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La Herramienta de Administración y Sustentabilidad Organizacional para Programas Nacionales de Control de la TB (MOST para la TB) es un proceso para mejorar la administración de un PNCT, cuyo resultado final es contribuir a lograr los tres objetivos principales de los PNCT.

The five-year Leadership, Management and Sustainability (LMS) Program was awarded to MSH in August 2005 by the US Agency for International Development's Office of Population and Reproductive Health, in the Bureau of Global Health, and concluded in December 2010.

Because resources available to improve global health are limited, it is becoming increasingly important for those who produce and disseminate health-related information and services to gauge the impact of their work.

Transforming Organizations to Improve Health

For four decades in more than 130 countries, Management Sciences for Health (MSH) has taken a whole-of-society approach to development: MSH works with governments to strengthen their leadership and governance capacity and with private and civil society organizations to improve service delivery systems. Through this locally driven approach, MSH regularly works its way out of a job.

Performance-based Financing (PBF) is a powerful means of increasing the quality and quantity of health services by providing incentives to suppliers to improve performance and achieve results.

In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO) program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs) from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008.

The WHO 2010 guidelines specify that a CD4 cell count is crucial to decisions about the eligibility of HIV-infected pregnant women for lifelong antiretroviral treatment (ART). In Malawi, however, access to CD4 cell count analysis is minimal.

In Bangladesh, fertility was high in the 1950s and declined to fewer than five births per woman in the early or mid-1990s like other developing countries. After that the level of fertility is stalled. The aim of this study is to assess the extent of unmet need for family planning among married women of reproductive age group in Bangladesh and to study the factors related to it.

Namibia had the fourth highest incidence of TB in the world and is among the countries most affected by HIV & AIDS. The country also faces a huge challenge in its pursuit of malaria eradication. In the face of these challenges, Namibia has an acute shortage of health care personnel, including in pharmaceutical care.

Objective: To assess whether linking the Global Alliance for Vaccine and Immunization (GAVI) service support with performance-based interventions has influenced the quality of reporting and of immunization systems. GAVI Service Support (ISS) combines performance assessment, recommendations and implementation support with financial reward.

To explore the process, major players and procedural success factors for recent public sector TB regimen changes, we conducted 166 interviews of country stakeholders in 21 of the 22 TB high-burden countries (HBCs).Stakeholders described 40 distinct regimen changes for drug-susceptible TB. Once countries committed to considering a change, the average timing was ∼1 year for decision-making and ∼2 years for roll-out. Stakeholders more often cited concerns that were program-based (e.g., logistics and cost) rather than patient-focused (e.g., side effects), and patient representatives were seldom part of decision making. Decision-making bodies in higher-income HBCs had more formalized procedures and fewer international participants. Pilot studies focused on logistics were more common than effectiveness studies, and the evidence base was often felt to be insufficient. Once implementation started, weaknesses in drug management were often exposed, with additional complications if local manufacturing was required. Best practices for regimen change included early engagement of budgeting staff, procurement staff, regulators and manufacturers. Future decision makers will benefit from strengthened decision-making bodies, patient input, early and comprehensive planning, and regimens and evidence that address local, practical implementation issues.

In this paper, we discuss the reasons why we urgently need a point-of-care (POC) CD4 test, elaborate the problems we have experienced with the current technology which hampers CD4-count coverage and highlight the ideal characteristics of a universal CD4 POC test.

Following over 30 years of conflict in Afghanistan, the Ministry of Public Health and its partners are rebuilding the pharmaceutical system to provide safe, affordable, and equitable access to medicines. Pharmaceutical system structures and processes are being strengthened; however, developing the pharmacy workforce is critical to ensuring the sustainability of these efforts.

This review article discusses the sustainability and robust advantages of planar chromatography that are critical to the successful performance of product quality assessments in resource limited areas including field applications.

Background: The current tuberculosis (TB) treatment landscape has been studied extensively, but researchers rarely consider how it creates challenges or opportunities for future regimen change.

By Newbrander, W., C. Peercy, M. Shepherd-Banigan, and P. Vergeer.International Journal of Health Planning and Management Epub 28 October 2011.

The number of people receiving antiretroviral treatment (ART) has increased considerably in recent years and is expected to continue to grow in the coming years. A major challenge is to maintain uninterrupted supplies of antiretroviral (ARV) drugs and prevent stock-outs.

By Rasschaert F, Pirard M, Philips MP, Atun R, Wouters E, Assefa Y, Criel B, Schouten EJ, Van Damme W.Journal of the International AIDS Society, July 6, 2011, vol. 14, suppl. 1:S3.Background: Global health initiatives have enabled the scale up of antiretroviral treatment (ART) over recent years.

Background: Recognition and referral of sick children to a facility where they can obtain appropriate treatment is critical for helping reduce child mortality. A well-functioning referral system and compliance by caretakers with referrals are essential.

Management Sciences for Health offers technical expertise and materials to assist countries to prepare and respond to severe pandemics and other disasters such as earthquakes, hurricanes, and other challenges to health, social, and economic well-­‐being.

From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health.

The objective of this study was to implement a rapid assessment of the performance of four malaria control strategies (indoor spraying, insecticide-treated bed nets, timely diagnosis, and artemisinin-based combination therapy) using adequacy criteria. The assessment was carried out in five countries of the Amazon subregion (Bolivia, Colombia, Ecuador, Guyana, and Peru). Although ACT is the strategy with the better implementation in all countries, major gaps exist in implementation of the other three malaria control strategies in terms of technical criteria, coverage and quality desired. The countries must implement action plans to close the gaps in the various criteria and thereby improve the performance of the interventions. The assessment tools developed, based on adequacy criteria, are considered useful for a rapid assessment by malaria control authorities in the different countries.

Background Globally, the monitoring of prompt and effective treatment for malaria with artemisinin combination therapy (ACT) is conducted largely through household surveys. This measure; however, provides no information on case management processes at the health facility level.

Described here is the first population genetic study of Plasmodium malariae, the causative agent of quartan malaria. Although not as deadly as Plasmodium falciparum, P. malariae is more common than previously thought, and is frequently in sympatry and co-infection with P. falciparum, making its study increasingly important. This study compares the population parameters of the two species in two districts of Malawi with different malaria transmission patterns—one seasonal, one perennial—to explore the effects of transmission on population structures. The extent of similarity between P. falciparum and P. malariae population structure described by the high level of multiple infection, the lack of significant population differentiation or haplotype clustering, and lack of linkage disequilibrium is surprising given the differences in the biological features of these species that suggest a reduced potential for out-crossing and transmission in P. malariae. The absence of a rise in P. malariae MOI with increased transmission or a reduction in MOI with age could be explained by differences in the duration of infection or degree of immunity compared to P. falciparum.

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