Economics, Econometrics and Finance Economics and Econometrics

HIV/AIDS Impact and Responses

Description

This cluster of papers focuses on the macroeconomic impact of HIV/AIDS in Sub-Saharan Africa, particularly in countries like South Africa. The research examines the effects of the HIV/AIDS epidemic on economic growth, development, healthcare systems, and poverty levels in the region.

Keywords

HIV/AIDS; economic growth; Sub-Saharan Africa; impact; macroeconomics; development; South Africa; epidemic; healthcare; poverty

One of the most urgent challenges in African economic development is to devise a strategy for improving statistical capacity. Reliable statistics, including estimates of economic growth rates and per-capita income, … One of the most urgent challenges in African economic development is to devise a strategy for improving statistical capacity. Reliable statistics, including estimates of economic growth rates and per-capita income, are basic to the operation of governments in developing countries and vital to nongovernmental organizations and other entities that provide financial aid to them. Rich countries and international financial institutions such as the World Bank allocate their development resources on the basis of such data. The paucity of accurate statistics is not merely a technical problem; it has a massive impact on the welfare of citizens in developing countries.Where do these statistics originate? How accurate are they? Poor Numbers is the first analysis of the production and use of African economic development statistics. Morten Jerven's research shows how the statistical capacities of sub-Saharan African economies have fallen into disarray. The numbers substantially misstate the actual state of affairs. As a result, scarce resources are misapplied. Development policy does not deliver the benefits expected. Policymakers' attempts to improve the lot of the citizenry are frustrated. Donors have no accurate sense of the impact of the aid they supply. Jerven's findings from sub-Saharan Africa have far-reaching implications for aid and development policy. As Jerven notes, the current catchphrase in the development community is evidence-based policy, and scholars are applying increasingly sophisticated econometric methods—but no statistical techniques can substitute for partial and unreliable data.
Objectives: This article provides an overview of a growing body of international research focusing on the structural and environmental factors that shape the spread of the HIV/AIDS epidemic, and create … Objectives: This article provides an overview of a growing body of international research focusing on the structural and environmental factors that shape the spread of the HIV/AIDS epidemic, and create barriers and facilitators in relation to HIV-prevention programs. Overview of structural-factors literature: Most of the research on structural and environmental factors can be grouped into a small number of analytically distinct but interconnected categories: economic (under)development and poverty; mobility, including migration, seasonal work, and social disruption due to war and political instability; and gender inequalities. An additional focus in research on structural and environmental factors has been on the effects of particular governmental and intergovernmental policies in increasing or diminishing HIV vulnerability and transmission. Interventions: A smaller subset of the research on structural factors describes and/or evaluates specific interventions in detail. Approaches that have received significant attention include targeted interventions developed for heterosexual women, female commercial sex workers, male truck drivers, and men who have sex with men. Conclusions: The structural and environmental factors literature offers important insights and reveals a number of productive intervention strategies that might be explored in both resource-rich and -poor settings. However, new methodologies are required to document and evaluate the effects of the structural interventions, which by their very nature involve large-scale elements that cannot be easily controlled by experimental or quasi-experimental research designs. Innovative, interdisciplinary approaches are needed that can move beyond the limited successes of traditional behavioral interventions and explicitly attempt to achieve broader social and structural change.
OBJECTIVES. It is critical to extend community-level acquired immunodeficiency syndrome (AIDS) prevention efforts beyond education alone and to develop models that better encourage behavioral changes. Gay men in small cities … OBJECTIVES. It is critical to extend community-level acquired immunodeficiency syndrome (AIDS) prevention efforts beyond education alone and to develop models that better encourage behavioral changes. Gay men in small cities are vulnerable to human immunodeficiency virus (HIV) infection due to continued high rates of risk behavior. This research introduced an intervention that trained popular people to serve as behavioral change endorsers to peers sequentially across three different cities. METHODS. Populationwide surveys were conducted of all men patronizing gay clubs in each city to establish risk behavior base rates. After a small cadre of popular "trendsetters" were identified, they received training in approaches for peer education and then contracted to communicate risk reduction recommendations and endorsements to friends. Surveys were repeated at regular intervals in all cities, with the same intervention introduced in lagged fashion across each community. RESULTS. Intervention consistently produced systematic reductions in the population's high-risk behavior (unprotected anal intercourse) of 15% to 29% from baseline levels, with the same pattern of effects sequentially replicated in all three cities. CONCLUSIONS. This constitutes the first controlled, multiple-city test of an HIV prevention model targeting communities. The results support the utility of norm-changing approaches to reduce HIV risk behavior.
PREFACE FUNDAMENTAL ISSUES What is Epidemiology? Case Studies: The Work of Doll and Hill Populations and Samples Measuring Disease Measuring the Risk Factor Causality Studies Using Routine Data Study Design … PREFACE FUNDAMENTAL ISSUES What is Epidemiology? Case Studies: The Work of Doll and Hill Populations and Samples Measuring Disease Measuring the Risk Factor Causality Studies Using Routine Data Study Design Data Analysis Exercises BASIC ANALYTICAL PROCEDURES Introduction Case Study Types of Variables Tables and Charts Inferential Techniques for Categorical Variables Descriptive Techniques for Quantitative Variables Inferences about Means Inferential Techniques for Non-Normal Data Measuring Agreement Assessing Diagnostic Tests Exercises ASSESSING RISK FACTORS Risk and Relative Risk Odds and Odds Ratio Relative Risk or Odds Ratio? Prevalence Studies Testing Association Risk Factors Measured at Several Levels Attributable Risk Rate and Relative Rate Measures of Difference Exercises CONFOUNDING AND INTERACTION Introduction The Concept of Confounding Identification of Confounders Assessing Confounding Standardization Mantel-Haenszel Methods The Concept of Interaction Testing for Interaction Dealing with Interaction Exercises COHORT STUDIES Design Considerations Analytical Considerations Cohort Life Tables Kaplan-Meier Estimation Comparison of Two Sets of Survival Probabilities The Person-Years Method Period-Cohort Analysis Exercises CASE-CONTROL STUDIES Basic Design Concepts Basic Methods of Analysis Selection of Cases Selection of Controls Matching The Analysis of Matched Studies Nested Case-Control Studies Case-Cohort Studies Case-Crossover Studies Exercises INTERVENTION STUDIES Introduction Ethical Considerations Avoidance of Bias Parallel Group Studies Cross-Over Studies Sequential Studies Allocation to Treatment Group Exercises SAMPLE SIZE DETERMINATION Introduction Power Testing a Mean Value Testing a Difference Between Means Testing a Proportion Testing a Relative Risk Case-Control Studies Complex Sampling Designs Concluding Remarks Exercises MODELLING QUANTITATIVE OUTCOME VARIABLES Statistical Models One Categorical Explanatory Variable One Quantitative Explanatory Variable Two Categorical Explanatory Variables Model Building General Linear Models Several Explanatory Variables Model Checking Confounding Longitudinal Data Non-Normal Alternatives Exercises MODELLING BINARY OUTCOME DATA Introduction Problems with Standard Regression Models Logistic Regression Interpretation of Logistic Regression Coefficients Generic Data Multiple Logistic Regression Models Tests of Hypotheses Confounding Interaction Model Checking Regression Dilution Case-Control Studies Outcomes with Several Ordered Levels Longitudinal Data Complex Sampling Designs Exercises MODELLING FOLLOW-UP DATA Introduction Basic Functions of Survival Time Estimating the Hazard Function Probability Models Proportional Hazards Regression Models The Cox Proportional Hazards Model The Weibull Proportional Hazards Model Model Checking Poisson Regression Pooled Logistic Regression Exercises META-ANALYSIS Reviewing Evidence Systematic Review A General Approach to Pooling Investigating Heterogeneity Pooling Tabular Data Individual Participant Data Dealing with Aspects of Study Quality Publication Bias Is Meta-Analysis a Valid Tool in Epidemiology? Exercises APPENDIX A: MATERIALS AVAILABLE FROM THE WEBSITE APPENDIX B: STATISTICAL TABLES APPENDIX C: EXAMPLE DATA SETS SOLUTIONS TO EXERCISES REFERENCES INDEX
Twenty years after the fall of apartheid, social and economic disparities persist in South Africa and have a profound effect on the health of the population. HIV infection and tuberculosis … Twenty years after the fall of apartheid, social and economic disparities persist in South Africa and have a profound effect on the health of the population. HIV infection and tuberculosis remain major health problems, and there are not enough health care workers.
This book marks the first step in a new review of health policy - a review that focuses specifically on sub - Saharan Africa. Several factors make this exercise particularly … This book marks the first step in a new review of health policy - a review that focuses specifically on sub - Saharan Africa. Several factors make this exercise particularly timely: 1) the concern that the economic downturn of the early 1980s may have adversely affected the health sector in Africa; 2) the need to evaluate the impact of primary health care strategies, especially the key elements of immunization and oral rehydration; 3) the completion of a substantial body of epidemiological and demographic analyses, which provides a much improved empirical basis for assessing health conditions and recent health trends; 4) the concern that the global emergence of Acquired Immune Deficiency Syndrome (AIDS) and its sharp impact in selected African foci have undermined development prospects in some countries; and 5) the potential value of explicitly seeking lessons from the Bank's experience with health sector operations in Africa. The chapters in this book were commissioned to address the third point - to assemble in one place lessons from the analyses of the epidemiological and demographic conditions that define the problems facing Africa's health systems. This book sets an important part of the agenda of work for African health officials over the next decade.
There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been … There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been seen in Pakistan in this regard. This paper presents an extensive literature review of the situation in developing countries and relates the similar factors responsible for shaping up of a health seeking behaviour and health service utilization in Pakistan. The factors determining the health behaviours may be seen in various contexts: physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behaviour of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioural health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population.
Forecasts of tuberculosis morbidity and mortality are presented for the decade 1990-99. An estimated 88 million new cases of tuberculosis, of which 8 million will be attributable to HIV infection, … Forecasts of tuberculosis morbidity and mortality are presented for the decade 1990-99. An estimated 88 million new cases of tuberculosis, of which 8 million will be attributable to HIV infection, will occur in the world during the decade; 30 million people are predicted to die of tuberculosis in the same period, including 2.9 million attributable to HIV infection. The number of new tuberculosis cases occurring each year is predicted to increase from 7.5 million (143 cases per 100,000) in 1990 to 8.8 million (152 per 100,000) in 1995 and 10.2 million (163 per 100,000) in the year 2000. In 1990, 2.5 million persons were estimated to have died of tuberculosis; at the same level of availability of treatment, it is predicted that 3.0 million tuberculosis deaths will occur in 1995 and 3.5 million in 2000. Demographic factors, such as population growth and changes in the age structure of populations, will account for 79.5% of the predicted increases in new cases. Age-specific incidence rates in sub-Saharan Africa are increasing due to the HIV epidemic and will account for the remaining 20.5% of the forecast increase in new cases. In WHO's South-East Asian Region and in Central and South America the age-specific incidence rates are expected to fall during 1990-2000, but at a slower rate than in previous years because of the expected increase in HIV seroprevalence.(ABSTRACT TRUNCATED AT 250 WORDS)Over the period 1990-99, an estimated 88 million new cases of tuberculosis (TB) will occur worldwide, of which 8 million will be attributable to HIV infection. 30 million people are predicted to die of TB over the period, including 2.9 million attributable to HIV infection. Given a constant level of treatment availability, the numbers of new cases and deaths will both increase each year over the period. Demographic factors such as population growth and changes in the age structure of populations will account for 79.5% of the predicted increases in new cases. Age-specific incidence rates in sub-Saharan Africa, however, are increasing due to the HIV epidemic and will account for the remaining 20.5% of the forecast increase in new cases. In the World Health Organization's Southeast Asia region and in Central and South America, age-specific incidence rates are expected to fall during 1990-2000, but at a slower rate than in previous years because of the expected increase in HIV seroprevalence. Finally, in the Western Pacific and Eastern Mediterranean regions, intervention strategies should reduce the age-specific incidence rates during the period, but population growth will fuel an increase in the total number of new cases until the year 2000.
Key Issues in Epidemiologic Research: An Overview. OBJECTIVES AND METHODS OR EPIDEMIOLOGIC RESEARCH. Fundamentals of Epidemiologic Research. Types of Epidemiologic Research. Design Options in Observational Studies. Typology of Observational Study … Key Issues in Epidemiologic Research: An Overview. OBJECTIVES AND METHODS OR EPIDEMIOLOGIC RESEARCH. Fundamentals of Epidemiologic Research. Types of Epidemiologic Research. Design Options in Observational Studies. Typology of Observational Study Designs. Measures of Disease Frequency: Incidence. Other Measures of Disease Frequency. Measures of Association. Measures of Potential Impact and Summary of the Measures. VALIDITY OF EPIDEMIOLOGIC RESEARCH. Validity: General Considerations. Selection Bias. Information Bias. Confounding. Confounding Involving Several Risk Factors. PRINCIPLES AND PROCEDURES OF EPIDEMIOLOGIC ANALYSIS. Statistical Inferences About Effect Measures: Simple Analysis. Overview of Options for Control of Extraneous Factors. Stratified Analysis. Matching in Epidemiologic Studies. Interaction, Effect Modification, and Synergism. Modeling: Theoretical Considerations. Modeling: Analysis Strategy. Applications of Modeling with No Interaction. Applications of Logistic Regression with Interaction, Using Unconditional ML Estimation. Applications of Modeling: Conditional Likelihood Estimation. Appendices. Index.
In his two page introduction to the Good research guide Martyn Denscombe tells us that the focus of this guide is to help researchers make good decisions, a pragmatic approach … In his two page introduction to the Good research guide Martyn Denscombe tells us that the focus of this guide is to help researchers make good decisions, a pragmatic approach which makes the book ...
This report discusses the economic impact of the Coronavirus/COVID-19 crisis across industries, and countries. It also provides estimates of the potential global economic costs of COVID-19, and the GDP growth … This report discusses the economic impact of the Coronavirus/COVID-19 crisis across industries, and countries. It also provides estimates of the potential global economic costs of COVID-19, and the GDP growth of different countries. The current draft includes estimates for 30 countries, under different scenarios.The report shows the economic effects of outbreak are currently being underestimated, due to over-reliance on historical comparisons with SARS, or the 2008/2009 financial crisis. At the date of this report, the duration of the lockdown, as well as how the recovery will take place is still unknown. That is why several scenarios are used. In a mild scenario, GDP growth would take a hit, ranging from 3-6% depending on the country. As a result, in the sample of 30 countries covered, we would see a median decline in GDP in 2020 of -2.8%. In other scenarios, GDP can fall more than 10%, and in some countries, more than 15%.Service-oriented economies will be particularly negatively affected, and have more jobs at risk. Countries like Greece, Portugal, and Spain that are more reliant on tourism (more than 15% of GDP) will be more affected by this crisis. This current crisis is generating spillover effects throughout supply chains. Therefore, countries highly dependent on foreign trade are more negatively affected. The results suggest that on average, each additional month of crisis costs 2.5-3% of global GDP.
Abstract COVID-19 has disrupted the Chinese economy and is spreading globally. The evolution of the disease and its economic impacts are highly uncertain, making formulation of appropriate macroeconomic policy responses … Abstract COVID-19 has disrupted the Chinese economy and is spreading globally. The evolution of the disease and its economic impacts are highly uncertain, making formulation of appropriate macroeconomic policy responses challenging. This paper explores seven plausible scenarios of COVID-19 and the macroeconomic outcomes using a global hybrid DSGE/CGE general equilibrium model. The results demonstrate that even a contained outbreak could significantly impact the global economy in the short run. Economic costs could be significantly avoided with greater investment in public health systems in all economies, particularly in economies where health care systems are less developed and population density is high.
The 30th Anniversary 2020 Human Development Report is the latest in the series of global Human Development Reports published by the United Nations Development Programme (UNDP) since 1990 as independent … The 30th Anniversary 2020 Human Development Report is the latest in the series of global Human Development Reports published by the United Nations Development Programme (UNDP) since 1990 as independent and analytically and empirically grounded discussions of major development issues, trends and policies. This report offers a thought-provoking, necessary alternative to paralysis in the face of alarming planetary change. Its release comes as the COVID-19 (coronarvirus) pandemic simultaneously offers a glimpse of what a ‘new normal’ could hold and opens up the opportunity for humanity to change course. The report also sets out new metrics of human development to guide us, including a new, experimental Planetary pressures-adjusted Human Development Index. The e-book for this publication has been converted into an accessible format for the visually impaired and people with print reading disabilities. It is fully compatible with leading screen-reader technologies such as JAWS and NVDA.
This article is a Joint UN Program on HIV/AIDS (UNAIDS) updated report from December 1999 on the AIDS epidemic. Observations included in the report are the following: 1) an estimated … This article is a Joint UN Program on HIV/AIDS (UNAIDS) updated report from December 1999 on the AIDS epidemic. Observations included in the report are the following: 1) an estimated 33.6 million HIV/AIDS-infected individuals (23.3 million in Africa); 2) in 1999, 5.6 million new infections (3.8 million are in Africa); 3) since the epidemic began, there have been 2.6 million AIDS-related deaths; and 4) the life expectancy has dropped to 45 years for the next 5 years. Furthermore, the antenatal estimates tend to underestimate the real level of HIV infection in women and the conclusion seems to indicate that there are significantly more women infected with HIV infection than men. UNAIDS estimates that the ratio for every 10 men infected, there are 12-13 women that are HIV-positive. It was suggested that a degraded macroeconomic situation directly influence the health services, which confirms the link between poverty and HIV infection. During the 1996 study conducted in South Africa, an estimate of 52% from the 11 million people between 16-30 years old were unemployed, half of them classified under marginalized with few prospects of formal sector employment. This has led young people to adopt short-term survival strategies, which often include exchanging sex for schooling, employment, money or shelter before long-term well-being. This article may prove to be a useful background for policy development aimed at reversing the situation.
This study aimed to estimate the proportion of cigarettes consumed in the Democratic Republic of the Congo (DRC) that are illicit and the extent of cigarette tax evasion; and to … This study aimed to estimate the proportion of cigarettes consumed in the Democratic Republic of the Congo (DRC) that are illicit and the extent of cigarette tax evasion; and to identify the origins of and factors associated with illicit cigarettes. Data were collected from May 15 to June 9, 2023. Stratified, multistage sampling was used to select 32 health areas from which empty cigarette packs were collected. Each collected pack was examined and classified as licit if it complied, or illicit if it did not comply, with the DRC’s tax stamp or written health warning requirements, or the requirements to have a notice indicating the prohibition of sale by/to minors or information on tar and nicotine content. We reported frequencies as numbers and percentages, and continuous variables as means or medians. We performed regression analysis and used adjusted odds ratios (aOR) and their 95% confidence intervals (CI) to measure associations. 8.6% (95% CI: 8.1, 9.2) of the 10622 empty cigarette packs collected were illicit, and had also evaded cigarette tax. 8.0% of the collected packs did not comply with written health warning requirements, 5.6% did not indicate the prohibition of sale by/to minors, and 4.5% did not have information on tar and nicotine content. Packs from low-income areas were more likely to be illicit than those collected from high-income areas (aOR 1.90; [95% CI: 1.48-2.43]). The likelihood of being an illicit cigarette increased with increasing susceptibility to armed conflict/insecurity. Packs from border provinces were less likely to be illicit than those from non-border provinces (aOR 0.48; [95% CI: 0.25-0.90]). All illicit cigarettes were imports from other countries. There is, therefore, a need to secure the cigarette supply chain, strengthening border controls and enforcement and compliance monitoring, and strengthening political commitment by ratifying the Protocol to Eliminate Illicit Trade in Tobacco Products.
Background: Primary health services such as health centers play a strategic role in improving the health status of the community, especially in coastal areas that often experience limited access to … Background: Primary health services such as health centers play a strategic role in improving the health status of the community, especially in coastal areas that often experience limited access to health services. However, the utilization of health center services by people in coastal areas is still relatively low and uneven. This phenomenon is influenced by various factors, both in terms of individuals, families, and the socio-cultural environment of the community. This study aims to analyze the relationship between family support, community cultural traditions, and the quality of health services on the utilization of health services in coastal health centers. Methods: This study aims to analyze the relationship between family support, community cultural traditions, and health service quality on the utilization of health services in coastal health centers. Results: The results of this literature study show that the utilization of health services in coastal areas is influenced by three main factors, namely:Family support plays an important role in encouraging individuals, especially the elderly and vulnerable groups, to access health services.People's cultural traditions are still very strong in influencing health behavior. Belief in traditional medicine, myths, and hereditary values is an obstacle in the use of modern health services. The quality of health services such as reliability, empathy, and patient orientation has been proven to have a significant relationship with the level of satisfaction and reutilization of health center services. Conclusion: Based on the results of a literature review of ten scientific articles, it can be concluded that the use of health services in coastal areas is influenced by three main factors, namely family support, community cultural traditions, and the quality of health services.
<title>Abstract</title> <bold>Background</bold> Climate Change and extreme weather events are recognized as the critical threat to public health, with severe effects on vulnerable populations in low- and middle-income countries. In India, … <title>Abstract</title> <bold>Background</bold> Climate Change and extreme weather events are recognized as the critical threat to public health, with severe effects on vulnerable populations in low- and middle-income countries. In India, these climatic stressors may further undermine the HIV response by disrupting services, exacerbating vulnerabilities, augmenting transmission and straining health systems. However, the evidence based on how climate change intersects with HIV responses remains limited and fragmented. Present study aimed to develop a comprehensive framework for identifying research priorities aimed at mitigating the impact of climate change on the HIV response in India. <bold>Methods</bold> Present work was carried out through the scoping review followed by a modified Delphi. Scoping review included peer-reviewed articles and grey literatures published between 2000 to 2023 following PRISMA guidelines. The database search comprises of PubMed, Scopus, Web of Science, and regional sources, focusing on studies that explore the interface of climate and HIV-related health outcomes, service delivery, and system resilience. The data was extracted from the selected articles, then analysed to identify the lessons of contextual relevance. Building on the findings of the scoping review a Modified Delphi Consensus method was used in three interactive rounds to develop a research framework and finalise major priorities. <bold>Results</bold> An initial pool of 88,292 records and 55 additional grey literature sources was narrowed down to 119 documents (83 academic papers and 36 reports) after screening for relevance and eligibility. Most of the included studies focused on climate migration, health service disruptions. though a large proportion were narrative reviews with limited high-quality evidences. The Evidence Gap Map revealed significant research deficiencies, especially in areas such as food insecurity, co-infections, and policy-level responses. Using a modified Delphi method, the research team identified four major researchable domains namely food insecurity, migration, health system disruption, and co-infections. <bold>Conclusion</bold> This was a first of its kind endeavour in Indian setting to direct investments in cross cutting areas of Climate Change &amp; HIV programs. The conceptual framework suggested that climate change affects the HIV response through interconnected pathways. The final research priorities aimed to guide evidence generation for policy action and resilient health systems.
Boda boda taxis play a significant role in Tanzania’s transportation sector. Still, the attitudinal behaviour of the riders has raised questions about the safety of the Boda Boda taxis. This … Boda boda taxis play a significant role in Tanzania’s transportation sector. Still, the attitudinal behaviour of the riders has raised questions about the safety of the Boda Boda taxis. This study assessed the behavioural attitude (human attributes) of Boda Boda riders in Dar es Salaam. In carrying out this assessment, the socio-economics of the Boda Boda Riders and their attitudinal behaviours towards safety practices were examined. The study adopted a cross-sectional survey approach to collect data; simple descriptive statistics were used to analyse the data collected. The study revealed that despite the training facilities available for Boda Boda riders in Dar es Salaam,67% of the Boda Boda riders did not receive any formal training. Driving under the influence of Alcohol was prevalent among Boda Boda riders in Dar es Salaam, as 26.67% of the respondents were culpable of this offence. The study further revealed that all the Boba Boba riders in Dar es Salaam were lacking in various safety measures. The study concludes that drug abuse was common among Boda Boda operators, regardless of the education level. The study, therefore, recommends that the dangers of the use of alcohol, drugs and other psychoactive substances should be included in the training curriculum to further enlighten Boda Boda riders on the dangers of riding under the influence of drugs. There should be strict regulations on traffic offenders.
FDA’s anticipated approval of lenacapavir comes at a time of global health cuts FDA’s anticipated approval of lenacapavir comes at a time of global health cuts
Latar Belakang: Program Jaminan Kesehatan Nasional bertujuan mencapai cakupan kesehatan universal. Pemanfaatan layanan kesehatan dipengaruhi oleh karakteristik predisposisi, pemungkin, dan kebutuhan. Tujuan penelitian menganalisis faktor yang berhubungan dengan pemanfaatan Jaminan … Latar Belakang: Program Jaminan Kesehatan Nasional bertujuan mencapai cakupan kesehatan universal. Pemanfaatan layanan kesehatan dipengaruhi oleh karakteristik predisposisi, pemungkin, dan kebutuhan. Tujuan penelitian menganalisis faktor yang berhubungan dengan pemanfaatan Jaminan Kesehatan Nasional di Kecamatan Majalengka Kabupaten Majalengka pada tahun 2024.Metode: Penelitian ini menggunakan desain cross sectional dengan teknik cluster random sampling dan melibatkan 183 responden. Analisis data menggunakan uji chi-square dan regresi logistik.Hasil: Analisis bivariat menunjukkan variabel usia, pendapatan, kepesertaan Jaminan Kesehatan Nasional, pengetahuan, kepuasan, dan dukungan keluarga memiliki nilai p-value &lt;0,05, artinya signifikan. Variabel jenis kelamin dan pekerjaan tidak signifikan nilai p-value &gt; 0,05. Pada analisis multivariat, kepuasan Jaminan Kesehatan Nasional memiliki pengaruh paling kuat terhadap pemanfaatan Jaminan Kesehatan Nasional dengan OR sebesar 30,190.Kesimpulan: partisipasi aktif dari kelompok masyarakat seperti kader kesehatan, tokoh agama, dan tokoh masyarakat juga sangat penting dalam mendukung pelaksanaan program Jaminan Kesehatan Nasional.
HIV testing plays a crucial role in care and management, serving as the first step for individuals to learn their HIV status and potentially begin antiretroviral therapy. This study examines … HIV testing plays a crucial role in care and management, serving as the first step for individuals to learn their HIV status and potentially begin antiretroviral therapy. This study examines trends and challenges related to HIV testing and individual factors like education, marital status, and occupation to enhance testing rates and control the HIV epidemic. A cross-sectional study evaluated HIV testing services (HTS) usage among men in Dodoma Urban, Ikungi District, and Babati Urban, collecting data through structured questionnaires from 378 men randomly selected at health facilities. SPSS was used to analyze the data to get descriptive and inferential findings. Results indicated significant improvements in HIV testing following the introduction of male-friendly health services, with annual testing for men standing at 77%. Younger men (under 35) had a higher testing rate of 58%, compared to 42% for those aged 35 and older (Chi- sq = 162.542, P = 0.000). Education level was crucial; 91.2% of men with secondary education or higher were tested, compared to 75.6% of those with primary education and 51.3% with no education. Married men had an 82.4% testing rate, while unmarried men tested at 78.5%. Occupation also influenced behavior; 84.7% of self-employed and 80.5% of employed men got tested, compared to 58.6% of unemployed men. The findings underscore the need for targeted outreach in HIV testing. The approach should consider education, marital status, and occupation being essential for promoting early detection and better healthcare outcomes.
Background: Children with multidrug-resistant (MDR) / rifampicin-resistant (RR)- tuberculosis (TB) are an important but neglected group in cost-effectiveness research. Digital health information systems enable new approaches to health-service cost analysis. … Background: Children with multidrug-resistant (MDR) / rifampicin-resistant (RR)- tuberculosis (TB) are an important but neglected group in cost-effectiveness research. Digital health information systems enable new approaches to health-service cost analysis. The Provincial Health Data Centre (PHDC) in the Western Cape, South Africa, collates disparate health system data including hospital inpatient and outpatient data, medication, laboratory tests, , and primary healthcare utilisation. Methods: Cost analysis was conducted using anonymised, integrated PHDC data for children with MDR/RR-TB between 1 January 2018 and 31 December 2021. Health-service costs were assessed by patient and disease characteristics including age, sex, drug susceptibility type, site of disease, and HIV status. Results: There was significant cost variation across the n=271 children in the data sample (median US$7,576 (IQR $2,725 - $22,986)). The distribution of total per patient costs fitted a gamma distribution (mean US$13,435, α = 0.93, β = 14,496). Regression analysis indicates age, disease site, living with HIV, and treatment duration had significant impact on costs, whereas the impact of resistance profile and sex was not significant. Conclusion: Treatment for MDR/RR-TB in children remains costly for health systems. Utilising routinely collected, real-world data from an established health information system enables accurate and representative insights to overall costs and major cost drivers. Costs were highly skewed, with a small proportion of patients incurring very high costs. This cost analysis can assist in decision-making and programme development at local and international levels and as an input to secondary analysis.
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Purpose This study aims to look into trends, precipitating factors and response to drug and substance misuse in Mbare suburb. This study comes against a background of an upsurge in … Purpose This study aims to look into trends, precipitating factors and response to drug and substance misuse in Mbare suburb. This study comes against a background of an upsurge in drug and substance misuse in Harare’s oldest suburb. This study also recommends appropriate measures for dealing with the scourge. Design/methodology/approach A mixed-methods research design was adopted to gather data from a total of 140 respondents (including 12 interview participants) who were selected using stratified random sampling and purposive sampling techniques. Data were collected using the questionnaire and in-depth interviews. Quantitative data were analysed using Statistical Package for Social Sciences, whereas qualitative data were analysed using thematic analysis. Findings Abuse of prescription drugs, followed by abuse of marijuana and harmful liquids, was cited as the dominant forms of drug and substance abuse. Family risk factors, in the form of early initiation and family history, as well as socio-economic factors such as unemployment, were pointed out as the major reasons for the increase in drug and substance abuse in Mbare suburb. Multi-stakeholder awareness campaigns, arrest and prosecution and police patrols were considered to be the most effective measures against drug and substance misuse. Originality/value Given the dearth of literature on the magnitude of the drug and substance misuse in Zimbabwe, with the available statistics coming from modest research endeavours and newspaper stories that do not fully capture the scope and nature of the problems at hand, this study provides context-specific information on a problem that has negatively impacted the socio-moral fabric.
Background In Ethiopia and other resource-limited settings, antiretroviral therapy (ART) has been instrumental in reducing the harmful impact of the HIV pandemic. ART program aims to decrease morbidity and mortality, … Background In Ethiopia and other resource-limited settings, antiretroviral therapy (ART) has been instrumental in reducing the harmful impact of the HIV pandemic. ART program aims to decrease morbidity and mortality, minimize healthcare costs, and enhance the quality of life for individuals living with HIV. However, the program faces several challenges, including poor medication adherence, a higher incidence of adverse effects, drug resistance, and persistent issues of discrimination and stigma. This study aimed to evaluate the implementation process of the antiretroviral therapy (ART) program among adult HIV/AIDS patients at Woldia General Hospital in Northeast Ethiopia. Methods Between June 1 and June 30, 2020, a mixed-method case study was conducted. A total of 384 patient charts were reviewed, and 402 individuals living with HIV/AIDS were interviewed using systematic random sampling technique and interviewer administered questionnaire. Additionally, six key informant interviews were conducted, and 30 observations of healthcare professionals were recorded. The quantitative data were entered into Epidata version 4.6 and subsequently transferred to STATA version 14 for analysis. Bivariable analysis was performed to identify variables with p -values less than 0.2 as potential candidates for multivariable logistic regression, with statistical significance set at p &amp;lt; 0.05. The qualitative data underwent transcription, translation into English, coding, thematic analysis, and manual interpretation. The overall implementation status of the program was assessed based on predefined evaluation criteria. Results According to national guidelines, 74.8% of the program was implemented consistently. Patient satisfaction was reported at 77%, healthcare personnel adherence to guidelines at 66%, and resource availability at 88.4%. Key challenges included shortages of test kits, Plumpy’Nut, and medications for opportunistic infections, as well as inadequate data management and issues with patient file handling. Most laboratory tests were not done according to the national guidelines. Additionally, refreshment training for health care providers was not given. Factors associated with patient satisfaction included the ability to disclose their condition (AOR = 3.25; 95% CI: 1.46, 7.26) and a waiting time of less than 30 min (AOR = 3.88; 95% CI: 1.26, 11.97). Conclusion The overall level of program implementation was very good. However, patient satisfaction did not meet the national target of 85%, and adherence to national guidelines was minimal. Essential supplies such as HIV test kits, Plumpy’Nut, viral load tests, and medications for opportunistic infections were not consistently available. Additionally, most laboratory tests were not conducted in accordance with the guidelines. Factors associated with patient satisfaction included the ability to disclose HIV status and waiting times of under 30 min.
Introduction The introduction and rapid scale-up of AntiRetroviral Treatment (ART) has contributed to a significant reduction in HIV-associated morbidities and mortalities, resulting in increasing life expectancy. Ageing with HIV presents … Introduction The introduction and rapid scale-up of AntiRetroviral Treatment (ART) has contributed to a significant reduction in HIV-associated morbidities and mortalities, resulting in increasing life expectancy. Ageing with HIV presents several challenges which affect peoples’ well-being and quality of life (QoL). Despite this, there is scarcity of research on the QoL of Elderly Persons Living with HIV (EPLHIV) in Sub-Saharan Africa (SSA), particularly in Ghana. This study, therefore, examines the QoL of the elderly population using a qualitative approach. Methods A purposive sampling method was used to select eight (8) participants for Key Informant Interviews (KIIs) and twenty-nine (29) participants for Focus Group Discussions (FGDs). In all, eight (8) KIIs with stakeholders and four (4) FGDs with EPLHIV were used to collect data for this study. Both the KIIs and FGDs interview guides addressed the four domains of the WHO’s Quality of Life (WHOQoL) Bref assessment tool; physical, psychological, social, and environmental health with the overall focus on evaluating quality of life. The data was analysed thematically using QSR NVivo 11. Results Of the 37 participants, majority (54%) of them were females, and a considerable proportion (94%) had attained formal education. The most prolonged duration of persons living with HIV among the respondents was 25 years. Four main themes were identified: physical health, social well being, environmental health, and psychological health. The study further revealed that EPLHIV reflect on their condition, face the dilemma of disclosing their status, are confronted with inadequate privacy for health care, wait long in the queue at the health facilities to be attended to, and have no focused or tailored HIV services for the EPLHIV and experiences worsened physical conditions. Conclusions The study’s findings shed light on the quality of life among EPLHIV, offering new evidence. Consequently, some of the conditions related to the various domains such as stigma, delay in receiving health care could negatively influence the QoL of EPLHIV. To improve the QoL of EPLHIV, it is imperative to implement specialized services tailored to the unique needs of EPLHIV. Additionally, healthcare workers at ART clinics should receive training in psychological and geriatric care counseling, considering the increasing life expectancy of EPLHIV. There should be counseling sessions on disclosure and non-disclosure to help those who want to disclose their status do so.
Archana Shahi , Gagandeep Bajaj , Anjali Pathak +1 more | International Journal For Multidisciplinary Research
Recent research underscores the imperative for enhanced sustainability and reduced disease transmission. Hierarchical models, operating across diverse scales and employing varied tools, present a promising avenue for addressing these challenges. … Recent research underscores the imperative for enhanced sustainability and reduced disease transmission. Hierarchical models, operating across diverse scales and employing varied tools, present a promising avenue for addressing these challenges. Prioritizing sustainability and adopting an isolation model can effectively mitigate risks and control the devastating impacts of global crises. By minimizing human interaction and implementing rigorous evaluation parameters, we can curtail disease spread and improve overall well-being. Data derived from secondary sources will be utilized to assess the effectiveness of this approach. This study will elucidate how a seemingly straightforward intervention, such as isolation, can exert a substantial influence on global sustainability and public health.
Nurwin Fozia , Okanga Anne Asiko | International Journal of Humanity and Social Sciences
Teenage pregnancies is a global public health concern more so in Vihiga county, the second smallest county in Kenya with the highest rural population in East and Central Africa with … Teenage pregnancies is a global public health concern more so in Vihiga county, the second smallest county in Kenya with the highest rural population in East and Central Africa with an average population of 1200 persons per square kilometer. In Kenya, in every four girls, one, between the ages of 15-19 becomes a mother. The purpose of this study was to identify the teen and preteen prevalence in Vihiga County. Simple random sampling was used to select the participants of the study. The findings found out that the preteen pregnancies rates are high and intervention is required for return to school and economic empowerment programmes. Policies relating to preteen pregnancies have to be reviewed to take into consideration the fact that majority of the affected never return to school. The practice Is they end up as dropouts and turn into child labour.
Background: HIV counseling and testing are foundational in the fight against HIV/AIDS, offering opportunities for prevention, early diagnosis, and treatment linkage. This study evaluated the effectiveness of HIV counseling and … Background: HIV counseling and testing are foundational in the fight against HIV/AIDS, offering opportunities for prevention, early diagnosis, and treatment linkage. This study evaluated the effectiveness of HIV counseling and testing services at an Apex Regional STD Centre in North India. Methods: A retrospective observational study was conducted from January to December 2023. Data were extracted from center registers, including the number of individuals receiving pre-test counseling, undergoing HIV testing, and testing positive. Partner engagement, HIV transmission routes, age and gender distribution, and referral of suspected TB cases were also analyzed. Quality indicators such as counseling completeness, content delivered, and partner notification services were reviewed.
This research utilised survival analysis to study and model data on human immunodeficiency virus (HIV) infection, among children aged one to ten years old. The study adopted the Gompertz parametric … This research utilised survival analysis to study and model data on human immunodeficiency virus (HIV) infection, among children aged one to ten years old. The study adopted the Gompertz parametric and Cox proportional semi parametric survival model to fit the HIV data and estimated the survival functions using the Kaplan-Meier estimator. The predictor variables of interest included age, weight, height, sex, mother-to-child transmission, residence, viral load, HIV and educational status of the parents. Purposive sampling technique was used to collect the required data from January, 2007 to December, 2021 at General Hospital Minna, Niger State. The analysis revealed that only viral load with a p-value of 0.000 was statistically significant predictor of the event, indicating it is significant at 0.05 level. This indicated lower risk of death and higher chance of surviving. The Gompertz model gave the best fit with Akaike Information Criterion of 569.17 and Bayesian Information Criterion of 609.19. Early initiation and consistent adherence to Antiretroviral Therapy (ART) can effectively suppress viral load. Children born to HIV-positive mothers, particularly those with unsuppressed viral loads, require regular monitoring due to their increased risk of death from mother-to-child transmission.
Abstract Immediately after Mozambique’s independence in 1975, the Mozambican Liberation Front ( frelimo ) started shaping the country’s new health services by announcing the nationalisation of all health care facilities … Abstract Immediately after Mozambique’s independence in 1975, the Mozambican Liberation Front ( frelimo ) started shaping the country’s new health services by announcing the nationalisation of all health care facilities and by adopting primary health care. As Portuguese doctors left Mozambique at the end of the colonial era, fewer than a hundred remained after independence. Doctors and nurses soon came from Bulgaria, China, Cuba, Guinea-Conakry and Italy. These medical professionals were called cooperantes in Portuguese. Those coming from state socialist countries were sent by their governments as a gesture of solidarity with the young nation. Those coming from Western countries were often left-wing militants committed to creating an alternative health system and to contribute to the revolution. Mozambique was seen as a place particularly well suited to the creation of a revolutionary medical utopia: with almost all the “capitalist” doctors gone, the new health services could be built from scratch. But the transformation ambition went beyond its borders. Together with the Mozambican Ministry of Health, the cooperantes became major disseminators of the Mozambican health experience abroad, actively seeking to influence the debate on international health care priorities and solutions. This paper aims to interrogate the cooperantes ’ experiences, to characterise their contribution to the Mozambican health services, and to explore how they adapted to the orientations of the Mozambican health authorities and to the constraints and shortages of the Mozambican context.
Human trafficking is a wide-ranging crime with numerous victims and various patterns. The population living mainly in low and middle-income countries of the Global South is more vulnerable to being … Human trafficking is a wide-ranging crime with numerous victims and various patterns. The population living mainly in low and middle-income countries of the Global South is more vulnerable to being trafficked. Selected countries from the Middle East, Central Asia, Southeast Asia, South Asia, Africa, and Latin America are samples used to examine human trafficking of scholarly works between 2013 and 2023. This article investigates research trends on human trafficking in the Global South from Asia, Africa, the Middle East, and Latin America between 2012 and 2024. A bibliometric method was adopted. Articles published in the Scopus-indexed journals were retrieved. The research period was designated from 2013 to 2023. The articles that were retrieved closely related to the topic were three hundred thirty-five. The overall number of authors is seven hundred and twenty-one people. The average number of authors per document is 2.2. International co-authors are 29%. Then, there are typically 101 single authors, and each writer publishes roughly three articles. Migration is an issue that articles discuss the most (n=335;81 works), followed by sex trafficking (n=335;75 publications), slavery (n=335;70 articles), forced labor (n=335;34 articles), smuggling (n=335;34 publications), child trafficking (n=335;17), human experiment (n=335;6) and terrorism (n=335;1 works). Africa has more articles than other regions in the Global South. The top three active institutions are the University of Georgia (USA) (12 articles), the University of Sultan Ageng Tirtayasa (10 publications), and the University of Nigeria (9 publications). The Journal of Human Trafficking is a journal with the highest citation. The issue mainly cited in the Marine Policy journal is forced labor. Migration, sex trafficking, and slavery are the dominant issues several journals address in dealing with human trafficking in the Global South. The literature on the terrorism of human trafficking in the Global South was notably lacking. The human experiment also has little attention.
Behavioral economics offers an innovative theoretical and practical framework for HIV/AIDS prevention by elucidating the irrational tendencies in individual decision-making. This review explores core behavioral economics concepts and their applications … Behavioral economics offers an innovative theoretical and practical framework for HIV/AIDS prevention by elucidating the irrational tendencies in individual decision-making. This review explores core behavioral economics concepts and their applications in HIV/AIDS prevention, including how salience bias, present bias, and loss aversion influence high-risk populations' behaviors. It also synthesizes empirical evidence on the effectiveness of nudge-based interventions in enhancing public health strategies, increasing HIV testing uptake, and improving treatment adherence.Additionally, the paper addresses key challenges in the field, such as interdisciplinary collaboration, cost-effectiveness analyses of economic incentives, and ethical and cultural considerations in implementation. Future research should further integrate sociocultural contexts specific to China to localize behavioral economics applications, refine intervention strategies, and optimize resource allocation. Such efforts will advance progress toward the global goal of ending the HIV epidemic by 2030.
The Abuja Declaration, which was endorsed in 2001, was a hallmark of African leadership’s decision to prevent and control human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Africa. … The Abuja Declaration, which was endorsed in 2001, was a hallmark of African leadership’s decision to prevent and control human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Africa. Since this declaration, there have been several achievements recorded in the fight against HIV and AIDS. This includes increased domestic and international financing, ground-breaking innovations and discoveries for effective screening, diagnosis, and treatment of HIV and AIDS, targeted interventions to address mother-to-child transmission, and tailored and innovative approaches to prevent new HIV infections, particularly among the key and vulnerable populations. However, unaddressed challenges still require urgent and accelerated interventions to attain and sustain the set 95-95-95 Joint United Nations Programme on HIV and AIDS (UNAIDS) target. As we are near the 2030 landmark, revitalisation of the commitments made in the Abuja Declaration is essential. African countries must increase their domestic resources to address the inequities and improve access to essential HIV and AIDS prevention and response interventions, particularly for adolescent girls and young women, children, and vulnerable populations. Revitalisation of sex education, social protection, and revisiting in-country laws that negatively impact the HIV prevention and response efforts are more essential than ever before. There is a clear need for rededication of political and leadership will and commitment as we envision epidemic control of HIV and AIDS by 2030. Countries need to develop an action-oriented, targeted, and all-inclusive roadmap for HIV and AIDS epidemic control by 2030.