Mental, neurological and substance use (MNS) disorders are a leading, but neglected, cause of morbidity and mortality in sub-Saharan Africa. The treatment gap for MNS is vast with only 10% of people with MNS disorders in low-income countries accessing evidence-based treatments. Reasons for this include low awareness of the burden of MNS disorders and limited evidence to support development, adaptation and implementation of effective and feasible treatments. The overall goal of the African Mental Health Research Initiative (AMARI) is to build an African-led network of MNS researchers in Ethiopia, Malawi, South Africa and Zimbabwe, who are equipped to lead high quality mental health research programs that meet the needs of their countries, and to establish a sustainable career pipeline for these researchers with an emphasis on integrating MNS research into existing programs such as HIV/AIDS. This paper describes the process leading to the development of AMARI's objectives through a theory of change workshop, successes and challenges that have been faced by the consortium in the last 4 years, and the future role that AMARI could play in further building MNS research capacity by brining on board more institutions from low- and middle-income countries with an emphasis on developing an evidence-based training curriculum and a research-driven care service.

Therapist-accompanied site visits may have various useful therapeutic functions and participants experience them positively.

In the spring of 1970, a national sample survey of 2486 adults (aged 20-80) was studied to ascertain U.S. public attitudes toward and experience with erotic materials. Twelve items measured whether or not those interviewed believed that looking at or reading sexual materials had certain effects on themselves or others. Initial description of the results revealed a considerable diversity of opinion. This report provides a multistage typology of those item responses, beginning with characterization of items as positive, neutral, or negative in effect. Striking age gradients were observed at each stage in the typology formation. At first glance, these results are hardly surprising, yet introduction of controls for level of education, gender, and reported previous levels of actual exposure to erotica did not appreciably change the age-graded response pattern. The last stage in the typology contained four levels and showed an attribute solely desirable and/or neutral effects to erotica. Those who expressed neutral and mixed (strongly positive and negative) views were somewhat older. The next age norms about explicit sexual materials took on a perception of no effects or a position of uncertainty. Finally, those who believed that pornography has largely or solely undesirable effects on its consumers were oldest. The replicability of the pattern suggests a specific order in the underlying process of change in values (historical and/or intraindividual).

No abstract

Between 1994 and 1996, the United States Agency for International Development (USAID) closed 23 country missions worldwide, of which eight were in West and Central Africa. To preserve United States support for family planning and reproductive health in four countries in that region, USAID created a subregional program through a consortium of US-based groups that hired mainly African managers and African organizations. This study assesses cost-effectiveness of the program through an interrupted time-series design spanning the 1990s and compares cost-effectiveness in four similar countries in which mission-based programs continued. Key indicators include costs, contraceptive prevalence rates, and imputed "women-years of protection." The study found that, taking into account all external financing for population and family planning, the USAID West Africa regional approach generated women-years of protection at one-third the cost of the mission-based programs. This regional approach delivered family planning assistance in West Africa cost-effectively, and the findings suggest that regional models may work well for many health and population services in small countries.