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Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade Jan 2001

Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade

HIV and AIDS

Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. …


Evidence For The Importance Of Community Involvement: Implications For Initiatives To Prevent Mother-To-Child Transmission Of Hiv, Ann Leonard, Purnima Mane, Naomi Rutenberg Jan 2001

Evidence For The Importance Of Community Involvement: Implications For Initiatives To Prevent Mother-To-Child Transmission Of Hiv, Ann Leonard, Purnima Mane, Naomi Rutenberg

HIV and AIDS

This paper offers lessons learned from a literature review of community involvement in biomedical and other technologies that can guide appropriate and effective introduction of services for prevention of mother-to-child transmission of HIV. A companion paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about barriers to using voluntary counseling and testing services; stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission …


Hiv And Partner Violence: What Are The Implications For Voluntary Counseling And Testing?, Carolyn Knapp Jan 2001

Hiv And Partner Violence: What Are The Implications For Voluntary Counseling And Testing?, Carolyn Knapp

HIV and AIDS

Millions of women around the world face two great threats to their health and well-being: HIV/AIDS and violence by an intimate partner. One of the strongest associations between the two is the role that violence and the threat of violence play in limiting a woman’s ability to negotiate safer sex with a partner. A similar fear of violence also discourages women who receive HIV voluntary counseling and testing (VCT) from telling partners about test results. This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Researchers …


Whose Education Counts? The Impact Of Grown Children's Education On The Physical Functioning Of Their Parents In Taiwan, Zachary Zimmer, Albert I. Hermalin, Hui-Sheng Lin Jan 2001

Whose Education Counts? The Impact Of Grown Children's Education On The Physical Functioning Of Their Parents In Taiwan, Zachary Zimmer, Albert I. Hermalin, Hui-Sheng Lin

Poverty, Gender, and Youth

Research has identified education as an important predictor of physical functioning in old age. Older adults in Taiwan tend to experience close ties to family members and high rates of adult child coresidence, much more so than is typical in Western cultures. These circumstances might imply additional health-related benefits stemming from the education of grown children. This association could arise in a number of ways, for instance through the sharing of health-related information between child and parent, the quality of caregiving efforts, monetary assistance for medical and other services, or through other psychosocial avenues. In this study, a nationally representative …


Determinants Of Educational Attainment Among Adolescents In Egypt: Does School Quality Make A Difference? [Arabic], Cynthia B. Lloyd, Sahar El Tawila, Wesley H. Clark, Barbara Mensch Jan 2001

Determinants Of Educational Attainment Among Adolescents In Egypt: Does School Quality Make A Difference? [Arabic], Cynthia B. Lloyd, Sahar El Tawila, Wesley H. Clark, Barbara Mensch

Poverty, Gender, and Youth

The paper explores empirically the relationship between school quality in Egyptian preparatory (middle) schools and the likelihood of school dropout either during preparatory school or before the completion of secondary school. Despite strong empirical evidence for the many positive social and economic returns associated with more years of schooling, there has been little research exploring how the quality of particular schools might influence grade levels attained. The authors address this research gap using detailed data on Egyptian preparatory schools (grades 6-8, the last three years of the eight years of basic schooling) that are linked with a national survey of …


Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer Jan 2001

Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer

Poverty, Gender, and Youth

Using data from Demographic and Health Surveys, this study examines living arrangements of older adults in 43 developing countries and compares patterns by gender, world regions, and macro-level measures of socioeconomic development. Indicators include household size, headship, relationship to head, and coresidence with spouse, children, and others. Unweighted regional averages and OLS regressions determine whether variations exist. Average household sizes are large, but a substantially higher proportion of elderly adults live alone than do individuals in other age groups. Females are more likely than males to live alone and are less likely to live with a spouse or to head …


Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys [Arabic], John Bongaarts, Zachary Zimmer Jan 2001

Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys [Arabic], John Bongaarts, Zachary Zimmer

Poverty, Gender, and Youth

Using data from Demographic and Health Surveys, this study examines living arrangements of older adults in 43 developing countries and compares patterns by gender, world regions, and macro-level measures of socioeconomic development. Indicators include household size, headship, relationship to head, and coresidence with spouse, children, and others. Unweighted regional averages and OLS regressions determine whether variations exist. Average household sizes are large, but a substantially higher proportion of elderly adults live alone than do individuals in other age groups. Females are more likely than males to live alone and are less likely to live with a spouse or to head …


Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain Jan 2001

Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain

Reproductive Health

Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC …


Ecological Degradation, Rural Poverty, And Migration In Ethiopia: A Contextual Analysis, Markos Ezra Jan 2001

Ecological Degradation, Rural Poverty, And Migration In Ethiopia: A Contextual Analysis, Markos Ezra

Poverty, Gender, and Youth

The interrelationships between ecological degradation, poverty, and rural out-migration in Ethiopia are examined using data from a Household and Community Survey conducted in 1994-95. The survey, which covered a sample of 2,000 households, collected retrospective data on changes in household composition, including migration of household members, during the period 1984 to 1994. The study hypothesizes that the decision to out-migrate in the impoverished rural areas of northern Ethiopia is influenced by a combination of factors based on individual, household and community characteristics. A multilevel analysis is applied to determine the role of these factors in the decision. The findings show …


Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett Jan 2001

Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett

Poverty, Gender, and Youth

There is accumulating evidence that social diffusion processes affect the pace of the adoption of modern contraception in societies undergoing fertility transition. In settings where mortality has declined and many other social and economic changes are underway, decisions about contraception are fraught with uncertainty and risk. In such circumstances, couples may rely on other persons for information and guidance. In this paper, we examine the influence of informal social networks on the contraceptive behavior of reproductive-age women, using longitudinal data collected in six communities in southern Ghana. Our results confirm the hypothesis that adoption of modern contraception is strongly affected …


The End Of The Fertility Transition In The Developed World, John Bongaarts Jan 2001

The End Of The Fertility Transition In The Developed World, John Bongaarts

Poverty, Gender, and Youth

By the late 1990s fertility in the developed world had declined to 1.6 births per woman, a level substantially lower than projected in the 1980s. This study examines recent trends and patterns in fertility in the developed world with particular emphasis on the effects and implications of changes in the timing of childbearing. The main objective is to demonstrate that while fertility in these countries is indeed low, women’s childbearing levels are not as low as period measures such as the total fertility rate suggest. To obtain a full understanding of the various dimensions of fertility change, several indicators are …


West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health Jan 2001

West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health

Reproductive Health

To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …


Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health Jan 2001

Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health

Reproductive Health

El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …


Benin: Diríjase A Los Hombres Para Aumentar El Uso De Los Servicios De Salud, Frontiers In Reproductive Health Jan 2001

Benin: Diríjase A Los Hombres Para Aumentar El Uso De Los Servicios De Salud, Frontiers In Reproductive Health

Reproductive Health

Después del inicio de las reformas del sector salud en 1994, el gobierno de Benin creó el Proyecto de Salud Familiar Integral, conocido localmente como PROSAF. Este proyecto opera en la región de Borgou, bajo el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Dicha región es en su mayoría rural y en ella se observan los problemas de salud más severos del país. Los gerentes de PROSAF deseaban entender por qué la gente no estaba utilizando los servicios a pesar de tener una salud deficiente, por lo que solicitaron al Centro Africano de Investigación en …


Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque Jan 2001

Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque

Poverty, Gender, and Youth

The principal aim of this study is to assess the strength in Pakistan of a set of hypothesized obstacles to practicing contraception. Our concern is those factors that prevent women from translating a desire to avoid becoming pregnant into contraceptive practice, a common predicament in Pakistan in recent decades. We analyze survey data collected in Punjab province in 1996 that contain unusually detailed measurement of various perceived costs of practicing contraception, as well as focused measurement of fertility motivation. The framework guiding the research specifies six major obstacles to contraceptive use: the strength of motivation to avoid pregnancy, awareness and …


Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health Jan 2001

Honduras: Posparto Y Post-Aborto, Momentos Para Hablar De Planificación Familiar, Frontiers In Reproductive Health

Reproductive Health

Aproximadamente la mitad de los partos en Honduras son atendidos en un hospital. Sin embargo, los hospitales generalmente no ofrecen servicios de planificación familiar a las pacientes en el posparto o el postaborto. En 1999, la Secretaría de Salud de Honduras (SSH) y el Population Council iniciaron un proyecto de dos años con el fin de ampliar el acceso a la consejería y a los servicios de planificación familiar después de un parto o de haber recibido tratamiento por un aborto incompleto. La intervención se realizó basándose en un proyecto previo del Population Council que mostró que el 30 por …


Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed Jan 2001

Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed

Reproductive Health

In September 1997, the Population Council and Lusaka’s University Teaching Hospital (UTH) launched a 15-month study to identify and explore the range of issues relating to the introduction of emergency contraception (EC) within a developing country context. The study allowed clinic-based family planning providers to accumulate enough first-hand experience to be able to identify strategies for overcoming difficulties associated with the introduction or delivery of EC services. One issue on most participants’ minds was the need to expand the delivery of EC services toward young women, especially out-of-school women, who are harder to reach. Participants recommended that future research activities …


Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow Jan 2001

Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité discusses the Manuela Ramos Movement and its efforts to improve women’s health and well-being through a range of empowerment strategies in rural Peru. A joint project with USAID, named Reprosalud, demonstrates how combining the resources of an international donor with local women’s organizations allows a more organic and multifaceted family planning program to develop. Such programs can produce impressive improvements on a number of indicators, including contraceptive use.


Household Size And Composition In The Developing World, John Bongaarts Jan 2001

Household Size And Composition In The Developing World, John Bongaarts

Poverty, Gender, and Youth

This study uses data from recent household surveys in 43 developing countries to describe the main dimensions of household size and composition in the developing world. Average household size varies only modestly among regions, ranging from 5.6 in the Near East/North Africa to 4.8 in Latin America. These averages are similar to levels observed in the second half of the nineteenth century in Europe and North America. About four out of five members of the household are part of the nuclear family of the head of the household. Household size is found to be positively associated with the level of …


Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur Jan 2001

Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur

Poverty, Gender, and Youth

For three decades, the Expanded Programme on Immunization (EPI) has been promoted as one of the key child health interventions in developing countries. Vaccines for six childhood diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, and tuberculosis) have been shown to be efficacious in preventing disease-specific morbidity and mortality, yet not all commentators are convinced that the EPI reduces all-cause child mortality. Numerous studies have found that measles vaccination programs substantially reduce all-cause child mortality, but recent findings from Guinea-Bissau suggest that diphtheria, pertussis, and tetanus (DPT) vaccine may increase all-cause child mortality. The present study uses five years of data from …


Household Size And Composition In The Developing World [Arabic], John Bongaarts Jan 2001

Household Size And Composition In The Developing World [Arabic], John Bongaarts

Poverty, Gender, and Youth

This study uses data from recent household surveys in 43 developing countries to describe the main dimensions of household size and composition in the developing world. Average household size varies only modestly among regions, ranging from 5.6 in the Near East/North Africa to 4.8 in Latin America. These averages are similar to levels observed in the second half of the nineteenth century in Europe and North America. About four out of five members of the household are part of the nuclear family of the head of the household. Household size is found to be positively associated with the level of …


The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar Jan 2001

The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar

Poverty, Gender, and Youth

This paper assesses whether audio computer-assisted self-interviewing (audio-CASI), a technique designed in the United States to collect data on sensitive behaviors, is a feasible method of survey data collection in a developing-country setting and whether it produces more valid reporting of sexual activity and related behaviors than traditional survey methods. The analysis is based on interviews with nearly 4,400 unmarried adolescents aged 15-21 in Nyeri, a rural district of Kenya that was selected because previous research had indicated a wide discrepancy in the reporting of premarital sexual behavior between boys and girls. The study was based on a quasi-experimental design …


Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya Jan 2001

Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya

Reproductive Health

Sexually transmitted infections (STIs), including HIV, currently have high salience on the health care agendas of many countries, including India. Strategies for their control are ideally based on a number of well-recognised principles. These include: assessments of the burden of disease; the availability of interventions at policy and programme levels, to influence behaviour change and technical ‘solutions’; and the calculated cost-effectiveness of these interventions. In the case of India, data to inform these principles are often lacking in the case of STI control. In this paper we have reviewed the evidence base for STI control in the Indian context. The …


Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health Jan 2001

Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health

Reproductive Health

Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …


South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health Jan 2001

South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health

Reproductive Health

In 2000, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and 7 affiliated peer education programs. The 12 centers, located in urban, peri-urban, and rural areas, offer very different services. The two centers of the KwaZulu-Natal Department of Health focus on providing reproductive health (RH) information and services to adolescents. The six centers of the Youth and Adolescent Reproductive Health Project provide a broader range of youth-friendly RH services, including counseling and life skills education, as well as modest recreational activities. The four centers run by loveLife have large …


Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health Jan 2001

Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health

Reproductive Health

After initiating health sector reforms in 1994, the Bénin government established the Integrated Family Health Project, known as PROSAF. Funded by the U.S. Agency for International Development, PROSAF operates in the Borgou region, which is mostly rural and has the country’s most severe health problems. PROSAF managers wanted to understand why local people were not using health services, despite their poor health. As noted in this brief, managers requested that the African Population and Health Research Centre (APHRC) study the way households and communities make decisions on health care. In a study conducted in 2000 with support from the Population …


South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health Jan 2001

South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health

Reproductive Health

To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, …


From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan Jan 2001

From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan

Poverty, Gender, and Youth

With access to safe, legal abortion under severe constraint or debate in many parts of the world, less attention has been paid to the issue of quality of abortion care. This issue of Quality/Calidad/Qualité explores two programs that operate in very different settings but with a shared commitment to providing high-quality abortion care in a context of broader reproductive health services: the Clinique d’Orthogénie of Broussais Hospital in France and Parivar Seva Sanstha in India. In both programs, each woman or girl who arrives for abortion receives crucial basic care, including: appropriate medical treatment to ensure complete abortion and safe …