International Public Health Commons^™

Infrastructure For Health: Empowering Village Health Teams In Uganda, Daniel C. Mays

GW Research Days 2013

BACKGROUND: The Ugandan National Health System, primarily organized by the Ministry of Health, utilizes community health workers which are structured as Village Health Teams (VHTs). Omni Med, a Boston-based NGO, works with the Ministry of Health to train and mobilize VHTs in the Mukono District.

OBJECTIVES: Understanding how VHTs are empowered to improve health in their communities, educating VHTs in health and medicine, mobilizing VHTs by providing motivation and oversight, and understanding VHT-member experiences through focus groups.

METHODS: Omni Med works with community chairpersons to organize VHT elections. Subsequently, Omni Med holds a training course on health topics like hygiene …

Examining The Impact Of International Volunteer Service And Village Health Teams On Community Health In Uganda's Mukono District, Caitlin M. Sherman, Anne E. Nichols

GW Research Days 2013

In many third world countries there is a dramatic shortage of doctors available for the countries' growing population. Similarly, the countries' infrastructure lacks adequate public transportation at an affordable cost. This is especially true throughout the continent of Africa. As a result, many people do not seek care until it is too late and do not receive basic medical education on how to keep their family and themselves healthy. To try to alleviate this issue many countries have begun training community health workers. In Uganda, they are called Village Health Teams (VHT). VHTs are people selected by their community to …

The Impact Of The Chinese Rural Healthcare System On Infectious Disease: A Study Of The History And Reform Of Chinese Healthcare, And The Global Implications Of Infectious Disease Control In China, John Barbadoro

Independent Study Project (ISP) Collection

China’s healthcare system has gone through significant changes in the 20^th and 21^st centuries. These changes have mirrored not only the political focus of the time, but also the social issues facing China. The NRCMCS for rural residents is a cheap annual fee that covers a percentage of medical costs. There are two urban equivalents, the BMIUE and BMIUR for urban employees through their job, and residency respectively. Despite the focus on cheaper healthcare for rural residents, the problems of income inequality and mistrust in the medical system are major problems that affect the health of this large …

Factors Influencing Management Of Type 2 Diabetes Among Vietnamese Seniors In Worcester, Ma, Marianne M. Sarkis, Amelia Angevine, Chantal Begley, Kristina Nguyen, Thuha Le

Local Knowledge: Worcester Area Community-Based Research

What are the effects of diabetes among Vietnamese seniors on themselves and their communities?

This study examines the role of the social and physical environment in influencing type 2 diabetes management among the Vietnamese senior community. The researchers employed a concurrent mixed methods approach, utilizing both quantitative and qualitative instruments. Eleven diabetics participated in individual interviews and seven non-diabetic caregivers comprised the focus group. The study results suggest that in the study sample, the most important factors in influencing management include factors in the physical environment, such as safety and location, as well as social factors, including individual and community …

Femininity, Dependency, And Patriarchy: The Marginalization Of Women With Japanese Encephalitis And Neurological Sequelae In The Northern Terai Region Of Uttar Pradesh, Katherine Ehrenreich

Independent Study Project (ISP) Collection

The present study seeks to determine how girls and women who have suffered from neurological sequelae after a Japanese encephalitis (JE) infection are marginalized in the Northern Terai region of Uttar Pradesh, India. Societal and familial values were studied in comparison to behaviors towards a neurologically disabled girl after a JE infection in order to determine how women infected with JE are excluded from cultural practices and norms. The 4 study was conducted in the Northern Terai region of Uttar Pradesh in the districts of Bahraich and Shrawasti under the guidance of DEHAT and Dr. Jitendra Chaturvedi. Semi-structured interviewing was …

An Ethical Analysis Of Incentives As “Nudges” Toward Better Health Outcomes: A Case Study Of Seva Mandir’S Immunization Program In Rural Udaipur, Julika Kaplan

Independent Study Project (ISP) Collection

Seva Mandir, a non-governmental organization working on tribal development issues in the Udaipur District of India, offers pregnant women and mothers one kilogram of lentils for every visit they make to the organization’s monthly immunization camps. This study assesses whether it is ethical to use incentive-based systems, as opposed to empowerment through health education, to “nudge” the rural poor in Udaipur toward immunization. The information presented in this study is based on twenty-nine interviews with pregnant women and mothers of children less than two years old conducted during six field visits to Seva Mandir’s immunization camps. Through data obtained from …

Las Multiplicidades De Salud Integral: Medicina Plural, Medicina Holística, Louise Highleyman

Independent Study Project (ISP) Collection

El Hospital Andino Alternativo de Chimborazo (H.A.A.CH.) es un hospital relativamente pequeño ubicado en la ciudad de Riobamba, la capital de la provincia de Chimborazo. Un proyecto de la Diócesis de Riobamba, lo que diferencia este hospital es la unión de tres áreas de medicina en el mismo lugar: medicina andina (o ancestral), medicina alternativa, y medicina alopática (o química).Los tres tipos de medicina “dan la libertad al paciente de elegir con qué tipo de medicina desea curarse.”[1] Aunque actualmente la mayoría de pacientes (70%, según la gerente) están transferidos por el Instituto Ecuatoriano de Seguridad Social (IESS) para …

Priority Interventions To Reduce Hiv Transmission In Sex Work Settings In Sub-Saharan Africa And Delivery Of These Services, Matthew F. Chersich, Stanley Luchters, Innocent Ntaganira, Antonio Gerbase, Ying-Ru Lo, Fiona Scorgie, Richard Steen

Population Health, East Africa

Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery.

Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes.

Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for …

Effectiveness Of A Community-Based Positive Prevention Intervention For People Living With Hiv Who Are Not Receiving Antiretroviral Treatment: A Prospective Cohort Study, Avina Sarna, Stanley Luchters, Eustasius Musenge, Jerry Okal, Matthew Chersich, Waimar Tun, Sabine Mall, Nzioki Kingola, Sam Kalibala

Population Health, East Africa

Background: We report effectiveness of an HIV-prevention intervention delivered by community health workers (CHWs) in Mombasa, Kenya, to PLHIV who have not initiated or who have discontinued ART-an often difficult-to-reach population because they fall outside the ambit of health care and prevention services.

Methods: A 2-arm cohort study assessed a structured risk-reduction intervention involving at least 4 one-to-one counseling sessions and personalized support. The control group received standard prevention services. CHWs recruited treatment-naïve people living with HIV (PLHIV) or those who had previously taken antiretroviral drugs. Data were analyzed using a Propensity Score Matched (PSM)-sample to control for baseline differences …

Exploring The Efficacy Of The Community Organization Health Model As A Tool For Evaluating Sport-For-Development Programs: A Qualitative Content Analysis Of Three Model Programs, Lauren Faye Denman

Master's Theses

The HIV/AIDS pandemic is currently one of the most pressing world-wide concerns regarding the health and well-being of our global population. Due to the lack of a cure, recent efforts have focused on prevention measures for the disease. HIV prevention, particularly with the youth population, has spawned creative programs, such as the use of sport as an educational tool to equip youth with the skills to avoid contracting HIV. Due to the potent effect sport-for-development efforts exhibit on both individual and cultural level change, it can be assumed that HIV prevention sport-for-development programs are worth maintaining. Within the use of …

From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit

HIV and AIDS

HIV treatment, care, and support, and PMTCT programs are most effective when based on the best available research evidence. This is the fundamental premise of evidence-based medicine. Equally well known is the dilemma of transforming evidence into practice, which is the subject of knowledge translation and implementation science. Even when the findings of clinical trials make their way into international and national program guidelines, they run up against competing priorities within public health and community programs, resource constraints, and institutional and human inertia. Understanding how to effectively change the approach used in program operations requires understanding how programs work in …

Documentation Of Hiv Prevention Research And Programmatic Learnings From India—Selected Peer-Reviewed Journal Publications From The Knowledge Network Project (Volume 1), Population Council

HIV and AIDS

Over the past decade (2000–11), India has achieved dramatic successes in reversing the HIV epidemic. These successes are largely due to the implementation of upscaled HIV-prevention interventions by the National AIDS Control Organization, two other donors, and nongovernmental organizations, under the National AIDS Control Program III. As the epidemic in India is concentrated in vulnerable subpopulations, these interventions were focused on high-risk groups. It is important to understand the lessons learned from the implementation of HIV-prevention programs and the vulnerabilities that need to be addressed to reach the goal of zero new infections. To support this understanding, the Population Council …

Prevalence Of Hiv, Hepatitis B And C, And Co-Infection In A Cohort Of Male Injection Drug Users In Delhi, Lopamudra Saraswati, Mary Philip Sebastian, Avina Sarna, Vartika Sharma, Ira Madan, Dean Lewis, Ibou Thior, Waimar Tun

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000 nationally with an HIV prevalence of 7.2 percent. Historically, the presence of IDU populations and associated HIV infection was concentrated in the northeastern states of the country. Recent evidence documents IDU populations in other parts of the country. Delhi has an estimated 17,000 IDUs and the second highest HIV prevalence in India at 18.3 percent. The probability of becoming infected with HIV after using an infected syringe ranges from 0.34 percent to 1.4 percent. By comparison, the risk for hepatitis C (HCV) ranges from 1.5 percent to 5 …

Linkage Politics And The Persistence Of National Policy Autonomy In Emerging Powers: Patents, Profits, And Patients In The Context Of Trips Compliance, Aseema Sinha, Tricia Olsen

CMC Faculty Publications and Research

The Trade Related Intellectual Property Agreement (TRIPS) has had a profound effect on industrialization and innovation, as well as access to medicines in cases of public health crisis such as HIV/AIDS. However, compliance with TRIPS has varied in developing countries, despite heightened international pressure. For instance, Brazil has pursued a coherent approach to its HIV/AIDS health crisis, while India has failed to take care of its HIV patients despite late compliance with the TRIPS agreement and the presence of business firms that produce the generic medicines for HIV/AIDS. This article suggests that divergence in TRIPS compliance is the result of …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …

Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga

HIV and AIDS

This study by the Population Council and the Zambia-Led Prevention Initiative was designed to examine the motivations of individuals volunteering as STEPS-OVC caregivers; to explore their experiences in service, including perceived barriers to carrying out their volunteer work and if, and how, their expectations for volunteering had been met or not; to assess individuals’ intent to continue caregiving; and to ascertain factors associated with volunteer productivity. Two main findings stand out from this study: that communitarian and religious helping values were virtually universal in the study population, and that a majority of the volunteers indicated economic and material interests and …

High Hiv Incidence Among Male Injection Drug Users In Delhi, India, Waimar Tun, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, Avina Sarna

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability …

Situation Analysis Of Programs To Meet The Hiv Prevention, Care, And Treatment Needs Of Persons With Disabilities In Ghana, Uganda, And Zambia, Waimar Tun, Jerry Okal, Katie D. Schenk, Meredith Sheehy, Emmanuel Kuffour, Selina F. Esantsi, Hilary Asiah, Grimond Moono, Felix Mutale, Rita Kyeremaa, Edson Ngirabakunzi, Atwijukire Justus

HIV and AIDS

National HIV strategic plans, HIV-related services, and HIV outreach efforts have tended to overlook persons with disabilities, and persons with disabilities are not reached by general HIV prevention, care, support, and treatment campaigns and services. To increase our understanding of how to make HIV programming more inclusive for persons with disabilities, HIVCore and partners conducted a three-country situation analysis (Uganda, Zambia, and Ghana). The study explored existing HIV services for persons with disabilities and determined the factors affecting their access to and use of HIV/sexual and reproductive health (SRH) services. Key findings: Persons with disabilities experience greater sexual vulnerability to …

A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland

HIV and AIDS

No standardized process exists for developing a set of agreed upon terms, definitions, and translations in local languages that ensures participants understand both technical and nontechnical terms used in a clinical trial context. HIV prevention trials deal with a disease that is stigmatized and with sexual behaviors that may not be openly discussed, thus care must be taken in the selection of words to ensure terms are appropriate for use in the context of a clinical trial and understandable but not offensive. The lack of a standardized process can make it difficult for researchers to decide which words to use, …

Doctors Without Borders: Putting The Pieces Together, Deniss Lujon

A with Honors Projects

No abstract provided.