Recent big items

The Population Policy Pendulum: Needs to Settle Near the Middle--And Acknowledge the Importance of Numbers

Tue, 27 May 2003 00:00:00 +0000

The Population Policy Pendulum: Needs to Settle Near the Middle--And Acknowledge the Importance of Numbers

Trends in Angola's Fertility (United Nations Workshop on Fertility Decline for High Fertility Countries)

Tue, 27 May 2003 00:00:00 +0000

Trends in Angola's Fertility (United Nations Workshop on Fertility Decline for High Fertility Countries)

Franchising of Health Services in Developing Countries

Tue, 27 May 2003 00:00:00 +0000

Grouping existing providers under a franchised brand, supported by training, advertising and supplies, is a potentially important way of improving access to and assuring quality of some types of clinical medical services. While franchising has great potential to increase service delivery points and method acceptability, a number of challenges are inherent to the delivery model: controlling the quality of services provided by independent practitioners is difficult, positioning branded services to compete on either price or quality requires trade-offs between social goals and provider satisfaction, and understanding the motivations of clients may lead to organizational choices which do not maximize quality or minimize costs. This paper describes the structure and operation of existing franchises and presents a model of social franchise activities that will afford a context for analyzing choices in the design and implementation of health-related social franchises in developing...

War and Reproduction: Angola’s Fertility in Comparative Perspective

Tue, 27 May 2003 00:00:00 +0000

For four decades, Angola has experienced war, which has inevitably inè uenced the country’s social development. The intensity and geographical spread of the war has è uctuated over that period. This paper examines fertility and other relevant socio-demographic characteristics in Angola and attempts to relate them to its protracted civil conè ict. To situate Angola’s fertility in the sub-Saharan context, comparisons are made with a selection of other African countries. The analysis paints a picture of a generally pre-transitional society characterised by an early start of childbearing, high fertility and a contraceptive prevalence that is among the lowest in Africa. Angola also trails behind most of the sub-continent in childhood mortality and maternal care indicators. The available data suggest that Angola’s fertility drops when hostilities peak and rebounds in the periods of relative peacefulness, and that these è uctuations are stronger in regions more affected by the é ghting...

Whither India? Ten Lessons Learned from the HIV Epidemic in Africa

Fri, 16 May 2003 00:00:00 +0000

Recent reports show that the HIV epidemic is rapidly spreading in parts of the largest Asian countries, namely India and China. Despite its strong foothold, there are still opportunities to minimize the problems if we apply these ten lessons learned from the HIV epidemic in Africa 1) The needed decisions will be controversial and require involvement of the beneficiaries in all aspects; 2) Focus on cost-effective programs especially those that affect the core transmission groups such as participants in transactional sex, intravenous drug use, and men who have sex with men; 3) Secure the commodities pipeline - adequate supplies of condoms and antibiotics are essential; 4) Invest only in projects that can be brought to scale; 5) Ensure appropriate delegation of needed tasks to optimize the effectiveness of health workers; 6) Reexamine the structure and work of international donors to exploit faster and more efficient ways to channel funds into the most effective programs; 7) Reduce...

Costing Cairo: An Annotated Bibiliography of the Cost Literature on ICPD Programme of Action Components in Sub-Saharan Africa

Fri, 16 May 2003 00:00:00 +0000

The 1994 International Conference on Population and Development (ICPD), held in Cairo, produced a Programme of Action accepted and signed by over 180 governments. The Programme of Action marked an important shift in the ideological framework of population programs. By stating such programs should ensure that “a full-range of reproductive health care services, including family planning, are accessible, affordable, acceptable and convenient to all users” (ICPD Programme of Action, 1994, 7.5.a), Cairo identified the crux of population programs to be the reproductive health of women, and expanded the notion of family planning accordingly. This bibliography was initiated as part of an effort to revise the original UNFPA estimates of the cost of implementing the Cairo agenda. It is focused on sub-Saharan Africa for two reasons. First, sub-Saharan Africa, by almost any measure, is most in need of improved provision of health services. Second, accuracy and completeness was a high...

A Case Study of the Integration of Environmental, Development, and Reproductive Health Programs: TACARE-Tanzania

Fri, 16 May 2003 00:00:00 +0000

A Case Study of the Integration of Environmental, Development, and Reproductive Health Programs: TACARE-Tanzania

Cost-Effectiveness of HIV Interventions for Resource Scarce Countries: Setting Priorities for HIV/AIDS

Mon, 28 Apr 2003 00:00:00 +0000

Objectives: Despite recent foundation donations and bilateral commitments there are insufficient funds to implement all of the desired interventions for AIDS prevention and treatment. This paper explores one methodto analyze the allocation of limited budgets. Methods: Based on existing data from African countries, we compare the cost-effectiveness of both HIV prevention and treatment interventions using cost per life-year saved as the outcome measure. We examined five prevention interventions: (1) voluntary counseling and testing; (2) prevention of mother-to-child transmission; (3) STD mass treatment for general population; (4) STD management for sex workers; and (5) blood screening – and four drug price scenarios for antiretroviral treatment for HIV+ patients. In a hypothetical country of one million people and a generalized epidemic, we performed a static budgetary simulation with constrained resources to estimate total life-years gained and number of HIV cases prevented/treated...