Mickey Chopra
Datos Biográficos
| ID | 165220 |
|---|---|
| NOMBRE | Mickey Chopra |
| NOMBRES | Mickey |
| APELLIDO | Chopra |
| FIRMA | CHOPRA M |
| AFILIACIONES | United Nations Children's Fund |
| ORCID | 0000-0003-4020-2937 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 56 |
| TOTAL DE CITAS | 46 |
| TOTAL COMO AUTOR | 56 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2001 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 4 |
Equity of maternal and child health services in Afghanistan
INTRODUCTION: Afghanistan's healthcare system faces geopolitical instability and inequities in maternal and child health (MCH) services, particularly associated with a temporary collapse in funding in 2021. We analysed coverage levels and spatiotemporal trends in sociodemographic inequalities in the country using data from the 2010/2011 and 2022/2023 Afghan Multiple Indicator Cluster Surveys. METHODS: The study's primary outcome was an adapted Co…
The cost of inaction on health equity and its social determinants
Rising levels of inflation, debt and macrofiscal tightening are putting expenditures on the social sectors including health under immense scrutiny. Already, there are worrying signs of reductions in social sector investments. However, even before the pandemic, evidence showed the significant returns on investments in health equity and its social determinants. Emerging data and trends show that these potential returns have increased during the COV…
Setting research priorities for global pandemic preparedness
Background: In this priority-setting exercise, we sought to identify leading research priorities needed for strengthening future pandemic preparedness and response across countries. Methods: The International Society of Global Health (ISoGH) used the Child Health and Nutrition Research Initiative (CHNRI) method to identify research priorities for future pandemic preparedness. Eighty experts in global health, translational and clinical research id…
Global health economics
Background: The Equitable Impact Sensitive Tool (EQUIST) was developed to address the limitations of the traditional cost-effectiveness analysis (CEA) in global health, which often overlooked equity considerations. Its primary aim was to create more effective and efficient health systems by explicitly incorporating equity as a key driver in health policy decisions. This was done in response to the recognition that, while CEA helped reduce mortali…
Research priorities to reduce the impact of Covid-19 in low- and middle-income countries
Background: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods:…
Health systems resilience and preparedness
COVID-19 has highlighted the importance of resilient health systems. The concept of resilience has been evolving, with attributes such as feedback loops, learning capacity, adaptable management, flexibility and openness to systemic change take on greater importance from the earlier emphasis upon more fixed attributes such as numbers of laboratories, surveillance systems, etc1–3 However, a recent review notes the missing role of power relations an…
Digital Health in Response to Covid‐19 in Low‐ and Middle‐income Countries
COVID‐19 has pulled back the curtain on health system fragility to expose persistent and deepening inequities worldwide. The limited capacity of low‐ and lower‐middle income countries (LMICs) to respond to the pandemic and its impact on the health of populations – particularly the most vulnerable – presents a marked challenge. In this context, countries face the enormous task of rethinking the way essential services will be delivered. A critical …
Using evidence, expert opinion and epidemiological model to understand pathways to survival and mortality
BACKGROUND: The reasons why episodes of illness can lead to fatal outcomes in affected persons in low resource settings are numerous and complex. A tool that allows policy makers to better understand those complexities could be useful to improve success of programmes that are implemented globally to reduce mortality. METHODS: We developed a "Pathways to Survival" (PATHS) tool: an epidemiological model using decision trees, available evidence and …
The roads to Universal Health Coverage
Opportunities during Covid-19 towards achieving Universal Health Coverage
Countdown to 2030
Global and regional estimates of the morbidity due to type I diabetes among children aged 0-4 years
Punching above their weight
Further research using this framework has considerable potential to advance effective policies to advance health and equity
Building resilient health systems
Health system resilience begins with measurement of critical capacities ahead of crisis say Margaret E Kruk and colleagues
Setting health research priorities using the CHNRI method
BACKGROUND: Several recent reviews of the methods used to set research priorities have identified the CHNRI method (acronym derived from the "Child Health and Nutrition Research Initiative") as an approach that clearly became popular and widely used over the past decade. In this paper we review the first 50 examples of application of the CHNRI method, published between 2007 and 2016, and summarize the most important messages that emerged from tho…
Countdown to 2015
Devolving countdown to countries
Background As the world embarks on the quest to achieve the sustainable development goals (SDGs), building on the momentum and lessons of the millennium development goals (MDGs), several aspects are clear. The SDGs are deliberately visionary and all-encompassing and in relation to health and nutrition, and include most of the social determinants of health. The health goal is also a much broader goal than the focus on maternal and child health and…
The Effect of Community-Based Prevention and Care on Ebola Transmission in Sierra Leone
Objectives. To examine the acceptability, use, effects on early isolation, and contribution to Ebola virus disease (EVD) transmission of Community Care Centers (CCCs), which were rapidly deployed in Sierra Leone during an accelerated phase of the 2014–2015 EVD epidemic. Methods. Focus group discussions, triads, and key informant interviews assessed acceptability of the CCCs. Facility registers, structured questionnaires, and laboratory records do…
Improving health aid for a better planet
BACKGROUND: International development assistance for health (DAH) quadrupled between 1990 and 2012, from US$ 5.6 billion to US$ 28.1 billion. This generates an increasing need for transparent and replicable tools that could be used to set investment priorities, monitor the distribution of funding in real time, and evaluate the impact of those investments. METHODS: In this paper we present a methodology that addresses these three challenges. We ca…
First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa
BACKGROUND: There is a paucity of data on the national population-level effectiveness of preventing mother-to-child transmission (PMTCT) programmes in high-HIV-prevalence, resource-limited settings. We assessed national PMTCT impact in South Africa (SA), 2010. METHODS: A facility-based survey was conducted using a stratified multistage, cluster sampling design. A nationally representative sample of 10 178 infants aged 4-8 weeks was recruited from…
How changes in coverage affect equity in maternal and child health interventions in 35 Countdown to 2015 countries
Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality
BACKGROUND: The aim of this study was to populate the Equitable Impact Sensitive Tool (EQUIST) framework with all necessary data and conduct the first implementation of EQUIST in studying cost-effectiveness of community case management of childhood pneumonia in 5 low- and middle-income countries with relation to equity impact. METHODS: Wealth quintile-specific data were gathered or modelled for all contributory determinants of the EQUIST framewor…
Understanding the determinants of the complex interplay between cost-effectiveness and equitable impact in maternal and child mortality reduction
Understanding the determinants of the complex interplay between cost-effectiveness and equitable impact in maternal and child mortality reduction Background One of the most unexpected outcomes arising from the efforts towards maternal and child mortality reduction is that all too often the objective success has been coupled with increased inequity in the population. The aim of this study is to analyze the determinants of the complex interplay bet…
Setting priorities for development of emerging interventions against childhood pneumonia, meningitis and influenza
A cute lower respiratory infections, which broadly include pneumonia and bronchiolitis, are still the leading cause of childhood mortality. ALRI contributed to 18% of all deaths in children younger than five years of age in 2008 [1], and the main pathogens responsible for high mortality were Streptococcus pneumoniae, Haemophilus influenzae and respiratory syncytial virus [2-4]. In addition, meningitis was estimated to contribute up to 200 000 dea…
Why do families still not receive the child support grant in South Africa? A longitudinal analysis of a cohort of families across South Africa
BACKGROUND: Child cash transfers are increasingly recognised for their potential to reduce poverty and improve health outcomes. South Africa's child support grant (CSG) constitutes the largest cash transfer in the continent. No studies have been conducted to look at factors associated with successful receipt of the CSG. This paper reports findings on factors associated with CSG receipt in three settings in South Africa (Paarl in the Western Cape …
Urban poverty in Cape Town
This paper describes key findings of a household livelihood survey conducted in impoverished African settlements in Cape Town, one of Africa’s wealthiest cities. Poverty in these areas is strongly shaped by the history of the Eastern Cape’s adverse spatial incorporation into the South African economy. Migrants from the rural areas are highly dependent on and integrated into the increasingly monetized economy - but are simultaneously marginalized …
Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa
We describe a number of pitfalls that may occur with the push to rapidly expand access to antiretroviral therapy in sub-Saharan Africa. These include undesirable opportunity costs, the fragmentation of health systems, worsening health care inequities, and poor and unsustained treatment outcomes. On the other hand, AIDS “treatment activism” provides an opportunity to catalyze comprehensive health systems development and reduce health care inequiti…
Factors Related to HIV Disclosure in 2 South African Communities
Disclosure of HIV status is an essential part of behavior modification and access and adherence to treatment in people infected with HIV. We conducted interviews in 2 South African communities of similar ethnic mix but with very different rates of disclosure of HIV status and found that disclosure was the catalyst for access to a variety of important and often essential resources. In the community with high rates of disclosure of HIV infection, d…
Taking Care of Business
In this article we examine the dynamics of social relationships in which alcohol use and risky sexual behaviors cooccur. As part of a larger biological and behavioral HIV surveillance survey, 20 men who lived in an urban, informal settlement on the outskirts of Cape Town, South Africa participated in in-depth interviews. Interview transcripts were analyzed according to a latent content analysis. Findings highlight the latent association between a…
The Effect of Community-Based Prevention and Care on Ebola Transmission in Sierra Leone
Objectives. To examine the acceptability, use, effects on early isolation, and contribution to Ebola virus disease (EVD) transmission of Community Care Centers (CCCs), which were rapidly deployed in Sierra Leone during an accelerated phase of the 2014–2015 EVD epidemic. Methods. Focus group discussions, triads, and key informant interviews assessed acceptability of the CCCs. Facility registers, structured questionnaires, and laboratory records do…
Key Challenges to Achieving Health for All in an Inequitable Society
The health inequalities in South Africa are rapidly worsening. Since 1994, the new democratic government has initiated a number of large-scale policies and programs with explicit pro-equity objectives that have improved access to health care and other social resources. However, these policies and programs have been constrained by macroeconomic policies that dictate fiscal restraint and give priority to technical rather than developmental consider…
First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa
BACKGROUND: There is a paucity of data on the national population-level effectiveness of preventing mother-to-child transmission (PMTCT) programmes in high-HIV-prevalence, resource-limited settings. We assessed national PMTCT impact in South Africa (SA), 2010. METHODS: A facility-based survey was conducted using a stratified multistage, cluster sampling design. A nationally representative sample of 10 178 infants aged 4-8 weeks was recruited from…
Implementing comprehensive and decentralised health systems
Risk factors for undernutrition of young children in a rural area of South Africa
Objective: To identify the factors associated with childhood undernutrition. Design: Cross-sectional survey. Setting: Hlabisa health district in KwaZulu/Natal, South Africa. Subjects: Eight hundred and sixty-eight children aged 3–59 months. Methods: Questionnaire survey and anthropometric survey of 516 random house-holds with children in the health district. Multivariate analysis took into account the hierarchical relationships between the propos…
Scaling up health promotion interventions in the era of HIV/Aids
A sustained scaled up response to global public health challenges such as HIV/AIDS will require a functioning and efficient health system, based on the foundation of strong primary health care. Whilst this is necessary, it is not sufficient. Health promotion strategies need to be put into place to better engage and support families and communities in preventing disease, optimize caring, creating the demand for services and holding service provide…
Inequalities in health in developing countries
Inequalities in health are important for overall well-being even in developing countries. But research into this area has lagged behind developed countries partly because of the lack of routine and longitudinal data. Insights from developed countries have highlighted how risk factors are clustered around poor people and the ways in which pathways of poverty and poor health are formed during their lives. This is being overlaid by the process of gl…
Urban poverty in Cape Town
This paper describes key findings of a household livelihood survey conducted in impoverished African settlements in Cape Town, one of Africa’s wealthiest cities. Poverty in these areas is strongly shaped by the history of the Eastern Cape’s adverse spatial incorporation into the South African economy. Migrants from the rural areas are highly dependent on and integrated into the increasingly monetized economy - but are simultaneously marginalized …
Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa
We describe a number of pitfalls that may occur with the push to rapidly expand access to antiretroviral therapy in sub-Saharan Africa. These include undesirable opportunity costs, the fragmentation of health systems, worsening health care inequities, and poor and unsustained treatment outcomes. On the other hand, AIDS “treatment activism” provides an opportunity to catalyze comprehensive health systems development and reduce health care inequiti…
Responding to the crisis in sub-Saharan Africa
In the chapter dealing with education and health, the report of the influential Commission for Africa prioritises basic health systems, HIV/AIDS, malaria and tuberculosis. In contrast, nutrition is given less than half a page and is reduced to parasite control and micronutrient support. Such neglect of nutrition is hard to understand in the context of increasing hunger and malnutrition across the continent. Sub-Saharan Africa is the only region i…
Achieving the Millennium Development Goals through mainstreaming nutrition
At the most recent meeting of the Standing Committee on Nutrition of the UN system in Geneva in March of this year (2006) there was a dramatic shift in the tenor of the opening plenary session. Three very high-ranking officials of three of the largest implementing UN agencies (WHO UNICEF World Bank) along with WFP and FAO produced -- independently of one another -- a clear consistent message focusing on the importance of nutrition for development…
Key Challenges to Achieving Health for All in an Inequitable Society
The health inequalities in South Africa are rapidly worsening. Since 1994, the new democratic government has initiated a number of large-scale policies and programs with explicit pro-equity objectives that have improved access to health care and other social resources. However, these policies and programs have been constrained by macroeconomic policies that dictate fiscal restraint and give priority to technical rather than developmental consider…
High Levels of Risk Behavior Among People Living with HIV Initiating and Waiting to Start Antiretroviral Therapy in Cape Town South Africa
Factors Related to HIV Disclosure in 2 South African Communities
Disclosure of HIV status is an essential part of behavior modification and access and adherence to treatment in people infected with HIV. We conducted interviews in 2 South African communities of similar ethnic mix but with very different rates of disclosure of HIV status and found that disclosure was the catalyst for access to a variety of important and often essential resources. In the community with high rates of disclosure of HIV infection, d…
Alma-Ata 30 years on
Setting Priorities in Global Child Health Research Investments
This article provides detailed guidelines for the implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are international agencies, large research funding donors, and national governments and policy-makers. The process has the following steps: (i) selecting the managers of the proce…
Improving the prevention and management of chronic disease in low-income and middle-income countries
Changes in Risk Behavior Among HIV-Positive Patients During Their First Year of Antiretroviral Therapy in Cape Town South Africa
The Associations of Voluntary Counseling and Testing Acceptance and the Perceived Likelihood of Being HIV-Infected Among Men with Multiple Sex Partners in a South African Township
Trade and social determinants of health
Socioeconomic disparities in access to HIV/Aids treatment programs in resource-limited settings
This study employs data from rural South Africa to determine whether there were socioeconomic differences in the profile of HIV-infected persons living in the community and HIV-infected patients presenting for hospital-based outpatient HIV/AIDS care and related services. There were 776 HIV-infected persons aged 18-35 years in Limpopo Province, South Africa who were included in the study, including 534 consecutive patients who presented for care a…
Social networks and concurrent sexual relationships – a qualitative study among men in an urban South African community
The aim was to explore and describe characteristics of males' social and sexual networks in a South African peri-urban community. Twenty in-depth interviews were conducted with men participating in a larger quantitative study where the median age of the men was 28.7 years and almost 56% had some high-school education, 17.2% were unemployed and 94.7% were not married. A Thematic Question Guide with open-ended questions was used for the interviews.…
Improving the coverage of the PMTCT programme through a participatory quality improvement intervention in South Africa
It is estimated that these improvements in coverage could avert 580 new infant infections per year in this district. This relatively simple participatory assessment and intervention process has enabled programme managers to use a data driven approach to improve the coverage of this important programme
Let them grow, make and eat – what
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Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia
Objective The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documen…
Countdown to 2015 decade report (2000–10)
The construction of an idealised urban masculinity among men with concurrent sexual partners in a South African township
BACKGROUND: The perspectives of heterosexual males who have large sexual networks comprising concurrent sexual partners and who engage in high-risk sexual behaviours are scarcely documented. Yet these perspectives are crucial to understanding the high HIV prevalence in South Africa where domestic violence, sexual assault and rape are alarmingly high, suggesting problematic gender dynamics. OBJECTIVE: To explore the construction of masculinities a…
The Feasibility of Implementing a Sexual Risk Reduction Intervention in Routine Clinical Practice at an ARV Clinic in Cape Town
Medicine (46 obras) · Environmental health (32 obras) · Political science (25 obras) · Global Maternal and Child Health (24 obras) · Nursing (23 obras) · Economic growth (21 obras) · Psychological intervention (20 obras) · Economics (18 obras) · Population (18 obras) · Public health (18 obras)