Assessing the Efficiency of Mother-to-Child HIV Prevention in Low- and Middle-Income Countries using Data Envelopment Analysis

AIDS is one of the most significant health care problems worldwide. Due to the difficulty and costs involved in treating HIV, preventing infection is of paramount importance in controlling the AIDS epidemic. The main purpose of this paper is to explore the potential of using Data Envelopment Analysis (DEA) to establish international comparisons on the efficiency implementation of HIV prevention programmes. To this effect we use data from 52 low- and middle-income countries regarding the prevention of mother-to-child transmission of HIV. Our results indicate that there is a remarkable variation in efficiency of prevention services across nations, suggesting that a better use of resources could lead to more and improved services, and ultimately, prevent the infection of thousands of children. These results also demonstrate the potential strategic role of DEA for the efficient and effective planning of scarce resources to fight the epidemic.HIV Prevention; DEA; Mother-to-Child HIV Transmission.

Operationalizing Free, Prior, and Informed Consent

The UN Declaration on the Rights of Indigenous Peoples (UNDRIP) has acknowledged varying ways in which international actors can protect, respect and remedy the rights of indigenous peoples. One of these methods is the concept of free, prior and informed consent (FPIC) as described in Articles 10, 19, 28 and 29. There has been much debate in the international community over the legal status of the UNDRIP, and member states have done little to implement it. In applied contexts, many entities like extractive industries and conservation groups are aware of risks inherent in not soliciting FPIC and have endeavored to create their own FPIC protocols when interacting with indigenous peoples. At present, there is an absence of FPIC protocol that has been developed by indigenous peoples themselves. A tribal FPIC law and protocol may serve as a starting point and model to actualize these rights for the development or use of culture, lands, territories and resources, and may serve to implement a portion of the UNDRIP. This article contends that indigenous peoples must develop and implement their own FPIC protocol in order to assert their human rights, and offers a model under United States law for Indian tribes to assert their sovereign and human rights without waiting for member state implementation

CMB Lensing Reconstruction in Real Space

We explore the reconstruction of the gravitational lensing field of the cosmic microwave background in real space showing that very little statistical information is lost when estimators of short range on the celestial sphere are used in place of the customary estimators in harmonic space, which are nonlocal and in principle require a simultaneous analysis of the entire sky without any cuts or excisions. Because virtually all the information relevant to lensing reconstruction lies on angular scales close to the resolution scale of the sky map, the gravitational lensing dilatation and shear fields (which unlike the deflection field or lensing potential are directly related to the observations in a local manner) may be reconstructed by means of quadratic combinations involving only very closely separated pixels. Even though harmonic space provides a more natural context for understanding lensing reconstruction theoretically, the real space methods developed here have the virtue of being faster to implement and are likely to prove useful for analyzing realistic maps containing a galactic cut and possibly numerous small excisions to exclude point sources that cannot be reliably subtracted.Comment: 21 pages, 8 figure

Operationalizing Free, Prior, and Informed Consent

The UN Declaration on the Rights of Indigenous Peoples (UNDRIP) has acknowledged varying ways in which international actors can protect, respect and remedy the rights of indigenous peoples. One of these methods is the concept of free, prior and informed consent (FPIC) as described in Articles 10, 19, 28 and 29. There has been much debate in the international community over the legal status of the UNDRIP, and member states have done little to implement it. In applied contexts, many entities like extractive industries and conservation groups are aware of risks inherent in not soliciting FPIC and have endeavored to create their own FPIC protocols when interacting with indigenous peoples. At present, there is an absence of FPIC protocol that has been developed by indigenous peoples themselves. A tribal FPIC law and protocol may serve as a starting point and model to actualize these rights for the development or use of culture, lands, territories and resources, and may serve to implement a portion of the UNDRIP. This article contends that indigenous peoples must develop and implement their own FPIC protocol in order to assert their human rights, and offers a model under United States law for Indian tribes to assert their sovereign and human rights without waiting for member state implementation

Making a Difference in Schools: The Big Brothers Big Sisters School-Based Mentoring Impact Study

School-based mentoring is one of the fastest growing forms of mentoring in the US today; yet, few studies have rigorously examined its impacts. This landmark random assignment impact study of Big Brothers Big Sisters School-Based Mentoring is the first national study of this program model. It involves 10 agencies, 71 schools and 1,139 9- to 16-year-old youth randomly assigned to either a treatment group of program participants or a control group of their non-mentored peers. Surveys were administered to all participating youth, their teachers and mentors in the fall of 2004, spring of 2005 and late fall of 2005.The report describes the programs and their participants and answers several key questions, including: Does school-based mentoring work? What kinds of mentoring experiences help to ensure benefits? How much do these programs cost? Our findings highlight both the strengths of this program model and its current limitations and suggest several recommendations for refining this promising model-recommendations that Big Brothers Big Sisters agencies across the country are already working to implement

Exploring the use of data envelopment analysis for evaluation in primary care

Primary care is currently at the heart of the National Health Service policy. The newly established organisations, known as Primary Care Groups and Trusts (PCG/Ts), have the crucial role of improving the efficiency and equity in primary care delivery. However, not many studies have focused on performance assessment in primary care provision. In this thesis we aim to contribute to a discussion regarding appropriate ways to compare the performance of primary care providers and the effective ways to use these results in order to improve performance in primary care. Following a review of the literature, a conceptual framework for performance assessment in primary care was developed in collaboration with a sample of PCG/Ts. This framework aims to establish a link between the local needs, the resources used, the services delivered and the outcomes achieved in primary care. Based on the relationships between these elements, four performance assessment criteria were defined: equity, efficiency, service effectiveness and cost effectiveness. DEA is then proposed to measure efficiency, service effectiveness and cost effectiveness, given the fact that it can handle multiple inputs and outputs without requiring the specification of a functional form. Following the Government’s policy of focusing on the management of chronic diseases, this conceptual framework is then applied to compare the performance of a sample of GP surgeries in terms of their delivery of diabetes care. An exploratory and formative comparison is undertaken in order to investigate why certain surgeries appear to perform better than others, and in order to identify ways in which some of the surgeries can improve their performance. The relationships between the different performance criteria are also investigated, together with the ways in which an adequate balance between the different criteria can be achieved. Several conclusions are arrived at and several contributions arc made to this research area. The usefulness of complementing efficiency analysis with equity and effectiveness analysis; the usefulness of following a formative methodology in the use of DEA; the importance of estimating the costs involved in achieving speciality based outcomes; the importance of area deprivation in the achievement of effectiveness and the limitations of the data available in primary care in England