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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.

In the CIPRA-SA trial (July 3, p. 33), Ian Sanne and colleagues compared the outcomes of nurse-monitored patients with those of doctor-monitored patients in an antiretroviral treatment (ART) program in South Africa and concluded that the outcomes of ART services provided by nurses were non-inferior to those provided by doctors.

Background:Increased availability and accessibility of antiretroviral therapy (ART) has improved the length and quality of life amongst people living with HIV/AIDS. This has changed the landscape for care from episodic to long-term care that requires more monitoring of adherence. This has led to increased demand on human resources, a major problem for most ART programs.

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.

Our aim was to explore peer counselors' work and their role in supporting patients' adherence to antiretroviral treatment (ART) in resource-limited settings in Ethiopia and Uganda. Qualitative semi-structured interviews were conducted with 79 patients, 17 peer counselors, and 22 providers in ART facilities in urban and rural areas of Ethiopia and Uganda.

In Malawi, high case fatality rates in patients with tuberculosis, who were also co-infected with HIV, and high early death rates in people living with HIV during the initiation of antiretroviral treatment (ART) adversely impacted on treatment outcomes for the national tuberculosis and ART programmes respectively. This article (1) discusses the operational research that was conducted in the country on cotrimoxazole preventive therapy, (2) outlines the steps that were taken to translate these findings into national policy and practice, (3) shows how the implementation of cotrimoxazole preventive therapy for both TB patients and HIV-infected patients starting ART was associated with reduced death rates, and (4) highlights lessons applicable to other settings and interventions.

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

Among adults eligible for antiretroviral therapy (ART) in Thyolo (rural Malawi) and Kibera (Nairobi, Kenya), this study (1) reports on retention and attrition during the preparation phase and after starting ART and (2) identifies risk factors associated with attrition.

St. Vincent and the Grenadines (SVG) is the largest marijuana producer in the Eastern Caribbean. As the European Union has phased out preferred access for its banana crop, marijuana has become one of the main sources of income and a safety net for many young men, in particular.

The national scale-up of antiretroviral therapy (ART) in Malawi is based on a public health approach, with principles and practices borrowed from the successful DOTS tuberculosis control framework. During the first 6 years, the number of patients registered on treatment increased from 3,000 to >350,000 in both the public and private sectors.

The objective of this study was to determine extent of HIV conspiracy belief endorsement among men who have sex with men (MSM) in Pretoria, and assess whether endorsement of HIV conspiracy beliefs are associated with inconsistent condom use and never testing for HIV. A cross-sectional survey using respondent-driven sampling was conducted between February and August 2009.

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.

Background Secondary infertility is a common, preventable but neglected reproductive health problem in resource-poor countries. This study examines the association of past sexually transmitted infections (STIs) including HIV, bacterial vaginosis, and factors in the obstetric history with secondary infertility and their relative contributions to secondary infertility. Methods

This training guide and these tools were created as part of the USAID STOP AI project to help local leaders prepare their communities to respond to widespread disease outbreaks. For more information about any of the tools on this page, or to request a copy to be sent to you, please contact Lisa Stone at LStone@msh.org. Facilitator Guide (PDF, 4.8 MB) Pandemic Toolkit (PDF, 9.4 MB)

In Haiti, it is rare for men to choose to have a vasectomy. Many believe this method of family planning robs a man of his virility. Yet in 2009, Sagesse Exilus chose to have a vasectomy at Fermathe hospital.

Apegnon Akpene is a 20 year-old mother of three: four year-old Joseph, two year-old Romance and one month-old Akou Jacqueline.

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