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Disability and HIV : a systematic review and a meta-analysis of the risk of HIV infection among adults with disabilities in Sub-Saharan Africa

DE BEAUDRAP, Pierre
MAC-SEING, Muriel
PASQUIER, Estelle
July 2014

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"More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported to be at increased risk of HIV. However, quantitative evidence on this remains scarce. A systematic review and a meta-analysis of the risk of HIV infection among people with disabilities living in Sub-Saharan Africa were undertaken. We searched all published or unpublished studies and national surveys reporting HIV prevalence among adults with disabilities living in Sub-Saharan Africa between 2000 and 2013. The risk ratio (RR) of HIV infection in people with disabilities versus people without disabilities was estimated through a random-effects meta-analysis. Of the 12,252 references screened, 13 studies were selected. HIV prevalence varied widely across studies from 1.1% to 29%. Pooled RRs of HIV infection in people with disabilities compared to the general population were 1.31 (1.02–1.69) overall; 1.16 (0.71–1.87) among people with mental illness or intellectual disabilities and 1.07 (0.58–1.95) among people with hearing disabilities. This meta-analysis provides evidence that people with disabilities do not have a lower risk of HIV when compared to the general population, and that women with disabilities are especially affected. A clear increasing gradient in the risk of HIV according to gender and disability status was also observed. The important heterogeneity across studies and their varying quality warrant a closer look at the intersection between disability and HIV. Additional studies with more systematic approaches and with higher-quality methodologies are required to further address this knowledge gap"

 

AIDS Care : Psychological and Socio-medical Aspects of HIV/AIDS, Volume 26, Issue 12

DOI: 10.1080/09540121.2014.936820

 

Knowledge and use of contraceptive methods amongst deaf people in Ghana

MPRAH, Wisdom K
2013

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Background: Persons with disabilities in general face serious barriers to sexual and reproductive health (SRH) information and services due to institutional and attitudinal barriers. However, because deaf people have unique communication and linguistic needs, which are often misunderstood or ignored, they face greater barriers than other persons with disabilities. Whilst available data indicated that there is a wide gap between knowledge and usage of contraceptive amongst Ghanaians, little is known about the level of contraceptive knowledge and usage amongst deaf people.

 

Objectives: The objective of the study was to investigate the level of knowledge and use of contraceptive methods amongst deaf people in Ghana with the aim of understanding their contraceptive behaviour and to improve access.

 

Method: The study was a participatory SRH needs assessment utilising a two-phase, sequential, mixed methods design. The study included 179 participants, consisting of focus groups with seven executives of Ghana National Association of the Deaf (GNAD), 10 male deaf adults, and 9 deaf female adults. A total of 152 deaf people, made up of students, women, and men participated in a survey, whilst one hearing person served as a key informant.

 

Results: The findings of the study indicated that of the 13 methods shown in the survey, only three were known to about 70% of the adults and 60% of the students. Level of knowledge of the remaining nine methods was low.

 

Conclusion: Clear and effective policies are needed to guide the provision of SRH information and services for deaf people in Ghana.

The role of local manufacturers in improving access to essential medicines|Creating opportunities for the scale-up of local pharmaceutical production

MOHAMED, Nazeem
November 2009

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The local manufacturing of pharmaceuticals is a hotly contested issue in many countries. It runs to the heart of key concerns such as quality, availability, and price of medicines. Some of the arguments of the local manufacturers are set out in this article by one of the co-chairs of the Medicines Transparency Alliance Uganda Council and Chairman of the Uganda Pharmaceutical Manufacturer's Association (UPMA)

Survey of the quality of selected antimalarial medicines circulating in Madagascar, Senegal, and Uganda

UNITED STATES PHARMACOPEIA DRUG AND INFORMATION PROGRAM
November 2009

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This report focuses on three of 10 sub-Saharan countries that were covered by a study examining the quality of key antimalarial medicines. A total of 491 samples of anti-malarial medicines (both artemisinin-based combination therapy and sulfadoxine-pyrimethamine products) were collected from the public sector, the regulated private sector and the informal market in these three countries. The study revealed a high failure rate among sampled antimalarials in all three countries, based both on Minilab and full-compendial or quality control laboratory testing

Special issue on access to medicines, pricing and generics

September 2009

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This issue has articles about medicine prices in Vietnam, Thailand and South Africa, generic medicines in Malaysia and Australia, anti-retroviral therapy in South Africa, and legislation and regulation in the retail pharmacy sector in low-income countries.
Southern Med Review : Vol 2, Issue 2

The push for local production, costs and benefits - a case study of Uganda’s Quality Chemicals|Africa Fighting Malaria policy paper

TAYLOR, James
et al
September 2009

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This research report considers the challenges faced by a local pharmaceutical firm - Quality Chemicals - in Uganda, which was started up as a 'solution' to reducing the high cost of medicines and improving access to medicines. "...many burdens and barriers to access continue to seriously hinder the success of such enterprises. Indirect government subsidies to exporters selling into African markets, and pressure by donors and lobbyists on innovator producers to offer developing countries subsidised prices, actually undermine the competitiveness and viability of these nascent firms. Furthermore, the focus on drug pricing and local production can actually undermine the overall aim to increase access to medicines"

A handbook for network support agents and other community workers supporting HIV prevention, care, support and treatment

March 2009

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This manual is intended to help network support agents and other community workers be more effective in disseminating standardised information about HIV and AIDS. It "...emphasises the importance of the acquisition of knowledge, skills and the right attitude needed to identify the psychosocial needs of people of people infected and affected by HIV/AIDS and address these needs by giving information, counselling and appropriate referrals. Knowledge of counselling and psychosocial care, is combined as much as possible with prevention activities such as adopting HIV basic care positive prevention and adherence to treatment"

Malaria treatment in Nigeria : the role of patent medicine vendors

OLADEPO, Oladimeji
et al
March 2009

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"This scoping study provides a quick assessment of the malaria treatment markets and the role played by patent medicine vendors in Nigeria, and offers ways to improve the regulation and provision of anti-malarial drugs. It documented the sources of drugs in the three states and people’s problems in getting access to appropriate treatment for malaria"

Community-based surveillance of antimicrobial use and resistance in resource-constrained settings|Report on five pilot projects

HOLLOWAY, Kathleen A
2009

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This document describes five pilot surveillance projects that were set up in India (three sites) and South Africa (two sites) with the aim of developing a model for undertaking integrated community-based surveillance in resource-constrained settings and generating baseline data. The methodology used in each area aimed to collect antimicrobial resistance (AMR) and use data from the same geographical area over time, but was modified to suit the particular characteristics of each site

South African national HIV prevalence, incidence, behavior and communication survey 2008 : turning a tide among teenagers ?

SHISANA, O
et al
2009

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"South Africa has the largest burden of HIV/AIDS and is currently implementing the largest antiretroviral treatment (ART) programme in the world. It is therefore fitting that South Africa is the first in the world to conduct three repeated national HIV population-based surveys to help monitor our response as a nation to the HIV/AIDS epidemic. This report is the third in a time series of population-based HIV seroprevalence surveys which started in 2002 and were repeated in 2005 and again in 2008"

Seizing the opportunity on AIDS and health systems

OOMMAN, Nandini
BERNSTEIN, Michael
ROSENZWEIG, Steven
August 2008

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This is a comparison of donor interactions with national health systems in Mozambique, Uganda, and Zambia - specifically: the health information systems, the supply chain systems for essential medicines, and human resources for health. It focuses on the US President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank’s Africa Multi-Country AIDS Program

Antimalarial drug quality in the most severely malarious parts of Africa - a six country study

BATE, Roger
COTICELLI, Philip
TREN, Richard
ATTARAN, Amir
May 2008

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This article describes research conducted on a range of antimalarial drugs, procured from private pharmacies in urban and peri-urban areas in the major cities of six African countries which were subjected to semi-quantitative thin-layer chromatography (TLC) and dissolution testing to measure active pharmaceutical ingredient content against internationally acceptable standards

Knowledge for action on equity in health in Uganda

MAKERERE UNIVERSITY, SCHOOL OF PUBLIC HEALTH
HEPS UGANAD - COALITION FOR HEALTH PROMOTION AND SOCIAL DEVELOPMENT
2008

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This is the report of a national meeting to promote policies for equity in health. It brought together government, academic and civil society institutions to explore, understand and propose options for reducing inequalities in health in Uganda

Interagency list of essential medical devices for reproductive health

WORLD HEALTH ORGANIZATION (WHO)
et al
2008

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This interagency list is a tool to support planning for the selection, quality assurance and procurement of medical devices to implement Maternal and Newborn Health (MNH) interventions, which are defined as the "Essential care to women and their newborn during pregnancy, childbirth and postnatal period: up to six weeks after delivery." The objective is to propose an international consensus on a rational selection of essential medical devices for reproductive health according to their public health relevance based on efficacy, safety and cost effectiveness. Published by the WHO on behalf of John Snow Inc., PATH, Population Action International, United Nations Population Fund, and the World Bank, in collaboration with the United Nations Children's Fund and Medecins Sans Frontieres. The WHO and partnering organisations plan to update this list every two years

Missing the target #5 : improving AIDS drug access and advancing health care for all

INTERNATIONAL TREATMENT PREPAREDNESS COALITION (ITPC)
December 2007

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This report documents how the mobilisation around AIDS is driving health systems advancement in China, Dominican Republic, Zimbabwe, Russia, Kenya, India, Cameroon, Zambia and Cambodia, and it highlights the need for improvements in broader systems of care and services to meet the needs of people living with HIV & AIDS and the communities in which they live. It also considers ARV procurement, registration and stock-outs in Argentina, Belize, Cambodia, China, Dominican Republic, India, Malawi, Morocco, Nigeria, Philippines, Russia, Uganda, Zambia, Zimbabwe

Early infant diagnosis of HIV through dried blood spot testing

PATHFINDER INTERNATIONAL / KENYA
October 2007

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Until recently the test used to diagnose HIV in babies under one-year has required sophisticated and expensive equipment. A new test has now been developed - dried blood spot testing which can be used to diagnose HIV as early as six weeks after a baby is born and has the advantage of being easy to prepare in a resource-limited setting and shipped to testing facilities without refrigeration. If a baby is given prophylactic antibiotics, such as cotrimoxazole, soon after birth and Antiretroviral Therapy (ART) as soon as is medically indicated, it has a good chance of surviving childhood and living a long, healthy life

Shadow report : Review of country coordinating mechanism proposals with SRH-HIV/AIDS integration submitted to the Global Fund round 7

DALY, M. Felicity
SCHECHTMAN, Lisa
August 2007

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This report considers efforts to integrate sexual and reproductive health (SRH) in the HIV & AIDS components of country coordinated proposals submitted in July 2007 by Country Coordinating Mechanisms (CCM) for the 7th Round of funding by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

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