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This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The third article presents a successful application in Mozambique of a leadership development program created by Management Sciences for Health (MSH).

This article is the second article in the Human Resources for Health journal's first quarterly feature. This article describes the experience of the Family Life Education Programme (FLEP), a reproductive health program that provides community-based health services through 40 clinics in five districts of Uganda, in improving retention and performance by using the Management Sciences for Health (MSH) Human Resource Management Rapid Assessment Tool.

Background: In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision.

Low-income countries with high HIV/AIDS burdens in sub-Saharan Africa must deal with severe shortages of qualified human resources for health. This situation has triggered the renewed interest in community health workers, as they may play an important role in scaling-up antiretroviral treatment for HIV/AIDS by taking over a number of tasks from the professional health workers.

Background: East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited.

To strengthen Haiti’s primary health care (PHC) system, the country first piloted performance-based financing (PBF) in 1999 and subsequently expanded the approach to most internationally funded non-government organizations. PBF complements support (training and technical assistance).

Background: The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option.

In 2011, the Malawi Ministry of Health (MOH) implemented an innovative approach (called "Option B+"), in which all HIV-infected pregnant and breastfeeding women are eligible for lifelong antiretroviral therapy (ART) regardless of CD4 count. Since that time, several countries have adopted the Option B+ policy. Using data collected through routine program supervision, this report is the first to summarize Malawi's experience implementing Option B+ under the direction of the MOH and supported by the Office of the Global AIDS Coordinator through the President's Emergency Plan for AIDS Relief (PEPFAR). In Malawi, the number of pregnant and breastfeeding women started on ART per quarter increased by 748%, from 1,257 in the second quarter of 2011 (before Option B+ implementation) to 10,663 in the third quarter of 2012 (1 year after implementation). Of the 2,949 women who started ART under Option B+ in the third quarter of 2011 and did not transfer care, 2,267 (77%) continue to receive ART at 12 months; this retention rate is similar to the rate for all adults in the national program. Option B+ is an important innovation that could accelerate progress in Malawi and other countries toward the goal of eliminating mother-to-child transmission of HIV worldwide.

Setting: The National Tuberculosis Programs of Ghana, Viet Nam and the Dominican Republic. Objective: To assess the direct and indirect costs of tuberculosis (TB) diagnosis and treatment for patients and households.

Background: Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa.

Return of Organization Exempt from Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code  

Year Ended June 30, 2012, drawn from audited financial statements.

Integrating health services ensures healthier mothers and children and leads to a more efficient, effective, and sustainable health system. MSH works with women at all levels of the health system to support healthy timing and spacing of pregnancy, antenatal care, safe delivery, and postpartum care.

Lot Quality Assurance Sampling (LQAS) is a component of Strengthening TB and HIV & AIDS Responses in Eastern Uganda (STAR-E), USAID project funded by the President's Emergency Plan for AIDS Relief (PEPFAR).

Summary Points Expansion of prevention of mother-to-child transmission in resource-limited settings remains a challenge. In many countries, most HIV-exposed infants do not benefit from PMTCT programs, which results in a 30% or more transmission rate.

Letter to the editor  Anna Coutsoudis and colleagues worry that international organisations have too hastily endorsed a strategy to provide lifelong triple antiretroviral therapy (ART), irrespective of CD4 count, to pregnant women with HIV in high-burden countries. This strategy for preventing mother-to-child transmission is called Option B+.

BackgroundThroughout Africa, the private sector plays an important role in malaria treatment complementing formal health services. However this sector is faced by a number of challenges including poor dispensing practices by unqualified staff.

Rationale, aims, and objectives: For a successful patient outcome, a high level of adherence to antiretroviral therapy (ART) is needed. A 2008 report in Tanzania indicated poor clinic attendance and a high lost to follow-up rate as major threats to optimal ART program effectiveness.

In developing countries, particularly in Africa, the provision of health services leans heavily towards today’s epidemics, including HIV and AIDS, malaria, tuberculosis and other infectious diseases. This calls for different approaches to the implementation of interventions from a public health perspective.

Background: Mortality and morbidity among HIV-exposed children are thought to be high in Malawi. We sought to determine mortality and health outcomes of HIV-exposed and unexposed infants within a PMTCT program.

The national scale up of antiretroviral therapy in Malawi is based on a public health approach, with principles and practices borrowed from the successful World Health Organization "DOTS" tuberculosis control framework.

A few underlying facts drove the decision to create a new society for health systems research (HSR). There is growing acknowledgement that health systems performance problems in low- and middle-income countries (LMICs) are a major impediment to making more rapid progress in achieving the Millennium Development Goals (MDGs) and ensuring universal health coverage.

Background: Maternal morbidity and mortality among HIV-infected women is a global concern. This study compared mortality and health outcomes of HIV-infected and HIV-uninfected mothers at 18–20 months postpartum within routine prevention of mother-to-child transmission of HIV (PMTCT) services in a rural district in Malawi.

As doctors, nurses and public health professionals are promoted into management and leadership positions in resource-poor countries around the world, they are tasked with leading teams and managing drugs and financial and material resources.

Background and methodology: The Standard Days Method (SDM) is a fertility-awareness-based method of family planning that helps users to identify the fertile days of the reproductive cycle (days 8–19). To prevent pregnancy users avoid unprotected sexual intercourse during these days.


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