Suchergebnisse

Virtual prevention of HIV transmission from parents to children is possible. This is cause for hope and renewed energy for prevention in general. The Global Plan is the most concerted and ambitious plan to date to protect children and to promote their care. But the inspiring and much appreciated global targets cannot be achieved, nor will they be realized in spirit in addition to form, without joint action between health services, affected women, their partners, families and communities and the wider society. In turn, this engagement is only possible under enabling political, legal, material and social conditions. Much has already been achieved, and community engagement can everywhere be seen in efforts to increase demand, to supply services and to create and improve enabling environments. Some of these initiatives are highly organized and expansive, with demonstrated success. Others are local but essential adjuncts to health services. The nature of this engagement varies because the challenges are different across countries and parts of countries. To be sustained and effective, community action must simultaneously be inclusive and supportive for those people who are affected, it must be appreciated and assigned a place within the broad systemic response, and it must promote and defend social justice.

Virtual prevention of HIV transmission from parents to children is possible. This is cause for hope and renewed energy for prevention in general. The Global Plan is the most concerted and ambitious plan to date to protect children and to promote their care. But the inspiring and much appreciated global targets cannot be achieved, nor will they be realized in spirit in addition to form, without joint action between health services, affected women, their partners, families and communities and the wider society. In turn, this engagement is only possible under enabling political, legal, material and social conditions. Much has already been achieved, and community engagement can everywhere be seen in efforts to increase demand, to supply services and to create and improve enabling environments. Some of these initiatives are highly organized and expansive, with demonstrated success. Others are local but essential adjuncts to health services. The nature of this engagement varies because the challenges are different across countries and parts of countries. To be sustained and effective, community action must simultaneously be inclusive and supportive for those people who are affected, it must be appreciated and assigned a place within the broad systemic response, and it must promote and defend social justice.

Self‐rating of pubertal development is the recommended method to assess puberty in large community‐based surveys of adolescent development and behavior. The aim of this study was to validate for the first time pubertal self‐assessment using the sexual maturation scale developed by Tanner among Black South African adolescents (n=182) aged between 10 and 18 years who were recruited and assessed at public schools in Soweto—Johannesburg. There was significant concordance between adolescents' and same sex health professional's assessment of pubic hair growth and breast development in females (κ coefficients .71 and .76, respectively; p<.0005), and pubic hair growth and genital development in males (κ coefficients .63 and .60, respectively; p<.0005). We conclude that the Tanner pubertal self‐rating appears to be a reasonably valid instrument to use among black South African youth. The tool can be administered in school or other community‐based settings with moderate confidence provided the procedure is thoroughly explained to the participant through the developed tutorial in the language of choice, and privacy and confidentiality are assured.

Longitudinal studies offer significant advantages in rendering data commensurate with the complexity of human development. However, incomplete enrolment and attrition over time can introduce bias. Furthermore, there is a scarcity of evaluative information on cohorts in developing countries. This paper documents various strategies adopted to minimize loss to follow up and describes a retrospective analysis of a small group of families who were missed during initial enrolment and through several subsequent rounds of data collection of the Birth to Twenty (BT20) birth cohort in Soweto–Johannesburg, South Africa that began in 1990. A purposive case study approach was used, and 10 of the 119 families missed at enrolment were interviewed to investigate why these families were not enrolled into the study. The findings demonstrate that high mobility, both within urban areas and between urban and rural areas, are a major challenge for longitudinal studies in densely populated urban areas. In addition, enrolment was also affected by individuals changing their names, largely motivated to facilitate access to employment under Apartheid, as well as varying motivations for participating in research. Longitudinal studies in the developing country context must be mindful of the political, social and economic climate that influences enrolment and ongoing cohort maintenance.

AbstractThe implementation of panel studies in developing countries can prove valuable in driving evidenced‐based policies. Case analysis from panel studies in developing countries are therefore useful in offering guidance and insight to deal with the immense challenges of implementing and following‐up a panel study in a developing country. The aim of this paper is to describe the follow‐up process within Birth to Twenty (Bt20), a birth cohort study in Johannesburg, South Africa, over the past 16 years; and to outline retention strategies and insight within the context of an urban, developing country setting. The main issues considered are: attrition (periodic and absolute), movement of individuals, name changes, cohort management and lessons learned. Copyright © 2007 John Wiley & Sons, Ltd.