The primary objective of this study was a comprehensive re-estimation of disability weights that quantify health losses for all non-fatal consequences of disease and injury for the Global Burden of Disease Study 2010. A total of 13,902 respondents were interviewed in Bangladesh, Indonesia, Peru and Tanzania, and 16,328 in a web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0.9 or higher in all surveys except in Bangladesh (0.75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0.05. Five (11%) health states had weights below 0.01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0.76) and severe multiple sclerosis (0.71). The researchers identified a broad pattern of agreement between the old and new weights (0.70), particularly in the moderate-to-severe range. However, in the mild range below 0.2, many states had significantly lower weights in this study than previously. In contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, the results of this study suggest highly consistent results.
Monitoring equity and research policy
To improve communication of research to policy-makers it will be necessary to strengthen researchers' communication skills; aim for close collaboration between researchers and policy-makers; construct an appropriate platform from which to communicate and strengthen institutional policy capacity for uptake. To improve communication of research to other researchers the strengthening of Southern research capacity is needed in order to enable Southern researchers to access Northern-produced research. Lastly, in order to improve communication of research to the poor and organisations working with the poor it will be necessary to incorporate communication activities into project design. This is according to a working paper from the Overseas Development Institute in the United Kingdom.
Community-based information systems (CBIS) are key to understanding how HIV programs are working to control the epidemic at the local level in countries with high burden. MEASURE Evaluation developed this collection of indicators to guide community-based HIV programs in monitoring their performance and thereby enhance informed decision making by governments, major donors, and implementing partners. The indicators cover the following themes: vulnerable children, prevention of mother-to-child transmission, key populations, HIV prevention, home-based care and data use cases. The site also provides useful resources and a summary list of indicators.
Trial participants from limited-resource settings often are given very little or nothing in terms of compensation for time, inconvenience and risks, as compared to their counterparts from developed countries. The reason most often cited by researchers, ethics committees and sponsors is the avoidance of undue inducements. This paper discusses the inherent conflict that may arise in trying to avoid undue inducement and in trying to minimise injustice in international research. It argues that research participants from both industrialised nations and limited-resource countries should be compensated equally since they suffer the same burdens and equally contribute towards the study by contributing the same product data.
This paper was commissioned as a background discussion paper for the Global Symposium on Health Systems Research, held in Switzerland from 16-19 November 2010. It explores experiences of and factors that influence how knowledge from health systems research (HSR) is translated into policy and practice, particularly at the national level, in low- and middle-income countries (LMICs). It found that whether the knowledge from health systems research (HSR) is used in policy and practice in low- and middle-income countries (LMICs) depends on the political economy context, the policy environment, institutional capacities and practice in the health system, and the research community. The study aims to link these four ‘streams’ and their impact on HSR. Although not always well documented, there is experience within LMIC on the strategic use of HSR. There are also some conditions that appear to be a greater challenge for LMICs, particularly low-income countries (LICs). International agencies have a more powerful influence on research agendas and resources in LICs, while resources for sustained research programmes and interaction are limited, as are the incentives, time, resources and authority for local personnel to gather and use evidence. Much LIC research is poorly published in accessible databases and a significant digital divide discourages HSR and its use. Local level personnel, especially in peripheral areas, face these constraints most sharply.
The IRIS/USAID project on developing poverty assessment tools has collected data on the poverty status of 12 low-income countries, adapting measurement tools for country-specific use. This paper proposes a methodology to construct an international poverty tool, or set of tools, that are easily applicable to a range of political economies.
Nosocomial transmission of XDR strains seems to have contributed to a major outbreak in HIV-positive individuals in Tugela Ferry, South Africa. To better understand how to control XDR tuberculosis, this issue of the Lancet presents a report of a new mathematical model, developed by Sanjay Basu and colleagues, of the transmission of tuberculosis in this region. Their model builds on previous tuberculosis models, and was corroborated by independently collected epidemiological data for the area. Such mathematical models of tuberculosis can be useful instruments for policymaking because they incorporate a representation of the natural history and transmission of infection and disease, and are the only way to rigorously explore the effects of policies before they are field-tested.
This report summarizes the findings of an assessment conducted for the United States Agency for International Development’s "Corridors of Hope" Initiative, a regional HIV/AIDS prevention project focusing on key sites along the Durban-Lusaka highway in southern Africa. Conducted in November 1999 in Messina, South Africa, Chirundu, Zambia, and Beitbridge and Chirundu in Zimbabwe, the assessment sought to develop, test, refine and package a standard participatory methodology for evaluating HIV risk, identifying prevention opportunities and designing grounded, coordinated regional prevention initiatives.
The AFRO’s Global Health Atlas brings together for analysis and comparison standardised data and statistics for diseases at country, regional, and global levels. The Atlas acknowledges the broad range of determinants that influence patterns of infectious disease transmission. Country fact sheets are available for South Africa.
The AFRO’s Global Health Atlas brings together for analysis and comparison standardised data and statistics for diseases at country, regional, and global levels. The Atlas acknowledges the broad range of determinants that influence patterns of infectious disease transmission. Country fact sheets are available for Swaziland.