Medicine and Health Sciences Commons^™

Nursing Home Ownership And Public Policy: An Historical Analysis, K. R. Kaffenberger

Graduate Doctoral Dissertations

In the early days of the United States, care of the disabled elderly outside the home meant the public almshouse. By the 1920s, private, nonprofit homes for the aged were prevalent. More recently, private, for-profit facilities have grown to dominate the field.

For-profit ownership has been controversial. Underlying the controversy is the concern that quality might be lowered in order to enhance profit.

This study asks why most nursing homes are privately owned and why most privately owned nursing homes are operated for profit. It does so with reference to The Nonprofit Economy, in which Burton Weisbrod describes a …

Manuel De Recherche Opérationnelle En Matière De Planification Familiale, Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

Le Manuel de recherche opérationnelle en matière de planification familiale, publié pour la première fois en anglais par le Population Council en 1984, se basait sur des projets de recherche en Asie. Cette seconde édition contient des sections révisées et développées. Le cas échéant, des exemples d'Amérique latine et d'Afrique ont été ajoutés. Le chapitre d'introduction comprend une exposé actualisé sur le processus de la recherche opérationnelle (RO) en matière de santé et planification familiale. De nouveaux chapitres concernent le choix du type d’intervention à tester dans une étude RO ainsi que les principaux éléments constituant un programme d'intervention. Le …

Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab

Reproductive Health

As more work in the area of male involvement in reproductive health (RH) is expected in Egypt, it is important that researchers and donor agencies become aware of existing studies, topics covered, and main research findings so duplication can be avoided. It is also important that policymakers and program managers learn about the results of existing studies so they can use those results in designing more effective policies to increase male involvement in Egypt. To address this need, the Population Council’s ANE OR/TA Project organized a seminar on “Disseminating Results of Research on Male Involvement in Reproductive Health in Egypt” …

Needs And Risks Facing The Indonesian Youth Population, Desti Murdijana

Reproductive Health

Youth are the leaders of tomorrow, but right now they face a formidable collection of problems that will determine the quality of their future lives and the lives of us all. Education, jobs, substance abuse, violence, sexuality, and marriage are examples of adolescent issues that demand special attention from researchers, youth activists and advocates, parents, and policymakers. In attempting to address these complex issues, we must be willing to confront ignorance, controversy, and cultural obstacles. Clear and focused policy and strategies must play a basic role in tackling these issues facing Indonesian adolescents. This paper provides a concise situation analysis …

Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain

Reproductive Health

The project "Involving Private Medical Practitioners (PMPs) in Family Planning Services" is an innovative initiative to involve PMPs in protecting the reproductive health (RH) of couples, attract private investment in the family planning (FP) sector, and eventually reduce the increasing financial pressure on the government. The project was implemented in two phases. In phase I, qualified PMPs from urban areas were given training on FP. In phase II, nonqualified PMPs were given training on FP. PIACT Bangladesh, a local NGO, conducted two pilot projects to involve the PMPs in FP. The first one was to involve qualified PMPs in urban …

Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett

Poverty, Gender, and Youth

Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d’Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda …

The Changing Social Environment For Adolescents In Kassena-Nankana District Of Northern Ghana: Implications For Reproductive Behavior, Barbara Mensch, Daniel Bagah, Wesley H. Clark, Fred N. Binka

Poverty, Gender, and Youth

This study reports on a primarily qualitative investigation of adolescent reproductive behavior in the Kassena-Nankana District, a rural isolated area in northern Ghana, where traditional patterns of marriage, family formation, and social organization persist. The study is based on in-depth interviews and focus groups with adolescents, parents, chiefs and traditional leaders, teachers, youth leaders, and health workers, supplemented by quantitative data from the 1996 wave of a panel survey of reproductive-aged women conducted by the Navrongo Health Research Centre. The social environment faced by adolescent boys and girls in the Kassena-Nankana District and its links to reproductive behavior are described. …

The Uncharted Passage: Girls' Adolescence In The Developing World, Barbara Mensch, Judith Bruce, Margaret E. Greene

Poverty, Gender, and Youth

Adolescence is a formative time of transition to adulthood. What happens between the ages of 10 and 19 shapes how girls and boys live out their lives as women and men—not only in the reproductive arena, but in the social and economic realm as well. Yet, despite its impact on human development, adolescence has been sidelined as a research and policy subject in developing countries. While all adolescents deserve our attention, the needs of adolescent girls in the developing world are particularly pressing. This monograph focuses on these girls, presenting statistics to examine the social and economic context of their …

La Familia En La Mira: Nuevas Perspectivas Sobre Madres, Padres E Hijos, Judith Bruce, Cynthia B. Lloyd, Ann Leonard, Patrice L. Engle, Niev Duffy

Poverty, Gender, and Youth

A pesar de la retórica de los últimos años que lamenta la pérdida de la "familia tradicional," las familias jamás se han podido encajonar en modelo único. "Familia" puede referirse a la gente que se ha vinculado entre sí por matrimonio o parentesco, o a los que pretenden descender de antecesores comunes. Las personas pueden formar y extender familias, ya sea mediante la adoptación o crianza de niños, o definiendo como familiares a gente no emparentada o mediante el establecimiento de sociedades consensuales. Las familias son tan adaptables como diversas, pues se reconfiguran a sí mismas en el transcurso de …

Migration, Sexual Behavior And Hiv Diffusion In Kenya, Martin Brockerhoff, Ann E. Biddlecom

Poverty, Gender, and Youth

The association of migration with the spread of AIDS in sub-Saharan Africa is well documented, yet the social and behavioral mechanisms underlying this relationship remain poorly understood. Using data from the 1993 Kenya Demographic and Health Survey, this paper examines whether migrants are more likely than nonmigrants to have multiple recent sexual partners and not to use condoms with those partners. Results indicate that migation is a critical factor in high-risk sexual behavior and that its importance varies by gender and by the direction of movement. Independent of marital and cohabitation status, social milieu, awareness of AIDS, and other crucial …

Women's Lives And Rapid Fertility Decline: Some Lessons From Bangladesh And Egypt, Sajeda Amin, Cynthia B. Lloyd

Poverty, Gender, and Youth

In some of the more traditional parts of the world, fertility is falling steadily, sometimes rapidly, in environments where women’s lives remain severely constrained. The recent experiences of Bangladesh and Egypt, both predominantly Muslim countries, are illustrative in this regard. Since the late 1970s, rural and urban areas in both countries have experienced steady declines in fertility, with recent declines in rural Bangladesh similar to those in rural Egypt, despite lower levels of development and higher rates of poverty. This paper provides an in-depth exploration of the demographic transition in these two societies as seen through the dual lens of …

On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

Demographers have known since the 1940s that standard measures of period fertility, such as the widely used total fertility rate, are distorted by changes in the timing of childbearing. Period fertility rates are depressed during years in which women delay childbearing and inflated in years when childbearing is accelerated. This problem is usually ignored because there has been no generally accepted method for solving it. This study proposes a method for removing the tempo distortions from the total fertility rate. The key assumption of the method is that period effects, rather than cohorts effects, are the primary force in fertility …

Adolescent Reproductive Health: Booklet For Parents, Rieny H. Hardjono, Rashmi Pachauri Rajan

Reproductive Health

In Indonesia, collaboration between the Center for Health Research, University of Indonesia, National Family Planning Coordinating Board (BKKBN), UNFPA Jakarta, and the Population Council resulted in production and distribution of two prototype modules as basic materials on reproductive health for families with school-age children and adolescents. An updated version for both parents and adolescents was published by BKKBN. The Population Council believed that international versions (in English) would be of value, as the gaps in information are similar worldwide with respect to topics covered by these modules. Youth are constantly thirsty for knowledge pertaining to their health, particularly their reproductive …

Family Planning Operations Research: A Book Of Readings, James R. Foreit, Tomas Frejka

Reproductive Health

For as long as there have been family planning programs, there has been family planning research. At the theoretical level, researchers examine the effect of fertility on health and socioeconomic development and study the determinants of fertility for individuals and populations. At the policy level, studies explore the role of family planning programs in modifying fertility and health. The development of new contraceptives is accompanied by clinical and pre-introductory trials in program settings. Surveys measure changes in contraceptive use and fertility, and the results are used to make decisions affecting programs. Finally, programs themselves carry out operations research (OR) to …

El Método Cope Para Mejorar El Cuidado De La Atención: La Experiencia De La Asociación Para La Planificación Familiar De Kenia, Janet Bradley, Judith Bruce, Soledad Diaz, Carlos Huezo, Kalimi Mworia

Poverty, Gender, and Youth

Esta es la primera de varias ediciones de Quality/Calidad/Qualité que describen métodos concebidos para ayudar tanto a los directores como al personal de los programas de planificación familiar a efectuar una evaluación propia de la calidad de los servicios que prestan. Estas herramientas dan a los patrocinadores de los programas la oportunidad de identificar las deficiencias en su entorno de servicio y proponer soluciones. El informe examina la experiencia de la Asociación Nacional de Planificación Familiar de Kenia, proporciona algunas lecciones aprendidas y demuestra que estos ejercicios de autoevaluación están, de hecho, dando como resultado una mejora de la calidad …

Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline

Poverty, Gender, and Youth

Theories of the fertility transition now routinely reserve a place for diffusion effects. Two fundamental behavioral mechanisms account for such effects: social learning and social influence. Social learning refers to the acquisition of information from others. The information might have to do with a new technology or with the health, social, and economic consequences of decisions. In the case of fertility, individuals might learn from others about the availability of a new contraceptive, or about health side effects of certain contraceptives, or about the apparent gains and losses from having fewer children and investing in their schooling. Social influence refers …

Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew

Reproductive Health

The presence of certain STIs increases the risk of the sexual transmission of HIV. Thus, controlling STIs can reduce the incidence of HIV. Almost all women in the East and Southern African regions attend MCH/FP clinics regularly, and recent surveys have shown that the prevalence levels of many STIs, including HIV, can be high for women seeking FP and antenatal services, even though they are frequently asymptomatic. MCH/FP services are provided by medically trained staff with many of the same skills needed for managing STIs. Consequently, several MCH/FP programs have started looking for ways to integrate STI management strategies, such …

A Discovery-Oriented Process Study Of Enactment In Family Therapy: Development Of The Family Therapy Enactment Rating Scale, Elizabeth Ong-Mythuan Fong

Psychology Theses & Dissertations

With the effectiveness of psychotherapy now well-supported in both the individual and family literatures (Garfield & Bergin, 1994), we are entering an era where questions of how and why therapy works are of interest. More specifically, there has been support and encouragement by some researchers (Rice & Greenberg, 1984; Mahrer, 1988) for the use of discovery-oriented methodologies to explore clinical phenomena that have yet to be empirically validated. The following is a discovery-oriented study of enactment, a structural family therapy intervention. The theoretical goals of enactments, their relevance to clinical practice, as well as how they are actually implemented in …

Grandparents Today: A Demographic Profile, Maximiliane E. Szinovacz

Sociology & Criminal Justice Faculty Publications

This article presents a demographic profile of grandparents, using the National Survey of Families and Households. Specific dimensions of grandparenthood addressed include grandparents' survival, the timing of grandparenthood, grandparents' involvement in other roles, surrogate parenting, and stepgrandparents. The data indicate considerable heterogeneity among grandparents of different genders and races or ethnicities. They also suggest modifications in previous descriptions of modern grandparenthood.

Do Population Policies Matter? Fertility And Politics In Egypt, India, Kenya, And Mexico, Anrudh K. Jain

Reproductive Health

How are effective population policies articulated and implemented? Have international agencies played a strong role in prompting developing-country governments to adopt and implement strong population policies? How has the international debate influenced deliberations on population issues in developing countries? The impetus for the four country studies presented in this book was provided by a desire to better understand some of these issues within specific contexts. Egypt, India, Kenya, and Mexico were selected because of their demographic weight, a long history of population policies and programs, and evidence of fertility decline. The four country studies examine the influence of many forces …

Oral Performances As Ritual: Animating The Invisible In Mormon Women's Miscarriage Stories, Kristin Leifson Ballif

Theses and Dissertations

This thesis is comprised of ten Mormon women's miscarriage stories and it is their stories that are used as the text for my analysis. The purpose of the study is to provide a space for these women to share their experiences and to reveal their cultural values and beliefs. Because the women are all Mormon, there are some distinctive cultural and religious values that are shared within their stories and it is these aspects that are analyzed and discussed within the text.

Women need to be able to share their miscarriage stories so as to alleviate feelings of isolation and …

Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Five categories of possible government influence on a nation’s fertility are explored: (1) through publicly funded programs that explicitly seek to affect family-size outcomes (2) through the legal order and system of public administration (3) through measures that affect economic opportunity, social mobility, and gender relations; (4) through public-sector expenditures and transfer payments keyed to age or family status; and (5) through the state’s supplanting of local beliefs and traditions with the symbols of national identity and through the parallel expansion of cultural frames of reference. Aside from the first of these, intentions to influence fertility are either incidental or …

The Impact Of An Integrated Micro-Credit Programme On Women's Empowerment And Fertility Behavior In Rural Bangladesh, Fiona Steele, Sajeda Amin, Ruchira Tabassum Naved

Poverty, Gender, and Youth

This paper examines the impact of participation in women’s savings and credit groups organized by Save the Children USA on women’s empowerment, contraceptive use, and fertility in a rural area of Bangladesh. The data are drawn from a panel survey conducted in 1993, shortly before the groups were formed, and in 1995 after interventions began. This quasi-experimental design enables us to identify the characteristics of women who chose to join savings groups. The findings show that those who joined tend to more educated and more socially independent than are women who did not. Thus, to control for selection bias, preintervention …

The Effects Of Primary School Quality On The Educational Participation And Attainment Of Kenyan Girls And Boys, Cynthia B. Lloyd, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

In Kenya, adolescent girls fare poorly relative to boys in an educational system characterized by enormous growth, deteriorating quality, and rising costs. Girls are more likely than boys to drop out of school prematurely and are less likely to do well on the primary school leaving exams that come at the end of grade eight. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 36 primary schools in which those adolescents reside, this paper investigates the effect of school quality on the likelihood of dropping out from primary school in three districts of Kenya. In …

The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain

Poverty, Gender, and Youth

Since 1982, the Maternal and Child Health and Family Planning Extension Project has compiled longitudinal panel data on rural women’s contact with household service providers who visit homes to discuss family planning and offer services to women on request. This study tests the hypothesis that home-based services reinforce customs of purdah (female seclusion) by sustaining the dependency and isolation of the women served by the program. Results show that household services improve women’s status. This effect is largely attributable to the impact of outreach on effective fertility regulation. Findings do not support the hypothesis that household service delivery is detrimental …

Incentive Schemes For School Attendance In Rural Bangladesh, Sajeda Amin, Gilda Sedgh

Poverty, Gender, and Youth

This paper examines the impact of two incentive schemes on school attendance in rural Bangladesh: a food-for-education program for poor primary school children and a female secondary school scholarship scheme. The data come from an in-depth village study, before and after the programs went into effect. Both programs provide direct financial incentives to families to send their children to and keep them in school. The data also allow for an assessment of an informal school program sponsored by BRAC, a national non-governmental institution, at the study sites. School enrollment in the target population increased more rapidly than would have been …

Covert Contraceptive Use: Prevalence, Motivations, And Consequences, Ann E. Biddlecom, Bolaji M. Fapohunda

Poverty, Gender, and Youth

This paper examines women’s covert use of contraceptives, that is, use without the knowledge of their husbands. Covert use may highlight conflict between husbands and wives about family planning, or it may reflect behaviors that spouses find difficult to discuss together. This study addresses three questions: 1) How is covert use measured in different settings? 2) How prevalent is it? and 3) What are the factors underlying covert use? We examine these questions by drawing on existing studies and detailed survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and a subsample of …

The Onset Of Fertility Transition In Pakistan, Zeba Sathar, John B. Casterline

Poverty, Gender, and Youth

Recent trends in fertility and contraceptive prevalence indicate that the marital fertility transition in Pakistan, which has been anticipated for three decades, has begun in the 1990s. Before that decade, the total fertility rate had exceeded 6 births per woman for at least three decades, and fewer than 10 percent of married women practiced contraception. The most recent survey data, collected in 1996- 97, show a total fertility rate of 5.3 births per woman and a contraceptive prevalence rate of 24 percent. Underlying this development are macroeconomic trends that have led to widespread economic distress at the household level, and …

Ensuring Community Participation In Mch/Fp Activities: Lessons Learned From A Pilot Project, Abbas Bhuiya, Ubaidur Rob, Maruf Rabban Quaderi

Reproductive Health

Family planning (FP) and maternal and child health (MCH) in Bangladesh have achieved commendable success in the recent past, mostly through a large-scale government service-delivery system supported by donors and nongovernmental organizations. Although encouraged by this success, there was concern about programmatic, financial, and social sustainability of the program, including quality of services. It is now believed that most of these concerns will be taken care of if effective community participation can be ensured. A pilot project was initiated in 1997 in Anowara, a low-FP-performing area in rural Chittagong, with assistance from the Population Council. The main objective of the …

Country Profile Of Women's Health And Development In Indonesia, Population Council

Reproductive Health

The “Country Profile of Women’s Health and Development in Indonesia” contains a thorough review of the following: Geographical, Political, Socio-Demographic, and Economic Profile of Indonesia; Status of Women; and Women’s Health Status. In view of the complexity of the problems facing women, the document concludes that Indonesia needs a plan for the future with a gender perspective that prioritizes increased life expectancy, legal protection, and empowerment for women. To reach this goal, Indonesia started by ratifying the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW) and set it into law in 1984. This convention, together with …