Determination of species

There are no author-identified significant results in this report

Effect of a mobile phone-based intervention on post-abortion contraception: a randomized controlled trial in Cambodia.

OBJECTIVE: To assess the effect of a mobile phone-based intervention (mHealth) on post-abortion contraception use by women in Cambodia. METHODS: The Mobile Technology for Improved Family Planning (MOTIF) study involved women who sought safe abortion services at four Marie Stopes International clinics in Cambodia. We randomly allocated 249 women to a mobile phone-based intervention, which comprised six automated, interactive voice messages with counsellor phone support, as required, whereas 251 women were allocated to a control group receiving standard care. The primary outcome was the self-reported use of an effective contraceptive method, 4 and 12 months after an abortion. FINDINGS: Data on effective contraceptive use were available for 431 (86%) participants at 4 months and 328 (66%) at 12 months. Significantly more women in the intervention than the control group reported effective contraception use at 4 months (64% versus 46%, respectively; relative risk, RR: 1.39; 95% confidence interval, CI: 1.17-1.66) but not at 12 months (50% versus 43%, respectively; RR: 1.16; 95% CI: 0.92-1.47). However, significantly more women in the intervention group reported using a long-acting contraceptive method at both follow-up times. There was no significant difference between the groups in repeat pregnancies or abortions at 4 or 12 months. CONCLUSION: Adding a mobile phone-based intervention to abortion care services in Cambodia had a short-term effect on the overall use of any effective contraception, while the use of long-acting contraceptive methods lasted throughout the study period

The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA):Data on mortality, by HIV status and stage on the HIV care continuum, among the general population in seven longitudinal studies between 1989 and 2014

Timely progression of people living with HIV (PLHIV) from the point of infection through the pathway from diagnosis to treatment is important in ensuring effective care and treatment of HIV and preventing HIV-related deaths and onwards transmission of infection. Reliable, population-based estimates of new infections are difficult to obtain for the generalised epidemics in sub-Saharan Africa. Mortality data indicate disease burden and, if disaggregated along the continuum from diagnosis to treatment, can also reflect the coverage and quality of different HIV services. Neither routine statistics nor observational clinical studies can estimate mortality prior to linkage to care nor following disengagement from care. For this, population-based data are required.The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa brings together studies in Kenya, Malawi, South Africa, Tanzania, Uganda, and Zimbabwe. Eight studies have the necessary data to estimate mortality by HIV status, and seven can estimate mortality at different stages of the HIV care continuum. This data note describes a harmonised dataset containing anonymised individual-level information on survival by HIV status for adults aged 15 and above. Among PLHIV, the dataset provides information on survival during different periods: prior to diagnosis of infection; following diagnosis but before linkage to care; in pre-antiretroviral treatment (ART) care; in the first six months after ART initiation; among people continuously on ART for 6+ months; and among people who have ever interrupted ART

Explaining inconsistencies between data on condom use and condom sales

BACKGROUND: Several HIV prevention programs use data on condom sales and survey-based data on condom prevalence to monitor progress. However, such indicators are not always consistent. This paper aims to explain these inconsistencies and to assess whether the number of sex acts and the number of condoms used can be estimated from survey data. This would be useful for program managers, as it would enable estimation of the number of condoms needed for different target groups. METHODS: We use data from six Demographic and Health Surveys to estimate the total annual number of sex acts and number of condoms used. Estimates of the number of sex acts are based on self-reported coital frequency, the proportion reporting intercourse the previous day, and survival methods. Estimates of the number of condoms used are based on self-reported frequency of use, the proportion reporting condom use the previous day and in last intercourse. The estimated number of condoms used is then compared with reported data on condom sales and distribution. RESULTS: Analysis of data on the annual number of condoms sold and distributed to the trade reveals very erratic patterns, which reflect stock-ups at various levels in the distribution chain. Consequently, condom sales data are a very poor indicator of the level of condom use. Estimates of both the number of sexual acts and the number of condoms used vary enormously based on the estimation method used. For several surveys, the highest estimate of the annual number of condoms used is tenfold that of the lowest estimate. CONCLUSIONS: Condom sales to the trade are a poor indicator of levels of condom use, and are therefore insufficient to monitor HIV prevention programs. While survey data on condom prevalence allow more detailed monitoring, converting such data to an estimated number of sex acts and condoms used is not straightforward. The estimation methods yield widely different results, and it is impossible to determine which method is most accurate. Until the reliability of these various estimation methods can be established, estimating the annual number of condoms used from survey data will not be feasible. Collecting survey data on the number of sex acts and the number of condoms used in a fixed time period may enable the calculation of more reliable estimates of the number of sex acts and condoms used

Effects of a mobile phone-based intervention to increase post-abortion family planning

Post-abortion family planning (PAFP) is important to reduce subsequent unintended pregnancies • There is limited evidence for mobile phone-based interventions (mHealth) to increase contraception use • Our formative research indicated that only 40% of women adopted effective PAFP (pill, intra-uterine device, implant, or injectable) at Marie Stopes International (MSI) Cambodia clinics • The objective of the MObile Technology for Improved Family Planning (MOTIF) trial was to assess the effects of a mHealth intervention to support PAFP in Cambodia The MOTIF intervention significantly improved use of effective contraception at four months post-abortion, in particular long- acting methods • Additional mobile phone-based support for PAFP should be considered in addition to existing abortion care services

Effects of a mobile phone-based intervention to increase post-abortion family planning

Post-abortion family planning (PAFP) is important to reduce subsequent unintended pregnancies • There is limited evidence for mobile phone-based interventions (mHealth) to increase contraception use • Our formative research indicated that only 40% of women adopted effective PAFP (pill, intra-uterine device, implant, or injectable) at Marie Stopes International (MSI) Cambodia clinics • The objective of the MObile Technology for Improved Family Planning (MOTIF) trial was to assess the effects of a mHealth intervention to support PAFP in Cambodia The MOTIF intervention significantly improved use of effective contraception at four months post-abortion, in particular long- acting methods • Additional mobile phone-based support for PAFP should be considered in addition to existing abortion care services

Data resource profile: network for analysing longitudinal population-based HIV/AIDS data on Africa (ALPHA Network)

The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network, http://alpha.lshtm.ac.uk/) brings together ten population-based HIV surveillance sites in eastern and southern Africa, and is coordinated by the London School of Hygiene and Tropical Medicine (LSHTM). It was established in 2005 and aims to (i) broaden the evidence base on HIV epidemiology for informing policy, (ii) strengthen the analytical capacity for HIV research, and (iii) foster collaboration between network members. All study sites, some starting in the late 1980s and early 1990s, conduct demographic surveillance in populations that range from approximately 20 to 220 thousand individuals. In addition, they conduct population-based surveys with HIV testing, and verbal autopsy interviews with relatives of deceased residents. ALPHA Network datasets have been used for studying HIV incidence, sexual behaviour and the effects of HIV on mortality, fertility, and household composition. One of the network’s substantive focus areas is the monitoring of AIDS mortality and HIV services coverage in the era of antiretroviral therapy. Service use data are retrospectively recorded in interviews and supplemented by information from record linkage with medical facilities in the surveillance areas. Data access is at the discretion of each of the participating sites, but can be coordinated by the network

Floods and health in Gambella region, Ethiopia: a qualitative assessment of the strengths and weaknesses of coping mechanisms

BACKGROUND: Floods are the most frequent and devastating type of natural disaster worldwide, causing unprecedented deaths, diseases, and destruction of property and crops. Flooding has a greater impact in developing countries due to lack of sufficient disaster management structures and a lack of economic resources. OBJECTIVE: This study was conducted with the aim of contributing to the knowledge base of development strategies that reduce flood-related health risks in developing countries. The study focused particularly on assessing the flood risks and health-related issues in the Gambella region of Ethiopia; with the intent of producing relevant information to assist with the improvements in the efficacy of the current flood coping strategies in the region. METHODS: Data were gathered through interviews with 14 officers from different government and non-governmental organizations and a questionnaire survey given to 35 flood victims in Itang woreda. A qualitative approach was applied and the data were analyzed using content analysis. RESULTS: It was found that flooding is a common problem in Gambella region. The findings also indicate that the flood frequency and magnitude has increased rapidly during the last decade. The increase in floods was driven mainly by climate change and changes in land use, specifically deforestation. The reported main impacts of flooding on human health in Gambella region were deaths, injuries, and diseases such as malaria and diarrhea. Another notable consequence of flooding was crop destruction and subsequent malnutrition. CONCLUSIONS: Three weaknesses that were identified in the current coping strategies for flood-related health impacts in Gambella region were a lack of flood-specific policy, absence of risk assessment, and weak institutional capacity. This study recommends new policy approaches that will increase the effectiveness of the current flood coping strategies to sustainably address the impact of flooding on human health

Employment Services Utilization and Outcomes among Substance Abusing Offenders Participating in California’s Proposition 36 Drug Treatment Initiative

California drug treatment programs may use funds to address barriers to work faced by Proposition 36 offenders, most of whom are not working at treatment entry, but employment services utilization and related behavioral outcomes have never been studied. This study examined primary data collected on 1,453 offenders by 30 programs during 2004 to explore the characteristics, employment services utilization, and outcomes of those who did and did not receive employment services while in drug treatment. One-year outcomes were mostly similar across groups, however, increases in the proportion of offenders employed, receiving income from employment and family or friends, and being paid for work were significantly greater among the received-employment-services group, and a greater proportion of this group also completed drug treatment. Employment services utilization was less likely for persons recruited from outpatient settings and more likely with greater severity of family/social problems and desire for services. Odds of employment one-year post-treatment entry were higher for those of Hispanic race/ethnicity (vs. White) and for those with treatment completion/longer retention but lower for those who were older, lived in specific counties, had greater employment problem severity at intake, and received other income-related services. Strategies for improving employment services utilization and outcomes among Proposition 36 offenders are discussed