIV/AIDS. The problem is further compounded by the lack of access to reproductive health information and services. UNICEF, recognising the magnitude of the problem, has undertaken to promote programmes to reduce children's vulnerability to HIV/AIDS, to diminish its impact on children, families and community and to take care of orphans and people living with AIDS. The present study is a situation analysis of children and adolescents carried out CORT to inform programme planning. (excerpt)
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  19. 19
    180839

    A qualitative evaluation of the impact of the Stepping Stones sexual health programme on domestic violence and relationship power in rural Gambia.

    Shaw M

    [Unpublished] 2002. Presented at the 6th Global Forum for Health Research, Arusha, Tanzania, November, 2002. [6] p.

    The work presented here came from a preliminary evaluation and was followed up by several applications for funding to carry out a prospective community randomised trial. So far none have been accepted. This may be partly due to the fact that such an evaluation runs against current funding culture. Because of it's holistic approach and focus on core skills in couple communication, the Stepping Stones programme is neither just an HIV prevention or just a domestic violence prevention programme, but has something to contribute to both (and would see the two problems as inter-related). Funding on the other hand is often organised 'vertically' by problem, and evaluation criteria may differ from one problem to another. For example donors who fund evaluation of HIV prevention activities usually require a biological outcome, and hence concentrate on geographical areas with high HIV incidence where the epidemic is seen as most severe. Where sociological outcomes are used this tends to be either the use of quantitative tools to assist in risk factor analysis, or qualitative tools which can assist in replication of the intervention. As such they are usually considered secondary to the primary (biological) outcomes. The hope here is that these interventions may provide a 'blueprint' which can subsequently be applied in low prevalence areas. However by concentrating on proximal rather than distal determinants of infection these blueprints may only capture 'half the story', leading to locally inappropriate assumptions about which groups or behaviours HIV prevention programmes should target. An example would be the demand by some donors that interventions should have an exclusive focus on adolescents, when in a polygamous society adolescent's risk is often mediated by the older generation. On the other hand community interventions against domestic violence are forced to rely on self reported behaviour (perhaps backed up by participant observation) as an outcome. If the intervention is also a reflexive process then qualitative studies become essential to describe a process of change which contains empowerment, group dynamic and normative dimensions. The locally appropriate nature of such interventions is used to justify participatory interventions as being more effective than didactic approaches, but at the same time in the epidemiological-evaluation paradigm it can be seen as problematic, because (I would argue incorrectly) a participatory process is assumed to generate a wide spectrum of outcomes (low replicability), which mitigates against quantitative evaluation. (excerpt)
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  20. 20
    178051

    Changing the focus.

    United Nations Development Programme [UNDP]. HIV and Development Programme

    New York, New York, UNDP, [2000]. 4 p.

    There is also a need for greater insight into why and how men and women enter into sexually-defined spaces and relations. For women, this may have to do with cultural imperatives which place high value on mother-hood and on the continuation of the lineage. Or the reason may have to do with economic imperatives, an inability to survive economically without the support of a man or except by commercial sex work. Or with a desire for the intimacy or companionship which a sexual relationship may give them or with a need for protection, a critical social role that men play. A women-centered analysis of desire and sexuality, of power and its impact, of relations of production and reproduction, of the social construction of kinship and gender, of the value of compassion and solidarity, that is, of the experience of being a woman, all contribute to a better understanding of why, for an individual woman, it may be so very difficult to remain uninfected. (excerpt)
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  21. 21
    101791

    Indicators for assessing health facility practices that affect breastfeeding. Report of the Joint WHO / UNICEF Informal Interagency Meeting, 9-10 June 1992, WHO, Geneva.

    World Health Organization [WHO]. Division of Diarrhoeal and Acute Respiratory Disease Control; UNICEF. Statistics and Monitoring Section

    Geneva, Switzerland, WHO, 1993. [3], 32 p. (WHO/CDR/93.1; UNICEF/SM/93.1)

    In March and June 1992, WHO and UNICEF held a joint informal interagency meeting on breast feeding at WHO headquarters in Geneva. The goal of the meeting was to reach consensus on the definitions of key breast feeding indicators which would allow one to assess whether health care facilities' procedures support, protect, and promote breast feeding practices. Section 2 of the meeting's summary report covers these indicators and their potential users. Identified potential users are maternity services, postnatal outpatient clinics including maternal and child health care services, pediatric inpatient services, and family planning services. Section 3 provides precise definitions of the indicators and the rational for their selection. Representatives from participating activities were asked to propose data collection methodologies to measure these indicators. The participating agencies included UNICEF, the WHO Working Group on Infant Feeding, The Population Council, World Alliance for Breastfeeding Action, Wellstart, the Institute for Reproductive Health at Georgetown University, USAID, the Swedish International Development Agency, and WHO. They agreed on health facility-based indicators of breast feeding. Section 4 discusses mainly indicators based on interviews with mothers at the time of infants' discharge or at the time of attending a clinic. It briefly covers those based on information collected from health facility staff or observation at the facility. The interviews with mothers were the basis for all the indicators agreed upon at the meeting, except for maternity services indicator 2 (breast milk substitutes and supplies receipt rate). Section 5 addresses methodological issues to be developed and sampling considerations. The annexes include a list of participants in the March and June meetings, sample data collection instruments (i.e., questionnaires), and breast feeding indicators for health facilities.
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  22. 22
    126428

    Interview schedule for Knowledge, Attitudes, Beliefs and Practices on AIDS. Phase I: African countries. A. Household form. B. Community characteristics. C. Individual questionnaire.

    World Health Organization [WHO]. Global Programme on AIDS. Social and Behavioural Research Unit

    [Unpublished] 1989 Feb. 28 p.

    The household interview form has spaces in which to designate a household's location and track interviewer visits with notation of visit results. Basic information can be recorded about the people over age 10 years who usually live in the household or who slept in the household on the preceding night. Data are then taken on the community characteristics form on the type of locality, travel time to the nearest large town, and facilities available in the community. The individual questionnaire is for people aged 15-64 years who slept in the household on the preceding night and is comprised of the following sections: identification; individual characteristics; awareness of AIDS; knowledge on AIDS; sources of information; beliefs, attitudes, and behavior; knowledge of and attitudes toward condoms; sexual practices; injection practices; locus of control; IV drug use; and drinking habits.
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  23. 23
    084813

    Population-related software in developing countries: a global survey.

    Vlassoff M; Nizamuddin M

    [Unpublished] 1993. Presented at the International Population Conference / Congres International de la Population, Montreal, Canada, August 24 - September 1, 1993. Sponsored by the International Union for the Scientific Study of Population [IUSSP]. 48 p.

    Findings from a survey on population-related software of institutions worldwide involved in demographic data analysis, in population policy formulation, or in training in population and development are presented. The software packages were developed by UN organizations, UNFPA-supported projects, government offices, universities, nongovernmental organizations and NGOs. In all, 286 questionnaires were received from institutions in 108 countries that reported the possession of 1747 software packages with an average of 6.1 packages/institution. 12 packages were distributed free of charge by the project Computer Software and Support for Population Activities. Only 31% of the 1747 packages were reported as being used frequently, 23% were reported to be seldom used, while 19% were never used and/or not planned to be used. Only MortPak-Lite, ISSA, and IMPS were used frequently in 24-33% of institutions. Less than 5% of institutions owned IMPECC, Blaise, POP-ILO, PopSyn, Recall Analysis, CAPPA, and HOST. UNFPA was directly involved in the development of PopMap which was frequently used at only 10% of institutions. 31% of the packages were mainly used as an aid in teaching demographic concepts in training courses. Target-Cost was found in 43% of the institutions, where it was used mainly for training. The corresponding percentages for some other packages were: MortPak-Lite (26%), PopMap (7%), Pc-Edit (17%), and DemProj (25%). Individually, PC-Edit (37%), ISSA (38%), and IMPS (30%) were used mainly for data entry and analysis. The projection programs DemProj (38%), FivFiv-SinSin (47%), and PEOPLE (55%) were mainly used for general demographic analysis and population projections. The most common reasons for not using packages were insufficient or unclear documentation and/or lack of trained personnel, and user-unfriendliness. Among the 283 institutions, around 6700 micros were reported to be in use, an average of almost 24 micros per institution.
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  24. 24
    081736
    Peer Reviewed

    A national study to monitor the safety of IUCD use.

    Richardson A; Paul C

    CONTRACEPTION. 1993 Apr; 47(4):359-66.

    To determine whether the known adverse effects of IUD use were kept to a minimum, 432 doctors were asked to complete questionnaires about their training and practice in IUD insertion, providing information about the insertion and the patient during a 3-month period. 349 doctors returned the first questionnaire. 93% of doctors had received some formal training in IUD insertion, although 54% had performed fewer than 5 supervised insertions before carrying out an unsupervised insertion. Only 8% had performed 10 or more supervised insertions. 58% had performed only 1 or no insertions in the month before the study period. 91% of respondents carried out more than 1 pelvic examination per week. Only 12% of doctors reported always prescribing prophylactic antibiotics. More doctors routinely took vaginal and cervical swabs for culture and cervical smears. 66% of doctors routinely arranged follow-up appointments. 98% of doctors routinely gave some information to women after IUD insertion. 90% of doctors provided a description of symptoms of infection. Information about women using an IUD was obtained from 129 doctors in 460 completed questionnaires about IUD insertions. Relative contraindications to IUD use included nulliparity, a history of suspected or proven pelvic inflammatory disease (PID), a significant risk of sexually transmitted disease (STD), and uncompleted family. Excluding uncompleted family, there were 126 insertions (27%) with at least 1 relative contraindication. Gynecologists performed 30% of the insertions in cases with relative contraindications compared with 48% for other doctors. 35 women who had IUDs inserted were nulliparous, and 4 of these were aged under 20, 11 women (2%) had an IUD inserted despite a history of suspected or proved PID. 12% of the women with IUDs were not in a stable sexual relationship; 9% had a history of STD, and 28% intended to have children in the future. 5% had both a risk factor for PID and an uncompleted family.
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  25. 25
    084629

    ECE directory of demographic centres in Europe and North America.

    United Nations. Economic Commission for Europe

    New York, New York, United Nations, 1992. xvii, 265 p.

    This directory of population centers in Europe, the US, and Canada was based on responses to a survey of 170 demographic research and/or training centers. Published information was available on 130 centers, due to deadlines. Countries providing information included Austria (3), belgium (5), Bulgaria (2), Canada (9), Cyprus (1), Czech and Slovak Federal Republic (2), Denmark (5), Finland (3), France (6), Germany (12), Greece (2), Hungary (1), Ireland (2), Italy (3), Luxembourg (1), Malta (2), Netherlands (6), Norway (2), Poland (5), Portugal (1), Rumania (2), Russian Federation (2), Spain (1), Switzerland (4), Turkey (3), Ukraine (1), UK (15), US (28), and the former Yugoslavia (3). The questionnaire distributed to the centers is included. Information requested included the following topics: name of institution, name of parent organization, name of director, postal address, telephone number, telex number, cable address, fax number, major functions (4 options indicated), status of institution (4 options), major areas of work in training and research and analysis (22 options), names of professional staff members, titles of major publications, titles of current major research projects of the institution, and titles of major surveys conducted since 1985.
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