International Public Health Commons^™

Cross-Continental Care: Us And Cuban Medical Internationalism In Bolivia, Madeleine Blain

Latin American Studies Honors Projects

How can something as commonplace as going to the doctor influence international politics? In Bolivia, medicine is bound in politics. The political structure of a country both influences the approach to health care, and determines how that approach is most effectively implemented internationally. Building upon a framework of conceptual difference between capitalist and socialist health systems, this paper examines “effective” models of US and Cuban international health care on both a political and individual level. Drawing on fieldwork conducted in a Bolivian hospital, interviews with doctors working internationally, and current literature, I seek to discern what defines “effective” international health …

Center For Global Health Newsletter, Center For Global Health, Old Dominion University

Center for Global Health Newsletter

January-June 2015 issue of Old Dominion University's Center for Global Health Newsletter.

Association Between Dietary Patterns During Pregnancy And Birth Size Measures In A Diverse Population In Southern Us, Uriyoan Colón-Ramos, Susan B. Racette, Jody M. Ganiban, Thuy G. Nguyen, Mehmet Kocak, Kecia N. Carroll, Eszter Volgyi, Frances A. Tylavsky

Global Health Faculty Publications

Despite increased interest in promoting nutrition during pregnancy, the association between maternal dietary patterns and birth outcomes has been equivocal. We examined maternal dietary patterns during pregnancy as a determinant of offspring’s birth weight-for-length (WLZ), weight-for-age (WAZ), length-for-age (LAZ), and head circumference (HCZ) Z-scores in Southern United States (n = 1151). Maternal diet during pregnancy was assessed by seven dietary patterns. Multivariable linear regression models described the association of WLZ, WAZ, LAZ, and HCZ with diet patterns controlling for other maternal and child characteristics. In bivariate analyses, WAZ and HCZ were significantly lower for processed and processed-Southern compared to healthy …

Co2 And H2o: Understanding Different Stakeholder Perspectives On The Use Of Carbon Credits To Finance Household Water Treatment Projects., Sarah K. Summers, Rochelle Rainey, Maneet Kaur, Jay P. Graham

Global Health Faculty Publications

Background

Carbon credits are an increasingly prevalent market-based mechanism used to subsidize household water treatment technologies (HWT). This involves generating credits through the reduction of carbon emissions from boiling water by providing a technology that reduces greenhouse gas emissions linked to climate change. Proponents claim this process delivers health and environmental benefits by providing clean drinking water and reducing greenhouse gases. Selling carbon credits associated with HWT projects requires rigorous monitoring to ensure households are using the HWT and achieving the desired benefits of the device. Critics have suggested that the technologies provide neither the benefits of clean water nor …

Challenges And Opportunities Associated With Neglected Tropical Disease And Water, Sanitation And Hygiene Intersectoral Integration Programs., E. Anna Johnston, Jordan Teague, Jay P. Graham

Global Health Faculty Publications

BACKGROUND:

Recent research has suggested that water, sanitation, and hygiene (WASH) interventions, in addition to mass drug administration (MDA), are necessary for controlling and eliminating many neglected tropical diseases (NTDs).

OBJECTIVES:

This study investigated the integration of NTD and WASH programming in order to identify barriers to widespread integration and make recommendations about ideal conditions and best practices critical to future integrated programs.

METHODS:

Twenty-four in-depth, semi-structured interviews were conducted with key stakeholders in the global NTD and WASH sectors to identify barriers and ideal conditions in programmatic integration.

RESULTS:

The most frequently mentioned barriers to WASH and NTD integration …

Tracking Global Fund Hiv/Aids Resources Used For Sexual And Reproductive Health Service Integration: Case Study From Ethiopia, Sangeeta Mookherji, Samantha Ski, Dale Huntington

Global Health Faculty Publications

Objective/Background

The Global Fund to Fight AIDS, Tuberculosis & Malaria (GF) strives for high value for money, encouraging countries to integrate synergistic services and systems strengthening to maximize investments. The GF needs to show how, and how much, its grants support more than just HIV/AIDS, TB and malaria.

Sexual and Reproductive Health (SRH) has been part of HIV/AIDS grants since 2007. Previous studies showed the GF PBF system does not allow resource tracking for SRH integration within HIV/AIDS grants. We present findings from a resource tracking case study using primary data collected at country level.

Methods

Ethiopia was the study …

Transforming Health Professions' Education Through In-Country Collaboration: Examining The Consortia Among African Medical Schools Catalyzed By The Medical Education Partnership Initiative., Zohray M. Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Miliard Derbew, Yakub Mulla, David Olaleye, Nelson Sewankambo

Health Policy and Management Faculty Publications

BACKGROUND: African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning.

METHODS: Semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These …

How Can We Better Evaluate Complex Global Health Initiatives? Reflections From The January 2014 Institute Of Medicine Workshop., Sangeeta Mookherji, Kate Meck

Global Health Faculty Publications

An IOM workshop on evaluation design drew on recent evaluations of 4 complex initiatives (PEPFAR; the Global Fund to Fight AIDS, TB and Malaria; the President’s Malaria Initiative; and the Affordable Medicines Facility-malaria). Key components for good evaluations: (1) a robust theory of change to understand how and why programs should work; (2) use of multiple analytic methods; and (3) triangulation of evidence to validate and deepen understanding of results as well as synthesis of findings to identify lessons for scale-up or broader application.

Changes In Malaria Prevention And Incidence Due To Political Restructuring Of Mozambique And South Africa, Nirmala K. Shivakumar

UROP Posters

The UN’s current Millennium Development Goal puts pressure on many countries to decrease malaria incidence by 2015, including Mozambique and South Africa. While Mozambique and South Africa have continually worked to decrease malaria incidence for the last five decades, neither country can claim elimination of disease by UN standards. This study analyzes the changes in political structure and the simultaneous changes in the malaria prevention programs of Mozambique and South Africa after the end of their respective civil wars in 1992 and 1994. This study analyzed public health, historical, and social science journal articles. This study examined political power distribution, …

Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council

HIV and AIDS

Nigeria, home to over 170 million people, has a disproportionately heavy youth population of 32 percent whose well-being is intricately tied to the country’s prospects for sustainable development. Nigeria has an HIV prevalence of 3.4 percent, the second highest number of infections in the world. In 2013, it was estimated that 160,000 adolescents in Nigeria were living with HIV. Although Nigeria has developed a national HIV strategic plan that forms a basis for the HIV response, national AIDS and related policies contain few youth-centered provisions. Overall, the national strategic plan targets youth as part of the general population. To fill …

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …

Addressing Mental Health Disorders And Hiv Vulnerability Of Marginalized Adolescents In Addis Ababa, Ethiopia, Nrupa Jani, Lung Vu, Sam Kalibala, Gebeyehu Mekonnen, Kay Lynn

HIV and AIDS

Ethiopia is experiencing an increasingly urban, female-centered HIV epidemic alongside a rise in rural migration of adolescents to Addis Ababa. Often these migrants are confronted by social challenges such as lack of education, inadequate housing, unstable employment conditions, and physical and sexual abuse. These difficult living circumstances contribute to psychological and mental health problems among these adolescents, potentially putting them at greater risk of acquiring HIV. However, knowledge about how targeted mental health interventions can impact HIV-related outcomes worldwide, and in Ethiopia, remains limited. The goal of this study was to pilot test a strategy for addressing mental health problems, …

Sexual And Reproductive Health And Rights Among Young People Living With Hiv In Uganda: Findings From The Link Up Baseline Survey, Population Council

HIV and AIDS

An estimated 3.7 percent of young people aged 15–24 years are living with HIV in Uganda, and face unique challenges in navigating a wide array of social, health, and developmental challenges as they transition to adulthood. Like all young people, those who live with HIV are starting to learn about their sexuality, often beginning to have intimate relationships or marry. In addition, they confront a myriad of complex issues associated with HIV status disclosure, initiation of and adherence to antiretroviral therapy, and deeply entrenched HIV-related stigma and discrimination. Young women bear a disproportionate share of this burden. Compared with men …

Sexual Health And Hiv Risk Behaviors Of Men Who Have Sex With Men In Myanmar—Baseline Findings From Link Up, Population Council, Burnet Institute

HIV and AIDS

In 2013, an estimated 189,000 people were living with HIV in Myanmar. The overall adult HIV prevalence is estimated to be around 0.5 percent, but key populations such as men who have sex with men (MSM) bear a disproportionate disease burden. According to national estimates, HIV prevalence among MSM is 20 times higher than in the general population, at 10 percent. Effective, targeted, innovative, and culturally appropriate interventions that have been shown to significantly reduce high-risk sexual behaviors among MSM are needed to reduce the HIV burden among this population. In Myanmar, as part of the Link Up project, Alliance …

Annotated Bibliography Of Nigerian Youth-Focused Hiv And Sexual And Reproductive Health Project Publications (Grey Literature), Population Council

HIV and AIDS

Adolescents and young adults (15–24 years) constitute about one-third of the total population of Nigeria, and their well-being is intricately tied to the country’s prospects for sustainable development. The HIV prevalence among 15–24-year-old men and women is 2.5 percent and 3.1 percent, respectively. In 2013, it was estimated that 160,000 adolescents (aged 10–19) in Nigeria were living with HIV. Rightfully, an increasing focus is being paid to the sexual and reproductive health (SRH) of young Nigerians, however it is essential that the dialogue and interventions around young people’s SRH be informed and take into account the body of evidence available …

Arv-Based Hiv Prevention For Women: State Of The Science And Considerations For Implementation In Zimbabwe. Report From A Provider Workshop, Population Council

HIV and AIDS

This report provides an overview of the presentations and discussions emerging from a Provider Workshop on ARV-Based HIV Prevention for Women: State of the Science and Considerations for Implementation in Zimbabwe convened by the Ministry of Health and Child Care and the Population Council in Harare in May 2014. The workshop in Zimbabwe is part of a broader global process to begin paving the path for microbicides introduction while awaiting the results of the ongoing confirmatory trial (FACTS 001) of tenofovir gel in South Africa. USAID is spearheading a global effort toward a “Shared Vision and Strategic Plan for Microbicide …

Introducing Antiretroviral (Arv)-Based Prevention Products For Women: A Guide To Strategic Decisionmaking And Planning, Population Council

HIV and AIDS

As evidence mounts that antiretrovirals (ARVs) are effective for HIV prevention, policymakers and program managers will need to determine whether and how best to introduce specific products into health care systems. Determining the most appropriate users within a particular country will depend on the overall context, the nature of the HIV epidemic within the country, and the opportunities available to reach and serve HIV-negative women with ARV-based prevention products and services. This toolkit was developed by the Population Council for use by governments, organizations, and donors who are in a position to support or add new HIV-prevention products into programs. …

Reach: Randomized Evaluation Of Hiv/Fp Service Models, Paul C. Hewett, Mutinta Nalubamba, Fiammetta Bozzani, Mardieh Dennis, Jean Digitale, Lung Vu, Eileen Yam, Mary Nambao

HIV and AIDS

The REacH (Randomized Evaluation of HIV/FP Service Models) project compares health service uptake of two models for HIV prevention and family planning service linkage and integration. This report details results which indicate that the enhanced client add-on service referral and follow-up arm with and without the escort increased the uptake of HIV testing and counseling services among women who had entered at family planning care entry points. The effect of the intervention was greater in the shorter term, improving uptake within six weeks, but nonetheless remained important through six months. The results indicate that the intervention can increase the numbers …

Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. At a workshop held in Burundi, 3–5 June 2014, the Population Council, Alliance Burundaise contre le SIDA, and local partners in Burundi identified successful activities, highlighted important challenges and best practices, and found innovative ways to improve Link Up programming. This document contains a selection of the most …