**8. Acknowledgment**

The authors acknowledge the support of the financial organizations and especially the willingness of those who made this study possible: children and adolescents affected by HIV/AIDS and caregivers of the five cities: Cali, Buenaventura, Barranquilla, Santa Marta y Cartagena.

Moreover, we extent our heartfelt thanks to all institution that offer services to families affected with HIV/AIDS, especially those who were agreed to cooperate with aims of this research:

In Cali city: Emsanar, Lila Mujer, Fundamor and Casa Gami.

In Buenaventura city: Fundación Si Buenaventura.

In Barranquilla city: Fundación François Xavier Bagnoud, Fundación Esperanza por la Vida, Susalud EPS, Fundación Grupo Estudio Barranquilla and Unidad Especial de Salud y Ambiente (UESA).

In Santa Marta city: Heres Salud E.U., Fundación Luz de Esperanza and Sistemas Integrales de Salud de Colombia (SISCO).

In Cartagena city: Unidad Médico Quirúrgica, Fundación Amigos Positivos, Sistemas Integrales de Salud de Colombia (SISCO) and Vivir Bien.

#### **9. References**

280 Health Management – Different Approaches and Solutions

According to the above, health professionals do not know for sure at what age a child should know their HIV diagnosis. Some believe that at 10 years a child is old enough to manage this information. Some believe that children should learn about biosecurity practices and adherence to treatment without knowing the diagnosis in a playful way, through stories, comics and other fun techniques. Health professionals recognize that children perceive that something happens with his/her bodies by going through periods

Caregivers and health professionals explain to children that drugs are for flu, pneumonia, heart problems, fever and other low-impact diseases, but do not tell the child that he/she

Colombian families interviewed showed a positive degree of satisfaction with Family Functioning and Social Support. Children have good quality of life, low virus load and have access to Antiretroviral Treatment. Some barriers were identified in health services

On the other hand, we consider important to offer some recommendations to access to Colombian children affected with HIV/AIDS. Not all health services in the Colombia cities have pediatrics patients with HIV. Once identified health services, health teams evaluate the research protocol, this assessment could take 2 or 3 months. Also, it is important to know that caregivers take children to health services once a month and informed consent must be obtained through a detailed explanation of the research and get his/her signature as the

Health services should provide to researches a private place for interviews. Many health

This type of researches must have a budget to be allocated to pay transportation costs of caregivers and HIV-positive children. These families have economic limitations to move to

Another recommendation is to consider extending the running time for such studies because

The authors acknowledge the support of the financial organizations and especially the willingness of those who made this study possible: children and adolescents affected by HIV/AIDS and caregivers of the five cities: Cali, Buenaventura, Barranquilla, Santa Marta y

Moreover, we extent our heartfelt thanks to all institution that offer services to families affected with HIV/AIDS, especially those who were agreed to cooperate with aims of this

In Barranquilla city: Fundación François Xavier Bagnoud, Fundación Esperanza por la Vida, Susalud EPS, Fundación Grupo Estudio Barranquilla and Unidad Especial de Salud y

In Santa Marta city: Heres Salud E.U., Fundación Luz de Esperanza and Sistemas Integrales

In Cartagena city: Unidad Médico Quirúrgica, Fundación Amigos Positivos, Sistemas

services were not including in this study for lack of such space.

In Cali city: Emsanar, Lila Mujer, Fundamor and Casa Gami.

Integrales de Salud de Colombia (SISCO) and Vivir Bien.

In Buenaventura city: Fundación Si Buenaventura.

of the difficulties identified in the location and recruitment of subjects.

of illness and drugs.

child's legal representative.

health services.

Cartagena.

research:

Ambiente (UESA).

de Salud de Colombia (SISCO).

**8. Acknowledgment** 

has HIV/AIDS.

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**16** 

**Strengthening Health** 

**Systems in Yemen: Review of** 

**Evidence and Implications for** 

**Effective Actions for the Poor** 

Ali A. Al-Mudhwahi3 and Majed Yahia Al-Gonaid3 *1Faculty of Medicine and Health Sciences, University of Sana'a,* 

Decisions about how best to use resources are always political decisions, but can be more effective if they are also informed by research. International reports and donor policies emphasise how research can help make health strategies more effective and the need for evidence based policies (WHO, 2004; Green & Bennet, 2007, Moynihan et al., 2008, WB,

The aim is to review international and Yemeni experiences in order to find evidence of proven effective strategies which would make the best use of the resources available for

A "successful strengthening strategy" is defined as changes which are implemented, which improve the quantity or quality of health services, especially for the poor, and which are sustained. This includes financing strategies to help poor people to access health

Concepts of "the health system" recognise that the lowest level "system" is not just a set of health services but also includes the patient or citizen, their family and community, which

**3.1 Why does Yemen need to strengthen its health system and health services?** 

may do more than health services to protect and care for a person's health.

Health research and health sector reviews in Yemen report evidence of:

**1. Introduction** 

improving health.

**2. Health system strengthening (HSS)** 

**3. Evidence basis for future strategy** 

2005).

services.

Abdulwahed Al Serouri1, John Øvretveit2,

*2MMC Karolinska Institute MMC, Stockholm,* 

*3Primary Health Care Sector, MoPHP,* 

*1,3Republic of Yemen* 

*2Sweden* 

