Iowa Finance Authority Low-Income Housing Tax Credit Program 2010 Qualified Allocation Plan, July 9, 2009

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 2011 Qualified Allocation Plan, November 29, 2010

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 2012 Qualified Allocation Plan, December 8, 2011

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 2013 Qualified Allocation Plan, October 9, 2012

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 2014 Qualified Allocation Plan, October 2, 2013

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 4% Qualified Allocation Plan, October 6, 2014

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 4% Qualified Allocation Plan, September 7, 2016

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 2015 9% Qualified Allocation Plan, October 6, 2014

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 2016 9% Qualified Allocation Plan, September 25, 2015

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Iowa Finance Authority Low-Income Housing Tax Credit Program 2017 9% Qualified Allocation Plan, September 23, 2016

As the Housing Credit Agency responsible for allocating Tax Credits in the State of Iowa, IFA must adopt a written Qualified Allocation Plan (QAP). The purpose of the QAP is to set forth the criteria that IFA will use in evaluating and monitoring Projects submitted to it by the Developer/Ownership Entity for consideration in making an allocation of Tax Credits. The Governor must approve the QAP after the public has had the opportunity to comment through a public hearing.

Does modifying the household food budget predict changes in the healthfulness of purchasing choices among low- and high-income women?

Food cost has a strong influence on food purchases and given that persons of low income often have more limited budgets, healthier foods may be overlooked in favour of more energy-dense lower-cost options. The aim of this study was to investigate whether modifications to the available household food budget led to changes in the healthfulness of food purchasing choices among women of low and high income. A quasi-experimental design was used which included a sample of 74 women (37 low-income women and 37 high-income women) who were selected on the basis of their household income and sent an itemised shopping list in order to calculate their typical weekly household shopping expenditure. The women were also asked to indicate those foods they would add to their list if they were given an additional 25% of their budget to spend on food and those foods they would remove if they were restricted by 25% of their budget. When asked what foods they would add with a larger household food budget, low-income women chose more foods from the ‘healthier’ categories whereas high-income women chose more foods from the less ‘healthier’ categories. However, making the budgets of low- and high-income women more ‘equivalent’ did not eradicate income differences in overall healthfulness of food purchasing choices. This study highlights the importance of cost when making food purchasing choices among low- and high-income groups. Public health strategies aimed at reducing income inequalities in diet might focus on promoting healthy diets that are low cost.

Mind the gap! : A discussion on the disparity between low and high income countries in the provision of mental health care and the implications for capacity building in Kenya’s nursing workforce.

About fourteen per cent of the global burden of disease has been attributed to mental, neurological and substance use disorders. A number of initiatives have been launched in recent years to respond to this, the World Health Organisation (WHO) introduced the Mental Health Gap Action Programme (mhGAP) to address the widening gap between what is needed to provide adequate mental health services and what is currently available, especially in low and middle income countries where the gap is widest.
This discussion paper will focus on mental health nursing in Kenya, a country in East Africa with a population of 42 million people. Mental illness is common in Kenya with up to twenty five per cent prevalence rates, yet mental health services are sparse at the tertiary and primary care level and mental health remains a low budget and policy priority for the government. The aim of this paper is to raise participants’ awareness of the challenges of delivering mental health nursing care in low-income countries such as Kenya, and to explore possible solutions to the problem.

Low health-related quality of life in school-aged children in Tonga, a lower-middle income country in the South Pacific

Background:
Ensuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children’s perception of their health-related quality of life (HRQoL) and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries.

Objectives:
To investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region.

Design:
A cross-sectional study from Tonga addressing all secondary schoolchildren (11–18 years old) on the outer island of Vava’u and in three districts of the main island of Tongatapu (2,164 participants). A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji). A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants). HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0.

Results:
HRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen’s d 1.0) and a small difference between Tonga and the lower income country Fiji (Cohen’s d 0.3). The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen’s d 0.6).

Conclusion:
The results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries.

Immunodeficiency at the start of combination antiretroviral therapy in low-, middle-, and high-income countries

OBJECTIVE To describe the CD4 cell count at the start of combination antiretroviral therapy (cART) in low-income (LIC), lower middle-income (LMIC), upper middle-income (UMIC), and high-income (HIC) countries. METHODS Patients aged 16 years or older starting cART in a clinic participating in a multicohort collaboration spanning 6 continents (International epidemiological Databases to Evaluate AIDS and ART Cohort Collaboration) were eligible. Multilevel linear regression models were adjusted for age, gender, and calendar year; missing CD4 counts were imputed. RESULTS In total, 379,865 patients from 9 LIC, 4 LMIC, 4 UMIC, and 6 HIC were included. In LIC, the median CD4 cell count at cART initiation increased by 83% from 80 to 145 cells/μL between 2002 and 2009. Corresponding increases in LMIC, UMIC, and HIC were from 87 to 155 cells/μL (76% increase), 88 to 135 cells/μL (53%), and 209 to 274 cells/μL (31%). In 2009, compared with LIC, median counts were 13 cells/μL [95% confidence interval (CI): -56 to +30] lower in LMIC, 22 cells/μL (-62 to +18) lower in UMIC, and 112 cells/μL (+75 to +149) higher in HIC. They were 23 cells/μL (95% CI: +18 to +28 cells/μL) higher in women than men. Median counts were 88 cells/μL (95% CI: +35 to +141 cells/μL) higher in countries with an estimated national cART coverage >80%, compared with countries with <40% coverage. CONCLUSIONS Median CD4 cell counts at the start of cART increased 2000-2009 but remained below 200 cells/μL in LIC and MIC and below 300 cells/μL in HIC. Earlier start of cART will require substantial efforts and resources globally.

Immunodeficiency in children starting antiretroviral therapy in low-, middle-, and high-income countries.

BACKGROUND The CD4 cell count or percent (CD4%) at the start of combination antiretroviral therapy (cART) is an important prognostic factor in children starting therapy and an important indicator of program performance. We describe trends and determinants of CD4 measures at cART initiation in children from low-, middle-, and high-income countries. METHODS We included children aged <16 years from clinics participating in a collaborative study spanning sub-Saharan Africa, Asia, Latin America, and the United States. Missing CD4 values at cART start were estimated through multiple imputation. Severe immunodeficiency was defined according to World Health Organization criteria. Analyses used generalized additive mixed models adjusted for age, country, and calendar year. RESULTS A total of 34,706 children from 9 low-income, 6 lower middle-income, 4 upper middle-income countries, and 1 high-income country (United States) were included; 20,624 children (59%) had severe immunodeficiency. In low-income countries, the estimated prevalence of children starting cART with severe immunodeficiency declined from 76% in 2004 to 63% in 2010. Corresponding figures for lower middle-income countries were from 77% to 66% and for upper middle-income countries from 75% to 58%. In the United States, the percentage decreased from 42% to 19% during the period 1996 to 2006. In low- and middle-income countries, infants and children aged 12-15 years had the highest prevalence of severe immunodeficiency at cART initiation. CONCLUSIONS Despite progress in most low- and middle-income countries, many children continue to start cART with severe immunodeficiency. Early diagnosis and treatment of HIV-infected children to prevent morbidity and mortality associated with immunodeficiency must remain a global public health priority.