Health Services Research Commons^™

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior., Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago.

METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey.

RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …

Devolpment Of A Scale To Assess Home Health Care Aides' Ability To Recognize Depression In Older Adults, Tina M. Nerney

Community & Environmental Health Theses & Dissertations

Depression afflicts 20% to 40% of people 65 and older. Depression in older adults is frequent and chronic. The challenge of a hospital stay and the knowledge of having a long term disability may increase the risk for a depressive episode. In today's health care environment older adults are being released from hospitals after a short length of stay and are frequently dependent on home health services for assistance with activities of daily living. Home health care aides are given the responsibility of providing these services to the older adult in the home environment and need to be aware of …

Where Do Elderly Veterans Obtain Care For Acute Myocardial Infarction: Department Of Veterans Affairs Or Medicare?, S M. Wright, J Daley, E S. Fisher, G E. Thibault

Dartmouth Scholarship

To examine Department of Veterans Affairs (VA) and Medicare hospitalizations for elderly veterans with acute myocardial infarction (AMI), their use of cardiac procedures in both systems, and patient mortality. DATA SOURCES: Merging of inpatient discharge abstracts obtained from VA Patient Treatment Files (PTF) and Medicare MedPAR Part A files. A retrospective cohort study of male veterans 65 years or older who were prior users of the VA medical system (veteran-users) and who were initially admitted to a VA or Medicare hospital with a primary diagnosis of AMI at some time from January 1, 1988 through December 31, 1990 (N = …

Beliefs And Practices About Reproductive Tract Infections: Findings From A Series Of Philippine Fgds, Marilou Palabrica-Costello, Carmeli Marie Chaves, Chona R. Echavez, Cecilia Conaco, Mariano Santiago

Reproductive Health

The past decade has been characterized by increasing concern about the medical, social, and economic problems associated with reproductive tract infections (RTIs). The goal of preventing and curing RTIs is now being prioritized by public health agencies in the developing world. Very little research has been conducted on the problem of RTIs in the local context, and it would be helpful for program managers if the knowledge and beliefs now being held about RTIs were more clearly delineated. Knowing more about the way in which these illnesses are viewed by the community, about traditional practices for preventing and curing RTIs, …

Models Of Christian Witness In Health Care, Anne Gewe

Faculty Books and Book Chapters

This book is intended to be of practical value for the health care practitioner seeking to view professional practice as a wholistic ministry which addresses spiritual, physical, emotional and socio-cultural aspects of health and illness. It is divided into three sections.

Using A Rapid Assessment Approach To Evaluate The Quality Of Care In An Integrated Program: The Experience Of The Family Health Division, Ministry Of Health, Botswana, Lucy Sejo Maribe, Baker Ndugga Maggwa, Ian Askew, Kate Miller

Reproductive Health

To strengthen existing efforts by the Government of Botswana in responding to the HIV/AIDS epidemic, USAID provided financial and technical assistance through the Botswana Population Assistance (BOTSPA) project. BOTSPA’s goal was to improve the quality and availability of family planning (FP) and sexually transmitted infection (STI) services through designing, implementing, and monitoring activities that would lead to the eventual institutionalization and sustainability of high-quality FP and STI/HIV/AIDS services. The Ministry of Health requested assistance from the Africa OR/TA Project II to develop and test an approach for routinely measuring the quality of service delivery and assessing skills retention by staff …

Integrating Sti/Hiv Management Strategies Into Existing Mch/Fp Programs: Lessons From Case Studies In East And Southern Africa, Baker Ndugga Maggwa, Ian Askew

Reproductive Health

Sub-Saharan Africa is confronting an HIV/AIDS epidemic and virtually all health programs in the region are seeking ways of preventing and reducing the spread of this virus. To compound the problem, the presence of certain sexually transmitted infections (STIs) is known to increase risk of the sexual transmission of HIV. The sub-Saharan region is believed to have some of the highest levels of STIs in the world, thus controlling STIs is not only an important reproductive health care strategy in itself but also a key strategy in reducing the spread of HIV. The strongest evidence to support this has come …

Emergency Contraception As An Element In The Care Of Rape Victims, Ricardo Vernon, Raffaela Schiavon, Silvia Elena Llaguno

Reproductive Health

In most states in Mexico, abortion is excluded as a crime in pregnancies resulting from rape. However, legislation does not specify the norms by which women can obtain a legal abortion, which makes it difficult to choose this alternative. A partial solution to unwanted pregnancies from rape would be to provide emergency contraception (EC). Psychologists were trained to provide information on EC to women who reported a rape at four public ministry agencies specialized in sexual crime. In addition, 11 medical backup referral centers were established. To scale up the strategy, workshops were provided to representatives from State Attorney General …

Postabortion Care Services In Kenya: Baseline Findings Of An Operations Research Study, Julie Solo, Deborah L. Billings

Reproductive Health

In Kenya, as throughout the world, the health consequences of unsafe abortion for women of reproductive age are significant. Hospital-based studies in Nairobi have shown that unsafely induced abortion accounts for as much as 35 percent of pregnancy-related mortality and at least 50 percent of hospitals’ gynecological admissions. The concept of postabortion care (emergency treatment, postabortion family planning counseling and services, links between emergency abortion treatment services and comprehensive reproductive health care) has gained wide acceptance as one model of providing comprehensive care to women suffering from abortion complications. Integration of these three components is rarely found in public health …

Reproductive Behavior Among Muslims In Uttar Pradesh, M.E. Khan, Bella C. Patel

Reproductive Health

Muslims form the largest minority group in India, according to the 1991 census, constituting about 12 percent of the country's population. India has the second largest Muslim population in the world. The growth rate of the Muslim population in India during the last three decades is somewhat higher than the non-Muslim population. The present paper, based on a large sample survey carried out in Uttar Pradesh, India, compares the reproductive behavior of Hindus and Muslims. An attempt has been made to examine the determinants of their differential fertility and family planning behavior.

Improved Reproductive Health And Std Services For Women Presenting To Family Planning Services In North Jakarta. Final Report Of Activities, Meiwita B. Iskandar, Catherine Vickers, Subadra Indrawati, Siti Nurul Qomariyah

Reproductive Health

The overall goal of this study was to develop an integrated program of reproductive tract infection/sexually transmitted disease (RTI/STD) clinical services within two family planning clinics in low-income neighborhoods in North Jakarta. Multiple training programs to introduce a standardized clinical evaluation for the detection, treatment, and management of RTI/STDs were conducted. Prior and subsequent to training, observations of health care provider (HCP) and client interactions were conducted to evaluate behavior changes among HCPs. Each consenting client received a standardized reproductive health history, a pelvic exam, and provided specimens for laboratory testing to detect RTIs. Through universal screening of the participants …

Situation Analysis Of Lgu Health Centers For Integrating Rti Management Within The Philippines Fp/Mch Program, Jesus Encena, Carmeli Marie Chaves, Marilou P. Costello, Chona R. Echavez

Reproductive Health

A Situation Analysis (SA) was conducted in seven local government health centers as part of a larger project studying the feasibility of integrating RTI services within the existing Family Planning/Reproductive Health Program of the Department of Health (DOH). The SA was part of a series of baseline activities conducted by the Family Planning Operations Research and Training Project as part of its study on Integrating RTI Management in Local Government Unit Health Centers. It was conducted by Population Council, Manila, for the DOH. Participating health centers were located in a large and highly urbanized community, a medium-sized city, and two …

Traditional Family Planning In Bangladesh, Alan Gray, Jamil H. Chowdhury, Bruce Caldwell, Ahmed Al-Sabir

Reproductive Health

“Traditional” methods of family planning (FP) generally are methods such as withdrawal and periodic abstinence that do not require contraceptive substances or devices, or clinical procedures. In 1991, approximately 38 million couples worldwide relied on withdrawal to prevent pregnancy, and 30-35 million relied on periodic abstinence. Together, these constituted one-quarter of all users of temporary methods of FP worldwide. In Bangladesh, the proportion using periodic abstinence or withdrawal was more than 20 percent of users of temporary methods. The reasons for use of traditional methods have not been investigated in Bangladesh, because of overriding attention to modern methods. Given that …

Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey

Reproductive Health

In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and …

An International Comparison Of Cancer Survival: Toronto, Ontario, And Detroit, Michigan, Metropolitan Areas, Kevin M. Gorey

Social Work Publications

OBJECTIVES: This study examined whether socioeconomic status has a differential effect on the survival of adults diagnosed with cancer in Canada and the United States.

METHODS: The Ontario Cancer Registry and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program provided a total of 58,202 and 76,055 population-based primary malignant cancer cases for Toronto, Ontario, and Detroit, Mich, respectively. Socioeconomic data for each person's residence at time of diagnosis were taken from population censuses.

RESULTS: In the US cohort, there was a significant association between socioeconomic status and survival for 12 of the 15 most common cancer sites; …

An Assessment Of Clinic Based Family Planning Services In Kenya: Results From The 1995 Situation Analysis Study, Lewis Ndhlovu, Julie Solo, Robert A. Miller, Kate Miller, Achola Ominde

Reproductive Health

This study’s objective was to assist the Kenya Ministry of Health (MOH), the National Council for Population and Development (NCPD), NGOs, and donor agencies in planning the expansion and improvement of family planning (FP) and other reproductive health (RH) services provided in Kenya. Data on the functioning of program subsystems and the quality of care provided were collected in May 1995 from 254 maternal and child health/family planning (MCH/FP) facilities throughout the country using a situation analysis approach. The study sample included a representative sample of facilities from the MOH and NGO sectors. It also included a census of all …