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Leng Z, Sha S, Dai S, Meng X, Li J, Jin J, Zheng W, Yang W, Mao C, Wang Z, Zhang L, Wang P, Yang T, Yang W. Role of social organization engagement in high-risk groups intervention against HIV/AIDS: a case study from 176 cities of China. Infect Dis Poverty 2022; 11:126. [PMID: 36575532 PMCID: PMC9794472 DOI: 10.1186/s40249-022-01048-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/01/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A high-risk prevention strategy is an effective way to fight against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The China AIDS Fund for Non-Governmental Organizations (CAFNGO) was established in 2015 to help social organizations intervene to protect high-risk populations in 176 cities. This study aimed to evaluate the role of social organizations in high-risk population interventions against HIV/AIDS. METHODS This study was based on the CAFNGO program from 2016 to 2020. The collected data included the number and types of social organizations participating in high-risk group interventions and the amount of funds obtained by these organizations each year. We explored the factors influencing the number of newly diagnosed AIDS cases using a spatial econometric model. Furthermore, we evaluated the effectiveness of intervention activities by comparing the percentages of the individuals who initially tested positive, and the individuals who took the confirmatory test, as well as those who retested positive and underwent the treatment. RESULTS Overall, from 2016 to 2020, the number of social organizations involved in interventions to protect HIV/AIDS high-risk populations increased from 441 to 532, and the invested fund increased from $3.98 to $10.58 million. The number of newly diagnosed cases decreased from 9128 to 8546 during the same period. Although the number of cities with overall spatial correlations decreased, the spatial agglomeration effect persisted in the large cities. City-wise, the number of social organizations (direct effect 19.13), the permanent resident population (direct effect 0.12), GDP per capita (direct effect 17.58; indirect effect - 15.38), and passenger turnover volume (direct effect 5.50; indirect effect - 8.64) were the major factors influencing new positive cases confirmed through the testing interventions performed by the social organizations. The initial positive test rates among high-risk populations were below 5.5%, the retesting rates among those who initially tested positive were above 60%, and the treatment rates among diagnosed cases were above 70%. CONCLUSIONS The spatial effect of social organizations participating in interventions targeting high-risk populations funded by CAFNGO is statistically significant. Nevertheless, despite the achievements of these social organizations in tracking new cases and encouraging treatment, a series of measures should be taken to further optimize the use of CAFNGO. Working data should be updated from social organizations to CAFNGO more frequently by establishing a data monitoring system to help better track newly diagnosed AIDS cases. Multichannel financing should be expanded as well.
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Affiliation(s)
- Zhiwei Leng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Sha Sha
- Chinese Preventive Medicine Association, Beijing, China
| | - Shuyu Dai
- Chinese Preventive Medicine Association, Beijing, China
| | - Xuehui Meng
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Jinfeng Li
- Chinese Preventive Medicine Association, Beijing, China
| | - Junyi Jin
- Chinese Preventive Medicine Association, Beijing, China
| | - Wenlin Zheng
- Chinese Preventive Medicine Association, Beijing, China
| | - Weihua Yang
- Chinese Preventive Medicine Association, Beijing, China
| | - Chuanju Mao
- Chinese Preventive Medicine Association, Beijing, China
| | - Zhenzhong Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Liujin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Peng Wang
- Chinese Preventive Medicine Association, Beijing, China.
| | - Tao Yang
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. .,Chinese Preventive Medicine Association, Beijing, China.
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Sanadgol A, Doshmangir L, Majdzadeh R, Gordeev VS. Engagement of non-governmental organisations in moving towards universal health coverage: a scoping review. Global Health 2021; 17:129. [PMID: 34784948 PMCID: PMC8594189 DOI: 10.1186/s12992-021-00778-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/14/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Developing essential health services through non-governmental organisations (NGOs) is an important strategy for progressing towards Universal Health Coverage (UHC), especially in low- and middle-income countries. It is crucial to understand NGOs' role in reaching UHC and the best way to engage them. OBJECTIVE This study reviewed the role of NGOs and their engagement strategies in progress toward UHC. METHOD We systematically reviewed studies from five databases (PubMed, Web of Science (ISI), ProQuest, EMBASE and Scopus) that investigated NGOs interventions in public health-related activities. The quality of the selected studies was assessed using the mixed methods appraisal tool. PRISMA reporting guidelines were followed. FINDINGS Seventy-eight studies met the eligibility criteria. NGOs main activities related to service and population coverage and used different strategies to progress towards UHC. To ensure services coverage, NGOs provided adequate and competent human resources, necessary health equipment and facilities, and provided public health and health care services strategies. To achieve population coverage, they provided services to vulnerable groups through community participation. Most studies were conducted in middle-income countries. Overall, the quality of the reported evidence was good. The main funding sources of NGOs were self-financing and grants from the government, international organisations, and donors. CONCLUSION NGOs can play a significant role in the country's progress towards UHC along with the government and other key health players. The government should use strategies and interventions in supporting NGOs, accelerating their movement toward UHC.
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Affiliation(s)
- Arman Sanadgol
- Department of Health Policy & Management, Tabriz Health Services Management Research Center, School of Management&Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Doshmangir
- Department of Health Policy & Management, Tabriz Health Services Management Research Center, School of Management&Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
- Social Determinants of Health Research Center, Tabriz Univerisity of Medical Sciences, Tabriz, Iran.
| | - Reza Majdzadeh
- CenterCommunity Based Participatory Research Center and Knowledge Utilization Research Center, Tehran Univerisity of Medical Sciences, Tehran, Iran
| | - Vladimir Sergeevich Gordeev
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Semitala FC, Camlin CS, Wallenta J, Kampiire L, Katuramu R, Amanyire G, Namusobya J, Chang W, Kahn JG, Charlebois ED, Havlir DV, Kamya MR, Geng EH. Understanding uptake of an intervention to accelerate antiretroviral therapy initiation in Uganda via qualitative inquiry. J Int AIDS Soc 2018; 20. [PMID: 29206357 PMCID: PMC5810312 DOI: 10.1002/jia2.25033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 11/10/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction The Streamlined Antiretroviral Therapy Initiation Strategy (START‐ART) study found that a theory‐based intervention using opinion leaders to inform and coach health care providers about the risks of treatment delay, provision of point of care (POC) CD4 testing machines (PIMA) and reputational incentives, led to rapid rise in ART initiation. We used qualitative research methods to explore mechanisms of provider behaviour change. Methods We conducted in‐depth interviews (IDIs) with 24 health care providers and nine study staff to understand perceptions, attitudes and the context of changes in ART initiation practices. Analyses were informed by the Theoretical Domains Framework. Results Rapid dissemination of new practices was enabled in the environmental context of an existing relationship based on communication, implementation and accountability between Makerere University Joint AIDS Program (MJAP), a Ugandan University‐affiliated organization that provided technical oversight for HIV service delivery at the health facilities where the intervention was implemented, and a network of health facilities operated by the Uganda Ministry of Health. Coaching carried out by field coordinators from MJAP strengthened influence and informal accountability for carrying out the intervention. Frontline health workers held a pre‐existing strong sense of professional identity. They were proud of attainment of new knowledge and skills and gratified by providing what they perceived to be higher quality care. Peer counsellors, who were not explicitly targeted in the intervention design, effectively substituted some functions of health care providers; as role models for successful ART uptake, they played a crucial role in creating demand for rapid ART initiation through interactions with patients. Point of care (POC) CD4 testing enabled immediate action and relieved providers from frustrations of lost or delayed laboratory results, and led to higher patient satisfaction (due to reduced costs because of ability to initiate ART right away, requiring fewer return trips to clinic). Conclusions Qualitative data revealed that a multicomponent intervention to change provider behaviour succeeded in the context of strong institutional and individual relationships between a University‐affiliated organization, government facilities, and peer health workers (who acted as a crucial link between stakeholders) and the community. Fostering stable institutional relationships between institutional actors (non‐governmental organization (NGOs) and ministry‐operated facilities) as well as between facilities and the community (through peer health workers) can enhance uptake of innovations targeting the HIV cascade in similar clinical settings.
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Affiliation(s)
- Fred C Semitala
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Makerere University Joint AIDS Program (MJAP), Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Carol S Camlin
- Division of HIV, ID and Global Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, Department of Medicine, University of California, San Francisco, CA, USA
| | - Jeanna Wallenta
- Philip R. Lee Institute for Health Policy Studies, Department of Epidemiology and Biostatistics, and Global Health Sciences, University of California, San Francisco, CA, USA
| | | | | | - Gideon Amanyire
- Makerere University Joint AIDS Program (MJAP), Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Wei Chang
- Philip R. Lee Institute for Health Policy Studies, Department of Epidemiology and Biostatistics, and Global Health Sciences, University of California, San Francisco, CA, USA
| | - James G Kahn
- Philip R. Lee Institute for Health Policy Studies, Department of Epidemiology and Biostatistics, and Global Health Sciences, University of California, San Francisco, CA, USA
| | - Edwin D Charlebois
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Diane V Havlir
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Moses R Kamya
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Makerere University Joint AIDS Program (MJAP), Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Elvin H Geng
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
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Lau JTF, Wang Z, Kim Y, Li J, Gu J, Mo PKH, Wang X. Low sustainability, poor governance, and other challenges encountered by grassroots non-governmental organizations targeting HIV prevention for men who have sex with men in China - a nation-wide study. AIDS Care 2017; 29:1480-1490. [PMID: 28271717 DOI: 10.1080/09540121.2017.1300630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Grassroots non-governmental organizations (NGOs) played pivotal roles in HIV prevention among men who have sex with men (MSM) in China. Their governance and sustainability issues were under-studied. This nation-wide study surveyed leaders of 202 of the HIV related NGOs in China.58.4% of the leaders believed that their NGO would last for ≤5 years; which was negatively associated with perceived good relationship with CDC. 65.3% mentioned ≥3 non-sustainability issues; associated factors included perceived inadequacies in prevention skills, management skills, policy support, technical support, operational support, and CDC's support; a reverse association was found for frequent collaboration with organizations in China. 30.6% of the leaders mentioned ≥7 governance issues; a stepwise model found a positive association with having no office and negative associations with number of full-time staff and core volunteers. These problems would severely limit the effectiveness of HIV prevention among MSM. Related improvements and support are warranted.
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Affiliation(s)
- Joseph T F Lau
- a Centre for Health Behaviours Research , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong SAR , China.,b Shenzhen Research Institute, The Chinese University of Hong Kong , Shenzhen , China.,c Centre for Medical Anthropology and Behavioral Health , Sun Yat-sen University , Guangzhou , China
| | - Zixin Wang
- a Centre for Health Behaviours Research , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong SAR , China.,b Shenzhen Research Institute, The Chinese University of Hong Kong , Shenzhen , China
| | - Yoona Kim
- a Centre for Health Behaviours Research , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong SAR , China
| | - Jinghua Li
- a Centre for Health Behaviours Research , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong SAR , China
| | - Jing Gu
- d School of Public Health , Sun Yat-sen University , Guangzhou , China
| | - Phoenix K H Mo
- a Centre for Health Behaviours Research , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong SAR , China
| | - Xiaodong Wang
- e Chengdu Tongle Health Consulting Service Center , Chengdu , China
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5
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Wang D, Xu X, Mei G, Ma Y, Chen R, Qin X, Hu Z. The Relationship Between Core Members' Social Capital and Perceived and Externally Evaluated Prestige and Cooperation Among HIV/AIDS-Related Civil Society Organizations in China. Eval Health Prof 2017; 40:61-78. [PMID: 28705012 DOI: 10.1177/0163278716684167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to investigate whether the core members' social capital was associated with individually perceived and externally evaluated prestige and cooperation among the HIV/AIDS-related civil society organizations (CSOs). To accomplish this, a cross-sectional study using multistage sampling was carried out in eight provinces of China. Data were collected from the 327 core members via questionnaires and self-evaluated performance of the respondents were evaluated and measured. The interviews were conducted with all core members and the supervisory staff of the local Centers for Disease Control and Prevention. Multivariate logistic regression analysis indicated that social support (adjusted odds ratio [a OR] = 1.87) and organizational commitment (a OR = 1.57) were significantly associated with a higher odds of prestige performance in self-evaluation. Furthermore, social support (a OR = 1.65), trust (a OR = 1.33), and organizational commitment (a OR = 1.52) were significantly correlated with cooperation performance. Trust was positively associated with the cooperation performance on external evaluation. These findings may provide a new perspective on challenges that the CSOs face in response to a growing HIV/AIDS epidemic in China. Social capital may increase performance and accelerate organizational growth, ultimately improving HIV/AIDS prevention and care.
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Affiliation(s)
- Danni Wang
- 1 School of Health Services Management, Anhui Medical University, Hefei, China.,2 Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,3 Department of Preventive Medicine, Bengbu Medical College, Bengbu, China
| | - Xiaoru Xu
- 1 School of Health Services Management, Anhui Medical University, Hefei, China
| | - Guangliang Mei
- 1 School of Health Services Management, Anhui Medical University, Hefei, China
| | - Ying Ma
- 1 School of Health Services Management, Anhui Medical University, Hefei, China
| | - Ren Chen
- 1 School of Health Services Management, Anhui Medical University, Hefei, China
| | - Xia Qin
- 1 School of Health Services Management, Anhui Medical University, Hefei, China
| | - Zhi Hu
- 1 School of Health Services Management, Anhui Medical University, Hefei, China.,2 Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
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6
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Owczarzak J, Filippova O, Phillips SD. A novel, bottom-up approach to promote evidence-based HIV prevention for people who inject drugs in Ukraine: protocol for the MICT ('Bridge') HIV prevention exchange project. Implement Sci 2014; 9:18. [PMID: 24491185 PMCID: PMC3924704 DOI: 10.1186/1748-5908-9-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/16/2014] [Indexed: 12/01/2022] Open
Abstract
Background Ukraine has one of the most severe HIV epidemics in Eastern Europe, with an estimated 1.6% of the adult population living with the virus. Injection drug use accounts for 36% of new HIV cases. Nongovernmental organizations in Ukraine have little experience with effective, theory-based behavioral risk reduction interventions necessary to reduce the scope of the HIV epidemic among Ukrainians who inject drugs. This study seeks to promote the use of evidence-based HIV prevention strategies among Ukrainian organizations working with drug users. Methods/design This study combines qualitative and quantitative methods to explore a model of HIV prevention intervention development and implementation that disseminates common factors of effective behavioral risk reduction interventions and enables service providers to develop programs that reflect their specific organizational contexts. Eight agencies, located in regions of Ukraine with the highest HIV and drug use rates and selected to represent key organizational context criteria (e.g., agency size, target population, experience with HIV prevention), will be taught common factors as the basis for intervention development. We will use qualitative methods, including interviews and observations, to document the process of intervention development and implementation at each agency. Using risk assessments with intervention participants, we will also assess intervention effectiveness. The primary outcome analyses will determine the extent to which agencies develop and implement an intervention for drug users that incorporates common factors of effective behavioral interventions. Effectiveness analyses will be conducted, and effect size of each intervention will be compared to that of published HIV prevention interventions for drug users with demonstrated effectiveness. This study will explore the role of organizational context on intervention development and implementation, including resource allocation decisions, problem-solving around intervention development, and barriers and facilitators to inclusion of common factors and delivery of a high quality intervention. Discussion This innovative approach to HIV prevention science dissemination and intervention development draws on providers’ ability to quickly develop innovative programs and reach populations in greatest need of services. It has the potential to enhance providers’ ability to use HIV prevention science to develop sustainable interventions in response to a rapidly changing epidemic.
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Affiliation(s)
- Jill Owczarzak
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N, Broadway, Hampton House Room 739, Baltimore 21205-1996, Maryland.
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7
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Tucker JD, Wong FY, Nehl EJ, Zhang F. HIV testing and care systems focused on sexually transmitted HIV in China. Sex Transm Infect 2012; 88:116-9. [PMID: 22345024 DOI: 10.1136/sextrans-2011-050135] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Over three-quarters of new HIV infections in China during 2009 were estimated to be from sexual transmission. Over half of those living with HIV do not know their serostatus and identifying and treating individuals with sexually transmitted HIV infection has been challenging. OBJECTIVE This global assessment explores Chinese systems for detecting and treating those with HIV infection with a particular focus on groups at increased risk of sexually transmitted HIV. METHODS Published literature, grey sources and non-governmental reports were reviewed to describe HIV testing and care systems in China. RESULTS HIV testing and care in China involve several parallel health systems and have been largely successful in reaching large numbers of vulnerable individuals. Provider-initiated testing and counselling has been more effective than voluntary counselling and testing programmes for expanding HIV testing efforts in China. Individuals with sexually transmitted HIV infection are underrepresented in the antiretroviral care system compared with other high-risk groups. CONCLUSIONS Comprehensive HIV testing and care bring together a number of Chinese health systems, but there are still gaps and challenges. Research and programmes focused on HIV testing and care for those with increased sexual risk are needed.
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Affiliation(s)
- Joseph D Tucker
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRJ-504, Boston, MA 02139, USA.
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8
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Monay V, Mangione CM, Sorrell-Thompson A, Baig AA. Services delivered by faith-community nurses to individuals with elevated blood pressure. Public Health Nurs 2010; 27:537-43. [PMID: 21087307 PMCID: PMC3363358 DOI: 10.1111/j.1525-1446.2010.00881.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Our study describes the services faith-community nurses provide to a community-dwelling sample of patients with elevated blood pressure. DESIGN AND SAMPLE The faith-community nurses completed a survey describing services provided to study participants at each patient encounter. We describe the type of contact and the frequency and types of services provided to these patients. From October 2006 to October 2007, we conducted a partnered study with a faith-community nursing program and enrolled 100 adults with elevated blood pressure from church health fairs. MEASURES Patient demographics and faith-community nurse services provided. RESULTS Data from 63 of 108 (58%) visits to faith-community nurses made by 33 participants were collected from surveys completed by the nurses. The majority of the participants were female (64%), Latino (61%), with an average age of 59 (SD=11) years and incomes below US$30,000 (83%). The most frequent services patients received from faith-community nurses were blood pressure measurement (73%), hypertension-specific education on dietary changes (67%), and supportive counseling (56%). CONCLUSIONS Faith-community nurses represent a new method of supportive self-management for low-income individuals with a chronic condition who may otherwise have limited access to health services. Further research is needed to understand the effect of faith-community nurse interventions on improving chronic disease health outcomes in these communities.
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Hagopian A, Spigner C, Gorstein JL, Mercer MA, Pfeiffer J, Frey S, Benjamin L, Gloyd S. Developing competencies for a graduate school curriculum in international health. Public Health Rep 2009; 123:408-14. [PMID: 19006985 DOI: 10.1177/003335490812300325] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Amy Hagopian
- University of Washington, Department of Health Services, School of Public Health and Community Medicine, Seattle, WA 98105, USA.
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10
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Kelly JA, Somlai AM, Benotsch EG, Amirkhanian YA, Fernandez MI, Stevenson LY, Sitzler CA, McAuliffe TL, Brown KD, Opgenorth KM. Programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean. AIDS Care 2006; 18:12-21. [PMID: 16282071 PMCID: PMC2265204 DOI: 10.1080/09540120500101757] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study assessed the programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in 75 countries in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean. Multiple databases and expert recommendations were used to identify one major HIV-prevention NGO in the capital or a large city in each country, and in-depth interviews were conducted with each NGO Director. Most NGOs are carrying out their programmes with minimal funding and few regularly employed personnel. Most are highly dependent on international donors, but reliance on small grants with short funding periods limits programme development capacity. HIV-prevention activities varied by region, with African NGOs most likely to use peer education and community awareness events; Eastern European NGOs most likely to offer needle exchange; Latin American NGOs to have resource centres and offer risk reduction programmes; and Caribbean organizations to use mass education approaches. Across regions, NGOs most often targeted the general public and youth, although specialized at-risk groups were the additional focus of attention in some regions. Limited funding, governmental indifference or opposition, AIDS stigma, and social discomfort discussing sex were often cited as barriers to new HIV-prevention programmes. NGOs are critical service providers. However, their funding, programmes, and resource capacities must be strengthened if NGOs are to realize their full potential in HIV prevention.
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Affiliation(s)
- J A Kelly
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53202, USA.
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Benotsch EG, Stevenson LY, Sitzler CA, Kelly JA, Makhaye G, Mathey ED, Somlai AM, Brown KD, Amirkhanian Y, Fernandez MI, Opgenorth KM. HIV prevention in Africa: programs and populations served by non-governmental organizations. J Community Health 2004; 29:319-36. [PMID: 15186017 DOI: 10.1023/b:johe.0000025329.10411.2a] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The AIDS epidemic in Africa remains an urgent health crisis. Non-governmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services and assistance to persons living with AIDS. African NGOs are conducting numerous HIV prevention programs with several at-risk populations, yet their efforts have only rarely been systematically documented. To address this gap in the literature, the authors surveyed one NGO in each of 29 African countries regarding their HIV prevention activities and populations served. This report provides details concerning HIV prevention activities across the continent and describes in detail innovative programs from Togo and South Africa. NGOs in the present sample operate with modest budgets and small staff sizes, yet conduct programs that reach large segments of their communities. NGOs were most likely to report community-level interventions such as peer-education or community outreach. Faced with an epidemic where the main transmission occurs via heterosexual activity, African NGOs were most likely to direct their attention to the general public and to youth. NGOs in Africa are struggling to implement sustainable, cost-effective programs with few resources. Strengthening the infrastructure and capacity of these key agencies is crucial to fighting the AIDS epidemic in Africa.
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Affiliation(s)
- Eric G Benotsch
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee 53202, USA.
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Chillag K, Bartholow K, Cordeiro J, Swanson S, Patterson J, Stebbins S, Woodside C, Sy F. Factors affecting the delivery of HIV/AIDS prevention programs by community-based organizations. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2002; 14:27-37. [PMID: 12092934 DOI: 10.1521/aeap.14.4.27.23886] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Community based organizations (CBOs) play a frontline role in HIV/AIDS prevention activities. CBOs face formidable challenges to effective delivery of HIV prevention services including client characteristics such as homelessness and CBO characteristics such as limited resources and staff turnover. Despite these obstacles, CBOs are generally well positioned to deliver services to specific high-risk populations because they understand their local communities and are connected to the groups they serve. [C1]This qualitative study illustrates that structural, sociocultural, organizational, and individual client factors both facilitate and act as barriers to delivery of HIV prevention services. These challenges and successes help identify critical technical assistance needs.
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Affiliation(s)
- Kata Chillag
- Division of HIV/AIDS Prevention-Epidemiology and Surveillance, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Solomon S, Ganesh AK. Role of nongovernmental organizations in the prevention and care of HIV disease in women and children. It makes a difference. Ann N Y Acad Sci 2000; 918:22-6. [PMID: 11131708 DOI: 10.1111/j.1749-6632.2000.tb05469.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Solomon
- Y.R.G. Centre for AIDS Research and Education, T. Nagar, Chennai 600017, India.
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14
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Asthana S, Oostvogels R. Community participation in HIV prevention: problems and prospects for community-based strategies among female sex workers in Madras. Soc Sci Med 1996; 43:133-48. [PMID: 8844919 DOI: 10.1016/0277-9536(95)00348-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The concept of strengthening community action within the context of HIV prevention is gaining popularity among health circles, with organizations such as gay volunteer groups in the U.S. providing positive evidence of the potential role of community participation in HIV/AIDS prevention and care efforts. Care must be taken, however, in assuming that participation can easily be achieved among all high-risk groups. This paper examines problems and prospects for participation in HIV prevention strategies among commercial sex workers (CSWs) in Madras. Based upon the experiences of a pilot project established by the Tamil Nadu State Government AIDS Cell and WHO, it finds that the organization of the commercial sex trade in Madras is not highly conducive to collective action. Identifying factors that have frustrated attempts to promote community-based strategies in the city, the paper suggests that this approach is unlikely to succeed unless there are significant changes to the institutional arrangements that keep sex workers in a position of subordination and exploitation.
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Affiliation(s)
- S Asthana
- Department of Social Policy, University of Plymouth, Drake Circus, U.K
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