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The Tradeoff Between Centralized and Decentralized Health Services: Evidence From a Major Anti-Poverty Program in Mexico
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| Presenter(s):
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| Arturo Vargas-Bustamante,
University of California, Berkeley,
avargas@berkeley.edu
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| Abstract:
This paper presents initial evidence on the effectiveness of two models of health services organization. It compares performance between centralized and decentralized services by taking advantage of health care provider duplication in rural Mexico. In contrast with the most common predictions in the literature and the recommendations of a wide array of international policy makers, the centralized provider of health services performs better. Households served by the centralized organization face less regressive out-of-pocket health care expenditures (45% lower), and observe higher utilization of preventive services (15% more). Fortunately, state providers improve significantly in those areas targeted by Oportunidades, the main anti-poverty policy in Mexico. The outcomes of centralized and decentralized organizations turn indistinguishable in those areas where Oportunidades operates. These findings are robust to the possible effect of time and type of decentralization, state and health infrastructure effects, Oportunidades' early treatment, the use of alternative measures and other confounders.
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Using the Extended Parallel Processing Model to Evaluate the Impact of Avian and Pandemic Flu Communication Programs: Lessons From Egypt's National Communication Campaign 2006
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| Presenter(s):
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| Douglas Storey,
Johns Hopkins University,
dstorey@jhuccp.org
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| Abstract:
This paper describes the impact evaluation of a 2006 avian flu communication campaign in Egypt. The campaign, which launched within hours of the first confirmed case of bird flu, was designed to manage the initial public response to an emerging avian outbreak and to minimize bird to human transmission of the H5N1 virus. Campaign messages and evaluation instrumentation were based on the Extended Parallel Processing Model (EPPM), which describes the interacting influence of emotional (threat) and rational (efficacy) perceptions on behavioral decisions. Measures of both individual and collective threat and efficacy were employed. Impact data were obtained from a nationally representative survey (n=4052) of 15-49 year old adults in 21 governorates. Results indicate positive effects of message recall on threat and efficacy perceptions and on the number of protective behaviors initiated following the launch of the campaign.
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Evaluation of HIV/AIDS Awareness Programs: How Well African American Religious Community Do?
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| Presenter(s):
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| Julien Kouame,
Western Michigan University,
julienkb@hotmail.com
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| Fatma Ayyad,
Western Michigan University,
fattmah@hotmail.com
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| Abstract:
This evaluation examines the efficiency and effectiveness of a HIV/AIDS awareness programs in African American Religious community (AARC), in a USA's small town. Qualitative data collection methods including, interviews, observations and focus group were used to gather data from the community's churches. Church leaders and church goers provided information regarding their churches' activities for HIV/AID awareness.
Data collected were analyzed qualitatively with qualitative data analysis software to answer the following evaluation questions: (1) Is the AARC's involved in HIV/AIDW awareness programs. (2) What are the obstacles preventing them (if not involved) to be involved? (3) Are the existence programs (if any) relevant for HIV/AID awareness and education? This paper presents potential gaps between community need and the church's activities, and our expectations for strengthening programs intended to HIV/AID awareness and Education in the AARC. As a result of this study, potential barriers to church involvement were discovered.
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Health Workers' Performance Evaluation: A Better Approach for Developing Countries
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| Presenter(s):
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| Julien Kouame,
Western Michigan University,
julienkb@hotmail.com
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| Abstract:
To observe health workers' (HW) performance over time after training, we assessed a sample of consultations of ill children 2–59 months of age with non-severe pneumonia. Data include information gathered from patient registers, interviews and observations. Our analysis included three indicators of case management quality: correct assessment, classification, and treatment. We assumed assessment was correct when a child with an acute respiratory infection had all ARI-related assessments done; classification was correct when a child with no severe classification who had IMCI-defined non-severe pneumonia was classified as having non-severe pneumonia by the HW; and treatment was correct when the HW prescribed a 7-day course of cotrimoxazole with a dosage appropriate for the child's weight. The study showed a short-term positive impact of the IMCI follow-up visit (i.e., when an IMCI trainer visits the HW shortly after IMCI training) on HW performance.
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