World Health & Population
From the Editor-in-Chief
This issue of World Health & Population presents an interesting and highly varied set of papers that have been published online by WHP. They are selected here as representative of outstanding recent contributions to the journal and include a discussion paper on healthcare implementation strategies for TB control, as well as country-specific papers from South Asia, sub-Saharan Africa and the Caucasus.
The initial paper in this volume, “Engaging Informal Providers in TB Control: What Is the Potential in the Implementation of the WHO Stop TB Strategy?” by Berthollet Bwira Kaboru et al. represents a collaboration between the Karolinska Institute in Stockholm and the World Health Organization (WHO) in Geneva. The authors point out that although informal providers/traditional health practitioners are routinely used in direct service delivery, they are underutilized across the other aspects of the WHO Stop TB Strategy, including enhancing prevention and improving adherence, exploring collaborative TB/HIV activities, strengthening health systems and delivering health services. Recognizing that most healthcare in resource-constrained countries is still delivered by traditional practitioners, the authors recommend that national tuberculosis programs explore more fully leveraging this resource and talent for Stop TB initiatives.
In “Privatization and Management Development in the Healthcare Sector of Georgia,” authors Daniel West, Michael Costello and Bernardo Ramirez describe the ongoing challenges of one of the newly independent states (NIS) of the former Soviet Union converting from the Soviet model of healthcare to a more western model. The article contains very interesting background on Georgia as an NIS (and other Central and Eastern European countries by implication). The authors focus on the provision of healthcare sector management education and training – and partnerships with US-based institutions in particular – as one key component for successful development of a new, decentralized and privatized healthcare system. The training partnerships are promising and are beginning to address the greatly increased demand for healthcare leaders, administrators and managers.
The third paper in this issue is a study of health-seeking behaviours and practices in rural, mountainous areas of Pakistan. In “Treating Common Illnesses among Children under Five Years: A Portrayal of Health-Seeking Behaviours and Practices in the Northern Areas of Pakistan,” Babar Shaikh and Dave Haran report on a cross-sectional survey consisting of 539 interviews in 25 villages. Their conclusions fit well within the classic knowledge–attitudes–practices paradigm: lack of knowledge about the child’s illness and not making it a priority were key factors behind a median 2–3 days delay in seeking care. The authors conclude that health education and health promotion programs must address the knowledge gaps about children’s illnesses and advocate appropriate health-seeking behaviours. Issues around quality of care in public health centres, and affordability in the private health sector, must also be addressed in order to improve health service utilization.
The final paper in this issue, “Religion, Condom Use Acceptability and Use within Marriage among Rural Women in Malawi,” was submitted by Adamson Muula and colleagues at the Gillings School of Global Public Health. This team has a long history of high-quality HIV research in Malawi. The current paper uses data from the Malawi Diffusion and Ideational Change Project (MDICP), a collaborative research project between the University of Malawi and the University of Pennsylvania. The sample size was a relatively large 1,664 ever-married women across 145 villages in three rural districts of the country. Rigorous cluster sampling strategies were applied. Muula et al. explore the impact of religious affiliation on condom acceptability and use within marriage. Counter to their hypothesis of finding differences between the faiths, the research showed that Christian women in rural Malawi were no more or no less likely to accept condom use than Muslim women, and that there was also no difference in attitude toward condom use within marriage among Malawian women. Acceptability of condom use when the partner is suspected or known to be HIV positive was high; however, reported use overall was much lower. Again within the knowledge–attitudes–practices paradigm, the authors report the “a positive attitude alone is not enough to influence behaviours.”
In conclusion, we hope that you find the papers in this issue interesting and worthwhile and that you will also consult others recently released online at www.worldhealthandpopulation.com. WHP remains committed to its mission to provide a forum for researchers and policy makers worldwide to publish and disseminate health- and population-related research, and to encourage applied research and policy analysis from diverse global and resource-constrained settings. WHP is indexed on MEDLINE and is accessible through PubMed.
We look forward to continued enthusiastic submission of manuscripts for consideration, peer review and publication. Finally, the editors and publishers of WHP are always interested in any comments or suggestions you might have on the papers or about the journal and our mission. Please feel free to write or email us.
About the Author(s)John E. Paul, PhD br> Editor-in-Chief, World Health & Population br> firstname.lastname@example.org
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