The implementation process is one of the steps of policy cycle, corresponding to the execution of activities which the purpose is to achieve previously defined targets. It could also be considered that policy's formulation and implementation means a process, subject to context and intervening actions. The building of theoretical models allows the evaluation of policies and programs to go beyond the dichotomist view of input x results and enables to understand the reasons of successful actions in different contexts and population groups. The evaluation process becomes an instrument to continuous reformulation of public policies and possibly leads to their reversal or substitution. An evaluation study based on program's theory shows the mechanisms which lead to changes. A self-evaluation model is proposed as a way to assist the manager in the identification of problems, the characterization of favorable factors to successful interventions and the measurement of effects. The present proposal was based upon three evaluation studies on actions for tuberculosis control which used of different methods and multiple sources of evidence. Main results observed were: lack of technical and managerial autonomy, shortage of both human and financial resources and also a deficient link among the programs ability to achieve the development of actions control.
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http://dx.doi.org/10.1590/s1413-81232010000700006 | DOI Listing |
Int J Tuberc Lung Dis
January 2025
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
Trop Med Health
January 2025
LaoLuxLab/Vaccine Preventable Diseases Laboratory, Institut Pasteur du Laos, Vientiane, Laos.
Background: Individuals with latent tuberculosis infection (LTBI) have a high risk of active infection, morbidity and mortality. Healthcare workers are a group who have increased risk of infection and onward transmission to their patients and other susceptible individuals; however, LTBI is often undiagnosed, and individuals are asymptomatic. Interferon gamma release assays (IGRA) can detect evidence of TB infection in otherwise asymptomatic individuals and are a good indication of LTBI.
View Article and Find Full Text PDFXi Bao Yu Fen Zi Mian Yi Xue Za Zhi
December 2024
Department of Infection and Immunology, Changsha First Hospital, Changsha 410005, China.
Objective To clarify the mechanism that HIV infection mediates mitochondrial damage of CD4 T lymphocytes (CD4 T cells) through mitogen-activated protein kinase (MAPK) pathway. Methods From October 1st, 2022 to March 31st, 2023, 47 HIV-infected people who received antiretroviral therapy (ART) for 4 years were recruited, including 22 immune non-responders (INR) and 25 responders (IR); and 26 sex and age-matched control participants (HC) who were negative for HCV, HBV, and HIV infections. The immune parameters were analyzed by flow cytometry.
View Article and Find Full Text PDFJ Pediatric Infect Dis Soc
January 2025
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, USA.
Introduction: Identifying tuberculosis infection (TBI) using interferon-gamma release assays (IGRAs) is a primary component of clinical and public health efforts to prevent pediatric tuberculosis. Pediatric data comparing the two IGRAs in the United States are very limited. We compared the performance of the two IGRAs among a large pediatric cohort tested for TBI and assessed whether discordance might be due to quantitative results close to test cut-off values.
View Article and Find Full Text PDFInt J Equity Health
January 2025
Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: The severe health challenge and financial burden of drug-resistant tuberculosis (DR-TB) continues to be an impediment in China and worldwide. This study aimed to explore the impact of Diagnosis-related group (DRG) payment on medical expenditure and treatment efficiency among DR-TB patients.
Methods: This retrospective cohort study included all DR-TB patients from the digitized Hospital Information System (HIS) of Wuhan Pulmonary Hospital and the TB Information Management System (TBIMS) with completed full course of National Tuberculosis Program (NTP) standard treatment in Wuhan from January 2016 to December 2022, excluding patients whose treatment spanned both before and after the DRG timepoint.
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