Because of increased global trade and travel, micro-organisms now travel globally faster than before. To track these microorganisms, whole genome sequence analysis is the ideal instrument, but to make effective use of the results a global genomic database for microorganisms is needed. In this editorial, the author argues that the introduction of genomic testing represents a giant step forward for developing countries in the fight against infectious diseases. He compares the introduction of this new technology to the spread of cellphones, which made expensive and exclusive landlines unnecessary and made communication possible for everybody. Similarly, identification and typing of microorganisms will suddenly become technically and economically feasible, enabling control and prevention efforts previously missing in many regions. At the same time, developing countries moving to use this technology will not need to develop expensive, specialised lab systems, since microbiological lab work will basically be the same for TB, enterobacteria, viruses, etc. The author calls on developing countries to participate in this process from the start.
Monitoring equity and research policy
Uganda is widely regarded as an HIV/AIDS success story, but the reality of this claim has rarely been critically investigated. Although evidence-based medicine is increasingly important, analysis of the Ugandan epidemiological situation shows that the so-called proof accepted for policy recommendations can be subject to creative interpretation. There are several policy lessons that can be learned from the response to HIV/AIDS in Uganda. (registration needed)
Uganda is widely regarded as an HIV/AIDS success story, but the reality of this claim has rarely been critically investigated. Although evidence-based medicine is increasingly important, analysis of the Ugandan epidemiological situation shows that the so-called proof accepted for policy recommendations can be subject to creative interpretation. There are several policy lessons that can be learned from the response to HIV/AIDS in Uganda, where declining prevalence rates of HIV-1 have been reported in a number of surveillance sites around the country since 1992. (This article requires registration.)
The paper reviews the experience with the emergency obstetric care (EmOC) process indicators, and evaluates whether the indicators serve the purposes for which they were originally created – to gather and interpret relatively accessible data to design and implement EmOC service programs. The authors conclude that The EmOC process indicators have been used successfully in a wide variety of settings. They describe vital elements of the health system and how well that system is functioning for women at risk of dying from major obstetric complications.
This paper sought to investigate the feasibility, the ease of implementation, and the extent to which community health workers with little experience of data collection could be trained and successfully supervised to collect data using mobile phones in a large baseline survey. A web-based system was developed to allow electronic surveys or questionnaires to be designed (on a word processor), sent to, and conducted on standard entry level mobile phones. The web-based interface permitted comprehensive daily real-time supervision of CHW performance, with no data loss. The system permitted the early detection of data errors in combination with real-time quality control and data collector supervision. In conclusion, the benefits of mobile technology, combined with the improvement that mobile phones offer over personal digital assistants (PDAs) – or palmtop computers – in terms of data loss and uploading difficulties, make mobile phones a feasible method of data collection that needs to be further explored.
Survey data are traditionally collected using pen-and-paper, with double data entry, comparison of entries and reconciliation of discrepancies before data cleaning can commence. We used Personal Digital Assistants (PDAs) for data entry at the point of collection, to save time and enhance the quality of data in a survey of over 21,000 scattered rural households in southern Tanzania.
Increasing global attention is focusing on ways to improve health systems and the contribution that research-informed policies can make to this. It has long been recognised that a range of factors is involved in the interactions between health research and policy-makers. The emerging focus on Health Research Systems (HRS) has identified additional mechanisms through which greater utilisation of research could be achieved. Assessment of the role of health research in policy-making is best undertaken as part of a wider study that also includes utilisation of health research by industry, medical practitioners, and the public. The utilisation of health research in policy-making should eventually lead to desired outcomes, including health gains, says an article in Health Research Policy and Systems.
The West African Health Organization (WAHO) implemented a research development program in West Africa during 2009–2013 with components of stewardship, financing, sustainable resourcing and research utilization. This paper describes how programme and lessons learnt, triangulating activity reports, an independent evaluation and the authors’ experiences with stakeholders. WAHO and major stakeholders validated these findings during a regional meeting. All 15 ECOWAS countries benefited from this regional research development programme. WAHO provided technical and financial support to eight countries to develop their policies, priorities and plans for research development to improve their research governance and organised capacity-strengthening training in health systems research methodology, resource mobilization, ethical oversight and on HRWeb, a research information management platform. WAHO helped launch a regional network of health research institutions to improve collaboration between regional participating institutions and mobilised funding for the programme. It supported 24 health research projects. High staff turnover, weak institutional capacities and ineffective collaboration were some of the challenges encountered during implementation. The regional collaborative approach to health research was found to be effective given the challenges in the region, and with research partnerships and funding helped strengthen local health research environments.
The World Mortality Report 2005 provides a broad overview of mortality changes in all countries of the world during the latter half of the 20th century. The main objective of this report is to compile and summarise available information about levels and trends of mortality and life expectancy for national populations; allowing a comparison of mortality data from different sources, and permitting an assessment of gaps in information, as well as insight on performance with respect to Millenium Development Goals.
Primary health care (PHC) in South Africa forms an integral part of both the country's health policies and health system and has been prioritised as a major strategy in achieving health for all. On the eve of the 30th anniversary of the Alma Ata Declaration, PHC is once again in the spotlight. How far have we come in the last 30 years? How far in the last three? The third edition of the District Health Barometer, the 2006/07 report sheds some light by monitoring the trend of key health and financial indicators in PHC over the last three years by district and province.