Professional Documents
Culture Documents
You can download back issues (2005 - 2010) of this newsletter at:
http://german-practice-collection.org/en/newsletters/hesp-news-and-notes
Table of Contents:
BOOKS ................................................................................ 4
Hanyane - A Village Struggles for Eye Health ........................................................................ 4
Gaining Health: Analysis of policy development in European countries for tackling
noncommunicable diseases .................................................................................................... 4
Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Reducing the
Treatment Gap, Improving Quality of Care ............................................................................. 4
Crime Prevention and Community Safety: Trends and Perspectives..................................... 5
TRAINING OPPORTUNITIES............................................ 27
Evaluation of Health Facilities, Programmes and Projects ................................................... 27
Universalizing Socioeconomic Security for the Poor ............................................................ 27
CARTOON ......................................................................... 28
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This book deals with primary eye care in the context of community health and develop-
ment and provides a practical guide to the diagnosis and management of common eye
problems. It is written for health workers involved in providing primary and secondary
eye care and will also be of relevance to all those striving to improve the health of peo-
ple in rural communities.
***
There is no greater threat to the health of people in the WHO European Region than
that of noncommunicable diseases, yet this is an area where the greatest health gains
are available at relatively modest cost. This book gives a detailed insight into the policy
development in eight European countries over several decades to address the chal-
lenge of noncommunicable diseases, and draws out the main themes to assist policy-
makers in formulating their own response.
***
Millions of people in sub-Saharan Africa suffer from mental, neurological, and substance
use (MNS) disorders, and most do not have the resources to obtain treatment. The
Uganda National Academy of Sciences and the Institute of Medicine hosted a workshop
to discuss the state of care for MNS disorders in sub-Saharan Africa.
***
The International Center for the Prevention of Crime publishes every two years an inter-
national overview of crime prevention. This year three important themes are covered in
the Report; organized crime, trends in migration and drug and alcohol abuse. In docu-
menting these themes, the Report shifts our thinking towards action in the mitigation of
problems that extend beyond the daily experience of crime and violence and into issues
of quality of life; the way in which individuals and communities are targeted by power
hungry and greedy others.
ONLINE PUBLICATIONS
HIV - AIDS - STI
The report shows that for the first time reductions in HIV prevalence among young peo-
ple have coincided with a change in sexual behaviour patterns among people. The re-
port also says that declines in HIV prevalence can be attributed to falling new HIV infec-
tions among young people - a breakthrough essential for breaking the trajectory of the
AIDS epidemic.
***
Scientists Find Antibodies that Prevent Most HIV Strains from Infecting
Human Cells
Discovery to Advance HIV Vaccine Design, Antibody Therapy for Other Diseases
Scientists have discovered two potent human antibodies that can stop more than 90
percent of known global HIV strains from infecting human cells in the laboratory, and
have demonstrated how one of these disease-fighting proteins accomplishes this feat.
According to the scientists, these antibodies could be used to design improved HIV vac-
cines, or could be further developed to prevent or treat HIV infection. Moreover, the
method used to find these antibodies could be applied to isolate therapeutic antibodies
for other infectious diseases as well.
***
This new report surveys the state of biomedical HIV prevention research, including the
first evidence of vaccine-induced protection in humans and the emergence of ARV-
based prevention - and provides strategic recommendations for moving forward in a
time of constrained resources and faltering commitment to ending AIDS. It offers unique
context and a timely critique for issues that will be center stage at the upcoming XVIII In-
ternational AIDS Conference (IAC) in Vienna, Austria.
***
UNAIDS Annual Report 2009
***
UNAIDS OUTLOOK Report 2010
The new UNAIDS Outlook report outlines a radically simplified HIV treat-
ment platform called “Treatment 2.0” that could decrease the number of
AIDS-related deaths drastically and could also greatly reduce the number
of new HIV infections. This includes the development of better combination treatment
regimens, cheaper and simplified diagnostic tools, and a low-cost community-led ap-
proach to delivery.
***
by Anatoli Kamali
Tropical Medicine & International Health, Vol. 15, Issue 8, pp. 975-980 (August 2010)
6 pp. 68 kB:
http://www3.interscience.wiley.com/cgi-bin/fulltext/123506362/PDFSTART
The most recent HIV prevention research has demonstrated the effect of male circumci-
sion on HIV acquisition, and lack of impact of HSV-2 treatment on HIV transmission and
acquisition. Use of HIV antiretroviral drugs (ARVs) for HIV prevention is a new area that
has attracted interest and a number of trials are examining the effect of oral Pre-
***
by Sheila Shettle
Campaign for Access to Essential Medicines, Médecins Sans Frontières,
July 2010
This document illustrates ten consequences of the funding retreat for people living with
HIV/AIDS in developing countries, drawing upon data from MSF field research released
at the XVIII International AIDS Conference (IAC) 2010 in Vienna, and experience pro-
viding ART over the last ten years.
***
Prognostic models have been developed for patients infected with HIV-1 who start com-
bination antiretroviral therapy (ART) in high-income countries, but not for patients in sub-
Saharan Africa. The authors developed two prognostic models to estimate the probabil-
ity of death in patients starting ART in sub-Saharan Africa.
***
For adults with human immunodeficiency virus (HIV) infection who have CD4+ T-cell
counts that are greater than 200 and less than 350 per cubic millimeter and who live in
areas with limited resources, the optimal time to initiate antiretroviral therapy remains
uncertain. The authors found that early initiation of antiretroviral therapy decreased the
rates of death and incident tuberculosis. Access to antiretroviral therapy should be ex-
panded to include all HIV-infected adults who have CD4+ T-cell counts of less than 350
per cubic millimeter, including those who live in areas with limited resources.
Médecins sans Frontières (MSF) intervened in the HIV/AIDS Kenyan epidemic at a time
when there were no other actors and the MoH was unable to cope with the situation.
MSF with its HIV/AIDS interventions around the world has demonstrated the feasibility
of offering HIV care and treatment services in both rural and urban, poor resource set-
tings.
The publication captures best practices and emerging elements for a more effective re-
sponse by peacekeepers to women’s security concerns. The document catalogues di-
rect and indirect efforts to combat sexual violence during and in the wake of war. While
the focus of this publication is on the practical methods by which military, police and ci-
vilian peacekeepers can prevent sexual violence, it is also part of a broader agenda to
improve the capacities of peacekeepers to protect civilians effectively.
***
Men are changing: Case study evidence on work with men and boys to
promote gender equality and positive masculinities
“Men are Changing” seeks to strengthen and broaden the evidence base on working
with men and boys. It describes and analyzes 12 programmes from around the world
that sought to alter the attitudes and behaviours of men in relation to sexuality, sexual
and reproductive health, violence and relationships. The report discusses challenges in
this field, provides an overview of emerging good practice, and makes recommenda-
tions for improving existing policy work, programmes and services.
The huge majority of the annual 6.3 million perinatal deaths and half a million maternal
deaths take place in developing countries and are avoidable. However, most of the in-
terventions aiming at reducing perinatal and maternal deaths need a health care system
offering appropriate antenatal care and quality delivery care, including basic and com-
prehensive emergency obstetric care facilities. To promote the uptake of quality care,
there are two possible approaches: influencing the demand and/or the supply of care.
***
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The primary objective in this essay is to present the available tools for priority setting
that could be used by policy makers in low-resource settings. The authors also provide
an assessment of the applicability and strengths of different tools in the context of ma-
ternal and child health in sub-Saharan Africa.
***
How much donor assistance is currently available for maternal, newborn, and child
health (MNCH) and how much additional financing will be needed? In this article, the au-
thors examine the best estimates of current donor assistance to MNCH and of future
funding that will be needed to reach MDGs 4 and 5. They lay out several limitations in
these estimates and end with their recommendations for improving the tracking of
MNCH financing flows and estimating the costs of scaling up MNCH interventions.
The “Safe Motherhood Hospital Program” in Thailand aims to improve maternal and
child health and reduce mortality among mother and child. The program has been in
place for 10 years, but there has been no impact evaluation of the program. In this re-
search, the authors evaluate whether the program has an impact on maternal mortality
and the cost of child delivery.
***
This manual is for Community Owned Resource Persons (CORPs). It contains the in-
formation CORPs can use to help rural communities to improve the health of children
under the age of five years. The manual is organized into topics called modules. Each
module contains the key messages, the role of the CORPs and questions for community
discussion. Modules about diseases include the danger signs, home care and preven-
tion activities. The information in each module focuses on disease prevention, health
promotion and health education for rural Africa.
***
Rapid diagnostic tests (RDTs) for malaria may help rationalize antimalarial drug use.
However, the economic effects of these tests may vary. In this setting the RDTs reduced
drug costs but did not offset the cost of the tests, although they also resulted in non-
monetary benefits, including improved management of patients and increased compli-
ance with test results.
***
by Jessica Cohen
Harvard School of Public Health & Brookings Institution, May 2010
This paper reports on a field experiment from Western Kenya in which subsidized ACTs
were made available in drug shops, along with subsidized Rapid Diagnostic Tests
(RDTs) for malaria. The authors estimate that the availability of subsidized RDTs in drug
shops can increase the fraction of ACT users who are malaria-positive by 11%. They
find that subsidizing RDTs can reduce wastage and be particularly cost-effective among
older children and adults if adherence to test results can be improved.
***
Malaria management policies currently recommend that the treatment should only be
administered after laboratory confirmation. Where microscopy is not available, rapid di-
agnostic tests (RDTs) are the usual alternative. The authors conclude that in the dry
season the RDT has a low positive predictive value, but a very high negative predictive
value for malaria-attributable fever. In the rainy season the negative test safely excludes
malaria in adults but not in children.
Tuberculosis
The spread of TB through populations already infected with HIV and the emergence of
drug-resistant strains of the disease are throwing up yet greater medical challenges.
Read this report as it outlines the major topical areas surrounding the treatment and di-
agnosis of tuberculosis.
***
by Theo Smart
HIV & AIDS Treatment in Practice, Issue 162, 14 July 2010
This edition of HATIP reviews what is known about multi-drug resistant tuberculosis in
people with HIV, and the health system issues which can lead to the failure of TB treat-
ment in this group of people.
***
The institutional and community norms that lead to the stigmatization of tuberculosis
(TB) are thought to hinder TB control. The authors performed a systematic review of the
literature on TB stigma to identify the causes and evaluate the impact of stigma on TB
diagnosis and treatment. Several themes emerged: fear of infection is the most common
cause of TB stigma; TB stigma has serious socioeconomic consequences, particularly
for women; TB stigma is perceived to increase TB diagnostic delay and treatment non-
compliance.
***
Patients treated for drug-susceptible tuberculosis remain sputum culture positive for
longer than conventionally believed. Drug resistance prolongs time to culture conver-
sion, although susceptibility testing methods vary in ability to predict this. Delayed smear
conversion is a poor predictor of multidrug-resistant disease.
The National Institute for Communicable Diseases (NICD) in collaboration with the
South African National Department of Health and World Health Organization (WHO), 1
July 2010
The updated 2010 healthcare workers handbook on influenza provides detailed guide-
lines on the diagnosis and management of influenza, both seasonal and pandemic in-
fluenza, for healthcare workers in South Africa.
***
Essential Medicines
With 95% of people with HIV/AIDS living in developing countries, it is urgent that re-
search and development take into account the particular needs of these populations.
Lifelong AIDS treatment requires constant access to newer and more potent drug regi-
mens when patients develop side effects or resistance to their medicines over time.
Demand for newer AIDS drugs is growing fast. However, the price of newer regimens
remains a major barrier to access. ‘Untangling the Web of Price Reductions’ is a pricing
guide and cannot be regarded as a company price list.
***
by Andreas Seiter
World Bank Publications, June 2010
***
Pharmacy networks can be established in hard-to-reach regions with little funding using
public-private partnership, resource-sharing models. Medicine prices and mark-ups
must be interpreted with consideration for regional costs of business. Health systems
researchers must document the positive and negative financial experiences of phar-
macy initiatives to inform future projects and advance access to medicines goals.
Social Protection
This report is based on research, conducted in collaboration with the Emergia Institute,
to consolidate the wealth of insights Allianz has gained in the first years of developing its
microinsurance business. Key facts on the state of microinsurance today, case studies
on existing Allianz microinsurance projects and perspectives from experts on the future
of microinsurance round out the report.
***
In this paper the authors propose a method to estimate externality effects in cash trans-
fer programmes, even in cases when the benefit is not randomly assigned. Externality is
***
by Abby Gray
ILO’s Microinsurance Innovation Facility, 2010
Microinsurance represents a promising new way to protect the poor, but reaching low-
income markets sustainably requires creative new strategies. Ten years ago, it would
have been difficult to imagine that a poor woman would file a claim and receive a medi-
cal diagnosis electronically from her home in rural India. The next ten years will un-
doubtedly bring new and equally unexpected technological developments - develop-
ments with the power to bring the security of microinsurance coverage to the two billion
people who need it most.
***
by Nishant Jain
Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH,
2010
The national health insurance scheme “Rashtriya Swasthya Bima Yojna” (RSBY) in In-
dia specifically targets families working in the informal sector and living below the pov-
erty line (BPL): it was designed to meet the special requirements of this particular target
population. The scheme has managed to reach out to more than 60 million people in
less than 2 years since its existence. It is currently being extended to other informal sec-
tor workers living above the poverty line, and many worker groups would like to use
RSBY as an insurance platform while bearing the costs of premiums themselves.
Human Resources
Increasing access to health workers in remote and rural areas through im-
proved retention
Global Policy Recommendations
***
Most developing countries face shortages of health workers in rural areas. This has pro-
found consequences for health service delivery, and ultimately for health outcomes. To
design policies that rectify these geographic imbalances it is vital to understand what
factors determine health workers’ choice to work in rural areas. The results of this study
suggest that in addition to economic incentives, intrinsic motivation and rural origin play
an important role in health workers’ decisions to work in a rural area, and that faith-
based institutions matter.
***
Bangladesh is one of the health workforce crisis countries in the world. In the face of an
acute shortage of trained professionals, ensuring healthcare for a population of 150 mil-
lion remains a major challenge for the nation. With the current shortage of physicians
and level of production in the country it was asserted that it is very unlikely for Bangla-
desh to have adequate number of physicians in the near future. Thus, making use of ex-
isting healthcare providers, such as Village Doctors, could be considered a realistic op-
tion in dealing with the prevailing crisis.
***
Strong political and financial support and strong leadership are needed for evidence-
informed policy making to become a reality in many countries. This is the overall finding
of this study and a follow-up consultative meeting during the Global Ministerial Forum on
Research for Health (Mali, 2008). The study and the findings in this Record Paper reflect
the perspectives of African scientists and policy makers, senior northern scientists, and
representatives of funding organisations.
***
This article is part of the BMC Health Services Research supplement: “Scaling-up health
services in low- and middle-income settings”:
http://www.biomedcentral.com/bmchealthservres/10?issue=S1
These papers are published at a critical time for health systems: while some countries
are on track to achieve the 2015 MDG targets, others are faltering and action is needed
now to accelerate progress. Important gaps in knowledge remain. In particular, our un-
derstanding of both policy development and service delivery strategies in fragile states
is limited, and there is scope for research on how to most effectively scale up services in
these environments.
***
3 pp. 76 kB:
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The EU report calls for more collaboration and coordination with research-
ers in Africa. Health research is one of the areas considered. Europe’s objective is to
support Africans in the development of their own scientific and technical skills and ca-
pacity, mastering the knowledge and technology needed for their development and the
implementation of their own research agenda. It aims to achieve this by opening up the
European Research Area (ERA) and developing equitable and effective research part-
nerships between the European Union (EU) and African institutions and their research-
ers.
***
HIV care and treatment services are primarily delivered in vertical antiretroviral (ART)
clinics in sub-Saharan Africa but there have been concerns over the impact on existing
primary health care services. This paper presents results from a feasibility study of a
fully integrated model of HIV and non-HIV outpatient services in two urban Lusaka clin-
ics.
The report shows that accessing information and knowledge online is not as simple as
switching on a computer, and that the wealth of information available on the internet to-
Education
The authors assess the impact on student knowledge, attitudes and behavior of a typi-
cal HIV-AIDS teacher training program, funded by the African Development Bank and
implemented with technical assistance from UNESCO in the Cameroon. Applying an
identification strategy they find that exposure to a trained teacher increases the appre-
hension of 12 to 13 year olds concerning HIV-AIDS, by rendering them less likely to be
willing to buy from an HIV-positive shopkeeper, and more likely to wish to remain sexu-
ally abstinent during adolescence.
***
by Sheridan Bartlett
The Aga Khan Foundation (AKF), January 2010
This report on early education reviews research evidence on interventions in the early
grades in low-income countries to assess their value. It finds that there seems to be
more impact derived from how development funding is spent on schoolchildren than
how much is spent.
***
A strategy to halt and reverse the HIV epidemic among people who inject
drugs in Asia and the Pacific 2010-2015
The strategy is a “call for action” designed to provide a practical tool for use by national
governments and developing agencies to guide their strategic planning process for the
next five years. It provides a framework for harmonizing existing strategies and work-
plans for harm reduction and universal access.
Global Health
Working Group on Health Systems Research Synthesis, Alliance for Health Policy and
Systems Research, 20 May 2010
Health system policy-makers and managers routinely face difficult decisions around im-
proving health and promoting equity. They must consider complex questions about ef-
fective strategies for organizing the overall health system and about designing and im-
plementing or changing and improving specific policy and programme options. For in-
stance, does contracting out services to the private sector improve access to health
care? How could the health system best retain trained health care providers in under-
served areas? Do conditional cash transfers improve the uptake of health interventions?
***
Re-thinking global health sector efforts for HIV and tuberculosis epidemic
control: promoting integration of programme activities within a strength-
ened health system
by Dermot Maher
BMC Public Health 2010, 10:394 (5 July 2010)
by Lawrence O. Gostin
The Harvard Law & Policy Review, Vol. 4, Nr. 2, 2010, pp. 271-294
The world’s distribution of the “good” of human health remains fundamentally unfair,
causing enormous physical and mental suffering by those who experience the com-
pounding disadvantages of poverty and ill health. If the health gap is unfair and unac-
ceptable, then how can the international community be galvanized to make a genuine
difference? In this article, the author proposes an international call to action through the
adoption of a Global Plan for Justice (GPJ).
***
The global health system is in a period of rapid transition, with an upsurge of funds and
greater political recognition, a broader range of health challenges, many new actors,
and the rules, norms and expectations that govern them in flux. The authors present a
series of four papers on one dimension of the global health transition: its changing insti-
tutional arrangements.
6 pp. 92 kB:
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bin/fulltext/123239299/PDFSTART
This issue of the IDS Bulletin is dedicated to discussing and reviewing the MDGs and
the global effort that grew from the UN Millennium Declaration. This article provides an
overview of this IDS Bulletin and introduces the key themes.
Development Assistance
The report is a specialized selection of researches ranging from the emergence of new
global donors such as India, China and South Africa as well as the establishment of a
new international financial architecture in South America to the impact of these trends
on the diverse economies of Asia, Africa and the Americas. This report provides devel-
opment actors important lessons, not just for improving South-South cooperation but
also for enhancing the development effectiveness of international development coopera-
tion as a whole.
***
This paper explores the link between donor aid and recipient budgets, and the role that
greater transparency and clearer information about aid can play in improving budget
transparency, the quality of budgetary decisions and accountability systems in develop-
ing countries.
***
This paper aims to assemble available information about the costs and benefits of
greater aid transparency, recognizing that further research is required on many of these
topics. The authors are explicit about the extent of uncertainty. They welcome com-
ments on their approach, and suggestions for better and less uncertain estimates of
both the costs and the benefits of aid transparency.
***
by Ilona Kickbusch
Health Promotion Switzerland, 2010
This paper deals with the food system as a prism of present and future challenges for
health promotion and sustainable development, and sets the attainment of a sustainable
food system – “a system that can supply safe, healthy food with positive social benefits
and low environmental impacts” – as the joint policy goal. It is aimed both at the health
promotion and the sustainable development community.
***
Corruption, Anti-corruption Efforts and Aid: Do Donors Have the Right Ap-
proach?
Corruption is the abuse of public office or entrusted power for private gain. This paper
looks at the linkages between good governance, new aid modalities and poverty reduc-
tion. It provides a review of the literature relating to corruption, anti-corruption efforts and
aid.
Others
by Sabina Alkire
United Nations Development Programme (UNDP), June 2010
The purpose of this background paper is to synthesize the discussions regarding the
concept of human development and - drawing on the extensive policy and academic lit-
eratures - to propose relationships between the concept of human development and
four related concepts: the Millennium Development Goals, Human Rights, Human Secu-
rity, and Happiness. Inequality, the duration of outcomes across time, and environ-
mental sustainability are also prominent due to their fundamental importance.
***
This paper described the authors’ experience in pioneering palliative care provision. In
particular it examines the steps to achieving wider availability of opioids for pain man-
agement for those with far advanced disease. Hospice Africa Uganda has been a model
facility in achieving high quality clinical care embedded in a strategy of advocacy and
education, using a multifaceted approach that has addressed logistical, policy and legis-
lative barriers.
***
Poverty is usually defined by the ‘US$-1-a-day’ line developed by the World Bank. But
does definition this tell the whole story? This report argues that we need a broader ap-
proach, based on human rights, which takes into account actual living standards.
***
The publication provides practical advice to organizations and companies that aim for in-
ternational standards, including those who may wish to achieve some form of interna-
tional accreditation. It provides a structured approach to assessing standards and pro-
cedures and highlights areas where improvements are required. It will help reduce pre-
ventable medical mistakes and improve the quality and, ultimately, the affordability of
health care for consumers.
ELECTRONIC RESOURCES
The Aid Effectiveness Portal
http://www.aideffectiveness.org/index.html
***
http://en.wikipedia.org/wiki/Development_Assistance_Database
In this issue:
Water Safety Plans for small-scale water supply systems in Romania
The Atlas of Water and Health
"Elephants and Butterflies on Moon" - My Internship in a NGO in Ouagadougou,
Burkina Faso
and more…
***
This monthly publication aims to provide a forum for providers of refugee legal aid. With
a focus on the global South, it aims to serve the needs of legal aid providers as well as
raise awareness of refugee concerns among the wider readership.
http://tensteps.org
The web site and video series aims to raise awareness, encourage early
adoption, promote training of health care staff, and build capacity for, and
to stimulate dialogue about, breastfeeding and its impact on the public, in
Web Portal: Free and Open Source Software (FOSS) for Health
http://www.foss-for-health.org/portal/
Free and Open Source Software (FOSS) for Health aims to build a FOSS
for eHealth Online Community - a venue for networking and exchanging ideas and ex-
perience on FOSS use. The web portal hopes to be a dynamic/evolving repository and
venue for interaction, sharing and supporting those who are interested in using free and
open source software in health concerns.
TRAINING OPPORTUNITIES
Evaluation of Health Facilities, Programmes and Projects
Consultancy Skills in International Cooperation in Health
6 - 17 September, 2010
Ruprecht-Karls-Universität Heidelberg, Germany
Course Content: The objective of this course is to enable health professionals and man-
agers to understand and apply the concepts and principles of evaluation when evaluat-
ing facilities, projects and programmes in the health sector and to improve their personal
and technical skills. Topics include: Planning and conducting an evaluation; principles,
methods, techniques and tools; effective writing techniques; the consultant: expecta-
tions and experiences; important skills and activities for consultancy.
Target Audience: Public health practitioners, medical doctors, nurses, policy makers,
programme/project planners, managers, paramedical staff, social scientists, educators.
***
Social provisioning and social security have rapidly risen in importance on national and
global development agenda, with one of the key policy questions being the balance be-
tween targeting those most in need or providing universal support for all. It is in this con-
text that this course has been designed with the objective of imparting knowledge and
skill-enhancing training on issues related to the universalization of socioeconomic secu-
rity for the poor and the socially excluded.
CARTOON
Most word processing programmes have a spell-checker built right in, so what does one
do for the web? If you spend most of your time writing out form fields, contributing to fo-
rums and writing in blogs, shouldn’t there be a way to spell check in your browser?
There is, actually, but mysteriously enough, it is only for Mozilla Firefox. Internet Ex-
plorer 8 has yet to receive a built-in spell checker.
In the meantime, let us learn how to enable the spellchecker in Firefox! It is usually en-
abled by default, but if, for any reason, you find it is not working go to: Tools > Options >
Advanced. Make sure the ‘General’ tab is selected. Then make sure the ‘Check my
Spelling as I Type’ option has a check-mark next to it.
That should do it! Now when you have misspelled something a squiggly red line will ap-
pear underneath it to warn you.
Best regards,
Dieter Neuvians MD