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Ndola Demonstration Project: A Midterm Analysis Of Lessons Learned, Horizons Program Jan 2002

Ndola Demonstration Project: A Midterm Analysis Of Lessons Learned, Horizons Program

HIV and AIDS

This report summarizes baseline and midterm findings of an intervention pilot study conducted by Horizons, LINKAGES, National Food and Nutrition Commission, District Health Management Team, Hope Humana, and the Zambia Integrated Health Program in Ndola District, Zambia. The aim of the research is to investigate how integrating services for the prevention of mother-to-child transmission (PMCT) of HIV into low-resource maternal and child health (MCH) and antenatal care (ANC) settings influences women’s ability to make and implement informed decisions about HIV. The intervention strengthened routine services and introduced HIV voluntary counseling and testing and PMCT counseling and services into the MCH/ANC …


Training Service Providers On Emergency Contraception: Lessons Learned From An Or Study, M.E. Khan, Sharif M.I. Hossain Jan 2002

Training Service Providers On Emergency Contraception: Lessons Learned From An Or Study, M.E. Khan, Sharif M.I. Hossain

Reproductive Health

The Bangladesh Directorate of Family Planning in collaboration with the Population Council, Pathfinder International, and John Snow, Inc. is conducting an operations research project to test the feasibility of introducing emergency contraceptive pills (ECP) in the national family planning (FP) program and to answer operational questions on implementing the use of ECP efficiently. In Bangladesh, 1.2 million births are unplanned and the number of menstrual regulation/abortions is increasing. ECP could be a good reproductive health intervention for women since it gives them a chance to avoid unwanted pregnancy. ECP does not induce abortion. In fact, it helps in reducing the …


Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta Jan 2002

Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta

HIV and AIDS

While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …


Best Practices In Cbd Programs In Sub-Saharan Africa: Lessons Learned From Research And Evaluation, Frontiers In Reproductive Health, Family Health International, Advance Africa Jan 2002

Best Practices In Cbd Programs In Sub-Saharan Africa: Lessons Learned From Research And Evaluation, Frontiers In Reproductive Health, Family Health International, Advance Africa

Reproductive Health

Community-based distribution (CBD) is the use of nonprofessional local distributors or agents to provide family planning (FP) methods—typically condoms, pills, and spermicides—and referral for other services. FP programs in Africa, Asia, and Latin America have implemented CBD programs for the past 30 years. There is a large body of evidence on the effectiveness, cost, and sustainability of CBD models. Most evidence supports using CBD where appropriate conditions exist. However, major changes have taken place in the context in which programs operate, including the onset of the HIV/AIDS pandemic, enhanced access to FP services, and increased demand for related reproductive health …


Men In Maternity Study: Men Matter, Anjana Das, Leila Caleb-Varkey, Anurag Mishra, Emma Ottolenghi, Dale Huntington Jan 2002

Men In Maternity Study: Men Matter, Anjana Das, Leila Caleb-Varkey, Anurag Mishra, Emma Ottolenghi, Dale Huntington

Reproductive Health

The Population Council and the Employees’ State Insurance Company are collaborating in a Men in Maternity (MiM) study in India to test a model of antenatal and postnatal services designed to help thousands of couples, especially men, redefine their roles in reproductive health and improve birth outcomes and maternal health. This is part of a global study that will assess the impact of male partnership in improving pregnancy outcomes and reproductive health, primarily by reducing the prevalence of STIs and increasing postpartum family planning use. Studies suggest that the lack of men’s participation in reproductive health actually undermines women’s health. …


Men In Maternity Study: A Summary Of The Findings From Pre-Intervention Interviews With Women And Their Husbands Attending Antenatal Clinics At Esic Facilities In Delhi, Anurag Mishra, Leila Caleb-Varkey, Anjana Das, Emma Ottolenghi, Dale Huntington, Susan E. Adamchak, Shahina Begum Jan 2002

Men In Maternity Study: A Summary Of The Findings From Pre-Intervention Interviews With Women And Their Husbands Attending Antenatal Clinics At Esic Facilities In Delhi, Anurag Mishra, Leila Caleb-Varkey, Anjana Das, Emma Ottolenghi, Dale Huntington, Susan E. Adamchak, Shahina Begum

Reproductive Health

The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). …


The End Of The Fertility Transition In The Developing World, John Bongaarts Jan 2002

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

Poverty, Gender, and Youth

Fertility declines are now underway in many developing countries, and the focus of the debate about future fertility trends is shifting from the early to the later phases of the transition. This study examines patterns and determinants of fertility in the developing world using UN estimates of the total fertility rates for 143 developing countries from 1950 to 2000. The main objective is to identify regularities in the past record that may provide clues to future trends. Three key findings emerge from this analysis. First, the pace of fertility decline decelerates as countries reach the later stages of the transition. …


Men In Maternity Study: Results From The Pre-Intervention Survey Of Pregnant Women And Their Husbands At The Three Interventions, And Of Only Women At Three Control Employees' State Insurance Corporation Dispensaries In Delhi, India: Preliminary Findings, Anurag Mishra, Leila Caleb-Varkey, Emma Ottolenghi, Anjana Das, Dale Huntington, Susan E. Adamchak Jan 2002

Men In Maternity Study: Results From The Pre-Intervention Survey Of Pregnant Women And Their Husbands At The Three Interventions, And Of Only Women At Three Control Employees' State Insurance Corporation Dispensaries In Delhi, India: Preliminary Findings, Anurag Mishra, Leila Caleb-Varkey, Emma Ottolenghi, Anjana Das, Dale Huntington, Susan E. Adamchak

Reproductive Health

The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council, is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). …


Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline Jan 2002

Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline

Poverty, Gender, and Youth

The objective of this research is to examine the association between social organization and reproductive behavior in one setting in sub-Saharan Africa. The particular focus is on the effects of social organization on the diffusion of innovative reproductive ideas and behaviors. Social diffusion is assumed to be strongly affected by patterns of informal social interaction, and these in turn are assumed to be determined in part by the social organization of local communities (gender relations, employment activity, voluntary organizations). The research draws on data collected in six communities in southern Ghana. The analysis reveals a weaker than expected association between …


Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang Jan 2002

Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang

Poverty, Gender, and Youth

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …


The Effect Of Gender Differences In Primary School Access, Type, And Quality On The Decision To Enroll In Rural Pakistan, Cynthia B. Lloyd, Cem Mete, Zeba Sathar Jan 2002

The Effect Of Gender Differences In Primary School Access, Type, And Quality On The Decision To Enroll In Rural Pakistan, Cynthia B. Lloyd, Cem Mete, Zeba Sathar

Poverty, Gender, and Youth

The paper explores the effect of primary school access, type, and quality on the decision to enroll in rural Pakistan using a 1997 survey especially designed for this purpose. A unique contribution of the paper is the construction of gender-specific dimensions of school accessibility and school quality according to school type (i.e., public vs. private). Within the same village, girls and boys often face starkly different options for schooling in terms of distance, type, and quality. Public primary schools are segregated by sex; private schools, whose numbers have grown rapidly in recent years in response to rising demand and the …


Universal Sexuality Education In Mongolia: Educating Today To Protect Tomorrow, Delia Barcelona, Laura Laski, Caitlin Gerdts Jan 2002

Universal Sexuality Education In Mongolia: Educating Today To Protect Tomorrow, Delia Barcelona, Laura Laski, Caitlin Gerdts

Poverty, Gender, and Youth

This issue of Quality/Calidad/Qualité demonstrates how Mongolia developed a national plan to a provide a comprehensive sexual and reproductive health curriculum and media for adolescents. Among the lessons learned from the Mongolian experience were the following: 1) questions about unwanted sexual relations and sexual roles were the most pressing among adolescents, especially girls; 2) printed media are efficient and inexpensive; and 3) parental opposition was almost nonexistent in certain settings—often they expressed gratitude for this education.


How Long Do We Live?, John Bongaarts, Griffith Feeney Jan 2002

How Long Do We Live?, John Bongaarts, Griffith Feeney

Poverty, Gender, and Youth

Period life expectancy is calculated from age-specific death rates using life table methods that are among the oldest and most fundamental tools of demography. These methods are rarely questioned, much less criticized. Yet changing age patterns of adult mortality in contemporary countries with high life expectancy provide a basis for questioning the conventional use of age-specific death rates and life tables. This paper argues that when the mean age at death is rising, period life expectancy at birth as conventionally calculated overestimates life expectancy. Estimates of this upward bias, ranging from 1.6 years for the United States and Sweden to …


Demographic Factors In East Asian Regional Integration, Geoffrey Mcnicoll Jan 2002

Demographic Factors In East Asian Regional Integration, Geoffrey Mcnicoll

Poverty, Gender, and Youth

The Remapping Asia project, to which this paper is a contribution, investigates broad spatial changes in the ways that East Asia’s political and social life are organized and economies operate. Such changes are attributable to planned action of governments, firms, and other organized groups and to the unorganized but in some measure predictable behavior of myriad families and individuals. The project’s particular interest is in processes of regionalization-both through the deliberate construction of political institutions and through the largely unplanned emergence of regional affiliations and identities. Demographic factors play a potentially significant part both in promoting and in impeding regional …


How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May Jan 2002

How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May

Poverty, Gender, and Youth

Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …


The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth Jan 2002

The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth

Poverty, Gender, and Youth

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …


Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim Jan 2002

Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim

Poverty, Gender, and Youth

In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …


Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim Jan 2002

Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim

Poverty, Gender, and Youth

Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …


Childcare, Mothers' Work, And Earnings: Findings From The Urban Slums Of Guatemala City [Arabic], Kelly Hallman, Agnes R. Quisumbing, Marie T. Ruel, Benedicte De La Briere Jan 2002

Childcare, Mothers' Work, And Earnings: Findings From The Urban Slums Of Guatemala City [Arabic], Kelly Hallman, Agnes R. Quisumbing, Marie T. Ruel, Benedicte De La Briere

Poverty, Gender, and Youth

This study investigates the effects of childcare on work and earnings of mothers in the slums of Guatemala City. Recognizing that mother’s work behavior may depend on the availability of childcare, the modeling approach allows participation in the labor force and use of formal daycare to be jointly determined. We also investigate whether a mother’s “status” within her household (as measured by the value of the assets she brought to her marriage) influences her entry into the labor force. Finally, we explore the impact of childcare prices on a mother’s earnings, conditional on her decision to work. The study uses …


Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh Jan 2002

Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh

Poverty, Gender, and Youth

To the extent that research on Vietnamese adolescents has been conducted, it has been concerned with unprotected and unsanctioned sexual activity and its health consequences, namely abortion and sexually transmitted diseases, especially HIV. The question we pose is whether this concern is warranted. Is the population community justified in focusing its attention on early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young people’s lives that should give us greater pause? The paper reviews the literature on adolescent sexual behavior in Vietnam and analyzes data …


'Bus Fare, Please': The Economics Of Sex And Gifts Among Adolescents In Urban South Africa, Carol E. Kaufman, Stavros E. Stavrou Jan 2002

'Bus Fare, Please': The Economics Of Sex And Gifts Among Adolescents In Urban South Africa, Carol E. Kaufman, Stavros E. Stavrou

Poverty, Gender, and Youth

Force or coercion are often a part of sexual relationships in South Africa, especially among adolescents. This coercion is also often pinioned by an economic exchange: gifts or favours for sex. Studies have pointed out the negative consequences of the exchanges which are often characterised by large age differences (‘sugar daddies’) or power imbalances. Perhaps more pervasive but largely ignored, gift-giving in same-age relationships also may be associated with sexual leverage, an exchange which somehow entitles one partner physical and sexual rights to the other’s body. The circumstances surrounding gifts and favours may shape young women’s and men’s sexual experiences, …


Are We Not Peasants Too? Land Rights And Women's Claims In India, Bina Agarwal Jan 2002

Are We Not Peasants Too? Land Rights And Women's Claims In India, Bina Agarwal

Poverty, Gender, and Youth

This edition of SEEDS explores the critical elements in securing effective and independent land rights for women in South Asia. The author presents a range of cooperative strategies for enabling women to retain and cultivate the land and shows how micro-credit and other programs can be redirected to increase the amount and productivity of land women control. Recognizing that new policies and political will are required to foster and sustain such experiments, the author ends with a summary of how women are organizing to place women’s access to land at the center of national and global agendas.


Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health Jan 2002

Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health

Reproductive Health

The Population Council’s Frontiers in Reproductive Health program, with funding from USAID, organized a consultative meeting on the practice of female genital cutting (FGC) in Nairobi, Kenya in April 2002. The meeting brought together a small group of researchers and program managers who are actively undertaking operations research and systematic program evaluations to review the state of the art concerning intervention research design and measurement issues. The deliberations at this workshop should stimulate interest both in undertaking operations research more routinely when programming anti-FGC activities and in furthering the development and application of research methods appropriate for this subject. Several …


What About Us? Bringing Infertility Into Reproductive Health Care, Okonofua Friday, Bishakha Datta Jan 2002

What About Us? Bringing Infertility Into Reproductive Health Care, Okonofua Friday, Bishakha Datta

Poverty, Gender, and Youth

Infertility is a major reproductive health problem throughout much of the world. Despite the prevalence and seriousness of infertility, the population and reproductive health field has largely neglected this problem. National policies and international donor organizations have been one-sided in their focus on programs designed to prevent unwanted pregnancies. This issue of Quality/Calidad/Qualité, with clinic-based narratives and case reports from India and Nigeria, illustrates what is involved in trying to address the problem of infertility in developing countries. A possible framework for incorporating limited infertility care into a family planning or reproductive health program includes providing education and counseling, preliminary …


Frontiers Capacity Building: An Overview, James R. Foreit Jan 2002

Frontiers Capacity Building: An Overview, James R. Foreit

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program is a cooperative agreement with USAID to improve family planning and reproductive health service delivery through operations research (OR). Frontiers builds on more than 20 years of research to improve family planning service delivery programs. A major goal of Frontiers is to transfer skills in OR so that public and private agencies in developing countries can conduct OR and apply research findings to reproductive health programs and policies. OR addresses problems in operational effectiveness, access, quality, and efficiency by investigating facets of programs that managers can control and change. As concluded in …


Kenya: Community Sensitization Must Precede Alternative Coming-Of-Age Rite, Frontiers In Reproductive Health Jan 2002

Kenya: Community Sensitization Must Precede Alternative Coming-Of-Age Rite, Frontiers In Reproductive Health

Reproductive Health

Female genital cutting (FGC) is practiced as a rite of passage in over half of Kenya’s districts. Kenyan nongovernmental agency Maendeleo Ya Wanawake (MYWO) has long conducted community sensitization focused on discouraging this practice. In 1996, MYWO began implementing the “alternative rite” (AR) intervention in sensitized communities. Girls participating in AR receive family life education in seclusion, followed by a public graduation ceremony recognizing them as adults. They are not cut as part of the ceremony. In 2000, the Population Council carried out an assessment of the AR program that sought to identify the impact of MYWO’s activities on knowledge …


Kenia: Sensibilizar A Comunidades Para Que Realicen Ritos Alternativos De Iniciación Con Las Niños, Frontiers In Reproductive Health Jan 2002

Kenia: Sensibilizar A Comunidades Para Que Realicen Ritos Alternativos De Iniciación Con Las Niños, Frontiers In Reproductive Health

Reproductive Health

La mutilación genital femenina (MGF) se practica como rito de transición en más de la mitad de los distritos de Kenia. Desde hace tiempo, la ONG Maendeleo Ya Wanawake (MYWO) ha sensibilizado a las comunidades de este país con el fin de promover el abandono de esta práctica. En 1996, la MYWO implementó una intervención para realizar un “Rito Alternativo” (RA) en las comunidades sensibilizadas. Las niñas que participan en estos RA reciben educación sobre la vida familiar durante un retiro y posteriormente participan en una ceremonia pública en la que se les reconoce como adultas. Lo más importante es …


Childcare, Mothers' Work, And Earnings: Findings From The Urban Slums Of Guatemala City, Kelly Hallman, Agnes R. Quisumbing, Marie T. Ruel, Benedicte De La Briere Jan 2002

Childcare, Mothers' Work, And Earnings: Findings From The Urban Slums Of Guatemala City, Kelly Hallman, Agnes R. Quisumbing, Marie T. Ruel, Benedicte De La Briere

Poverty, Gender, and Youth

This study investigates the effects of childcare on work and earnings of mothers in the slums of Guatemala City. Recognizing that mother’s work behavior may depend on the availability of childcare, the modeling approach allows participation in the labor force and use of formal daycare to be jointly determined. We also investigate whether a mother’s “status” within her household (as measured by the value of the assets she brought to her marriage) influences her entry into the labor force. Finally, we explore the impact of childcare prices on a mother’s earnings, conditional on her decision to work. The study uses …