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Full-Text Articles in Medicine and Health Sciences

Designing Hiv/Aids Intervention Studies: An Operations Research Handbook, Andrew A. Fisher, James R. Foreit, John E. Laing, John E. Stoeckel, John Townsend Jan 2002

Designing Hiv/Aids Intervention Studies: An Operations Research Handbook, Andrew A. Fisher, James R. Foreit, John E. Laing, John E. Stoeckel, John Townsend

HIV and AIDS

This handbook has several objectives and uses. First, it is designed to help HIV/AIDS researchers develop and write a detailed operations research proposal. An appropriate use of the handbook is as a resource in workshops or courses on research design and proposal development. Thus, the organization of the handbook follows that of a research proposal, starting with identifying, defining, and justifying a research problem, and ending with how to prepare a budget. Although the handbook is not an academic textbook on research methods, it does provide a review of many key concepts and important methods essential for conducting HIV/AIDS field …


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 …


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 …


Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle Jan 2002

Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle

HIV and AIDS

A study conducted in Dakar, Senegal by researchers from the National AIDS Council, Cheikh Anta Diop University, and the Horizons program obtained information on the needs, behaviors, knowledge, and attitudes of men who have sex with men (MSM). This study offers important insights into the sexuality of MSM, their vulnerability to STI/HIV, and the role of violence and stigma in their lives. The results also highlight the lack of sexual health services and information available to cover the specific needs of MSM. The results of this study were summarized during a meeting held in April 2001 in Dakar and raised …


Hiv/Aids-Related Stigma And Discrimination: A Conceptual Framework And An Agenda For Action, Richard Parker, Peter Aggleton, Kathy Attawell, Julie Pulerwitz, Lisanne Brown Jan 2002

Hiv/Aids-Related Stigma And Discrimination: A Conceptual Framework And An Agenda For Action, Richard Parker, Peter Aggleton, Kathy Attawell, Julie Pulerwitz, Lisanne Brown

HIV and AIDS

In 1987, Jonathan Mann, then director of the WHO Global Programme on AIDS, identified three phases of the HIV/AIDS epidemic: the epidemic of HIV, the epidemic of AIDS, and the epidemic of stigma, discrimination, and denial. Despite international efforts to tackle HIV/AIDS since then, stigma and discrimination (S&D) remain among the most poorly understood aspects of the epidemic. This poor understanding is due in part to the complexity and diversity of S&D, but also to limitations in current thinking within the field and the inadequacy of available theoretical and methodological tools. This paper proposes a new conceptual framework to help …


Training And Support Of Developing-Country Population Scientists: A Panel Report—Summary And Recommendations, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd Jan 2002

Training And Support Of Developing-Country Population Scientists: A Panel Report—Summary And Recommendations, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd

Poverty, Gender, and Youth

From its earliest days, the Population Council has recognized the importance and value of training population scientists from developing countries. Since 1952, the Council’s social science fellowship program has sustained a commitment to this goal; approximately 1,500 fellowships have been awarded for pre- and postdoctoral training in population studies. While the demand for population scientists remains strong, the field has changed substantially since those early years and a review of the program was needed. The Mellon Foundation funded a project in 2000 to assess future needs for training and support of population scientists from developing countries and assembled an international …


Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya Jan 2002

Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya

Reproductive Health

The goal of this study was to determine the sustainability of the postabortion care (PAC) training and service delivery intervention introduced in the Hospital Nacional Daniel Alcides Carrión in Lima, Peru, and the extent to which the outcomes of the intervention have continued. The objectives of the study were to assess changes over time in the following outcomes: the use of manual vacuum aspiration for incomplete abortion, provision of family planning information to postabortion patients, acceptance of contraception by postabortion patients prior to discharge, provision of medical care information to patients, length of hospital stay, and resources used by the …


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 …


Integrating Hiv Prevention And Care Into Maternal And Child Health Care Settings: Lessons Learned From Horizons Studies, Naomi Rutenberg, Sam Kalibala, Charles Mwai, James Rosen Jan 2002

Integrating Hiv Prevention And Care Into Maternal And Child Health Care Settings: Lessons Learned From Horizons Studies, Naomi Rutenberg, Sam Kalibala, Charles Mwai, James Rosen

HIV and AIDS

Many women in the developing world still lack access to high-quality HIV/AIDS prevention and care services. To address this problem, Horizons has undertaken a range of operations research efforts that examine the integration of HIV-related care in the maternal-child health setting. At a workshop held in Kenya in July 2001, participants discussed the experience to date and formulated practical strategies for improving the integration. This consultation report summarizes that discussion according to the following seven key program components: Training and Motivation to Improve the Performance of Health Workers; Supervision of HIV Services and Quality Assurance of HIV Testing; Caring for …


Strategic Assessment Of Reproductive Health In The Dominican Republic, Suellen Miller, Argelia Tejada, Patricio Murgueytio Jan 2002

Strategic Assessment Of Reproductive Health In The Dominican Republic, Suellen Miller, Argelia Tejada, Patricio Murgueytio

Reproductive Health

This report documents the findings of a strategic assessment of reproductive health in the Dominican Republic (DR), carried out by the Ministry of Health and Social Welfare (SESPAS) and the Dominican Social Security Institute with support from the Population Council’s Expanding Contraceptive Choice (ECC) program and its Latin American and Caribbean regional offices, and the United States Agency for International Development (USAID). The USAID/DR has been working closely with SESPAS to understand the major reproductive health problems in the DR. To better assist SESPAS and to plan the country’s Reproductive Health Strategy for 2002–2007, USAID asked the Population Council’s ECC …


Greater Involvement Of Plha In Ngo Service Delivery: Findings From A Four-Country Study, Horizons Program Jan 2002

Greater Involvement Of Plha In Ngo Service Delivery: Findings From A Four-Country Study, Horizons Program

HIV and AIDS

At the conclusion of the Paris AIDS Summit in 1994, 42 governments issued a declaration supporting the greater involvement of people living with HIV/AIDS (PLHA) in policy formulation and service delivery. Despite growing recognition of its importance, there has been little research that examines PLHA involvement in the delivery of prevention, care, and support services in developing countries and its effects on PLHA, others affected by HIV/AIDS, and nongovernmental organizations (NGOs). To address this gap, the Horizons Program and the International HIV/AIDS Alliance conducted a study of PLHA involvement in NGOs in Burkina Faso, Ecuador, Maharashtra State, India, and Zambia …


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.


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 …


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. …


Institutional Support For A Program Of Activities Within The Pilot Health Project In The West Bank And Gaza, Health, Development, Information And Policy Institute Jan 2002

Institutional Support For A Program Of Activities Within The Pilot Health Project In The West Bank And Gaza, Health, Development, Information And Policy Institute

Reproductive Health

This document contains reports on three activities undertaken by the Pilot Health Project (PHP) in order to upgrade antenatal and postpartum services for Palestinian women. Specifically, it includes results of a survey and a comprehensive assessment of the antenatal and postpartum care services, including family planning, that are currently provided at the project clinics. The findings show that the shortage of care provided to women during the perinatal period could be partially overcome by conducting home visits to provide information on many reproductive health issues, to help women and their families make decisions regarding their future fertility, and to provide …


Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil Jan 2002

Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil

Reproductive Health

The Center for Development in Primary Health Care (CDPHC), in collaboration with the Population Council’s FRONTIERS program, developed a 19-month training program to strengthen and improve existing maternal and children’s health and family planning services and to promote the establishment of the standardized basic package of services at Pilot Health Project (PHP) clinic sites in the West Bank and Gaza. There were four key start-up activities, including: 1) an assessment of standards of care provided at PHP clinics; 2) a review of formative research; 3) the development of clinical training manuals and curricula; and 4) the development of behavior change …


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 …


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 …


Midline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Barbara Mensch, Wesley H. Clark, Shahina Begum, Bela Patel Uttekar, Sohini Roychowdhury Jan 2002

Midline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Barbara Mensch, Wesley H. Clark, Shahina Begum, Bela Patel Uttekar, Sohini Roychowdhury

Reproductive Health

The Population Council in collaboration with CARE India has been conducting an operations research (OR) study to investigate the impact of adding a livelihoods component to the Action for Slum Dwellers' Reproductive Health, Allahabad (ASRHA) Project in Uttar Pradesh run by CARE India. The ASRHA Project selected peer educators from the slums and trained them in providing reproductive health (RH) information, communication skills, and group formation techniques. After the peer educators completed training, they conducted group sessions about livelihoods and savings. RH sessions were held alongside vocational counseling sessions. Population Council staff provided vocational training courses, both in the slums …


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. …


Using Men As Community-Based Distributors Of Condoms, Cynthia P. Green, Stephanie Joyce, James R. Foreit Jan 2002

Using Men As Community-Based Distributors Of Condoms, Cynthia P. Green, Stephanie Joyce, James R. Foreit

Reproductive Health

The HIV/AIDS epidemic has led program managers to seek approaches to family planning (FP) that will also help combat HIV/AIDS and other sexually transmitted infections (STIs). These approaches include use of simplified STI diagnosis and treatment protocols and promotion of male and female condoms. One aspect of condom promotion that is receiving increased attention is the idea of adding men to community-based distribution (CBD) programs. The male latex condom is the only contraceptive method that, when used correctly and consistently, provides protection against STIs, including HIV/AIDS. Currently, an estimated 6 to 9 billion male condoms are used worldwide annually. However, …


Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco) Jan 2002

Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco)

Reproductive Health

The Institute for Behavioral Studies and Research completed an operations research project entitled “Among Youth” targeting adolescents in the Mokolo neighborhood of Yaoundé, Cameroon. The results presented in this report show that adolescents in Mokolo, more often than their counterparts in the control site, adopted behavioral changes to prevent STI/HIV transmission and unwanted pregnancies as a result of the intervention. The report concludes that peer education combined with mass media campaigns form an important strategy for targeting youth with reproductive health and family planning messages and can help adolescents translate knowledge into healthy lifestyles. Integration of reproductive health messages into …


Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols Jan 2002

Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols

Reproductive Health

In Indonesia, paternalistic models of health care, social distance between clients and service providers, and cultural norms discourage family planning clients from playing an active role in consultations. This report discusses the interventions needed to encourage clients to communicate more openly and more vigorously with providers. The study confirmed that educational interventions directed to family planning clients can help them become effective partners in their own care, assuming they meet with receptive providers. Communication interventions like Smart Patient complement and reinforce provider interpersonal communication and counseling training by giving clients the confidence and the skills to take advantage of increased …