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Understanding the needs of orphans and other children affected by HIV and AIDS in Africa : the state of the science

BIRDTHISTLE, Isolde
April 2004

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To date, responses to the needs of orphans and vulnerable children have not typically been guided by research, though a body of empirical evidence related to the impact of HIV and AIDS on children is growing. USAID/AFR/SD and the SARA project commissioned a review of 48 selected studies to summarize the findings that represent the most current understanding of children's vulnerability due to AIDS. The review captures what is known and not yet known about the impact of HIV and AIDS on the survival, health, education, social, and emotional needs of children; identifies the content gaps and methodological limitations of existing research; suggests priorities for future research; and informs programmatic and political responses

Debunking the myths in the US global AIDS strategy : an evidence-based analysis

CENTER FOR HEALTH AND GENDER EQUITY (CHANGE)
March 2004

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This key report takes a critical look at the US Global AIDS Strategy. It argues that responses to the crisis are not based upon evidence, but rather upon political and fundamentalist religious ideologies. The US AIDS strategy is critically reviewed section by section and evaluated according to evidence. The core assumptions in the strategy around prevention, treatment and funding mechanisms are challenged by the authors, who draw on evidence and data from a range of scientific and public health literature. The evidence overwhelmingly contradicts the assumptions on which the PEPFAR strategy is based, raising serious questions for those working those working to tackle the crisis

Getting research into practice

HEALTH INFORMATION FORUM (HIF)
2004

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Lessons from medical research may take years to get through to the frontline of healthcare. This is exacerbated in developing countries where there are difficulties in dissemination and barriers that prevent healthcare providers acting on new findings. Furthermore, most biomedical research is in high-income countries, and the results are not necessarily applicable in low-income countries. This meeting explored these issues through three short presentations (on dynamics and barriers, systematic reviews and recent changes in healthcare information and emerging challenges) followed by small-group and plenary discussion

Empowered to differ : stakeholders' influences in community-based rehabilitation

FINKENFLÜGEL, Harry
2004

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'Empowered to differ' equally addresses researchers and CBR professionals. The book gives an overview about the developments in the field of community-based rehabilitation since 1978, using the examples of CBR projects in Southern Africa. Finkenflügel asks for the knowledge and the evidence for CBR and to what extent the roles, interests and powers of stakeholders can contribute to this knowledge and evidence

National household HIV prevalence and risk survey of South African children

BROOKS, Heather
SHISANA, Olive
RICHTER, Linda
2004

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This valuable new report looks at the levels of infection of HIV and AIDS, the levels of orphaning and child headed households, sexual debut and sexual experiences and risk factors and risk environments for children aged 2-14 in South Africa. This has been investigated as the HSRC recognizes that there is very little known about HIV prevalence rates among children or about the risk factors that predispose them to becoming infected. The study looks at the social and community risk factors that predispose children to HIV infection as well as the impact of the epidemic on children in terms of orphan status and child headed households. It examines children’s knowledge of HIV and AIDS prevention, their knowledge about sexual behaviour and HIV as well as their own patterns of sexual behaviour and changes in that behaviour. This study is interesting as it explicitly includes young children

Double burden : a situation analysis of HIV/AIDS and young people with disabilities in Rwanda and Uganda

YOUSAFZAI, Aisha
EDWARDS, Karen
2004

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This analysis was carried out by Save the Children UK after reports from the field suggested that disabled people were not accessing HIV prevention information or services, despite being at higher risk of infection. It outlines ways in which disabled people are not fully included in safer-sex communications: for instance blind people hear talk about condoms, but have never held one; the necessity to have a sign-language interpreter for deaf people compromises their right to confidentiality; young girls with disabilities are more likely to be raped and are less able to negotiate safe sex. It recommends the greater integration of disabled people into health and HIV communications and further research to develop disabled-friendly means of communication

Palliative care in Sub-Saharan Africa : an appraisal

HARDING, Richard
HIGGINSON, Irene
2004

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This report was written from the belief that palliative care is, and will be for the forseeable future, an essential component in the continuum of managing HIV/AIDS in sub-Saharan Africa. There is now a wealth of experience in sub-Saharan Africa about the ways in which palliative care can be delivered both affordably and effectively. However, there remains a lack of properly documented evidence and research to demonstrate the importance of this work and promote its development. This report provides a review of existing evaluations of palliative care projects in sub-Saharan Africa with an emphasis on isolating the factors that lead to sustainability, local ownership and scaling up; the role of palliative care in the management of HIV/AIDS and how to integrate palliative care and Anti-Retroviral Therapy (ART); primary health based care projects in two countries, Kenya and Malawi, that could provide lessons for the implementation of palliative care; lessons from other parallel programmes which mirror palliative care delivery, for example, tuberculosis programmes, and primary care programmes with good links to local clinics and hospitals, and community mobilization and empowerment projects linked to health facilities. In this way it contributes to the effort of providing an evidence base to demonstrate the importance of palliative care and provides a source of reference for policy makers, practitioners, donors and researchers

Persons with disability : study commissioned by the Corporate Planning Unit of the City of Joburg as a component of the human development agenda

WHITEHEAD, Melissa
2004

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The aim of this research is to highlight problems with, and identify gaps in, the human development agenda as they relate to persons with disability in the City of Johannesburg. The research report also gives an overview of the methodologies applied.
The report is useful for organisations and persons who want to learn more about the situation of disabled persons in Johannesburg. Also it is of interest for researchers and organisations that are developing research methodology and policy

World report on knowledge for better health : strengthening health systems

WORLD HEATLH ORGANIZATION (WHO)
2004

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The objective of this report is to describe strategies to reduce global disparities in health through improvements in health research systems at national and international levels and systematic application of evidence-based knowledge. It takes stock of the current state of health research around the world and reaches the following conclusions: increased investments are needed for a new, innovative approach to research on health systems; health research must be managed more effectively if it is to contribute to strengthening health systems and building public confidence in science; stronger emphasis should be placed on translating knowledge into action to improve health by bridging the gap between what is known and what is actually being done. The report provides a compass to reorient health research so that it may respond more effectively to public health challenges on a national and global level. This reorientation requires a strengthening of the health research sector, an environment that is more conducive to research-informed policy and practice, and more focus on key priorities for research to improve health systems. While building on past achievements, the report's recommendations highlight aspects of the health research sector that, if managed more closely, could reap even more benefits for public health in future

The effectiveness of web-based vs non-web-based interventions : a meta-analysis of behavioural change outcomes

WANTLAND, D J
et al
2004

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The use of the Internet to deliver web-based interventions to patients is increasing rapidly. The use and effectiveness of web-based interventions to encourage an individual's change in behaviour compared to non-web-based interventions have not been substantially reviewed; hence this meta-analysis was undertaken. This article presents a systematic review of web-based therapies intended to encourage an individual's behaviour change. Sixteen of seventeen included studies revealed the outcomes of improved knowledge and/or improved behavioural outcomes for participants using web-based interventions. Outcomes included increased exercise time, knowledge of nutritional status, slower health decline

AIDS discrimination in Asia

ASIA PACIFIC NETWORK OF PEOPLE LIVING WITH HIV/AIDS (APN+)
2004

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Study of the discrimination faced by people living with HIV/AIDS. The study generated both qualitative and quantitative data. Its findings indicate that AIDS-related discrimination is prevalent in every sector of society. Age and educational background do not affect the level of discrimination faced, but sex, state of health and marital status do. Women are more likely than men to experience discrimination within the family and community because of their HIV status

Family and community practices that promote child survival, growth and development : a review of the evidence

HILL, Zelee
KIRKWOOD, Betty
EDMOND, Karen
2004

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This technical review paper presents the evidence for twelve key practices, identified by UNICEF and WHO to be of key importance in providing good home-care for the child to prevent or treat the Integrated Management of Childhood Illness conditions, in order to ensure survival, reduce morbidity, and promote healthy growth and development. The twelve key practices are: immunisation, breastfeeding, complementary feeding, micronutrients, hygiene, treated bed nets, food and fluids, home treatment, care-seeking, adherence, stimulation, and antenatal care. The paper has 3 objectives: 1. To summarise the available evidence 2. to identify gaps in knowledge 3. To make recommendations concerning next steps and priority-setting for both programme action and research

Living conditions among people with activity limitations in Zimbabwe : a representative regional survey

EIDE, Arne H
et al
December 2003

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"This report presents the findings of a study about the livelihoods of people with disability in Zimbabwe using data from household surveys with and without people with disabilities. The report, one of a series of regional research reports to establish baseline data on living conditions among people in Southern Africa, looks at the fields of health, employment, education, living conditions and services for people with disabilities"

Evaluation and utilization of traditional methods of communication in Cameroon's central, southern, eastern and extreme northern regions : case study 20

FOOD AND AGRICULTURE ORGANIZATION (FAO). Communication for Development Group
August 2003

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This study's main objectives are to evaluate traditional means of communication; to note their constraints; to select the traditional methods which can best be used for the diffusion of information and to devise a strategy for implementing the selected method of traditional communication. The methodology of this survey is based on the Active Method of Participative Research.
The study illustrates that the traditional media for communication in Cameroon are: the gong and songs accompanied by dances (in all of the surveyed provinces); the xylophone (in the center and south); griot [travelling poet] and balafon (in the east); colleagues of the traditional chiefs (Lawanes, Djaoros); and messengers of traditional chiefs or muezzins (extreme north).There are numerous constraints to using individuals in devising communications strategies: a lack of trained musicians, the lack of initiative on the part of the village elders, the disinterest of the youth, conflict among the different generations, the proliferation of modern communications technologies, the complexity of training in various methods, the possible alteration of messages, a lack of motivation and the slow speed of transmission. The study notes that the best methods for the diffusion of information in the regions surveyed in Cameroon are: the gong, the colleagues and messengers of traditional chiefs to organize village meetings in which reproductive health issues could be raised, singing and dancing, travelling poets and xylophones.
In order to devise effective strategies for conveying messages about reproductive health through these traditional methods of communication, traditional authorities must be engaged early on in the process and informed of the importance of these means of communication; qualified individuals must be identified as resources and others trained; and a training of trainers must be conducted

Information and communication technologies and poverty reduction in Sub Saharan Africa : a learning study (synthesis)

GERSTER, Richard
ZIMMERMAN, Sonja
2003

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A report of the learning study carried out as part of the Building Digital Opportunities (BDO) programme.The study focuses on mapping the experiences of BDO partners with ICTs and poverty reduction in order to enable BDO partners to improve their understanding of the role of ICTs in poverty reduction and play a pro-poor role in multilateral forums like the World Summit on the Information Society (WSIS). It draws on research into the use of information and communication technology in Mali, Uganda and Zambia, and examines progress in fulfilling BDO's global objective to ensure that such technology contributes to the achievement of the 8 Millenium Development Goals and 17 Millenium Development Targets

Drug and therapeutics committees : a practical guide

HOLLOWAY, Kathleen
GREEN, Terry
2003

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This guide provides guidance to doctors, pharmacists, hospital managers and other professionals who may be serving on Drug and Therapeutics Committees (DTCs) and/or who are concerned with how to improve the quality and cost efficiency of therapeutic care. It is relevant for all kinds of DTCs - whether in public or private hospitals and whether at district or tertiary referral level. This manual covers a committee's functions and structure, the medicines formulary process, and how to assess new medicines. The chapters on tools to investigate drug use and strategies to promote rational use are followed by a discussion of antimicrobial resistance and infection control. The publication concludes by explaining in detail how to start a committee or improve the effectiveness of an existing one

Health : an ecosystem approach

LEBEL, Jean
2003

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Can people remain healthy in a world that is sick? Many ecological disasters can be directly traced to careless exploitation of the environment, with human beings as first perpetrator and then victim. Our health closely mirrors the health of our surroundings: this is the basis of the Ecohealth approach. It recognizes the links between humans and their biophysical, social, and economic environments, and that these links are reflected in the population's state of health. This is a new area of research, requiring input from scientists, community and interest groups, and decision-makers. This book describes this new approach, providing lessons and recommendations from various IDRC-supported research activities. It demonstrates how decision-makers, in particular, can use the ecohealth approach to formulate policies and solutions that are both immediately visible and sustainable over the long term

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