Suchergebnisse

This study explored the challenges facing 1st-year alternatively certified teachers of mathematics and science in urban middle schools. Four teachers, participants in a National Science Foundation (NSF)-funded Robert Noyce Scholarship Program, were followed from preservice training through their 1st year of teaching, having taken part in innovative coursework, workshops, and internship training. Through focus groups, interviews, and classroom observations, data were collected to analyze their experiences in economically disadvantaged settings. The researchers explored key aspects of the scholars' experiences, including their struggles with student performance and motivation, ways in which they developed strategies to strengthen their self-efficacy and resilience, and how novel strategies for assessing learning improved their teaching. By examining their perceptions of classroom situations and cultural contexts, and their emerging coping mechanisms, others can learn about how novice teachers may be better prepared to work in challenging environments, and develop recommendations for enabling teacher-training programs to meet the needs of their students.

IntroductionLeadership is a key factor in the success of HIV prevention and treatment. Positive HIV‐related outcomes are also affected by funding levels for HIV, health sector resources, disease burden and the socio‐economic environment. Leadership on HIV as well as these other factors are affected by the quality of political governance of the country, which may be an overarching factor that influences the making of effective responses to the HIV epidemic.AimThe aim of the study was to investigate the association between quality of political governance, on one hand, and coverage of antiretroviral therapy (ART) and prevention of mother‐to‐child transmission (PMTCT), on the other, in low‐ to middle‐income countries.MethodsThis investigation was carried out through a global review, online data sourcing and statistical analyses. We collected data on health burden and resources, the socio‐economic environment, HIV prevalence, ART and PMTCT coverage and indicators of political governance. Outcome variables were coverage of ART (from 2004) and PMTCT (from 2007) to 2009 as a percentage of persons needing it. Potential predictors of treatment coverage were fitted with a baseline multilevel model for univariable and multivariable analyses.ResultsCountries with higher levels of political voice and accountability, more political stability and better control of corruption have higher levels of ART coverage but not PMTCT coverage. Control of corruption (in standard deviation units) had a strong association with ART (AOR=1.82, p=0.002) and PMTCT (AOR=1.97, p=0.01) coverage. Indicators of economic development were not significant when control of corruption was included in the multivariable regression model. Many countries in all income groups had high ART but not PMTCT coverage (e.g. Mexico, Brazil and Romania in the upper‐middle‐income group; Papua New Guinea and Philippines in the lower‐middle‐income group; and Cambodia, Laos and Comoros in the low‐income group). Very few low‐income countries (notably, Haiti and Kenya) had high PMTCT coverage.ConclusionsOur research found a significant relationship between quality of political governance and treatment coverage. Measures and policies for improving the quality of political governance should be considered as a part of HIV programme implementation to more effectively improve the welfare of people living with HIV, particularly mothers living with HIV and their babies.

Abstract Background Male circumcision (MC) has been shown to reduce the risk of HIV acquisition among heterosexual men, with WHO recommending MC as an essential component of comprehensive HIV prevention programs in high prevalence settings since 2007. While Papua New Guinea (PNG) has a current prevalence of only 1%, the high rates of sexually transmissible diseases and the extensive, but unregulated, practice of penile cutting in PNG have led the National Department of Health (NDoH) to consider introducing a MC program. Given public interest in circumcision even without active promotion by the NDoH, examining the potential health systems implications for MC without raising unrealistic expectations presents a number of methodological issues. In this study we examined health systems lessons learned from a national no-scalpel vasectomy (NSV) program, and their implications for a future MC program in PNG. Methods Fourteen in-depth interviews were conducted with frontline health workers and key government officials involved in NSV programs in PNG over a 3-week period in February and March 2011. Documentary, organizational and policy analysis of HIV and vasectomy services was conducted and triangulated with the interviews. All interviews were digitally recorded and later transcribed. Application of the WHO six building blocks of a health system was applied and further thematic analysis was conducted on the data with assistance from the analysis software MAXQDA. Results Obstacles in funding pathways, inconsistent support by government departments, difficulties with staff retention and erratic delivery of training programs have resulted in mixed success of the national NSV program. Conclusions In an already vulnerable health system significant investment in training, resources and negotiation of clinical space will be required for an effective MC program. Focused leadership and open communication between provincial and national government, NGOs and community is necessary to assist in service sustainability. Ensuring clear policy and guidance across the entire sexual and reproductive health sector will provide opportunities to strengthen key areas of the health system.