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Your search found 185 Results

  1. 1
    335935

    Atlas of eHealth country profiles 2013. eHealth and innovation in women's and children's health. Based on the findings of the 2013 survey of ColA countries by the WHO Global Observatory for eHealth.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2014. [132] p.

    This atlas is based on the 2013 WHO / ITU joint survey that explored the use of eHealth for women’s and children’s health in countries targeted by the Commission on Information and Accountability for Women’s and Children’s Health (CoIA). The objective of the country profiles is to describe the status in 2013 of the use of ICT for women’s and children’s health in 64 responding CoIA countries. This is a unique reference source for policy makers and others involved in planning and implementing eHealth services in countries.
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  2. 2
    335934

    eHealth and innovation in women's and children's health: A baseline review. Based on the findings of the 2013 survey of CoIA countries by the WHO Global Observatory for eHealth. Executive summary.

    World Health Organization [WHO]; International Telecommunication Union [ITU]

    [Geneva, Switzerland], WHO, 2014. [4] p. (WHO/HIS/KER/EHL/14.1)

    Improving the health of women and children is a global health imperative, reflected in two of the most compelling Millennium Development Goals which seek specifically to reduce maternal and infant deaths by 2015. This joint report by the World Health Organization (WHO) and the International Telecommunication Union (ITU), based on a 64-country survey, demonstrates -- as never before in such detail -- the vital role that information and communication technologies (ICTs) and particularly eHealth are playing today in helping achieve those targets. It demonstrates how, every day, eHealth is saving the lives of women, their babies and infants in the some of the most vulnerable populations around the world, in a wide variety of innovative ways.
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  3. 3
    335208

    The PMNCH 2013 report. Analysing progress on commitments to the Global Strategy for Women’s and Children’s Health.

    Partnership for Maternal, Newborn and Child Health

    Geneva, Switzerland, World Health Organization [WHO], Partnership for Maternal, Newborn and Child Health, 2013. [104] p.

    The main objective of this year’s report is to assess the extent to which the 293 stakeholders who have made commitments to the Global Strategy since its launch in 2010 (up to June 2013) have implemented their commitments, and the extent to which implementation is contributing to reaching the goals of the Global Strategy for Women’s and Children’s Health. It is not a comprehensive stocktaking of all that is being done at national, regional and global levels to improve women’s and children’s health. The content of the report is based on a range of information sources and data collection methods as relevant to the nature of the individual commitments and their implementation. The methods used were: a content analysis of all commitment statements from the Every Woman Every Child website; an online survey sent to commitment-makers, of which 120 fully completed the survey; detailed interviews based on semi-structured questionnaires with a selection of stakeholders; and an extensive desk review of relevant literature and databases.
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  4. 4
    357499
    Peer Reviewed

    Maternal & Newborn Health Road Maps: a review of progress in 33 sub-Saharan African countries, 2008-2009.

    Ekechi C; Wolman Y; de Bernis L

    Reproductive Health Matters. 2012 Jun; 20(39):164-8.

    The 2006 Maputo Plan of Action aimed to help African nations to achieve the Millennium Development Goals related to reducing maternal mortality, combatting HIV and AIDS, and reducing infant and child mortality within integrated sexual and reproductive health care plans. In 2008 and 2009, UNFPA worked with senior Ministry of Health officials and national UNFPA, UNICEF and WHO teams in 33 African countries to review their development of national Maternal and Newborn Health strategies and plans through a self-assessment survey. The survey showed that many key components were missing, in particular there was poor integration of family planning; lack of budgetary, infrastructure and human resources plans; and weak monitoring and evaluation provisions. The maternal and newborn health Road Map initiative has been the single most important factor for the initiation and development of the national maternal and newborn health plans for many African countries. However the deficiencies within these national plans need to be addressed before a significant reduction in maternal and newborn mortality can realistically be achieved. Copyright (c) 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
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  5. 5
    334316

    Global income inequality by the numbers: In history and now. An overview.

    Milanovic B

    [Washington, D.C.], World Bank, Development Research Group, Poverty and Inequality Team, 2012 Nov. [30] p. (Policy Research Working Paper No. 6259)

    The paper presents an overview of calculations of global inequality, recently and over the long-run as well as main controversies and political and philosophical implications of the findings. It focuses in particular on the winners and losers of the most recent episode of globalization, from 1988 to 2008. It suggests that the period might have witnessed the first decline in global inequality between world citizens since the Industrial Revolution. The decline however can be sustained only if countries’ mean incomes continue to converge (as they have been doing during the past ten years) and if internal (within-country) inequalities, which are already high, are kept in check. Mean-income convergence would also reduce the huge “citizenship premium” that is enjoyed today by the citizens of rich countries.
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  6. 6
    334132
    Peer Reviewed

    Child mortality estimation: Accelerated progress in reducing global child mortality, 1990-2010.

    Hill K; You D; Inoue M; Oestergaard MZ

    PLOS Medicine. 2012 Aug; 9(8):e1001303.

    Monitoring development indicators has become a central interest of international agencies and countries for tracking progress towards the Millennium Development Goals. In this review, which also provides an introduction to a collection of articles, we describe the methodology used by the United Nations Inter-agency Group for Child Mortality Estimation to track country-specific changes in the key indicator for Millennium Development Goal 4 (MDG 4), the decline of the underfive mortality rate (the probability of dying between birth and age five, also denoted in the literature as U5MR and 5q0). We review how relevant data from civil registration, sample registration, population censuses, and household surveys are compiled and assessed for United Nations member states, and how time series regression models are fitted to all points of acceptable quality to establish the trends in U5MR from which infant and neonatal mortality rates are generally derived. The application of this methodology indicates that, between 1990 and 2010, the global U5MR fell from 88 to 57 deaths per 1,000 live births, and the annual number of under-five deaths fell from 12.0 to 7.6 million. Although the annual rate of reduction in the U5MR accelerated from 1.9% for the period 1990-2000 to 2.5% for the period 2000-2010, it remains well below the 4.4% annual rate of reduction required to achieve the MDG 4 goal of a two-thirds reduction in U5MR from its 1990 value by 2015. Thus, despite progress in reducing child mortality worldwide, and an encouraging increase in the pace of decline over the last two decades, MDG 4 will not be met without greatly increasing efforts to reduce child deaths.
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  7. 7
    354311
    Peer Reviewed

    The world health organization multicountry survey on maternal and newborn health: study protocol.

    Souza JP; Gulmezoglu AM; Carroli G; Lumbiganon P; Qureshi Z

    BMC Health Services Research. 2011; 11:286.

    BACKGROUND: Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health. METHODS/DESIGN: This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that ranges from two to three months according to the annual number of deliveries. DISCUSSION: Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more comprehensive dialogue with governments, professionals and civil societies, health systems or facilities for promoting best practices, improving quality of care and achieving better health for mothers and children.
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  8. 8
    333614

    Developing a family planning goal for 2015 that supports MDG-5b.

    Ross J; Stover J

    Washington, D.C., Futures Group, Health Policy Initiative, 2010 Sep. [5] p. (USAID Contract No. GPO-1-01-05-00040-00)

    A clear goal for family planning, related to MDG-5b, is needed for consideration by the September meeting of the UN High-Level Plenary Meeting on the MDGs. The Health Policy Initiative project has used historical trends along with an exploration of alternative scenarios to assist in the selection of that goal. In addition, to make explorations rapid and convenient, links were established between contraceptive use, unmet need, and demand that permitted rapid exploration of alternative action assumptions. That kind of analysis can be employed in the future for updates and related applications, in addition to aiding the pending decision on an international family planning goal for MDG-5b for 2015. Agreement on a quantitative objective for contraceptive use by 2015 can focus donor and government energies to enlarge access to alternative contraceptive methods, with improved quality of service, through both public and private channels.
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  9. 9
    333566

    Legal frameworks for eHealth. Based on the findings of the second global survey on eHealth.

    Wilson P

    Geneva, Switzerland, World Health Organization [WHO], 2012. [89] p. (Global Observatory for eHealth Series Vol. 5)

    Given that privacy of the doctor-patient relationship is at the heart of good health care, and that the electronic health record (EHR) is at the heart of good eHealth practice, the question arises: Is privacy legislation at the heart of the EHR? The second global survey on eHealth conducted by the Global Observatory for eHealth (GOe) set out to answer that question by investigating the extent to which the legal frameworks in the Member States of the World Health Organization (WHO) address the need to protect patient privacy in EHRs as health care systems move towards leveraging the power of EHRs to deliver safer, more efficient, and more accessible health care. (Excerpt)
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  10. 10
    349179
    Peer Reviewed

    Synthetic evaluation of the effect of health promotion: impact of a UNICEF project in 40 poor western counties of China.

    Bi Y; Lai D; Yan H

    Public Health. 2010 Jul; 124(7):376-91.

    OBJECTIVE: To synthetically evaluate the effects of a health promotion project launched by the Ministry of Health of China and the United Nations Children's Fund (UNICEF) in 40 poor western counties of China. STUDY DESIGN: The two surveys were cross-sectional studies. Stratified multistage random sampling was used to recruit subjects. METHODS: Data were collected through two surveys conducted in the 40 'UNICEF project counties' in 1999 and 2000. After categorizing the 27 evaluation indicators into four aspects, a hybrid of the Analytic Hierarchy Process, the Technique for Order Preference by Similarity to Ideal Solution, and linear weighting were used to analyse the changes. The 40 counties were classified into three different levels according to differences in the synthetic indicator derived. Comparing the synthetic evaluation indicators of these two surveys, issues for implementation of the project were identified and discussed. RESULTS: The values of the synthetic indicators were significantly higher in 2000 than in 1999 (P=0.02); this indicated that the projects were effective. Among the 40 counties, 11 counties were at a higher level in 2000, 10 counties were at a lower level, and others were in the middle level. Comparative analysis showed that 36% of village clinics were not licensed to practice medicine, nearly 50% of village clinics had no records of medicine purchases, nearly 20% of village clinics had no pressure cooker for disinfection, and 20% of pregnant women did not receive any prenatal care. CONCLUSIONS: The health promotion projects in the 40 counties were effective. Health management, medical treatment conditions, maternal health and child health care have improved to some extent. However, much remains to be done to improve health care in these 40 poor counties. The findings of this study can help decision makers to improve the implementation of such improvements. Copyright 2010 The Royal Society for Public Health. All rights reserved.
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  11. 11
    333197

    mHealth: New horizons for health through mobile technologies. Based on the findings of the Second Global Survey on eHealth.

    World Health Organization [WHO]. Global Observatory for eHealth

    Geneva, Switzerland, WHO, 2011. [112] p. (Global Observatory for eHealth Series Vol. 3)

    This report aims to make policy-makers aware of the mHealth landscape and the main barriers to implement or scale mHealth projects. It combines the results and analysis of the data gathered from the mHealth survey and is complemented by five country case studies and a review of the current literature related to mHealth. (Excerpt)
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  12. 12
    347664

    On the map: charting the landscape of girl work.

    International Center for Research on Women [ICRW]

    Washington, D.C., ICRW, 2010. 43 p.

    Girls receive a disproportionally small share of the total development dollars invested globally each year, but the field is primed for even greater action and investment. Before charting the way forward, it is important to understand more about current efforts underway on behalf of girls. ICRW designed a mapping exercise to identify the scope and range of work on issues related to girls being undertaken by key development actors. The exercise also helped analyze the core directions, opportunities, and gaps inherent across the efforts of multiple stakeholders. This report presents the key findings from this exercise, describing what we have learned about the donors and organizations engaged in working with girls, the policy and program efforts underway, and current and future directions for the field.
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  13. 13
    332869

    Atlas eHealth country profiles. Based on the findings of the Second Global Survey on eHealth.

    World Health Organization [WHO]. Global Observatory for eHealth

    Geneva, Switzerland, WHO, 2011. [244] p.

    This publication presents data on the 114 WHO Member States that participated in the 2009 global survey on eHealth. Intended as a reference to the state of eHealth development in Member States, the publication highlights selected indicators in the form of country profiles. The objectives of the country profiles are to: describe the current status of the use of ICT for health in Member States; and provide information concerning the progress of eHealth applications in these countries. (Excerpt)
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  14. 14
    332856

    Telemedicine: opportunities and developments in Member States: report on the second global survey on eHealth, 2009.

    World Health Organization [WHO]. Global Observatory for eHealth

    Geneva, Switzerland, WHO, 2010. [96] p.

    The telemedicine module of the 2009 survey examined the current level of development of four fields of telemedicine: teleradiology, teledermatogy, telepathology, and telepsychology, as well as four mechanisms that facilitate the promotion and development of telemedicine solutions in the short- and long-term: the use of a national agency, national policy or strategy, scientific development, and evaluation. Telemedicine -- opportunities and developments in Member States discusses the results of the telemedicine module, which was completed by 114 countries (59% of Member States). Findings from the survey show that teleradiology currently has the highest rate of established service provision globally (33%). Approximately 30% of responding countries have a national agency for the promotion and development of telemedicine, and developing countries are as likely as developed countries to have such an agency. In many countries scientific institutions are involved with the development of telemedicine solutions in the absence of national telemedicine agencies or policies; while 50% of countries reported that scientific institutions are currently involved in the development of telemedicine solutions, 20% reported having an evaluation or review on the use of telemedicine in their country published since 2006. (Excerpt)
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  15. 15
    332290

    Supporting country-led initiatives to strengthen national health information systems in East Africa.

    Coleman T; Garten AD

    Washington, D.C., Futures Group, Health Policy Initiative, 2009 Oct. [34] p. (USAID Contract No. GPO-I-01-05-00040-00)

    In response to a growing recognition of the importance of reliable and timely health information systems (HIS) to support improved decisionmaking for public health action and health systems strengthening, USAID supported a regional forum in East Africa that focused on engaging HIS champions from key public sectors -- including health, finance, telecommunications, and vital statistics -- and supporting country ownership of HIS. Toward that end, delegations from six focus countries (Ethiopia, Kenya, Malawi, Rwanda, Tanzania, and Uganda, with Namibia and Sudan as observers) convened for a three-day workshop, "Country Ownership Strategies: Leadership Forum on Health Information Systems," in Addis Ababa from August 10-13, 2009. As part of the preparation and planning for this forum, the USAID |Health Policy Initiative, Task Order 1 designed and executed a semi-structured qualitative survey to capture the current state of HIS in each of the six focus countries. This report highlights the results of that survey and includes background materials that supported the survey process. Given the overall success of the first forum, USAID is exploring ways to replicate this activity in other regions and continue to provide country-specific technical and financial assistance for HIS strengthening..
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  16. 16
    344378
    Peer Reviewed

    Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa.

    Shah A; Fawole B; M'imunya JM; Amokrane F; Nafiou I; Wolomby JJ; Mugerwa K; Neves I; Nguti R; Kublickas M; Mathai M

    International Journal of Gynaecology and Obstetrics. 2009 Dec; 107(3):191-7.

    OBJECTIVE: To assess the association between cesarean delivery rates and pregnancy outcomes in African health facilities. METHODS: Data were obtained from all births over 2-3 months in 131 facilities. Outcomes included maternal deaths, severe maternal morbidity, fresh stillbirths, and neonatal deaths and morbidity. RESULTS: Median cesarean delivery rate was 8.8% among 83439 births. Cesarean deliveries were performed in only 95 (73%) facilities. Facility-specific cesarean delivery rates were influenced by previous cesarean, pre-eclampsia, induced labor, referral status, and higher health facility classification scores. Pre-eclampsia increased the risks of maternal death, fresh stillbirths, and severe neonatal morbidity. Adjusted emergency cesarean delivery rate was associated with more fresh stillbirths, neonatal deaths, and severe neonatal morbidity--probably related to prolonged labor, asphyxia, and sepsis. Adjusted elective cesarean delivery rate was associated with fewer perinatal deaths. CONCLUSION: Use of cesarean delivery is limited in the African health facilities surveyed. Emergency cesareans, when performed, are often too late to reduce perinatal deaths.
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  17. 17
    328452
    Peer Reviewed

    Stakeholders' opinions and expectations of the Global Fund and their potential economic implications.

    Galarraga O; Bertozzi SM

    AIDS. 2008 Jul; 22 Suppl 1:S7-S15.

    OBJECTIVES: To analyse stakeholder opinions and expectations of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and to discuss their potential economic and financial implications. DESIGN: The Global Fund commissioned an independent study, the '360 degrees Stakeholder Survey', to canvas feedback on the organization's reputation and performance with an on-line survey of 909 respondents representing major stakeholders worldwide. We created a proxy for expectations based on categorical responses for specific Global Fund attributes' importance to the stakeholders and current perceived performance. METHODS: Using multivariate regression, we analysed 23 unfulfilled expectations related to: resource mobilization; impact measurement; harmonization and inclusion; effectiveness of the Global Fund partner environment; and portfolio characteristics. The independent variables are personal and regional-level characteristics that affect expectations. RESULTS: The largest unfulfilled expectations relate to: mobilization of private sector resources; efficiency in disbursing funds; and assurance that people affected by the three diseases are reached. Stakeholders involved with the fund through the country coordinating mechanisms, those working in multilateral organizations and persons living with HIV are more likely to have unfulfilled expectations. In contrast, higher levels of involvement with the fund correlate with fulfilled expectations. Stakeholders living in sub-Saharan Africa were less likely to have their expectations met. CONCLUSIONS: Stakeholders' unfulfilled expectations result largely from factors external to them, but also from factors over which they have influence. In particular, attributes related to partnership score poorly even though stakeholders have influence in that area. Joint efforts to address perceived performance gaps may improve future performance and positively influence investment levels and economic viability.
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  18. 18
    327859
    Peer Reviewed

    The next 5 years of global HIV / AIDS policy: Critical gaps and strategies for effective responses.

    Szekeres G

    AIDS. 2008; 22 Suppl 2:S9-S17.

    The University of California, Los Angeles Program in Global Health performed a landscape analysis based on interviews conducted between November 2006 and February 2007 with 35 key informants from major international organizations conducting HIV/AIDS work. Institutions represented included multilateral organizations, foundations, and governmental and non-governmental organizations. The purpose of this analysis is to assist major foundations and other institutions to understand better the international HIV/AIDS policy landscape and to formulate research and development programmes that can make a significant contribution to moving important issues forward in the HIV/AIDS policy arena. Topics identified during the interviews were organized around the four major themes of the Ford Foundation's Global HIV/AIDS Initiative: leadership and leadership development; equity; accountability; and global partnerships. Key informants focused on the need for a visionary response to the HIV pandemic, the need to maintain momentum, ways to improve the scope of leadership development programmes, ideas for improving gender equity and addressing regional disparities and the needs of vulnerable populations, recommendations for strengthening accountability mechanisms among governments, foundations, and civil society and on calling for increased collaboration and partnership among key players in the global HIV/AIDS response. (Author's)
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  19. 19
    327213

    Tobacco use among students aged 13 - 15 years - Sri Lanka, 1999 - 2007.

    United States. Center for Disease Control [CDC]

    MMWR. Morbidity and Mortality Weekly Report. 2008 May 23; 57(20):545-549.

    Tobacco use is one of the major preventable causes of premature death and disease in the world. The World Health Organization (WHO) attributes approximately 5 million deaths per year to tobacco use, a number expected to exceed 8 million per year by 2030. In 1999, the Global Youth Tobacco Survey (GYTS) was initiated by WHO, CDC, and the Canadian Public Health Association to monitor tobacco use, attitudes about tobacco use, and exposure to secondhand smoke (SHS) among students aged 13-15 years. Since 1999, the survey has been completed by approximately 2 million students in 151 countries. A key goal of GYTS is for countries to repeat the survey every 4 years. This report summarizes results from GYTS conducted in Sri Lanka in 1999, 2003, and 2007. The findings indicated that during 1999-2007, the percentage of students aged 13-15 years who reported current cigarette smoking decreased, from 4.0% in 1999 to 1.2% in 2007. During this period, the percentage of never smokers in this age group likely to initiate smoking also decreased, from 5.1% in 1999 to 3.7% in 2007. Future declines in tobacco use in Sri Lanka will be enhanced through development and implementation of new tobacco-control measures and strengthening of existing measures that encourage smokers to quit, eliminate exposure to SHS, and encourage persons not to initiate tobacco use. (excerpt)
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  20. 20
    326278

    Using national resources to finance contraceptive procurement. Policy brief.

    John Snow [JSI]. DELIVER

    Arlington, Virginia, JSI, DELIVER, [2008]. [9] p. (Policy Brief)

    Driven by the increasing demand for and popularity of family planning, increasing population size, and changing demographics with more couples entering their fertile years, the financing requirement for contraceptives has become increasingly onerous. Strategies to finance contraceptives include expansion of the donor base; increased use of cost recovery, including revolving drug funds; greater use of the private sector; and direct government financing of contraceptive procurement. None of these is mutually exclusive, and to ensure contraceptive security, most countries are likely to use some or all of these approaches, and many others. Evidence suggests that many governments are beginning to finance contraceptive procurement using national resources, but limited data are publicly available regarding the global extent of this financing. This brief details the findings of a survey of the extent to which national governments of developing countries are using national resources to finance contraceptive procurement. The brief examines the different types of financing used, some of the benefits of this type of financing, and some of the issues it raises. Hopefully, this study can be repeated to track spending and will spur more rigorous efforts to measure this practice. (excerpt)
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  21. 21
    325823
    Peer Reviewed

    Intimate partner violence and women's physical and mental health in the WHO multi-country study on women’s health and domestic violence: An observational study.

    Ellsberg M; Jansen HA; Heise L; Watts CH; Garcia-Moreno C

    Lancet. 2008 Apr; 371(9619):1165-1172.

    This article summarises findings from ten countries from the WHO multi-country study on women's health and domestic violence against women. Standardised population-based surveys were done between 2000 and 2003. Women aged 15-49 years were interviewed about their experiences of physically and sexually violent acts by a current or former intimate male partner, and about selected symptoms associated with physical and mental health. The women reporting physical violence by a partner were asked about injuries that resulted from this type of violence. 24 097 women completed interviews. Pooled analysis of all sites found significant associations between lifetime experiences of partner violence and self-reported poor health (odds ratio 1.6 [95% CI 1.5-1.8]), and with specific health problems in the previous 4 weeks: difficulty walking (1.6 [1.5-1.8]), difficulty with daily activities (1.6 [1.5-1.8]), pain (1.6 [1.5-1.7]), memory loss (1.8 [1.6-2.0]), dizziness (1.7 [1.6-1.8]), and vaginal discharge (1.8 [1.7-2.0]). For all settings combined, women who reported partner violence at least once in their life reported significantly more emotional distress, suicidal thoughts (2.9 [2.7-3.2]), and suicidal attempts (3.8 [3.3-4.5]), than non-abused women. These significant associations were maintained in almost all of the sites. Between 19% and 55% of women who had ever been physically abused by their partner were ever injured. In addition to being a breach of human rights, intimate partner violence is associated with serious public-health consequences that should be addressed in national and global health policies and programmes. WHO; Governments of the Netherlands, Norway, Sweden, Switzerland, and UK; Rockefeller Foundation; Urban Primary Health Care project of the Government of Bangladesh; Swedish Agency for Research Cooperation with Developing Countries (SAREC/Sida); United Nations Fund for Population Activities (UNFPA); and Trocaire. (author's)
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  22. 22
    325889
    Peer Reviewed

    Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries.

    Valentine N; Darby C; Bonsel GJ

    Social Science and Medicine. 2008 May; 66(9):1939-1950.

    Quality of care research has reached some agreement on concepts like structure, process and outcome, and non-clinical versus clinical processes of care. These concepts are commonly explored through surveys measuring patient experiences, yet few surveys have focused on patient, or "user", priorities across different quality dimensions. Population surveys on priorities can contribute to, although not replace participation in, policy decision making. Using 105,806 survey interview records from the World Health Organization's (WHO's) general population surveys in 41 countries, this paper describes the relative importance of eight domains in the non-clinical quality of care concept WHO calls "health systems responsiveness". Responsiveness domains are divided into interpersonal domains (dignity, autonomy, communication and confidentiality) and structural domains (quality of basic amenities, choice, access to social support networks and prompt attention). This paper explores variations in domain importance by country-level variables (country of residence, human development, health system expenditure, and "geographic zones") and by subpopulations defined by sex, age, education, health status, and utilization. Most respondents selected prompt attention as the most important domain. Dignity was selected second, followed by communication. Access to social support networks was identified as the least important domain. In general, convergence in rankings was stronger across subpopulations within countries than across countries. Yet even across diverse countries, there was more convergence than divergence in views. These results provide a ranking of quality of care criteria for consideration during health reform processes further to the usual emphasis on clinical quality and supply-side efficiency. (author's)
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  23. 23
    323969

    Global Youth Tobacco Surveillance, 2000 -- 2007.

    Warren CW; Jones NR; Peruga A; Chauvin J; Baptiste JP

    MMWR. Morbidity and Mortality Weekly Report. 2008 Jan 25; 57(1):1-28.

    Tobacco use is a major contributor to deaths from chronic diseases. The findings from the Global Youth Tobacco Survey (GYTS) suggest that the estimate of a doubling of deaths from smoking (from 5 million per year to approximately 10 million per year by 2020) might be an underestimate because of the increase in smoking among young girls compared with adult females, the high susceptibility of smoking among never smokers, high levels of exposure to secondhand smoke, and protobacco indirect advertising. This report includes GYTS data collected during 2000-2007 from 140 World Health Organization (WHO) member states, six territories (American Samoa, British Virgin Islands, Guam, Montserrat, Puerto Rico, and the U.S. Virgin Islands), two geographic regions (Gaza Strip and West Bank), one United Nations administered province (Kosovo), one special administrative region (Macau), and one Commonwealth (Northern Mariana Islands). For countries that have repeated GYTS, only the most recent data are included. For countries with multiple survey sites, only data from the capital or largest city are presented. GYTS is a school-based survey of a defined geographic site that can be a country, a province, a city, or any other geographic entity. GYTS uses a standardized methodology for constructing sampling frames, selecting schools and classes, preparing questionnaires, conducting field procedures, and processing data. GYTS standard sampling methodology uses a two-stage cluster sample design that produces samples of students in grades associated with students aged 13-15 years. Each sampling frame includes all schools (usually public and private) in a geographically defined area containing any of the identified grades. In the first stage, the probability of schools being selected is proportional to the number of students enrolled in the specified grades. In the second sampling stage, classes within the selected schools are selected randomly. All students in selected classes attending school the day the survey is administered are eligible to participate. Student participation is voluntary and anonymous using self-administered data collection procedures. The GYTS sample design produces independent, cross-sectional estimates that are representative of each site. The findings in this report indicate that the level of cigarette smoking between boys and girls is similar in many sites; the prevalence of cigarette smoking and use of other tobacco products is similar; and susceptibility to initiate smoking among never smokers is similar among boys and girls and is higher than cigarette smoking in the majority of sites. Approximately half of the students reported that they were exposed to secondhand smoke in public places during the week preceding the survey. Approximately eight in 10 favor a ban on smoking in public places. Approximately two in 10 students own an object with a cigarette brand logo on it, and one in 10 students have been offered free cigarettes by a tobacco company representative. Approximately seven in 10 students who smoke reported that they wanted to stop smoking. Approximately seven in 10 students who smoked were not refused purchase of cigarettes from a store during the month preceding the survey. Finally, approximately six in 10 students reported having been taught in school about the harmful effects of smoking during the year preceding the survey. The findings in this report suggest that interventions that decrease tobacco use among youth (e.g., increasing excise taxes, media campaigns, school programs in conjunction with community interventions, and community interventions that decrease minors' access to tobacco) must be broad-based, focused on boys and girls, and have components directed toward prevention and cessation. If effective programs are not developed and implemented soon, future morbidity and mortality attributed to tobacco probably will increase. The synergy between countries in passing tobacco-control laws, regulations, or decrees; ratifying the WHO Framework Convention on Tobacco Control; and conductingGYTS offers a unique opportunity to develop, implement, and evaluate comprehensive tobacco-control policy that can be helpful to each country. The challenge for each country is to develop, implement, and evaluate a tobacco-control program and make changes where necessary. (author's)
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  24. 24
    323461
    Peer Reviewed

    Monitoring effectiveness of programmes to prevent mother-to-child HIV transmission in lower-income countries.

    Stringer EM; Chi BH; Chintu N; Creek TL; Ekouevi DK

    Bulletin of the World Health Organization. 2008 Jan; 86(1):57-62.

    Ambitious goals for paediatric AIDS control have been set by various international bodies, including a 50% reduction in new paediatric infections by 2010. While these goals are clearly appropriate in their scope, the lack of clarity and consensus around how to monitor the effectiveness of programmes to prevent mother-to-child HIV transmission (PMTCT) makes it difficult for policy-makers to mount a coordinated response. In this paper, we develop the case for using population HIV-free child survival as a gold standard metric to measure the effectiveness of PMTCT programmes, and go on to consider multiple study designs and source populations. Finally, we propose a novel community survey-based approach that could be implemented widely throughout the developing world with minor modifications to ongoing Demographic and Health Surveys. (author's)
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  25. 25
    313995
    Peer Reviewed

    Generations and Gender Survey (GGS): Towards a better understanding of relationships and processes in the life course.

    Vikat A; Speder Z; Beets G; Billari FC; Buhler C

    Demographic Research. 2007 Nov 30; 17(14):389-440.

    The Generations and Gender Survey (GGS) is one of the two pillars of the Generations and Gender Programme designed to improve understanding of demographic and social development and of the factors that influence these developments. This article describes how the theoretical perspectives applied in the survey, the survey design and the questionnaire are related to this objective. The key features of the survey include panel design, multidisciplinarity, comparability, context-sensitivity, inter-generational and gender relationships. The survey applies the life course approach, focussing on the processes of childbearing, partnership dynamics, home leaving, and retiring. The selection of topics for data collection mainly follows the criterion of theoretically grounded relevance to explaining one or more of the mentioned processes. A large portion of the survey deals with economic aspects of life, such as economic activity, income, and economic well-being; a comparably large section is devoted to values and attitudes. Other domains covered by the survey include gender relationships, household composition and housing, residential mobility, social networks and private transfers, education, health, and public transfers. The third chapter of the article describes the motivations for their inclusion. The GGS questionnaire is designed for a face-to-face interview. It includes the core that each participating country needs to implement in full, and four optional submodules on nationality and ethnicity, on previous partners, on intentions of breaking up, and on housing, respectively. The participating countries are encouraged to include also the optional sub-modules to facilitate comparative research on these topics. (author's)
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