Newest Publications

The Evidence Base for Programming for Children Affected by HIV/AIDS in Low Prevalence and Concentrated Epidemic Countries. This working paper is the result of collaboration between the United Nations Children’s Fund (UNICEF) and URC’s Quality Assurance and Workforce Development Project (QAP). Worldwide, the commitment to protect and support children affected by HIV/AIDS is growing, and countries with low level or concentrated epidemics are increasingly developing and putting in place special programs to support these children. The goal of the working paper was to summarize and weigh the evidence on a myriad of challenges faced by children affected by HIV/AIDS in low prevalence and concentrated epidemic countries in order to facilitate evidence-based programming. (142 pages)
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Evaluation of Knowledge, Attitudes, and Practices of Health Care Providers toward HIV-positive Patients in Tanzania: This report presents an evaluation of the prevalence and manifestations of stigma and discrimination by Tanzanian health care providers toward people with HIV/AIDS. QAP conducted interviews with providers in three public hospitals in Dar es Salaam to assess stigma and discrimination and their associations with providers’ HIV/AIDS knowledge, their perceived risk of infection, their willingness to care for people with HIV/AIDS, and the availability of protective wear. Most providers expressed at least one negative attitude, such as blame for infection. Discriminatory practices were rare but included selective use of universal precautions, denial of services, substandard treatment, and failure to respect patients’ rights.  HIV knowledge was inversely associated with negative attitudes, and providers who feared HIV infection through casual contact had significantly more negative attitudes.  In addition, stigma was associated with providers’ selective use of universal precautions.  However, these providers willingly provide care to HIV/AIDS patients. The study concludes that HIV-related stigma and discrimination may be attributable to poor HIV related knowledge and fear of infection. It recommends communicative forums and training to allay provider fears and improve understanding of HIV and infection methods. 
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Manual para la humanización y adecuación cultural de la atención del parto (HACAP) [Manual on the Humanization and Cultural Adaptation of Delivery Care]: Developed jointly by QAP, the Ministry of Health of Ecuador, and Family Care International, this manual facilitates a process to adapt delivery care to cultural expectations.  It provides guidance for conducting a series of three workshops that bring together health care providers, traditional birth attendants, community leaders, and mothers to discuss cultural practices and preferences and to identify changes that can be made to facility-based delivery care to make institutional delivery more acceptable to expectant mothers.  Through role-playing and discussion, participants learn how delivery care is provided at a hospital and by traditional midwives in the community.  Those who would change facility-based delivery are allowed to make suggestions, while medical staff have opportunities to consider community preferences and explain to participants any evidence that controverts those preferences. Through the process, hospital staff and midwives come to understand and respect each other’s practices (82 pages including survey instruments; available only in Spanish). Download report. (82 pages including survey instruments; available only in Spanish).  

Testing a PMTCT Infant-feeding Counseling Program in Tanzania:  This report describes the results of an assessment of job aids and take-home materials that nurse-counselors used in helping expectant mothers select an infant-feeding method.  In countries with high rates of HIV/AIDS, such as Tanzania, preventing HIV transmission while at the same time protecting the infant from other potentially fatal conditions, such as diarrhea and malnutrition, is difficult.  The tested job aids and take-home materials, available elsewhere on this website, included longer materials that were retained by counselors and brief brochures that counselors used in discussion with mothers and then gave to mothers to keep.  By comparing the experiences, knowledge, and behaviors of mothers who were and were not counseled with the aids, the study found that those who used them were better informed and more able to sustain their chosen infant-feeding practices.  The report also recommends further consideration of international criteria relating to infant feeding in resource-restrained settings.
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