The Community Antiretroviral (ARV) Therapy Support Group (CASG) program aims to address low retention rates in Mozambique's HIV treatment program and the absorptive capacity of the country's health facilities. CASG provides patients with the opportunity to form groups, whose members provide peer support and collect ARV medications on a rotating basis for one another. Based on the promising results in one province, a multi-site level evaluation followed. We report on qualitative findings from this evaluation from the patient perspective on the role of social relationships (as facilitated through CASG) in conferring time, financial, educational and psychosocial benefits that contribute to improved patient retention. These findings may be helpful in informing what aspects of social relationships are critical to foster as CASG is implemented within a greater number of Mozambican health facilities, and as other countries design and implement related models of care and treatment with a support group component.

INTRODUCTION: Research has shown that partnerships between public health agencies, service providers, and other key stakeholders can expand resources and facilitate focus on community health issues more effectively than can any agency or organization acting alone. There is, however, little empirical evidence drawn from actual public health emergency responses to support this claim. The US response to novel influenza A (H1N1) virus provided the Centers for Disease Control and Prevention (CDC) the opportunity to explore whether, and the extent to which, state, local and territorial health departments strengthened partnerships with key partner agencies and sectors. METHODS: Participants included the CDC Public Health Emergency Response (PHER) grantees comprised of 62 state, territorial and local health departments. PHER grantees completed an assessment instrument in May 2011, including questions asking them to rate their partnership strength (on a four-point ordinal scale) with six types of partners before and after the H1N1 response. Grantees additionally reported if and how PHER funding contributed to enhancing the strength of these partnerships. RESULTS: Sixty-one PHER grantees (61/62, 98%) completed the assessment instrument's partnerships section. PHER grantees reported that their partnerships with retail pharmacies were most strengthened (mean increase = 1.11 (on a four-point ordinal scale), SD = .82). This was followed by schools (K-12) (mean increase = .90, SD = .58); private medical providers (mean increase = .81, SD = .68); immunization authorities (mean increase = .80, SD = .61); main education authorities (mean increase = .75, SD = .68); and businesses (mean increase = .74, SD = .61). Mean PHER grantee increases in the strength of each partner type were statistically significant for all partner types (P < .01). Grantees reported that PHER funding contributed to enhancing the strength of their partnerships with schools most frequently (46/46, 100%), and businesses least frequently (31/37, 83.8%). CONCLUSIONS: This inquiry provides evidence that state, territorial, and local health department partnerships with key sectors, agencies, and programs were strengthened after the H1N1 response. It further demonstrates that the CDC's PHER funding contributed to the health departments' reports of increased partnership strength.

Since 2001, the Centers for Disease Control and Prevention's Public Health Emergency Preparedness cooperative agreement has supported state, territorial, and local public health departments in preparing for and responding to public health emergencies. This conceptual article describes complexities identified and lessons learned in developing community preparedness performance measures for the Centers for Disease Control and Prevention's public health preparedness program. Challenges arose in (a) defining community; (b) measuring meaningful community engagement; and (c) determining a strategy for collecting, aggregating, and analyzing data from diverse state, territorial, and local health departments. This article contributes to prior work describing conceptual challenges in developing standardized measures of performance at the federal level and suggests ways to potentially mitigate general performance measurement challenges as well as measurement complexities specific to community preparedness. It may be informative for those state, territorial, and local health departments currently implementing (or contemplating implementing) community preparedness activities and for individuals more generally engaged in performance measurement.

The Centers for Disease Control and Prevention's Sustainable Management Development Program (SMDP) partners with low- and middle-resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program's impact however, was variable. Hence, there was a need to both engage in a strategic planning process and collect useful data to inform the process. We therefore designed a qualitative evaluation and findings that emerged concerning our program’s contribution to individual career advancement and professional growth; the need for institutional support and a champion to move public health management capacity development efforts forward in low- and middle-resource countries; and interest in diverse professional learning opportunities contributed to program improvement and suggested new strategic directions for CDC's global public health management service delivery. Our inquiry provides a concrete example of how qualitative methods, specifically key informant interviews, can provide useful data for strategic planning within public health settings. It may be useful to readers who are interested in conducting strategic planning within public health and other related areas including health care, mental and behavioral health, and the social sciences.