National disease-control programmes, like that for tuberculosis, in countries with a high burden of disease are often organized in a vertical manner. Clinical management of individual patients in such a set-up is strongly driven by topdown implementation of a set of guidelines embedded in a hierarchical supervision structure. As such, the strength and the organization of a national disease-cont...

Approximately 80% of HIV cases are transmitted sexually and a further 10% perinatally or during breastfeeding. Hence, the health sector has looked to sexual and reproductive health programmes for leadership and guidance in providing information and counselling to prevent these forms of transmission, and more recently to undertake some aspects of treatment. This paper reviews and assesses the co...

PROBLEM The expiry of medicines in the supply chain is a serious threat to the already constrained access to medicines in developing countries. APPROACH We investigated the extent of, and the main contributing factors to, expiry of medicines in medicine supply outlets in Kampala and Entebbe, Uganda. A cross-sectional survey of six public and 32 private medicine outlets was done using semi-str...

Over the last 3 decades there have been marked changes i n leprosy control policies . Until the early 1 940's the practice had been the compulsary segre­ gation of leprosy patients in colonies . I This was later replaced by their treat­ ment in leprosy villages. 2. 3 Before the introduction of the sulphone drugs , isolation was the main method of leprosy control . After the introduction of sulp...

The aim of this article is to promote and encourage ulcer care at the lowest possible level, as near to the patient' s home as possible, and to stimulate paramedical workers and physicians in peripheral units to take responsibility for such treatment. Traditionally surgeons, often working full time in leprosy institutions, in vertical leprosy programmes have given ulcer care. As integration pro...

Anthony Harries and colleagues (June 3, p 1870) do well to explore the tensions between technical and public-health approaches to the HIV/ AIDS epidemic in Malawi. However, they miss opportunities to discuss several fundamental issues. Important lessons could be learned from neighbouring countries. In Mozambique, the antiretroviral treatment (ART) scale-up programme is very similar to that of M...

Croatia started implementing the national programs for early breast cancer detection in 2006, early detection of colon cancer and early detection of cervical cancer. A possible way to improve the adherence of the women to the screening on breast cancer could be by transferring the responsibility for the program implementation from the public health institutes to family physicians. The Project: ...

There are no known studies that have been conducted focusing on the congruency or discrepancy of pre service agricultural education programmes in relation to secondary school agriculture teaching in Zimbabwe. The purpose of this study was therefore to make a qualitative investigation on the contribution of pre service agricultural education training programmes to the teaching of high school Agr...

parallel non-Task Force initiatives such as The Gambia Hepatitis Group are neglected). Only at ground level do the files fail. The women's movement in Indonesia or village health workers in Thailand are seen from above, from memos and reports by outsiders. Thus a reference to an Indonesian village split by unbridged ravines, creating difficulties for vaccinators (p. 104) appears as a rare, refr...

Background Over the past few decades diabetes has emerged as an important non-communicable disease in SubSaharan Africa (SSA). Sight loss from Diabetic Retinopathy (DR) can be prevented with screening and early treatment. The objective of this paper is to outline the required actions and considerations in the planning and development of DR screening services.   Methods A multiple-case study app...