Efforts within the past decade to address the HIV/AIDS pandemic in sub-Saharan Africa have dealt with HIV/AIDS principally as a medical concern—despite the fact that doctors continue to be confronted with the complex relationship of the disease to broader social issues. When medical and governmental institutions fail, artists step in. Contemporary performances in Uganda often focus on gender and health-related issues specific to women and youths, in which song texts warn against risky sexual environments or unprotected sexual behavior. Music, dance, and drama are principal tools of local initiatives that disseminate information, mobilize resources, and raise societal consciousness regarding issues related to HIV/AIDS. Through case studies, song texts, interviews, and testimonies, Singing for Life: HIV/AIDS and Music in Uganda examines the links between the decline in Uganda’s infection rate and grassroots efforts that make use of music, dance, and drama. Only when supported and encouraged by such performances drawing on localized musical traditions have medical initiatives taken root and flourished in local healthcare systems. Gregory Barz shows how music can be both a mode of promoting health and a force for personal therapy, presenting a cultural analysis of hope and healing.

This open access book is a collection of 12 case studies capturing decades of experience improving health care and outcomes in low- and middle-income countries. Each case study is written by healthcare managers and providers who have implemented health improvement projects using quality improvement methodology, with analysis from global health experts on the practical application of improvement methods. The book shows how frontline providers in health and social services can identify gaps in care, propose changes to address those gaps, and test the effectiveness of their changes in order to improve health processes and outcomes. The chapters feature cases that provide real-life examples of the challenges, solutions, and benefits of improving healthcare quality and clearly demonstrate for readers what quality improvement looks like in practice:Addressing Behavior Change in Maternal, Neonatal, and Child Health with Quality Improvement and Collaborative Learning Methods in GuatemalaHaiti’s National HIV Quality Management Program and the Implementation of an Electronic Medical Record to Drive Improvement in Patient CareScaling Up a Quality Improvement Initiative: Lessons from Chamba District, IndiaPromoting Rational Use of Antibiotics in the Kyrgyz RepublicStrengthening Services for Most Vulnerable Children through Quality Improvement Approaches in a Community Setting: The Case of Bagamoyo District, TanzaniaImproving HIV Counselling and Testing in Tuberculosis Service Delivery in Ukraine: Profile of a Pilot Quality Improvement Team and Its Scale‐Up JourneyImproving Health Care in Low- and Middle-Income Countries: A Case Book will find an engaged audience among healthcare providers and administrators implementing and managing improvement projects at Ministries of Health in low- to middle-income countries. The book also aims to be a useful reference for government donor agencies, their implementing partners, and other high-level decision makers, and can be used as a course text in schools of public health, public policy, medicine, and development. ACKNOWLEDGMENT:This work was conducted under the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project, USAID Award No. AID-OAA-A-12-00101, which is made possible by the generous support of the American people through the U.S. Agency for International Development (USAID). DISCLAIMER:The contents of this book are the sole responsibility of the Editor(s) and do not necessarily reflect the views of USAID or the United States Government. div=""^

HIV/AIDS continues to take a tremendous toll on the populations of many countries, especially in sub-Saharan Africa. In some countries with high HIV prevalence rates, life expectancy has declined by more than a decade and in a few cases by more than two decades. Even in countries with HIV prevalence of around 5 percent (close to the average for sub-Saharan Africa), the epidemic can reverse gains in life expectancy and other health outcomes achieved over one or two decades. This volume highlights work conducted under the umbrella of a World Bank work program on “The Fiscal Dimension of HIV/AIDS,” including country studies on Botswana, South Africa, Swaziland, and Uganda. It covers four aspects of the fiscal dimensions of HIV/AIDS: First, it aims for a comprehensive analysis of the fiscal costs of HIV/AIDS, with a wider scope than a costing analysis focusing on only the policy response to HIV/AIDS. Second, it embeds the analysis of HIV/AIDS costs in a discussion of the fiscal context, and interprets these costs as a quasi-liability, not a debt de jure, but a political and fiscal commitment that binds fiscal resources in the future and cannot easily be changed, and very similar to a pension obligation or certain social grants or services. Third, it develops tools to assess the (fiscal dimensions of) trade-offs between HIV/AIDS policies and measures that take into account the persistence of these spending commitments. Fourth, most of the fiscal costs of HIV/AIDS are ultimately caused by new infections, and this study estimates the fiscal resources committed (or saved) by an additional (or prevented) HIV infection. Building on these estimates, the analysis here is able to assess the evolving fiscal burden of HIV/AIDS over time.

This book was originally written as a doctoral dissertation. The research in this book was carried out among banana-farming households in the districts of Masaka and Kabarole in Uganda. A gendered livelihood approach was used. The research focused on the identification of critical factors that need to be taken into consideration in the development of relevant policies for HIV/AIDS-affected agriculture-based households or those that are at risk. The book shows that HIV/AIDS causes significant negative effects on the lives of those affected. Their resources are affected due to HIV/AIDS-related labour loss and asset-eroding effects and disinvestment in production and child education. While in the overwhelming majority of the affected cases the effects of AIDS are negative and lead to increased impoverishment and vulnerability, for some households HIV/AIDS-related effects are manageable. It is concluded that a household’s socio-economic status and demographic characteristics influence the magnitude of HIV/AIDS-related impacts experienced and capacity to cope. The book also highlights some historically specific social practices, policies, and ideologies that continue to maintain or reproduce distinct forms of inequality, with certain social groups being marginalized and others being privileged. Unless these are redressed, they will continue to aggravate people’s vulnerability regardless of the type of shock that they are exposed to or experience.

Significant progress in HIV prevention and control has been achieved worldwide. This book reviews emerging challenges and new opportunities for prevention. Chapters cover such topics as challenges in the media within the context of advancing technologies and societal perceptions, barriers to antiretroviral treatment and suggestions for improvement, opportunities in nanotechnology-based drug delivery systems, the central role of sexual and reproductive health in consolidating a human rights-based program, and much more. Client-focused models for integrating employment as a social determinant in the HIV/AIDS programs are discussed and recommended.

Over the past decade, effective prevention and treatment policies have resulted in global health organizations claiming that the end of the HIV/AIDS crisis is near and that HIV/AIDS is now a chronic but manageable disease. These proclamations have been accompanied by stagnant or decreasing public interest in and financial support for people living with HIV and the organizations that support them, minimizing significant global disparities in the management and control of the HIV pandemic. The contributors to this edited collection explore how diverse communities of people living with HIV (PLHIV) and organizations that support them are navigating physical, social, political, and economic challenges during these so-called “post-crisis” times.

The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.