R4D Yemen

Eliciting policymakers' and stakeholders' opinions to help shape health system research priorities in the Middle East and North Africa region

Fri, 20 Apr 2012 05:15 GMT

Document Type: Journal Article
Creator: El-Jardali, F.; Makhoul, J.; Jamal, D.; Ranson, M. K.; Kronfol, N. M.; Tchaghchagian, V.

Production Year: 2010

Citation: El-Jardali, F.; Makhoul, J.; Jamal, D.; Ranson, M. K.; Kronfol, N. M.; Tchaghchagian, V. Eliciting policymakers' and stakeholders' opinions to help shape health system research priorities in the Middle East and North Africa region. Health Policy and Planning (2010) 25 (1) 15-27. [DOI: 10.1093/heapol/czp059]

Summary: Evidence-informed decisions can strengthen health systems. Literature suggests that engaging policymakers and other stakeholders in research priority-setting exercises increases the likelihood of the utilization of research evidence by policymakers. To our knowledge, there has been no previous priority-setting exercise in health policy and systems research in countries of the Middle East and North Africa (MENA) region. This paper presents the results of a recent research priority-setting exercise that identified regional policy concerns and research priorities related to health financing, human resources and the non-state sector, based on stakeholders in nine low and middle income countries (LMICs) of the MENA region. The countries included in this study were Algeria, Egypt, Jordan, Lebanon, Morocco, Palestine, Syria, Tunisia and Yemen. This multi-phased study used a combination of qualitative and quantitative research techniques. The overall approach was guided by the listening priority-setting approach, adapted slightly to accommodate the context of the nine countries. The study was conducted in four key phases: preparatory work, country-specific work, data analysis and synthesis, and validation and ranking. The study identified the top five policy-relevant health systems research priorities for each of the three thematic areas for the next 3–5 years. Study findings can help inform and direct future plans to generate, disseminate and use research evidence for LMICs in the MENA region. Our study process and results could help reduce the great chasm between the policy and research worlds in the MENA region. It is hoped that funding agencies and countries will support and align financial and human resources towards addressing the research priorities that have been identified.

A potyvirus isolated from Senna occidentalis

Wed, 17 Aug 2011 09:34 GMT

Document Type: Miscellaneous
Creator: Walkey, D.G.A.; Spence, N.J.; Clay, C.M.; Miller, A.

Production Year: 1994

Citation: Plant Pathology (1994) 43 (4) 767-773 [DOI: 10.1111/j.1365-3059.1994.tb01619.x]

Summary: A potyvirus causing severe mosaic symptoms was isolated from Senna occidentalis (syn. Cassia occidentalis) in the Yemen Republic and Ethiopia. It was transmitted mechanically and by Myzus persicae in a non-persistent manner. The flexuous, rod-shaped particles had a mean length of 830 nm, and pinwheels and scrolls were observed by electron microscopy of thin sections of infected Nicotiana clevelandii leaves. Its host range was narrow with only a few legume species, Nicotiana clevelandii and N. benthamiana susceptible to experimental infection. This virus was purified from N. clevelandii and the coat protein had a molecular mass of 34-5 kDa. It reacted positively in ELISA with monoclonal antibody 197 that is specific for potyviruses, but was not decorated by antibodies to any other potyvirus tested when examined by electron microscopy. The virus has been tentatively named cassia severe mosaic potyvirus.

Using content analysis to measure the influence of media development interventions: Elections training for journalists in Yemen

Mon, 24 Jan 2011 06:02 GMT

Document Type: Miscellaneous

Production Year: 2006

Citation: BBC World Service Trust, UK. 8 pp.

Summary: This report examines the use of content analysis to measure the influence of training for journalists on media organisations’ output.

The potential for clinical review meetings to reduce hospital maternal deaths in Yemen.

Thu, 25 Nov 2010 05:09 GMT

Document Type: Miscellaneous
Creator: Diamond, J.; Stones, W.; Diamond, I.

Production Year: 0

Citation: University of Southampton, Southampton, UK., Working Paper No. 22.

Cost sharing for primary health care: Lessons from Yemen.

Tue, 12 May 2009 04:47 GMT

Document Type: Miscellaneous
Creator: Al Serouri, A.; Balabanova, D.; Al Hibshi, S.

Production Year: 2002

Citation: Oxfam Working Papers series, Oxford: Oxfam, 84 pp.

Summary: The dilemma of how to meet the primary health needs of the population, especially poor people, with diminishing government resources, is a major issue for government, policy makers and donors in Yemen. This study seeks to demonstrate the impact of cost sharing on the population of Yemen, and specifically on poor and vulnerable people. The authors show that health care is increasingly unaffordable for most people, particularly in rural areas. They aim to alert decision makers to features of cost-sharing policies that are likely to hamper equitable access to services, and prevent quality improvements and sustainability. The study highlights the essential elements of an equitable health-financing policy in Yemen; affordable and locally available drugs and services; rational drug use; improved staff training; and continuous support and supervision by the implementing agency.

Vulnerability of national economies to the impacts of climate change on fisheries.

Mon, 09 Feb 2009 05:22 GMT

Document Type: Miscellaneous
Creator: Allison, E. H.; Perry, A. L.; Badjeck, M. C.; Adger, W. N.; Brown, K.; Conway, D.; Halls, S.; Pilling, G. M.; Reynolds, J. D.; Andrew, N. L.; Dulvy, N. K.

Production Year: 2009

Citation: Fish and Fisheries (2009) 24 pp. [Published online: Feb 4 2009; doi: 10.1111/j.1467-2979.2008.00310.x]

Summary: Anthropogenic global warming has significantly influenced physical and biological processes at global and regional scales. The observed and anticipated changes in global climate present significant opportunities and challenges for societies and economies. We compare the vulnerability of 132 national economies to potential climate change impacts on their capture fisheries using an indicator-based approach. Countries in Central and Western Africa (e.g. Malawi, Guinea, Senegal, and Uganda), Peru and Colombia in north-western South America, and four tropical Asian countries (Bangladesh, Cambodia, Pakistan, and Yemen) were identified as most vulnerable. This vulnerability was due to the combined effect of predicted warming, the relative importance of fisheries to national economies and diets, and limited societal capacity to adapt to potential impacts and opportunities. Many vulnerable countries were also among the world's least developed countries whose inhabitants are among the world's poorest and twice as reliant on fish, which provides 27% of dietary protein compared to 13% in less vulnerable countries. These countries also produce 20% of the world's fish exports and are in greatest need of adaptation planning to maintain or enhance the contribution that fisheries can make to poverty reduction. Although the precise impacts and direction of climate-driven change for particular fish stocks and fisheries are uncertain, our analysis suggests they are likely to lead to either increased economic hardship or missed opportunities for development in countries that depend upon fisheries but lack the capacity to adapt.

Identifying barriers to TB diagnosis and treatment under a new rapid diagnostic scheme.

Fri, 23 Jan 2009 04:49 GMT

Project Status: Current
Project Background: Tuberculosis is the main cause of adult death due to infection in developing countries and its diagnosis in these settings requires the examination of multiple sputum samples using smear microscopy. Although smear microscopy was described more than 100 years ago, front line facilities still rely on it as a low cost, relatively simple and robust diagnostic test in the absence of alternatives. Despite its widespread use, microscopy has substantial limitations: it is insensitive, identifying only 40% to 75% of adults with pulmonary tuberculosis and the examination of multiple specimens is costly in time and economic expense for both services and patients. The disease disproportionately affects poor populations in remote areas and individuals often have to travel long distances and sell personal assets to access services. Many patients are unaware of the number of days required for diagnosis and, as several visits are necessary, are unable to adhere. As patients can only initiate treatment if they have been formally diagnosed, improving the efficiency of the process is crucial for increasing access to treatment. Improved diagnostic efficiency could be achieved by modifying the way sputum specimens are processed in order to increase the sensitivity of microscopy, examining a reduced number of specimens and accelerating the collection of samples to within a single day.

Project Objectives: The purpose of this study is to identify barriers to Tuberculosis (TB) treatment uptake and strengthen the evidence that accelerated diagnostic schemes lead to increased access to treatment in high incidence countries. The study will, in populations with high TB incidence:
1. Identify barriers preventing adults from completing the diagnostic process for TB when examined through new accelerated schemes.
2. Establish whether accelerated schemes for diagnosis results in an increased uptake of TB treatment.
3. Identify changes required by health services to address these barriers.

Opportunities and Choices Newsletter, Issue No. 2

Mon, 19 Nov 2007 18:00 GMT

Document Type: Magazine/Newsletter
Creator: Hennink, M.

Production Year: 2000

Citation: Hennink, M. Opportunities and Choices Newsletter, Issue No. 2. University of Southampton, Southampton, UK (2000) 8 pp.

Summary: This newsletter discusses involvement in the Opportunities and Choices Programme (collaboration on joint research initiatives, small grants for proposal development, participation in workshops), and announces the development of the programme website and the establishment of a reproductive health discussion list. Current projects are described: Effective Dissemination Strategies for Reproductive Health Research; Perceptions of Risk of HIV Infection in Kenya; Improving Men's Awareness of Reproductive Health Services; Social Demographic Aspects of Young People's Sexual Behaviour in Malawi; Service Utilisation and Birth Spacing in India; Opportunities for All: strategies for Providing Family Planning Services to Vulnerable Sub-Groups; Fertility and Family Planning amongst the Urban Poor in Sana'a,Yemen; and How do Doctors Receive and Assimilate Medical Information? Information on new projects, visits made and planned, visitors, forthcoming events and publications is also included.

Development and transfer of technology for Desert Locust monitoring, forecasting and control

Mon, 19 Nov 2007 18:00 GMT

Project Status: Completed
Project Background: In the aftermath of a number of Desert Locust plagues and upsurges in the 1980's and early 1990's, DFID and other agencies re-evaluated their approaches to locust management in order to move away from a focus on emergency assistance to one in which the emphasis is on preparedness and prevention. In 1994 FAO, which holds the international remit for coordinating Desert Locust forecasting and control, initiated the Emergency Prevention System (EMPRES) (Desert Locust Component) with the main goal of minimising the risk of plagues through well directed surveys and timely interventions. At the same time, DFID redefined its own locust aid strategy which included the development and transfer of appropriate technology through existing institutional structures. for both initiatives the first geographical focus of activities was the important locust breeding areas around the Red and Arabian Seas and the DFID funded work is carried out in collaboration with other donor funded projects within the EMPRES framework

Project Objectives: 1. To develop information acquisition, management and dissemination systems in the Eritrean and Yemeni Ministries of Agriculture.
2. To devise field guidelines for locust surveys and control.
3. Desert locust population development is closely dependent on weather and vegetation conditions and environmental and vegetation status, data collection is an integral part of the locust information.

Intended Outputs: Establishment of monitoring, forecasting and management systems for Desert Locusts in national centres

Dissemination of guidelines for survey, forecasting and control procedures.

Improving community spate irrigation systems

Mon, 19 Nov 2007 18:00 GMT

Project Status: Awaiting Confirmation of Completion
Project Background: Spate irrigation supports the livelihoods of large numbers of economically marginal farmers in parts of Africa, the Middle East, and South Asia. Irrigation practice and organisation are very different from conventional perennial irrigation, having evolved to cope with the inherent uncertainty in the number, timing, and magnitude of uncontrolled spate flows. Substantial investments to improve the livelihoods of spate irrigators were made in the 1970s and 80s in Pakistan and the Republic of Yemen. The approach was based on linking traditional community spate systems, so that they could be supplied from new multi-gated river intakes and conventionally designed canal networks. Many of these initiatives have proved to be more or less unsuccessful, due to high O and M costs, inappropriate institutional and engineerng concepts, and disputes between communities over water rights, etc. Following this experience, more recent developments in Pakistan and Eritrea are based on simpler incremental improvements to farmer operated community systems, building on the strengths of traditional spate irrigation, while providing options that enable farmes to handle uncontrolled spate flows and the very high sediment loads. In Yemen, parts of agency managed spate schemes are now to be returned to community management. These approaches offer the best chance of providing sustainable improvements to the livelihoods of subsistence farmers in regions where spate flows can be diverted. Little guidance is available to organisations (Development Agencies, NGOs, consultants, etc.) involved in resolving the complex interaction of engineering, agronomic, social and institutional issues involved when spate irrigation is to be improved, or extended to new areas. (This was highlighted as a constraint by FARM-Africa, when attempting to obtain guidance to support development of DFID-funded spate irrigation systems in Southern Ethiopia). The project aims to remove this constraint, through research to identify the technical and institutional factors that have resulted in successful improvements to spate irrigation systems, relating these to specific local conditions. There is much to be learned from some farming communities, who have developed sophisticated water control and water sharing arrangements, and the accumulated experience of agencies involved in developing spate irrigation. A high proportion (70% or more) of rural communities in semi-arid areas rely on agriculture for their livelihoods. Irrigation, which in the regions considered is often only feasible by diversion of spate flows from ephemeral rivers, has the potential to be the most effective means of sustaining rural livelihoods - and making a substantial contribution to poverty reduction. (Spate irrigation is almost exclusively used for the production of subsistence, rather than commercial crops). The research outputs will benefit the poorer elements of spate irrigating communities, including sharecroppers and landless workers providing labour.

Project Objectives: To promote sustainable improvement of community spate irrigation systems, so as to improve and secure the livelihoods of poor farmers in semi-arid regions.

Intended Outputs: Factors leading to successful improvement of community spate irrigation identified and related to specific local conditions.

Tested guidelines and other outputs developed and disseminated.