br We welcome the efforts by Robert Cohen
We welcome the efforts by Robert Cohen and colleagues to promote country-specific targets for post-2015 health goals.
Publications from the Consortium of Universities for Global Health () conference included a welcome focus on the building of effective global health education programmes. Historically, health-worker education has occurred mainly in schools of medicine, nursing, and public health. Progress has been achieved in increasing the capabilities of such institutions in developing countries. As health systems become increasingly complex, however, the importance of management capabilities has come into sharp focus. Health professionals are often promoted to leadership roles, yet specific skillsets needed for the running of these systems are not part of their clinical training. Many educational institutions are not equipped to impart the transformative leadership and management capabilities needed to run increasingly complex organisations, particularly in resource-constrained settings facing faculty shortages. Partnerships between health professional education institutions and specialised management and business schools could be very valuable. Since many of the best management and business schools in developing countries are private (mostly non-profit) , collaboration will entail public–private partnerships.
Findings from the US National Institute of Mental Health (NIMH) Project Accept (May issue) further show the importance of the incorporation of routine HIV counselling and testing data to monitor prevalence and investigate epidemic drivers in a community. The reduction in the incidence of HIV in the intervention group was attributed to the behavioural and lifestyle modification of people who were HIV positive in the communities. However, the highest change would have been expected in the group with the highest prevalence (KwaZulu-Natal). Community-based HIV counselling and testing can improve testing rates and help to increase knowledge about Gefitinib drivers that can vary within a few miles. Use of knowledge about the epidemic from behavioural data obtained during community-based HIV counselling and testing can be important to design interventions that will have a large effect on the community. Several countries, such as Nigeria, have in place patient intake forms for collection of behavioural data during HIV counselling and testing, but these data are hardly used to understand the epidemic drivers in the community. Not too long ago, UNAIDS revised downwards the number of people stated to be living with HIV in the world. One of the main reasons for the new estimate was better data available for projections. Routine HIV counselling and testing data could substantially improve the quality of estimates.
In the past two decades, community screening programmes for chronic kidney disease have been progressively increasing in rural and urban areas of low-income and middle-income nations. However, screened individuals are seldom maintained on active follow-up even when they have been identified with risk factors. This problem particularly applies to patients living in rural areas where major barriers are low awareness about renal disease and its management, and, more importantly, poor transport infrastructure and precarious family financial conditions that prevent young adults from taking time off work to attend city hospitals.
The sandy dune area of Thar and the marshy lands of Parkar, covering an area of 19 638 km, lie to the southeast of Sindh province, Pakistan. Thar is one of the most densely populated desert areas in the world. The population of 914 000 subsists on rain-dependent agriculture and animal husbandry. The region faces adverse climatic conditions, with droughts every 4–5 years bringing devastation to socioeconomic conditions. Rainfall is irregular, with an annual average of 50–300 mm. Between March, 2013, and February, 2014, there was a rainwater shortfall of 30%. 128 children and 105 adults succumbed to the disaster. Pneumonia, acute respiratory infection, and diarrhoea were among the major reported illnesses in children. Malnutrition is another serious health burden. 60% of the children admitted at the District Headquarter Hospital are malnourished, 54% moderately and 9% severely.