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1999

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Full-Text Articles in Medicine and Health Sciences

Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council Jan 1999

Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council

Reproductive Health

The health status of women, men, and children in sub-Saharan Africa remains the poorest in the world. Moreover, virtually every country in the region is suffering mediocre economic growth or economic decline, thereby reducing the ability of their health care systems to respond adequately, and increasing dependence on external donor assistance. In terms of reproductive health (RH), the region is faced with high levels of unwanted fertility; high levels of maternal, child, and infant morbidity and mortality; and an almost exponential growth in HIV prevalence. Access to and quality of RH services remains poor in most countries, thereby maintaining unmet …


Integrating Sti And Mch/Fp Services, Population Council Jan 1999

Integrating Sti And Mch/Fp Services, Population Council

Reproductive Health

The integration of STI and HIV/AIDS information and services into existing MCH/FP programs has been strongly supported in recent years, following recommendations from the 1994 Cairo ICPD. Moreover, it is now widely accepted that early detection and management of STIs can reduce the incidence of HIV infection. Thus, there are powerful incentives to increase efforts to broaden the capacity of MCH/FP programs to provide STI prevention and management information and services for their clients, both as a comprehensive reproductive health service and as a preventive measure for reducing the transmission of HIV. As described in this brief, the Africa OR/TA …


Housing And Population Health: A Review Of The Literature, Stephen Hwang, Esme Fuller-Thomson, J. David Hurlchanski, Toba Bryant, Youssef Habib, Wendy C. Regoeczi Jan 1999

Housing And Population Health: A Review Of The Literature, Stephen Hwang, Esme Fuller-Thomson, J. David Hurlchanski, Toba Bryant, Youssef Habib, Wendy C. Regoeczi

Sociology & Criminology Faculty Publications

Research into the relationship between housing and health has frequently been narrowly focused, fragmented, and of marginal practical relevance to either housing or health studies. Population health research, in its reference to the importance of the social and physical environment, rarely mentions housing. While it has been recognized for some time that there is a need for the development of a co-ordinated, integrated and cumulative body of housing and health research, there is still very little formal co-ordination between housing policy and population health policy. More attention needs to be paid to measuring the nature and extent to which better …


L'Approche De L'Analyse Situationnelle Pour L'Évaluation Des Services De Planification Familiale Et De Santé De La Reproduction: Manuel De Recherche, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba Jan 1999

L'Approche De L'Analyse Situationnelle Pour L'Évaluation Des Services De Planification Familiale Et De Santé De La Reproduction: Manuel De Recherche, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba

Reproductive Health

Une bonne prestation de services de planification familiale mettant l'accent à la fois sur l'accès et la qualité est la clé des objectifs interdépendants de satisfaction des besoins individuels et la réalisation du succès programmatique. L'analyse de situation (AS) fournit un lien nécessaire entre le responsable de programme et la cliente qu'il essaie de servir. Les données recueillies par l’AS offrent une image représentative du fonctionnement des composantes et permettent de «voir» l'expérience de la cliente. Les analyses situationnelles aident le responsable de programme à atteindre le plus grand but en termes de gestion—celui d’une administration efficace d'un service de …


Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan Jan 1999

Improving Quality Of Care In India's Family Welfare Programme: The Challenge Ahead, Michael A. Koenig, M.E. Khan

Reproductive Health

This book on family planning in India includes detailed empirical data and analysis of the various dimensions of quality of care in different regions of the country. Focus areas include: women’s perceptions of the care they receive; observations of provider-client interactions; barriers to quality of service delivery; existing interregional variations; contraceptive choice and interpersonal relations; technical quality of care; and the effect of the target system on the work style of outreach staff. All elements of the quality-of-care framework elaborated by Judith Bruce are well documented and their relationships to broader program constraints are clearly identified. The overall impression one …


The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council Jan 1999

The Tostan Story: Breakthrough In Senegal Ending Female Genital Cutting [Arabic], Population Council

Reproductive Health

In Senegal, elements of the Tostan education program were fundamental to the ending of the practice of female genital cutting (FGC) which has persisted for centuries, despite outside efforts to abolish such a dangerous and harmful operation. This paper is an attempt by those who lived through these events to share the experience with others. At a time when there has been little reduction in the numbers of women ending FGC in 28 African countries, when different programs and strategies have rarely succeeded in making an impact on the number of women still practicing FGC despite laws abolishing the tradition, …


Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda Jan 1999

Mexico: Training Health Providers On Domestic Violence, Susan Pick, Lydia Miranda

Reproductive Health

This project was designed to disseminate, expand use, and promote institutionalization of a program to train healthcare professionals to address domestic violence. The program was developed and implemented by the Instituto Mexicano de Investigación de Familia y Población (IMIFAP), a nongovernmental organization that promotes reproductive health. IMIFAP designed an 18-hour workshop, entitled “Health Services Respond to Domestic Violence,” to sensitize health professionals to domestic violence issues and develop strategies for recognizing and managing cases of domestic violence. Following the workshop, strong and significant increases in knowledge about domestic violence and its management in primary healthcare services were found. Workshop participants …


Cognitively Impaired Elderly Individuals And Durable Powers Of Attorney For Healthcare, Nicole Rae Newman Jan 1999

Cognitively Impaired Elderly Individuals And Durable Powers Of Attorney For Healthcare, Nicole Rae Newman

Theses Digitization Project

No abstract provided.


Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao Jan 1999

Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao

Poverty, Gender, and Youth

Despite ongoing declines in fertility in many countries, the population of the world is experiencing a period of rapid expansion, and its size is expected to exceed 10 billion by the end of the demographic transition. Three causes of this growth are identified and quantified: 1) fertility above the replacement level of two surviving children per woman, 2) continuing declines in mortality, and 3) population momentum resulting from a young age structure. A set of simple analytic expressions is proposed for estimating these factors from standard demographic indicators. Population momentum is shown to be the main cause of future growth …


Measuring Living Standards With Proxy Variables, Mark R. Montgomery, Michele Gragnolati, Kathleen A. Burke, Edmundo Paredes Jan 1999

Measuring Living Standards With Proxy Variables, Mark R. Montgomery, Michele Gragnolati, Kathleen A. Burke, Edmundo Paredes

Poverty, Gender, and Youth

Very few demographic surveys in developing countries gather information on household income or consumption expenditure, despite the theoretical importance of these measures. Consequently, researchers have been forced to rely on ad hoc collections of proxy measures for living standards, and the properties of these proxies have not been systematically analyzed. In this research, we ask what hypotheses can be tested using proxy variables, and evaluate the performance of proxy measures in relation to consumption expenditures per adult, our preferred measure of living standards. We find that the proxy variables commonly employed in demographic research are very weak predictors of consumption …


Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline Jan 1999

Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline

Poverty, Gender, and Youth

Fertility has declined substantially in developing countries in the period since 1960, primarily as the result of increases in contraceptive prevalence. Little dispute is found on this point, but considerable debate has arisen about the causes of the increase in contraceptive prevalence. One unresolved issue is the causal contribution of changes in fertility desires. The sources of increase in contraceptive prevalence are analyzed in 22 countries in Latin America, Asia, and Africa in the period from the 1970s to the 1990s, using World Fertility Surveys and Demographic and Health Surveys data. Through regression decomposition, change in prevalence is attributed to …


The Decline Of Female Circumcision In Egypt: Evidence And Interpretation [Arabic], Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark Jan 1999

The Decline Of Female Circumcision In Egypt: Evidence And Interpretation [Arabic], Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than …


The Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts Jan 1999

The Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts

Poverty, Gender, and Youth

This study examines the role of tempo effects in the fertility declines of developing countries. These effects temporarily inflate the total fertility rate (relative to the actual fertility of cohorts of women) during periods when the age at childbearing declines and they deflate it when childbearing is postponed. An analysis of data from the World Fertility Surveys and the Demographic and Health Surveys demonstrates that fertility trends observed in many developing countries are likely to be distorted by changes in the timing of childbearing. In most countries women are delaying childbearing, which implies that observed fertility is lower than it …


Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar Jan 1999

Premarital Sex And School Dropout In Kenya: Can Schools Make A Difference?, Barbara Mensch, Wesley H. Clark, Cynthia B. Lloyd, Annabel Erulkar

Poverty, Gender, and Youth

Although an overall decline has occurred in adolescent fertility in Kenya, the proportion of births to teenagers that takes place prior to marriage is rising. At the same time that premarital sex and childbearing have increased, educational participation has expanded considerably, especially for girls. Using data from nearly 600 adolescents aged 12-19 in combination with data collected from 33 primary schools that the adolescents attended, this paper explores whether certain aspects of the school environment affect the likelihood of early and unprotected sex among adolescent girls and boys in three districts of Kenya. Because of the concern with “schoolgirl pregnancy” …


Urban Growth In Developing Countries: A Review Of Projections And Predictions, Martin Brockerhoff Jan 1999

Urban Growth In Developing Countries: A Review Of Projections And Predictions, Martin Brockerhoff

Poverty, Gender, and Youth

Comparison of the United Nations’ earliest and most recent projections to the year 2000 suggests that urban and city growth in developing regions has occurred much more slowly than was anticipated as recently as 1980. A modified “urban population explosion” in developing countries since the 1970s conforms to explanatory models of urban growth developed by economists around 1980. Trends in productivity and terms of trade, in particular, have been highly favorable to agriculture as compared to manufacturing, presumably slowing migration to urban centers. Increases in national population growth rates have produced less than commensurate in rates of city growth, further …


The Decline Of Female Circumcision In Egypt: Evidence And Interpretation, Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark Jan 1999

The Decline Of Female Circumcision In Egypt: Evidence And Interpretation, Omaima El-Gibaly, Barbara L. Ibrahim, Barbara Mensch, Wesley H. Clark

Poverty, Gender, and Youth

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl’s marriageability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than …


Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah Jan 1999

Indonesia: Analysis Of Conflicting Crisis-Related Research Results, Michelle Gardner, Lila Amaliah

Reproductive Health

This report aims to explain the discrepancies in crisis-related research results in Indonesia, and to recommend methodologies to enhance future crisis-related monitoring and surveillance. The discussion aims to identify where the discrepancies are in the readily available data, and how these discrepancies can be explained. The report does not attempt to clarify the impact that the economic crisis is having on the health status of women and children in Indonesia. Recommendations are made to deal with the following findings: Aggregation of data may hide important crisis impacts; attribution of identified changes to the economic crisis may be misleading; differences in …


Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon Jan 1999

Mexico: Informing Service Providers And Factory Workers About Emergency Contraception, Ricardo Vernon

Reproductive Health

The goal of this project was to inform physicians, pharmacists, and female factory workers about emergency contraception (EC) through mailings of booklets and posters. These materials were developed in a previous operations research project conducted by the Instituto Mexicano de Investigación de Familia y Población and supported by the Population Council INOPAL III project with funding from USAID. The study found that recipients generally liked the print materials and welcomed information about EC. Within three weeks of receiving the materials, many reported that they had taken immediate action to make EC available and/or to educate others about EC. This project …


Lessons From Community-Based Distribution Of Family Planning In Africa, James F. Phillips, Wendy L. Greene, Elizabeth F. Jackson Jan 1999

Lessons From Community-Based Distribution Of Family Planning In Africa, James F. Phillips, Wendy L. Greene, Elizabeth F. Jackson

Poverty, Gender, and Youth

This paper reviews findings and experiences from efforts to implement community-based family planning services in sub-Saharan Africa. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt or is considerably less than was observed in similar projects in Asia in the 1970s and 1980s. Reasons for the constrained impact of community-based family planning in Africa are reviewed and assumptions about the efficacy and mechanism of community-based distribution (CBD) are discussed. Whereas several contrasting approaches to CBD have been tried, little is known about the relative merits of alternative CBD approaches.


Population Weights In The International Order, Geoffrey Mcnicoll Jan 1999

Population Weights In The International Order, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Population relativities play little part in the international system. A nation’s economic and military power is influenced by population size, but as one factor among many. Formal relations among states exclude population from consideration by the principle of sovereign equality. Three sources of possible change in this situation are explored, in which states would be “population-weighted” to a greater degree than before. Convergence of productivity levels around the world, expected by many, would bring the economic and population rankings of states more into line. Such convergence is occurring, but selectively and for the most part quite slowly. Anticipation of its …


The Costs Of Integrating Reproductive Health Services: An Example Using Syndromic Management Of Stis In Family Planning Clinics In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Barbara Janowitz, Laura Johnson, Andrew Thompson, Caroline West Jan 1999

The Costs Of Integrating Reproductive Health Services: An Example Using Syndromic Management Of Stis In Family Planning Clinics In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Barbara Janowitz, Laura Johnson, Andrew Thompson, Caroline West

Reproductive Health

Estimates from the United Nations Population Fund indicate that the costs of family planning (FP) and other reproductive health (RH) services are increasing and that it will be difficult for donors and countries to meet these costs. Many institutions delivering RH services operate significantly below their physical capacity to see clients, and much of the equipment required for expanding RH services may already be available for use. The marginal costs of adding infrastructure could be low. Many institutions have staff that are not fully occupied, and thus the staff necessary to expand RH services may also be in place. In …


Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu Jan 1999

Quality Of Care And Utilisation Of Mch And Fp Services At Kenyan Health Facilities, Lewis Ndhlovu

Reproductive Health

Quality of services is playing an increasingly important role in many family planning (FP) programs. In 1995, a national Situation Analysis Study of 254 health facilities was conducted in Kenya to assess the status and quality of FP services in the country. An in-depth survey of a subsample of 28 health facilities was conducted the following year. From these facilities, 1,834 women were interviewed about their experiences with services at facilities when they sought antenatal, child health, and FP services. The goal of the survey was to examine the links between quality of care in FP services and contraceptive behavior. …


Demand For And Cost-Effectiveness Of Integrating Rti/Hiv Services With Clinic-Based Family Planning Services In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Sithokozille Simba, Hazel M.B. Dube, Rick Homan, Barbara Janowitz, Ahmed Latif, Peter R. Mason Jan 1999

Demand For And Cost-Effectiveness Of Integrating Rti/Hiv Services With Clinic-Based Family Planning Services In Zimbabwe, Baker Ndugga Maggwa, Ian Askew, Caroline S. Marangwanda, Sithokozille Simba, Hazel M.B. Dube, Rick Homan, Barbara Janowitz, Ahmed Latif, Peter R. Mason

Reproductive Health

The current spread of HIV/AIDS poses a major threat to individual lives and national economies in many sub-Saharan African countries. The region also has some of the highest levels of other reproductive tract infections (RTIs) in the world. Some of these RTIs increase the risk of sexual transmission of HIV infection. Thus, the control of RTIs is seen not only as an important reproductive health care strategy to alleviate symptoms of infection and long-term gynecological, obstetric, and neonatal complications, but also as a key strategy in reducing the spread of HIV/AIDS. As a result, all national health care programs in …


Review Of The Policy Process In Bangladesh Following Icpd, Nancy J. Piet-Pelon, Ubaidur Rob, Syeda Nahid Mukith Chowdhury, Abul Barkat, Sushil Ranjan Howlader, Sharif M.I. Hossain, Ismat Bhuiya, Siraj-Us- Saleheen Jan 1999

Review Of The Policy Process In Bangladesh Following Icpd, Nancy J. Piet-Pelon, Ubaidur Rob, Syeda Nahid Mukith Chowdhury, Abul Barkat, Sushil Ranjan Howlader, Sharif M.I. Hossain, Ismat Bhuiya, Siraj-Us- Saleheen

Reproductive Health

The International Conference on Population and Development (ICPD) in Cairo in 1994 was the culmination of months of national and international discussions. The issues had been crafted into a Program of Action, which represented a potential shift in thinking. Delegates left the conference espousing a new paradigm and a broad definition of what people, especially women, should expect from their national health services. Governments were encouraged to recognize that the improved health status of women could only be achieved by a life-cycle approach and that health depended not only on good family planning information and services but on women’s empowerment …


Estimating Costs Of Post-Abortion Services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico, Population Council Jan 1999

Estimating Costs Of Post-Abortion Services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico, Population Council

Reproductive Health

Health care systems around the world are facing problems providing quality care with increasingly constrained resources. While modern practices and diagnostic tests have made pregnancy a much less risky event than in the past, not all pregnancies have a favorable outcome. Spontaneous abortion occurs in 15–45% of all known pregnancies, and studies show that 25% of all obstetric/gynecology hospital admissions are for incomplete abortion. Given the high level of resources devoted to treating this condition, it is imperative to develop cost-effective methodologies to provide quality care. Unsafe abortion performed by untrained and inexperienced providers is the fourth leading cause of …


Reproductive Decisionmaking In The Context Of Hiv/Aids In Ndola, Zambia, Naomi Rutenberg, Ann E. Biddlecom, Frederick A.D. Kaona Jan 1999

Reproductive Decisionmaking In The Context Of Hiv/Aids In Ndola, Zambia, Naomi Rutenberg, Ann E. Biddlecom, Frederick A.D. Kaona

Reproductive Health

Family planning (FP) programs are increasingly being considered as a logical focal point for STD and HIV/AIDS prevention services because they serve large numbers of women at risk, address the sensitive issue of sexual behavior and fertility control, and the methods for preventing unwanted pregnancy and disease can be the same. FP programs, by providing contraceptive methods, are currently one of the few sources of assistance in the sub-Saharan African region for preventing perinatal transmission of HIV, while the promotion of barrier methods contributes to the prevention of heterosexual transmission. Given this potential, research is needed to understand how the …


Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri Jan 1999

Implementing A Reproductive Health Agenda In India: The Beginning, Saroj Pachauri

Reproductive Health

At the International Conference on Population and Development (ICPD) in 1994, the nations of the world agreed to give special attention to girls’ education, women’s health, infant survival, and women’s empowerment, and to provide comprehensive reproductive health (RH) services to enable couples to achieve their reproductive goals. The government of India launched a reproductive and child health program in October 1997. This book begins a review of the processes underway to operationalize the program. It brings together several important initiatives at various stages of development and examines key policy and program issues based on empirical research and field experience. The …


Mortality Decline And The Demographic Response: Toward A New Agenda, Mark R. Montgomery Jan 1999

Mortality Decline And The Demographic Response: Toward A New Agenda, Mark R. Montgomery

Poverty, Gender, and Youth

A central proposition of demographic transition theory is that declines in infant and child mortality can encourage subsequent declines in fertility. Even the earliest formulations of the theory recognized that fertility decline would occur only with a lag, but neither theory nor empirical work has explored the length of such lags. This paper urges that individual perceptions and beliefs about mortality risks, conspicuously absent from the demographic research agenda, be studied directly. It proceeds to link mortality perceptions to health care decisionmaking and investments in children. The paper concludes by calling for a new agenda on mortality decline. This agenda …


Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias Jan 1999

Case Finding And Case Management Of Chlamydia And Gonorrhea Infections Among Women: What We Do And Do Not Know, Nicole Haberland, Beverly Winikoff, Nancy L. Sloan, Christiana Coggins, Christopher J. Elias

Reproductive Health

As the world grapples with the HIV pandemic, the implementation of the agenda determined by the International Conference on Population and Development (1994) at Cairo, and the matter of providing health services of adequate quality in an ethical, gender-sensitive manner, new questions are arising about how to attend to reproductive tract infections, including sexually transmitted infections (STIs), among women. This paper reviews the results of validation studies of syndromic algorithms, other nonlaboratory clinically based tools, and risk scoring for finding women infected with chlamydia and gonorrhea, particularly among those attending family planning and antenatal clinics in developing countries. The results …


The Disability Kaleidoscope, Mary Crossley Jan 1999

The Disability Kaleidoscope, Mary Crossley

Articles

The question of whom our society truly wants to protect from adverse discrimination based on bodily difference is ultimately a question for the body politic. The aim of this article, by contrast, is to use the analytical tools provided by scholars in the field of disability studies to scrutinize how lawmakers to date have understood the concept of impairment as one form of bodily difference. By viewing administrative and judicial treatments of impairment through a disability studies lens, I have sought to give the disability kaleidoscope a turn and thus to provide the reader with an altered view of impairment …