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WHAT'S NEW THIS THURSDAY: FAMILY PLANNING, ETHIOPIA; DOWNSIZING AT GFATM; NEW MODELS FOR LARGE PROSPECTIVE STUDIES

Wednesday, 20th of June 2012

 

• WHAT’S NEW THIS THURSDAY: FAMILY PLANNING, ETHIOPIA; DOWNSIZING AT GFATM; NEW MODELS FOR LARGE PROSPECTIVE STUDIES

 

• FAMILY PLANNING, ETHIOPIA

 

Reprod Health. 2011 Dec 8

Determinants of low family planning use and high unmet need in Butajira District, South Central Ethiopia

Mekonnen W, Worku A.

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. wubegzierm@gmail.com

Abstract below; full text is at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248357/?tool=pubmed

BACKGROUND:

The rapid population growth does not match with available resource in Ethiopia. Though household level family planning delivery has been put in place, the impact of such programs in densely populated rural areas was not studied. The study aims at measuring contraception and unmet need and identifying its determinants among married women.

METHODS:

A total of 5746 married women are interviewed from October to December 2009 in the Butajira Demographic Surveillance Area. Contraceptive prevalence rate and unmet need with their 95% confidence interval is measured among married women in the Butajira district. The association of background characteristics and family planning use is ascertained using crude and adjusted Odds ratio in logistic regression model.

RESULTS:

Current contraceptive prevalence rate among married women is 25.4% (95% CI: 24.2, 26.5). Unmet need of contraception is 52.4% of which 74.8% was attributed to spacing and the rest for limiting. Reasons for the high unmet need include commodities' insecurity, religion, and complaints related to providers, methods, diet and work load. Contraception is 2.3 (95% CI: 1.7, 3.2) times higher in urbanites compared to rural highlanders. Married women who attained primary and secondary plus level of education have about 1.3 (95% CI: 1.1, 1.6) and 2 (95% CI: 1.4, 2.9) times more risk to contraception; those with no child death are 1.3 (95% CI: 1.1, 1.5) times more likely to use contraceptives compared to counterparts. Besides, the odds of contraception is 1.3 (95% CI: 1.1, 1.6) and 1.5 (1.1, 2.0) times more likely among women whose partners completed primary and secondary plus level of education. Women discussing about contraception with partners were 2.2 (95% CI: 1.8, 2.7) times more likely to use family planning. Nevertheless, contraception was about 2.6 (95% CI: 2.1, 3.2) more likely among married women whose partners supported the use of family planning.

CONCLUSIONS:

The local government should focus on increasing educational level. It must also ensure family planning methods security, increase competence of providers, and create awareness on various methods and their side effects to empower women to make an appropriate choice. Emphasis should be given to rural communities.

• DOWNSIZING AT GFATM

Reported by Reuters/Geneva The Global Fund, an organisation that has received millions of dollars from Bill Gates but has been accused of misusing donor funds, is cutting its workforce and tightening its focus on 20 countries hardest hit by Aids, tuberculosis and malaria. The Global Fund’s general manager Gabriel Jaramillo said in a statement that the fund had completed a re-organisation that would rebalance its workforce with 39% more people managing grants and 38% fewer in support roles. Jaramillo took over in January after an investigation found a “grave misuse of funds” at the fund, a unique public-private financial institution that spends donor money on tackling three of the world’s biggest killer diseases. The revelation prompted governments such as Sweden and Germany to freeze their contributions to the fund, forcing the fund to scrap new grants until 2014. Jaramillo’s promise to bring efficiency, accountability and results got a swift vote of confidence from the Bill & Melinda Gates Foundation, which pledged $750mn in January, more than the $650mn that the Microsoft chairman’s charity has contributed since the fund’s launch 10 years ago. But more is needed from governments, which have provided the bulk of the $22.6bn that has been raised by the Geneva-based organisation to date for its work in 150 countries, paying for 3.5mn anti-retroviral drug treatments and 9mn tuberculosis treatments. A source close to the fund said that the re-organisation would involve about 120-130 redundancies, largely in strategy and research jobs, but more posts would also be added, so the fund would shrink from about 650 to about 600 staff overall.

 

• NEW MODELS FOR LARGE PROSPECTIVE STUDIES

From the American Journal of Epidemiology. Full text is at

http://aje.oxfordjournals.org/content/175/9/859.full?etoc

1.    Am. J. Epidemiol. (2012) 175 (9): 859-866. doi: 10.1093/aje/kwr453 First published online: March 12, 2012

 

New Models for Large Prospective Studies: Is There a Better Way?

1.       Teri A. Manolio^*, Brenda K. Weis, Catherine C. Cowie, Robert N. Hoover, Kathy Hudson,

   Barnett S. Kramer, Chris Berg, Rory Collins, Wendy Ewart, J. Michael Gaziano,

   Steven Hirschfeld, Pamela M. Marcus, Daniel Masys, Catherine A. McCarty,

  John McLaughlin, Alpa V. Patel, Tim Peakman, Nancy L. Pedersen, Catherine Schaefer,

  Joan A. Scott, Timothy Sprosen, Mark Walport and Francis S. Collins

1.       ^*Correspondence to Dr. Teri A. Manolio, Office of Population Genomics, National Human Genome Research Institute, 5635 Fishers Lane, Suite 3058, MSC 9307, Bethesda, MD 20892-9307 (e-mail: manolio@nih.gov).

       Received May 23, 2011.

       Accepted November 9, 2011.

Abstract

Large prospective cohort studies are critical for identifying etiologic factors for disease, but they require substantial long-term research investment. Such studies can be conducted as multisite consortia of academic medical centers, combinations of smaller ongoing studies, or a single large site such as a dominant regional health-care provider. Still another strategy relies upon centralized conduct of most or all aspects, recruiting through multiple temporary assessment centers. This is the approach used by a large-scale national resource in the United Kingdom known as the “UK Biobank,” which completed recruitment/examination of 503,000 participants between 2007 and 2010 within budget and ahead of schedule. A key lesson from UK Biobank and similar studies is that large studies are not simply small studies made large but, rather, require fundamentally different approaches in which “process” expertise is as important as scientific rigor. Embedding recruitment in a structure that facilitates outcome determination, utilizing comprehensive and flexible information technology, automating biospecimen processing, ensuring broad consent, and establishing essentially autonomous leadership with appropriate oversight are all critical to success. Whether and how these approaches may be transportable to the United States remain to be explored, but their success in studies such as UK Biobank makes a compelling case for such explorations to begin.