The Bamako Initiative in Benin and Guinea: Improving the Effectiveness of Primary Health Care

let me know if you'd like the whole paper and I'll email it to you:

Wiley InterScience: Journal: Abstract: "The objective of the health system revitalization undergone in Benin and Guinea since 1986 is to improve the effectiveness of primary health care at the periphery. Second in a series of five, this article presents the results of an analysis of data from the health centres involved in the Bamako Initiative in Benin and Guinea since 1988. Data for the expanded programme of immunization, antenatal care and curative care, form the core of the analysis which confirms the improved effectiveness of primary health care at the peripheral level over a period of six years. The last available national data show a DPT3 immunization coverage of 80% in 1996 in Benin and 73% in 1995 in Guinea. In the Bamako Initiative health centres included in our analysis, the average immunization coverage, as measured by the adequate coverage indicator, increased from 19% to 58% in Benin and from less than 5% to 63% in Guinea between 1989 to 1993. Average antenatal care coverage has increased from 5% in Benin and 3% in Guinea to 43% in Benin and 51% Guinea. Utilization of coverage with curative care has increased from less than 0.05 visit per capita per year to 0.34 in Guinea and from 0.09 visit per capita per year to 0.24 in Benin. Further analysis attempts to uncover the reasons which underlie the different levels of effectiveness obtained in individual health centres. Monitoring and microplanning through a problem-solving approach permit a dynamic process of adaptation of strategies leading to a step by step increase of coverage over time. However, the geographical location of centres represents a constraint in that certain districts in both countries face accessibility problems. Outreach activities are shown to play an especially positive role in Guinea, in improving both immunization and antenatal care coverage."

Cyclone Sidr Kills 35o in Bangladesh - New York Times

Cyclone Sidr Kills 35o in Bangladesh - New York Times: "Packing winds of over 100 miles an hour, the furious cyclone that swept across the low-lying watery edges of southern Bangladesh late Thursday downed trees, sent mobile telephone towers crashing and swept away mud and thatch homes.

The government's acting secretary for disaster management, Ayub Mian, told reporters at a press conference in Dhaka today that at least 350 people had been killed by Cyclone Sidr, as it is called, while a private television station estimated the death toll to have crossed 500 [...]"

Safe abortion services virtually non-existent despite 1985 law | Gender Issues Health & Nutrition | News I

IRIN Africa | West Africa | Ghana | GHANA: Safe abortion services virtually non-existent despite 1985 law | Gender Issues Health & Nutrition | News Item : "Ghana has one of Africa's most liberal abortion laws but because of lingering stigma, fear and misunderstanding, safe, affordable abortion services remain virtually non-existent and unsafe abortion is a major cause of death, observers say [...]

"Asantao survived after an emergency operation, but many women do not. Maternal mortality in Ghana stands at about 540 per 100,000, and it is estimated that 22 to 30 percent of those deaths are from unsafe abortion, health experts say..."

(found via Wedia)

Uncovered stories and attention economics

My heart's in Accra - Uncovered stories and attention economics: "...Matt and Emily are the founders of Wedia, a new non-profit designed to call attention to undercovered humanitarian crises around the world. Their first efforts have been in matching up professional journalists and videographers with aid organizations responding to famine in Niger and other global crises, producing high-quality video that could be used by international news organizations to report on breaking stories.

Matt and Emily have discovered that there’s no shortage of undercovered stories to tell, and that journalists are deeply interested in telling these stories [...] "

sociodemographic correlates and barriers of maternal healthcare

One Source Record: "Maternal mortality and morbidity continue to be high despite the existence of national programs for improving maternal and child health in India. This could be related to several factors, an important one being non-utilization or under-utilization of maternal health-care services, especially amongst the rural poor and urban slum population due to either lack of awareness or access to health-care services. Understanding of the knowledge and practices of the community regarding maternity care during pregnancy, delivery and postnatal period is required for program implementation. Therefore, the present study was carried out to evaluate the sociodemographic correlates and barriers of maternal healthcare utilization amongst married women aged 15-45 years living in a slum in Delhi."

feedback for 11/13

• Good discussion. Not quite brought together in conclusion. Dr. Kessler’s presence and comments most welcome.
• Great class discussion. Too bad more people weren’t present.
• Really enjoyed the broad focus on media especially the focus on blogging. Neda it was great how you tied it all together at the end citing the disjoint between public health and the media. Kudjoe and Dina, I really enjoyed the scope of your presentation from the history of P.C. health to current models and examples. Thank you.
• Bennett: good solid presentation. Stimulating, considerable discussion.
• Abbas and Dowlatshahi: Basic concepts well delineated, perhaps more discussion of obstacles would be warranted; more attention to finance issues – good use of specific examples from different countries.
• Bennett: Must try to define key terms, acronyms more. Great presentation, good class participation. Still not much information on the blog.
• Great speakers! I like the discussion on media images but I feel that the topic on primary health care should be one of the earlier topics.
• Very good class participation was promoted by the presenters. Good class scenario to demonstrate primary health care.
• Well-researched slides. Please share your resources online!

more upcoming events!

Dear Heilbrunn Department, (*please forward to your networks, friends, family, and colleagues)*

Amnesty International recently released a report on sexual violence against native women, "Maze of Injustice." I wanted to alert you to this and invite you and ask you to inform any current or former students and faculty who may be interested in attending. Additionally, if there are faculty who have colleagues who are interested, please pass this along also. Thank you - Matthew Kennis, Amnesty International

Here's a link to the full report: *http://www.amnestyusa.org/women/maze/report.pdf*



You are invited to attend a reception and public program at The Smithsonian National Museum of the American Indian in New York City. The event is being hosted by Rose Styron, Kerry Kennedy and Larry Cox, Executive Director of Amnesty International USA./*

*Where: *Smithsonian National Museum of the American Indian, One Bowling Green (across from Battery Park in downtown Manhattan)
*When: *Thursday, November 15, 2007, 6 – 8 p.m.
*What: *Learn about Amnesty International’s groundbreaking report: Maze of Injustice: The failure to protect indigenous women from sexual violence in the USA.

*/_Speakers include:_/*
*Georgia Little Shield, Executive Director, Pretty Bird Women House*
*Winona Flying Earth, Sitting Bull College and South Dakota Coalition Against Domestic Violence*
/Hors d'oeuvres and cocktails will be served.
This event is free and open to the public. Guests are Welcome
*/RSVP to Matthew Kennis by Monday, November 12; 212-633-4169 or mkennis@aiusa.org/*



The Global Health Club, Student Physicians for Social Responsibility and
the Einstein Umbrella for Health and Social Justice invite you to attend
Global Health Night on November 29 at 7:00 PM in Robbins Auditorium.

The keynote Speaker is Stephen Lewis, formerly Canadian Ambassador to
the UN and UN Special Envoy for HIV/AIDS in Africa. Currently, Mr. Lewis
is Co-director of AIDS-Free World, an international AIDS advocacy
organization. He is also a Professor in Global Health at McMaster
University.

In addition to the lecture by Mr. Lewis, there will be presentations by
medical students on their global health projects in Bolivia and Uganda
and a brief talk by the first citizen of the USA to graduate from the
Latin American Medical School in Havana, currently a first year resident
in Primary Care at Montefiore.

announcement from Dr. Brown

The Center for Family and Community Medicine is pleased to invite you to join us for a discussion on "Tradition and Innovation in Generalism," with Kevin Grumbach, M.D., professor and chair of the Department of Family and Community Medicine at the University of California, San Francisco and chief of Family and Community Medicine at San Francisco General Hospital.

Date: Thursday, November 29, 2007

Time: 4 - 6 p.m. Refreshments will be served.

Location: Russ Berrie Science Pavilion, 1st floor
(1150 St. Nicholas Avenue @ 168th Street)

For more information or to RSVP, please contact Ashley Cross at 212-304-7455 or ac2738@columbia.edu.

Background of guest speaker:

Kevin Grumbach, M.D. is professor and chair of the Department of Family and Community Medicine at the University of California, San Francisco and chief of Family and Community Medicine at San Francisco General Hospital. He is the director of the UCSF Center for California Health Workforce Studies, co-director of the UCSF Center for Excellence in Primary Care, and co-director of the Community Engagement Program for the UCSF Clinical Translational Science Institute. His research on topics such as primary care physician supply and access to care, racial and ethnic diversity in the health professions, and the impact of managed care on physicians have been published in major medical journals such as The New England Journal of Medicine and JAMA, and cited widely in both health policy forums and the general media. He co-authored the best-selling textbook on health policy, "Understanding Health Policy - A Clinical Approach," and the recent book, "Improving Primary Care - Strategies and Tools for a Better Practice." Dr. Grumbach is co-chair of the UCSF University-Community Partnership Council, and a founding member of the California Physicians' Alliance, the California chapter of Physicians for a National Health Program.

This is the second lecture in the 2007-2008 "Discovering the Primary Care Imperative" series, hosted by the Center for Family and Community Medicine. www.columbiacfcm.org

From origins to implications: key aspects in the debate over the digital divide

From origins to implications: key aspects in the debate over the digital divide: "Defined as the differential extent to which rich countries and poor countries benefit from various forms of information technology (IT), the global digital divide has been extensively measured and described in national as well as international debates. The problem, however, is that the topic is highly fragmented in the literature, with few attempts to put the parts into a coherent analytical framework. More precisely, there has been no specific attempt to pinpoint the main issues that influence one's view of the importance of the digital divide and the policies demanded by the different points of view. The goal of this paper, accordingly, is to fill this important gap in the literature in an analytical schema that recognizes the ways in which the impact of innovations depends heavily on how they are generated and diffused. At each stage of this sequential process are key issues that influence one's view of the digital divide. It matters a great deal for instance on whether the divide is in some sense unique, or just another manifestation of the general technological relationship between rich and poor countries. It is also the case that the size of the divide depends heavily on how it is measured. Yet another example is that the extent of the potential impact of IT will influence our view of the foregone opportunities associated with limited uptake of this technology in developing countries."

During one month of protests, military government steps up propaganda, censorship and violence against journalists

The use of violence and censorship against Burmese journalists trying to cover the protests that began a month ago is a “detestable strategy” aimed at preventing them from doing their job, Reporters Without Borders and the Burma Media Association said today. It has been accompanied by an increase in propaganda in the state and privately-owned media controlled by the military government.

Links on Primary Health Care at www.networklearning.org/phc.html

considering the role of media in MCH

Think back to the first day of class and the Rosling presentation. The world's poorest countries are growing technological platforms faster than wealth and health. That means technological platforms will play a critical role in the later developments of health and wealth. In light of this, tomorrow's class is a critically important topic: the role of media in MCH.

Here are some resources for further exploring this topic:

The African Information Society Initiative: A Seven-year Assessment

Bienvenue sur Kidal.info: "Le site d'informations sur la région de Kidal"

Internet Computing, IEEE: Internet filtering in China

Open Networks, Closed Regimes: The Impact of the Internet on Authoritarian Rule - Google Books