References of "Tropical Medicine & International Health [=TM & IH]"
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See detailThe evaluation of the Paris declaration on aid effectiveness: what does it tell us? What results for the health sector?
Martini, Jessica; Paul, Elisabeth ULg; Ireland, Megan et al

in Tropical Medicine & International Health [=TM & IH] (2011), 16(S1), 331

Five years after the signing of the Paris Declaration on aid effectiveness by donors and developing countries, there is a climate of high expectations about the results achieved and the impact at sector ... [more ▼]

Five years after the signing of the Paris Declaration on aid effectiveness by donors and developing countries, there is a climate of high expectations about the results achieved and the impact at sector level. Several evaluations and monitoring surveys have been conducted by the OECD to measure progress made so far in implementing the principles of ownership, alignment, harmonisation, results and mutual accountability. For the health sector, results have also been documented in the context of the International Health Partnership (IHP+). We critically reviewed all the aid effectiveness surveys and evaluations published since 2005 by the OECD and IHP+ so as to analyse what results have been achieved so far as well as the relevance of the frameworks used. To date, results of the implementation of the Paris Declaration are mixed. In the health sector, good progress has been achieved in terms of country ownership and coordination, while alignment and use of country systems, managing for results and mutual accountability lag behind. However, the results recorded often reflect different interpretation of the indicators depending on the respondent, the data available or the time of the survey. Making generalisations is therefore difficult and comparisons between country surveys and over time may not be appropriate. Linking progress in aid effectiveness with improvements in health outcomes is also controversial. Results from the evaluations of the Paris Declaration should be used with caution in the current debate about aid effectiveness. What do the indicators used actually tell us? How realistically can aggregated scores reflect complex issues such as aid effectiveness in different countries, by different donors and over time? Improved evaluation is clearly needed. Data collection should be more rigorous and at sector level contextual factors and behaviour change should be better assessed, over a longer term and through more qualitative comprehensive methods. [less ▲]

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See detailHealth systems strengthening through insurance subsidies: the GFATM experience in Rwanda
Kalk, A; Groos, N; Karasi, Jean Claude ULg et al

in Tropical Medicine & International Health [=TM & IH] (2010), 15(1), 94-7

The Global Fund Against AIDS, Tuberculosis and Malaria (GFATM) approved only three 'health systems strengthening' projects ever, one of them in Rwanda. This project intends to enhance financial access to ... [more ▼]

The Global Fund Against AIDS, Tuberculosis and Malaria (GFATM) approved only three 'health systems strengthening' projects ever, one of them in Rwanda. This project intends to enhance financial access to health care by subsidising health insurance for the poor in order to combat the three diseases successfully. It was submitted to a mid-term evaluation in 2007. The findings of this evaluation are presented and triangulated with experience gained through several years of membership in the Rwandan Country Coordinating Mechanism and the multi-stakeholder 'Working Group on Mutuelles': The GFATM-funded project improved dramatically the financial access of its target group, the very poor--reaching approximately one Rwandan in six. Because of the established rigid regulatory framework, its impact on other population strata was more ambiguous. Improved financial access went hand-in-hand with growing health service utilisation and improvements in the population's health status, including better control of AIDS, tuberculosis and malaria. This success was achieved with limited financial resources. In consequence, interventions that strengthen health systems should always be considered for a prominent--if not a priority role--in GFATM-funded projects. [less ▲]

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See detailSWAps in motion: Lessons from case studies in six African countries
Paul, Elisabeth ULg; Laokri, Samia; Robert, Annie

in Tropical Medicine & International Health [=TM & IH] (2009), 14(Supplement 2), 18

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See detailA seroepidemiological study of human cysticercosis in West Cameroon
Nguekam, J. P.; Zoli, A. P.; Zogo, P. O. et al

in Tropical Medicine & International Health [=TM & IH] (2003), 8(2), 144-149

We studied the occurrence of human cysticercosis in 4993 individuals from three rural communities of Menoua Division, West Province of Cameroon. Circulating antigens of Taenia solium metacestodes were ... [more ▼]

We studied the occurrence of human cysticercosis in 4993 individuals from three rural communities of Menoua Division, West Province of Cameroon. Circulating antigens of Taenia solium metacestodes were detected in 0.4%, 1.0% and 3.0% of the serum samples taken in Bafou, Bamendou and Fonakekeu, respectively, and examined using a monoclonal antibody-based enzyme-linked immunosorbent assay. This test detects only carriers of living cysticerci and gives thus a good idea of the presence of Active cysticercosis. The percentage of persons infected with cysticercosis increased with age. Twenty-two of the 34 seropositives underwent computed tomography (CT) of the brain. Thirteen of them were CT-scan positive, which shows that neurocysticercosis was present in 59.1% of the tested seropositive persons. No living cysticerci were detected among 20 seronegative people. About 20.6% of the seropositives had a history of or current taeniasis against only 1.9% of the seronegatives. Based on these figures and on the data on porcine cysticercosis (prevalence: 11%) and human taeniasis (prevalence: 0.13%) collected in the same region, we conclude that T. solium cysticercosis is an endemic, but overlooked public health problem in West Cameroon. [less ▲]

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See detailLes determinants du comportement de recours au centre de sante en milieu urbain africain: resultats d'une enquete de menage menee a Kinshasa, Congo
Manzambi Kuwekita, Joseph ULg; Tellier, V.; Bertrand, Françoise ULg et al

in Tropical Medicine & International Health [=TM & IH] (2000), 5(8), 563-70

This study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1,000 households in the health districts of ... [more ▼]

This study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1,000 households in the health districts of Kinshasa, Congo in 1997. For the most recent episode of illness, the respondents turned to seven types of care: the health centre (37%), private dispensaries (26.5%), self-medication through a pharmacy (23.9%), traditional practitioner (21%), traditional self-medication (16.9%), private outpatients' clinic (16.7%) and a reference hospital (10.4%). Past logistics have shown that patients resort to a health centre rather than another type of care structure (P = 0.05) when looking for quality care, reasonable prices and the availability of varied services. On the other hand, concern about the geographical proximity in relation to the family's residence calls for using the private dispensary. When looking for a doctor or the existence of a 'convention', families are more inclined to choose a private officially recognized outpatients' clinic. Those who had been looking for a solution to a special type of illness opted primarily for a traditional practitioner. In conclusion, the results of this study show that if people choose the care offered by health centres, it is because they judge it to be of good quality. The integrated care offered by the same technician, with a required training, is a major asset in the acceptability of the first line of primary health care in Kinshasa. This study suggests that it would no doubt be beneficial to integrate non-official private care structures into the primary health care system, as far as it is possible for them to achieve a level of quality comparable to that of the health centres. In order that the traditional practitioner might play an important complementary role in the realization of primary health care, even in urban areas, the possibility of promoting sites of communication should be studied. Moreover, considering the weak buying power of the city's inhabitants and the previous existence of tontines out of solidarity, the 'conventions' providing relief of health care costs, under the leadership of the local communities, should be integrated into the organization of the urban health system. [less ▲]

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