Evaluating quality of contraceptive counseling: An analysis of the method information index

The Method Information Index (MII) is calculated from contraceptive users\u27 responses to questions regarding counseling content-whether they were informed about methods other than the one they received, told about method-specific side effects, and advised what to do if they experienced side effects. The MII is increasingly reported in national surveys and used to track program performance, but little is known about its properties. Using additional questions, we assessed the consistency between responses and the method received in a prospective, multicountry study. We employed two definitions of consistency: (1) presence of any concordant response, and (2) absence of discordant responses. Consistency was high when asking whether users were informed about other methods and what to do about side effects. Responses were least consistent when asking whether side effects were mentioned. Adjusting for inconsistency, scores were up to 50 percent and 30 percent lower in Pakistan and Uganda, respectively, compared to unadjusted MII scores. Additional questions facilitated better understanding of counseling quality

Infrastructure procurement capacity gaps in Nigeria public sector institutions

Purpose: The achievement of sustainable development goals is linked to the procurement of public infrastructure in a manner that meets key procurement objectives, such as sustainability, value-for-money, transparency and accountability. At the heart of achieving these procurement objectives and others is the capacity of public procurement institutions. Whereas previous reports have hinted that there are deficiencies in procurement capacity in Nigeria, insights regarding critical aspects of organisational capacity deficiencies among different tiers of government agencies is limited. This study investigates the critical gaps in the procurement capacity of state and local government agencies involved in the procurement of public infrastructure in Nigeria.Design/methodology/approach: The study employed a survey of public infrastructure procurement personnel which yielded 288 responses.Findings: Among 23 operationalised items that are related to organisational procurement capacity, none is perceived to be adequate by the procurement personnel. Additionally, among 14 procurement objectives only one is perceived as being attained to at least a high extent.Originality/value: The findings underscore the acuteness of organisational procurement capacity weaknesses among public procurement institutions within Nigeria’s governance structure. It is, thus, imperative for policy makers within state and local government to formulate, resource and implement procurement capacity building initiatives/programmes to address these deficiencies. Additionally, the organisational procurement capacity items operationalised in this study could serve as a useful blueprint for studying capacity deficiencies among public infrastructure procurement agencies in other developing countries, especially within sub-Saharan Africa where several countries have been implementing public procurement reforms

Public health in Thailand: Emerging focus on non‐communicable diseases

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86815/1/hpm1078.pd

Environmental impacts of food retail: A framework method and case application

© 2015 Elsevier Ltd. The food retail sector is the gatekeeper between consumers and producers and has substantial influence on consumption and production choices via procurement and provision decisions. Food provision and consumption systems embody huge environmental impacts worldwide. Food retailers as gatekeepers have a key role to play to enable sustainable consumption and provision to become common practice. In this paper, a framework to attribute emissions and water use to individual and all food retail businesses and their products by geographical area and postcode of cities is presented. As far as the current authors are aware, such a framework has not been generated for food retail sector businesses before, primarily due to barriers to input-output modelling of the sector. The scientific value added is that a novel approach to overcome barriers is presented as well as the required framework. The framework is illustrated for Southampton, but can be applied in other regions of the world where similar data exist. The value of a business's product emissions estimates (generated by the framework) is they can be a first step in informing product prioritisation for focussing information searches or more detailed life cycle analysis to make sustainable procurement and choice editing decisions. The approach has value to government, businesses and non-government organisations (NGOs) in developing strategy and planning sustainable provision and procurement; by helping benchmark sustainable shopping provision, prioritisation of retail businesses and product categories for sustainable procurement/choice editing

Design for occupational safety and health of workers in construction in developing countries: A study of architects in Nigeria

Purpose. Design for safety (DfS) of workers is amongst the prominent ways of tackling poor occupational safety and health performance in construction. However, in developing countries there is extremely limited research on DfS. This study thus makes an important contribution to the subject of DfS in developing countries by specifically examining the awareness and practice of DfS amongst architects within the construction sector of Nigeria. Materials and methods. A survey of architects, yielding 161 valid responses, was conducted. Results. While there is high awareness of the concept of DfS, the actual practice is low. Additionally, although there is high interest in DfS training, the engagement in DfS training is low. Significantly, awareness of DfS, training and education related to DfS, and membership of a design professional body have very limited bearing on the practice of DfS by architects. Conclusions. The findings are thus symptomatic of the prevalence of influential DfS implementation barriers within the construction sector. Industry stakeholders should seek to raise the profile of DfS practice within the sector. Furthermore, similar empirical studies in the construction sector of other developing countries would be useful in shedding light on the status of DfS in these countries

Long-term care cost drivers and expenditure projection to 2036 in Hong Kong

<p>Abstract</p> <p>Background</p> <p>Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC) expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036.</p> <p>Methods</p> <p>We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions.</p> <p>Results</p> <p>Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure.</p> <p>Conclusion</p> <p>The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning.</p

Labour markets and wages in Australia 2010

In this article we present data on earnings and hours in 2010 and, using data over a longer time frame, show how the character of the Australian labour market has significantly changed in recent decades. Among other things, we demonstrate a continued shift towards part-time work and, across full-time and part-time labour markets, a change in the distribution of jobs towards more highly skilled occupations. We continue to argue that traditional indicators of labour-market activity, such as headline unemployment and earnings in full-time employment, are only able to partially explain the health of the labour market. There is an urgent need to better understand other dimensions such as underemployment, part-time employment and part-time earnings

"Before we used to get sick all the time": perceptions of malaria and use of long-lasting insecticide-treated bed nets (LLINs) in a rural Kenyan community

<p>Abstract</p> <p>Background</p> <p>Malaria is a leading global cause of preventable morbidity and mortality, especially in sub-Saharan Africa, despite recent advances in treatment and prevention technologies. Scale-up and wide distribution of long-lasting insecticide-treated nets (LLINs) could rapidly decrease malarial disease in endemic areas, if used properly and continuously. Studies have shown that effective use of LLINs depends, in part, upon understanding causal factors associated with malaria. This study examined malaria beliefs, attitudes, and practices toward LLINs assessed during a large-scale integrated prevention campaign (IPC) in rural Kenya.</p> <p>Methods</p> <p>Qualitative interviews were conducted with 34 IPC participants who received LLINs as part of a comprehensive prevention package of goods and services. One month after distribution, interviewers asked these individuals about their attitudes and beliefs regarding malaria, and about their use of LLINs.</p> <p>Results</p> <p>Virtually all participants noted that mosquitoes were involved in causing malaria, though a substantial proportion of participants (47 percent) also mentioned an incorrect cause in addition to mosquitoes. For example, participants commonly noted that the weather (rain, cold) or consumption of bad food and water caused malaria. Regardless, most participants used the LLINs they were given and most mentioned positive benefits from their use, namely reductions in malarial illness and in the costs associated with its diagnosis and treatment.</p> <p>Conclusions</p> <p>Attitudes toward LLINs were positive in this rural community in Western Kenya, and respondents noted benefits with LLIN use. With improved understanding and clarification of the direct (mosquitoes) and indirect (e.g., standing water) causes of malaria, it is likely that LLIN use can be sustained, offering effective household-level protection against malaria.</p