Health Policy Commons^™

Community-Based Approaches To Prevention Of Mother-To-Child Transmission Of Hiv: Findings From A Low-Income Community In Kenya, Susan Kaai, Carolyn Baek, Scott Geibel, Peter Omondi, Benson Ulo, Grace Muthumbi, Carol Nkatha, Naomi Rutenberg

HIV and AIDS

The Horizons program, in partnership with International Medical Corps and Steadman Research Services International, conducted an intervention study in Kibera, an urban slum in Nairobi, Kenya to determine what effect three different community-based activities had on utilization of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants and peer counselors as PMTCT promoters. Data from the study showed that there were positive trends during the study period in most of the PMTCT indicators, including knowledge of MTCT, …

Beacon Of Hope: Evaluation Of The Kenya Girl Guides Association Hiv/Aids Program For School Children, Karusa Kiragu, George Odingo, Milka Juma, Jane Mbugua, Magdalen Waweru, Wamuyu Mahinda, Beatrice Mwaniki, Charity Muturi, Simon Ochieng, Tobey C. Nelson, Ann P. Mccauley

HIV and AIDS

This Horizons report presents findings from an evaluation of the Kenya Girl Guides Participatory Peer Education Program for HIV and AIDS Prevention. The objective of the program was to train Girl Guide patrol leaders as peer educators, who in turn would communicate key information and concepts about such topics as HIV prevention, relationships, and self-esteem to other Girl Guides, and ultimately to their school peers. The results demonstrate that peer education conducted by Girl Guides is a feasible strategy for imparting HIV and AIDS education to school-going youth; however, such a program would need to be branded, strengthened, and appropriately …

Transcending Boundaries To Improve The Food Security Of Hiv-Affected Households In Rural Uganda: A Case Study, Katharine Coon, Jessica Ogden, John Odolon, Anthony Obudi-Owor, Charles Otim, James Byakigga, Peter Spebanja

HIV and AIDS

A case study conducted in Tororo, Uganda found that a partnership between TASO, an AIDS service NGO and agricultural extension, was successful in helping HIV-affected communities improve food security. This Horizons study reports that four participatory training workshops developed through the alliance resulted in improved management capacity and more collaborative organizational structures among the district partners. This in turn created the conditions for the AIDS community workers and other field partners to work more effectively together with farmers’ groups at the local level to identify and address constraints to food security.

Reaching Truckers In Brazil With Non-Stigmatizing And Effective Hiv/Sti Services, Magda Chinaglia, Sheri A. Lippman, Julie Pulerwitz, Maeve De Mello, Rick Homan, Juan Diaz

HIV and AIDS

Research with mobile populations has demonstrated that men in the mobile workforce tend to be exposed to greater HIV risk, and have higher sexually transmitted infection (STI) and HIV prevalence, than those in less mobile or non-mobile professions. At the request of the Brazilian Ministry of Health and with support from USAID/Brazil, the Population Council conducted an assessment in Brazilian border areas to determine which populations were most in need of HIV prevention activities. The research revealed the presence of an extremely mobile, international truck driver community with little to no access to HIV prevention, testing, and treatment services. The …

Continuum Of Care For Hiv-Positive Women Accessing Programs To Prevent Parent-To-Child Transmission: Findings From India, Vaishali Sharma Mahendra, Rupa Mudoi, Archana Oinam, Venkat Pakkela, Avina Sarna, Sucheta Panda, Ashok Rau, L. Birendrajit Singh, Naomi Rutenberg

HIV and AIDS

This study examined the efforts of PPTCT programs in different cities in India to offer women a continuum of care, and shows that the programs have both strengths and shortcomings. The government launched a national treatment program that offers antiretroviral therapy (ART) to HIV-positive women, children below 15 years of age, and men. However, since the start-up of the ART program there have been concerns about limited access to and utilization of these services by women and children. To address these shortcomings, the PPTCT programs studied should strengthen their referral systems to public and private treatment and family planning services, …

The Cost-Effectiveness Of Improving Diabetes Care In U.S. Federally Qualified Community Health Centers, Elbert S. Huang, Qi Zhang, Sydney E. S. Brown, Melinda L. Drum, David O. Meltzer, Marshall H. Chin

Community & Environmental Health Faculty Publications

Objective. To estimate the incremental cost-effectiveness of improving diabetes care with the Health Disparities Collaborative (HDC), a national collaborative quality improvement (QI) program conducted in community health centers (HCs).

Data Sources/Study Settings. Data regarding the impact of the Diabetes HDC program came from a serial cross-sectional follow-up study (1998, 2000, 2002) of the program in 17 Midwestern HCs. Data inputs for the simulation model of diabetes came from the latest clinical trials and epidemiological studies.

Study Design. We conducted a societal cost-effectiveness analysis, incorporating data from QI program evaluation into a Monte Carlo simulation model of diabetes.

Data Collections/Extraction …

Las Vegas: A Sustainable Urban Environment For Health?, Nancy Menzel

Nevada Journal of Public Health

The rapid growth of Las Vegas has resulted in negative consequences for the health of its residents to a level that threatens the area’s sustainability. This article reviews key indicators of population health in Las Vegas through the framework of the US Centers for Disease Control and Prevention’s Healthy People in Healthy Places and concludes that public health professionals, citizens, businesses, and political leaders must act now to protect and improve population health.

Key Findings From An Evaluation Of The Mothers2mothers Program In Kwazulu-Natal, South Africa, Carolyn Baek, Vuyiswa Mathambo, Sibongile Mkhize, Irwin Friedman, Louis Apicella, Naomi Rutenberg

HIV and AIDS

The Horizons program of Population Council, in collaboration with Health Systems Trust, completed the first evaluation of mothers2mothers (m2m) as part of its introduction in KwaZulu-Natal Province, South Africa. It is the first external evaluation that provides quantitative evidence about the role of the well-known m2m program in complementing services to prevent mother-to-child transmission of HIV (PMTCT). m2m is a peer support program that aims to provide education and psychosocial support to HIV-positive pregnant women and new mothers, help women access existing health care, and follow up with mothers and babies to ensure they receive appropriate medical care after delivery. …

The Health Insurance Debate In Canada: Lessons For The United States?, Mary Anne Bobinski

Faculty Articles

This Essay begins with an intentionally ambiguous title. Are comparisons to Canada relevant and useful for policy-makers in the United States and, if so, what lessons can we learn? Part II of this Essay highlights some of the risks and benefits of cross-border comparisons between the United States and Canada. In Part III, I analyze some of the key data points often cited in comparing the two health care systems. Part IV explores the current Canadian debate about private health insurance. Finally, in Part V, I focus on the lessons from Canada for the health insurance debate in the United …

Snapshot 2007: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Ethnic Differentials In Parental Health Seeking For Childhood Illness In Vietnam, Bussarawan Teerawichitchainan, James F. Phillips

Poverty, Gender, and Youth

The recent introduction of user fees for Vietnam’s primary healthcare services has generated concern that economic policies may adversely affect health-seeking behavior and health outcomes of the poor, particularly among impoverished families who are members of socially marginalized minority groups. This Population Council working paper examines this debate by analyzing parental recall of illness and care-seeking for sick children under age 5 recorded by the 2001–02 Vietnam National Health Survey. Ethnic differentials are evident in all geographic and income levels, although adverse effects of minority status are most pronounced among poor households in remote areas. Results suggest that social equity …

Xdr Tuberculosis, The New International Health Regulations, And Human Rights, David P. Fidler, Philippe Calain

Articles by Maurer Faculty

No abstract provided.

Book Review: Social Justice: The Moral Foundations Of Public Health And Health Policy, Robin West

Georgetown Law Faculty Publications and Other Works

This essay is a review of Social Justice: The Moral Foundations of Public Health and Health Policy by Madison Powers & Ruth Faden (2006).

In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate? In a world filled with inequalities in health and well-being, which inequalities matter most and are the most morally urgent to address? In order to answer these questions, Powers and Faden develop a unique theory of social justice that, while developed for the specific contexts of public health and health …

Disparities In Health And Well-Being Among Latinos In Washington Heights/Inwood, 2000–2005, Ana Motta-Moss

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report analyzes how well the residents of Washington Heights/Inwood (WH/IN) have fared on selected health indicators set forth by the NYC Department of Health and Mental Hygene between 2000 and 2005.

Methods: Data on Latinos and other racial/ethnic groups were obtained from the U.S. Census Bureau American Community Survey, reorganized for public use by the Minnesota Population Center, University of Minnesota, IPUMSusa. Cases in the dataset were weighted and analyzed to produce population estimates.

Results: Immigrant families in particular face a multitude of health concerns, as well as specific barriers to accessing health care services. The socioeconomic and …

An Exploratory Study Of Pet Raising And Health Of The Elderly People In Hong Kong, Cheung Ming, Alfred Chan, Kam Wing, Kevin Cheung, Lam Fat Lo

APIAS Monograph 專題論文

Introduction:

Pets such as dogs, cats and fish were popular in many other countries (Marx et al., 1988; Gammonley, 1991; Brodie & Biley, 1999; PIAS, 2002). In Hong Kong, pet owners increased to 0.26 million (Census and Statistics Department, 2006). Dating back to 1980s, a research study reported the association between pet ownerships and health benefits for humans (McNicholas et al., 2005). According to the report, domesticated pets brought a sense of companionship and provided pet owners with pleasure. These pets could be tools for enhancing human social relationship and could also provide their owners with emotional comfort. Recent studies …

Fairness Issues In Law And Mental Health: Directions For Future Social Work Research, Jose B. Ashford, Jane Holschuh

The Journal of Sociology & Social Welfare

Concepts from the procedural justice literature in social psychology are examined that offer useful guidance for social work researchers with interests in investigating informal adjudications, speciality treatment courts, and other areas of the administrative process previously neglected in mental health services research. These theoretical concepts are offered as an alternative to the therapeutic jurisprudence framework being adopted by some social workers in the field of law and mental health. The issues outlined in this paper also draw on the health services and psychotherapy literature to highlight issues involving process and procedure as social justice and their significance for advancing a …

Health Information Technology In The United States: The Information Base For Progress, David Blumenthal, Catherine M. Desroches, Karen Donelan, Sara J. Rosenbaum, Timothy Ferris

Health Policy and Management Faculty Publications

Health information technology (HIT) has the potential to advance health care quality by helping patients with acute and chronic conditions receive recommended care, diminishing disparities in treatment and reducing medical errors. Nevertheless, HIT dissemination has not occurred rapidly, due in part to the high costs of electronic health record (EHR) systems for providers of care—including the upfront capital investment, ongoing maintenance and short-term productivity loss. Also, many observers are concerned that, if HIT follows patterns observed with other new medical technologies, HIT and EHRs may diffuse in ways that systematically disadvantage vulnerable patient populations, thus increasing or maintaining existing disparities …

Creating Progam Logic Models: A Toolkit For State Flex Programs, John A. Gale Ms, Andrew F. Coburn Phd, Stephanie Loux Ms

Population Health & Health Policy

A logic modeling toolkit developed by the Flex Monitoring Team is available for use by state Medicare Rural Hospital Flexibility Programs (Flex Programs) in planning for and managing their Flex programs. The use of the Program Logic Model (PLM) Toolkit will provide states with a tool to assist in:

Planning, managing, reporting on, and assessing their Flex Program goals, activities, and accomplishments;

• Developing buy-in among key Flex Program stakeholders;
• Clarifying the underlying program assumptions;
• Identifying and defining measurable outcomes;
• Linking state-level Flex Program strategies and activities to specific and measurable outcomes; and
• Reporting program results to both internal and external …

Data Integration And Storage: Managing And Using Home And Community-Based Services Data For Quality Improvement, Carolyn E. Gray Mph, Maureen Booth Mrp, Ma

Disability & Aging

This paper reports on data integration from a program manager’s perspective. The paper is not meant to be an exhaustive research document, nor does it single out any one correct approach. The paper is meant to facilitate communication between program units and analytic staff and serve as one reference for states as they continue to improve upon data collection techniques and use this information for ongoing quality management and improvement.

Survey Findings: Children Served By Mainecare, 2005, Catherine Ormond, Deborah Thayer

Disability & Aging

No abstract provided.

Designing Employer-Sponsored Mental Health Benefits, Rachel Sethi, Joanne Jee, Lisa Chimento, D. Richard Mauery

Health Policy and Management Faculty Publications

No abstract provided.

Reducing Aids-Related Stigma And Discrimination In Indian Hospitals, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly

HIV and AIDS

People living with HIV/AIDS in India, as elsewhere, face stigma and discrimination in a variety of contexts. Research in India has shown that stigma and discrimination against HIV-positive people and those perceived to be infected are common in hospitals and act as barriers to seeking and receiving critical treatment and care services. Recognizing the need to move beyond documentation of the problem, three New Delhi hospitals; SHARAN, an Indian NGO; and the Horizons program, with support from the National AIDS Control Organisation (NACO), carried out an operations research project to develop and test responses to hospital-based stigma and discrimination against …

Promoting More Gender-Equitable Norms And Behaviors Among Young Men As An Hiv/Aids Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento

HIV and AIDS

The Population Council and the Promundo Institute studied the effectiveness of interventions in Brazil designed to change the attitudes of young men in relation to gender norms and reducing the risk of contracting HIV/STIs. One conclusion of the study was the recognition of the importance of engaging young people (men and women) in the issue of gender relations and the risks of HIV contamination. The results of the study indicate that addressing inequitable gender norms, particularly those that define masculinity, can be an important element of HIV prevention strategies. These findings suggest that group education interventions can successfully influence young …

Abc Messages For Hiv Prevention In Kenya: Clarity And Confusion, Barriers And Facilitators, Julie Pulerwitz, Tiffany Lillie, Louis Apicella, Ann P. Mccauley, Tobey C. Nelson, Simon Ochieng, Peter Mwarogo, Karusa Kiragu, Edward Kunyanga

HIV and AIDS

The Horizons Program and FHI/IMPACT developed a collaborative research study to explore how adults and youth in Kenya define and perceive the ABC (abstinence/being faithful/consistent condom use) terms and behaviors. Additional objectives of the study were to identify attitudes and norms around the ABC behaviors that influence perceptions of them, and the role of important actors in transmitting messages about them. Findings highlight potential challenges in promoting each of the ABC behaviors, as well as some positive elements that can be built upon when developing programs. HIV prevention programs that incorporate ABC messages—both in Kenya and elsewhere—should consider a number …

Examining Adherence And Sexual Behavior Among Patients On Antiretroviral Therapy In India, Avina Sarna, Indrani Gupta, Sanjay Pujari, A.K. Sengar, Rajiv Garg, Ellen Weiss

HIV and AIDS

With increased availability of ART, HIV-positive individuals are living healthier lives and continuing or resuming sexual activity. However, optimism related to ART’s success in slowing disease progression, reducing viral load, and improving health status may lead to more risky sexual practices and a possible increase in transmission of infections. To determining the sexual behavior of HIV-positive persons on ART, the Horizons program, in collaboration with research partners in Delhi and Pune, conducted a study to assess current levels of adherence to ART among a sample of people living with HIV/AIDS, identify the factors that influence their adherence to treatment, and …

Orphans And Vulnerable Youth In Bulawayo, Zimbabwe: An Exploratory Study Of Psychosocial Well-Being And Psychosocial Support, Laelia Gilborn, Louis Apicella, Jonathan Brakarsh, Linda Dube, Kyle Jemison, Mark Kluckow, Tricia Smith, Leslie M. Snider

HIV and AIDS

This Population Council Horizons report presents findings from an exploratory study by the Regional Psychosocial Support Initiative and Catholic Relief Services’ Support to Replicable, Innovative Village/Community-level Efforts Program of vulnerable youth living in and around Bulawayo, Zimbabwe. It describes their demographic characteristics, exposure to stress and trauma, and psychosocial well-being. The report also highlights the relationships between psychosocial well-being outcomes and exposure to stress and trauma, and the differences in psychosocial well-being between males and females, orphaned and nonorphaned youth, and younger and older adolescents. The report concludes with program and research implications.

Exploring Current Practices In Pediatric Arv Rollout And Integration With Early Childhood Programs In South Africa: A Rapid Situation Analysis, Desiree Michaels, Brian Eley, Lewis Ndhlovu, Naomi Rutenberg

HIV and AIDS

This Horizons program report describes the status of pediatric HIV treatment in selected sites in South Africa, identifies gaps in service delivery, and proposes recommendations for strengthening services and expanding children’s access to treatment. The study provides much needed information on critical issues of pediatric HIV care, especially regarding health service and contextual issues surrounding the expansion of access to treatment for HIV-infected children, and key factors that facilitate sustainability of treatment by young children. The aims of the study were to identify successful program strategies in pediatric HIV treatment in South Africa and to determine priority knowledge gaps to …

Pastoral Care In Education, Lydia Hearn, Renee Campbell-Pope, Joanne House, Donna Cross

Research outputs pre 2011

EXECUTIVE SUMMARY

1. During the past decade, there has been growing recognition the school environment plays a major role in the social and emotional competence and wellbeing of children. As a consequence, increasing national and international commitment has been directed towards the development of Health Promoting Schools2, with efforts being made to assess how curriculum and pastoral practice can best contribute to students’ social, emotional, physical and moral wellbeing. Within Australia, the National Safe Schools Framework3 has set as a key priority the importance of achieving a shared vision of physical and emotional safety and wellbeing for all students …

Snapshot 2006: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Living Up To Their Name: Profamilia Takes On Gender-Based Violence, Claudia Garcia-Moreno, Rachel E. Goldberg

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité describes the evolution of Profamilia through its work on gender-based violence in the Domincan Republic.Their project was conceived along two simultaneous paths: providing support services directly to women and girls who had experienced violence and initiating advocacy in the wider policy arena. Profamilia joined the commission that ultimately designed and promoted a law to increase protection against violence, especially domestic violence against women and children. Although the clinics now run a dynamic service program, the agency has also sustained its advocacy activities. Most of Profamilia’s advocacy work is undertaken in partnership with other NGOs or with …