Implementing the Agenda for Global Action on human resources for health : Analysis from an international tracking survey

Peer reviewedPublisher PD

Removal of childbirth delivery fees : the impact on health workers in Ghana

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Start-stop funding, its causes and consequences : a case study of the delivery exemptions policy in Ghana

This article looks at the issue of sustaining funding for a public programme through the case study of the delivery exemptions policy in Ghana. The Government of Ghana introduced the policy of exempting users from delivery fees in September 2003 in the four most deprived regions of the country, and in April 2005 it was extended to the remaining six regions in Ghana. The aim of the policy of free delivery care was to reduce financial barriers to using maternity services. Using materials from key informant interviews at national and local levels in 2005, the article examines how the policy has been implemented and what the main constraints have been, as perceived by different actors in the health system. The interviews show that despite being a high-profile public policy and achieving positive results, the delivery exemptions policy quickly ran into implementation problems caused by inadequate funding. They suggest that facility and district managers bear the brunt of the damage that is caused when benefits that have been promised to the public cannot be delivered. There can be knock-on effects on other public programmes too. Despite these problems, start-stop funding and under-funding of public programmes is more the norm than the exception. Some of the factors causing erratic funding—such as party politics and intersectoral haggling over resources—are unavoidable, but others, such as communication and management failures can and should be addressed.This work was undertaken as part of an international research programme— Initiative for Maternal Mortality Programme Assessment (IMMPACT), funded by the Bill & Melinda Gates Foundation, the Department for International Development, the European Commission and USAID

Distribution of First Instar Gypsy Moths (Lepidoptera: Lymantriidae) Among Saplings of Four Tree Species Common in the Great Lakes Region

We examined the inter-tree distribution of first instar gypsy moth larvae under natural dispersal conditions in the field in Michigan in 1991. The study focused on saplings of northern red oak (Quercus rubra), white oak (Q. alba), red maple (Acer rubrum), and witch-hazel (Hamamelis virginiana), which are common understory components of forests in the Great Lakes region. Large-volume trees with foliage that is well-developed early in the spring should provide an excellent surface area for catching newly-hatched gypsy moth larvae, which are randomly dispersed by wind in the spring around the time of leaf flush or shortly thereafter. Comparing across tree species in our study, red maples had the largest crown volumes and wellflushed leaf material, but very few larvae were found on these trees at both sampling times in mid-May. Despite the lack of larvae on red maple, these trees were liberally covered with gypsy moth silk, indicating that many larvae landed on these plants but left rapidly when they apparently found the trees to be an unacceptable food source. Among the other three tree species, patterns of larval distribution reflected levels of host phenological development during both sampling periods, with more insects occurring on tree species that had more advanced leaf development. The highest numbers of larvae were found on northern red oak and witch-hazel. Intermediate num­bers of insects were present on white oak. Trends in insect distribution also paralleled patterns seen in tree phenology across slope gradients. Defoliation ratings corresponded well to measures of first instar presence for each tree species. Northern red oak and witch-hazel trees experienced more early defoliation on average than did red maple and white oak. For those tree species that are acceptable hosts of the gypsy moth, average level of phenological development for a given tree, species, or forest stand at the time of larval dispersal can be an important predictor of plant or stand susceptibility to gypsy moth establishment and subsequent defoliation

Estimating the Number of Eggs per Egg Mass of the Forest Tent Caterpillar, Malacosoma Disstria (Lepidoptera: Lasiocampidae)

Calculation of the number of eggs per egg mass of the forest tent caterpillar, Malacosoma disstria Hiibner, is required in survey and population studies. Eggs are usually laid in cylindrical masses around twigs of trees. Hodson (1941) determined the number of eggs in egg masses of the forest tent caterpillar by counting the number of eggs around the circumference and multiplying by the number of rows. This technique is apparently reliable for comparative counts, but because the eggs are frequently laid in oblique rather than straight rows on the twig, counts of both length and circumference are subject to error. In addition, adjacent rows are often offset to form a honeycomb pattern which leads to inaccuracies in length and circumference counts. Because of these shortcomings, we developed a quicker and more accurate method not subject to the effects of oblique or honeycomb egg patterns

Differences in Emergence Date and Size Between the Sexes of \u3ci\u3eMalacosoma Americanum\u3c/i\u3e the Eastern Tent Caterpillar (Lepidoptera: Lasiocampidae)

Malacosoma americanum males were smaller and began to pupate earlier than females. Since the sexes spent the same amount of time as pupae, males also emerged earlier. The adaptive significance of these results is discussed. Emergence data revealed an interesting sidelight; no moths emerged from cocoons inside tents

The Role of Tree Clinics in Urban Forestry

A tree clinic analyzes tree problems and recommends appropriate actions to the public. The objective of tree clinics is to inform the citizen about urban trees. This paper is based on the experiences of 30 tree clinics held in Ann Arbor during the last eight years. The ingredients necessary for a successful tree clinic are discussed: (I) active sponsor, (2) suitable date and time, (3) good location, (4) proper publicity, (5) diversified experts, (6) proper organization, (7) sizable public turnout, and (8) follow-up publicity and acknowledgments

Accuracy and Precision of Insect Density and Impact Estimates

In estimating insect density and impact, entomologists are understandably interested in accuracy of estimation, but they almost always are dealing with precision because of bias due to an invalid estimator, probability sampling, or nonsampling errors. Definitions related to statistical estimation are reviewed and the concepts of accuracy and precision examined. Interval estimation and optimum sample size determination related to accuracy and precision, using the concept of allowable error, are examined. Criteria for selecting the best estimator in tenns of accuracy and precision are presented, and the distortion of probability statements due to bias is discussed. Accuracy and precision are compared and contrasted using two examples: (I) estimating insect density and (2) estimating insect impact. Adjusted and more accurate estimators can be obtained if the bias of an estimator can be estimated from a preliminary sample