The impact of a hybrid social marketing intervention on inequities in access, ownership and use of insecticide-treated nets

BACKGROUND: An ITN intervention was initiated in three predominantly rural districts of Eastern Province, Zambia, that lacked commercial distribution and communication infrastructures. Social marketing techniques were used for product and message development. Public sector clinics and village-based volunteers promoted and distributed subsidized ITNs priced at $2.5 per net. A study was conducted to assess the effects of the intervention on inequities in knowledge, access, ownership and use of ITNs. METHODS: A post-test only quasi-experimental study design was used to compare intervention and comparison districts. A total of 2,986 respondents were interviewed. Survey respondents were grouped into four socio-economic (SES) categories: low, medium-low, medium and high. Knowledge, access, ownership and use indicators are compared. Concentration index scores are calculated. Interactions between intervention status and SES help determine how different SES groups benefited from the intervention. RESULTS: Although overall use of nets remained relatively low, post-test data show that knowledge, access, ownership and use of mosquito nets was higher in intervention districts. A decline in SES inequity in access to nets occurred in intervention districts, resulting from a disproportionately greater increase in access among the low SES group. Declines in SES inequities in net ownership and use of nets were associated with the intervention. The largest increases in net ownership and use occurred among medium and high SES categories. CONCLUSION: Increasing access to nets among the poorest respondents in rural areas may not lead to increases in net use unless the price of nets is no longer a barrier to their purchase

Renal supportive and palliative care: position statement.

Since the introduction of haemodialysis in the management of acute kidney injury in the 1940s and for chronic kidney disease (CKD) in the 1960s dialysis has become one of the most successful advances in medical technology, with almost 11 000 patients currently receiving dialysis in Australia and almost 2500 in New Zealand. Like all medical technologies, its place continues to evolve. For a time, dialysis was seen as a treatment best delivered only to younger patients without diabetes; today the greatest uptake of dialysis is in patients over age 65 and the most common cause of needing dialysis is diabetes. Along with these extended criteria for dialysis, that have evolved over many years, has come the recognition that the older dialysis patient often has considerable co-morbidity and frailty, that time spent on dialysis is not always beneficial to these patients and that their overall prognosis is considerably worse than their younger counterparts. CARI guidelines recommend that ‘an expectation of survival with an acceptable quality of life’ is a useful starting point for recommending dialysis

Creative Compliance, Constructive Compliance: Corporate Environmental Crime and the Criminal Entrepreneur

Purpose While corporations may embrace the concepts of social and environmental responsibility, numerous examples exist to show corporations claiming to act sustainably and responsibly, while simultaneously showing disregard for the communities in which they operate and causing considerable environmental damage. This chapter argues that such activities illustrate a particular notion of Baumol’s (1990) criminal entrepreneurialism where both creative and constructive compliance combine to subvert environmental regulation and its enforcement. Design/methodology/approach This chapter employs a case study approach assessing the current corporate environmental responsibility landscape against the reality of corporate environmental offending. Its case study shows seemingly repeated environmental 'offending' by Shell Oil against a backdrop of the company claiming to have integrated environmental monitoring and scrutiny into its operating procedures. Findings The chapter concludes that corporate assertion of environmental credentials is itself often a form of criminal entrepreneurship where corporations embrace voluntary codes of practice and self-regulation while internally promoting the drive for success and profitability and/or avoidance of the costs of true environmental compliance deemed too high. As a result this chapter argues that responsibility for environmental damage requires regulation to ensure corporate responsibility for environmental damage. Originality/value The chapter employs a green criminological perspective to its analysis of corporate social responsibility and entrepreneurship. Thus it considers not just strict legal definitions of crime and criminal behaviour but also the overlap between the legal and the illegal and the preference of Governments to use administrative or civil penalties as tools to deal with corporate environmental offending

Building a tuberculosis-free world: The Lancet Commission on tuberculosis

___Key messages___ The Commission recommends five priority investments to achieve a tuberculosis-free world within a generation. These investments are designed to fulfil the mandate of the UN High Level Meeting on tuberculosis. In addition, they answer