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Full-Text Articles in Social and Behavioral Sciences
Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade
Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade
HIV and AIDS
Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. …
Evidence For The Importance Of Community Involvement: Implications For Initiatives To Prevent Mother-To-Child Transmission Of Hiv, Ann Leonard, Purnima Mane, Naomi Rutenberg
Evidence For The Importance Of Community Involvement: Implications For Initiatives To Prevent Mother-To-Child Transmission Of Hiv, Ann Leonard, Purnima Mane, Naomi Rutenberg
HIV and AIDS
This paper offers lessons learned from a literature review of community involvement in biomedical and other technologies that can guide appropriate and effective introduction of services for prevention of mother-to-child transmission of HIV. A companion paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about barriers to using voluntary counseling and testing services; stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission …
Hiv And Partner Violence: What Are The Implications For Voluntary Counseling And Testing?, Carolyn Knapp
Hiv And Partner Violence: What Are The Implications For Voluntary Counseling And Testing?, Carolyn Knapp
HIV and AIDS
Millions of women around the world face two great threats to their health and well-being: HIV/AIDS and violence by an intimate partner. One of the strongest associations between the two is the role that violence and the threat of violence play in limiting a woman’s ability to negotiate safer sex with a partner. A similar fear of violence also discourages women who receive HIV voluntary counseling and testing (VCT) from telling partners about test results. This study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending a VCT clinic in Dar es Salaam, Tanzania. Researchers …
Power In Sexual Relationships: An Opening Dialogue Among Reproductive Health Professionals, Population Council, Interagency Gender Working Group (Igwg)
Power In Sexual Relationships: An Opening Dialogue Among Reproductive Health Professionals, Population Council, Interagency Gender Working Group (Igwg)
Reproductive Health
The discussions summarized in this report indicate that gender-based power inequalities hinder communication between partners, limit the ability of individuals and couples to talk about or achieve desired child spacing and family-size goals, limit effective use of reproductive health services, undercut men’s and women’s attainment of sexual health and pleasure, and increase substantially their vulnerabiliy to HIV/AIDS and other sexually transmitted infections. This report summarizes the proceedings of a meeting, co-sponsored by the Population Council and USAID’s Men and Reproductive Health Subcommittee, that responded to an increasing groundswell of interest in opening a dialogue on power in sexual relationships. The …
Whose Education Counts? The Impact Of Grown Children's Education On The Physical Functioning Of Their Parents In Taiwan, Zachary Zimmer, Albert I. Hermalin, Hui-Sheng Lin
Whose Education Counts? The Impact Of Grown Children's Education On The Physical Functioning Of Their Parents In Taiwan, Zachary Zimmer, Albert I. Hermalin, Hui-Sheng Lin
Poverty, Gender, and Youth
Research has identified education as an important predictor of physical functioning in old age. Older adults in Taiwan tend to experience close ties to family members and high rates of adult child coresidence, much more so than is typical in Western cultures. These circumstances might imply additional health-related benefits stemming from the education of grown children. This association could arise in a number of ways, for instance through the sharing of health-related information between child and parent, the quality of caregiving efforts, monetary assistance for medical and other services, or through other psychosocial avenues. In this study, a nationally representative …
Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer
Living Arrangements Of Older Adults In The Developing World: An Analysis Of Dhs Household Surveys, John Bongaarts, Zachary Zimmer
Poverty, Gender, and Youth
Using data from Demographic and Health Surveys, this study examines living arrangements of older adults in 43 developing countries and compares patterns by gender, world regions, and macro-level measures of socioeconomic development. Indicators include household size, headship, relationship to head, and coresidence with spouse, children, and others. Unweighted regional averages and OLS regressions determine whether variations exist. Average household sizes are large, but a substantially higher proportion of elderly adults live alone than do individuals in other age groups. Females are more likely than males to live alone and are less likely to live with a spouse or to head …
Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain
Introducing Emergency Contraception In Bangladesh: A Feasibility Study, M.E. Khan, Sharif M.I. Hossain
Reproductive Health
Approximately 28,000 maternal deaths occur every year in Bangladesh due to pregnancy and delivery-related complications, while many more women suffer major physical and psychological injuries. Available statistics indicate an increase in menstrual regulation (MR) and abortions, most performed by untrained practitioners under unhygienic conditions. Introducing emergency contraception (EC) in the national family planning (FP) program in Bangladesh could substantially reduce unwanted pregnancies and as result MR/abortions should also decrease. Because MR/abortions in Bangladesh significantly contribute to high maternal morbidity/mortality, introducing EC could be an important reproductive health intervention to provide couples with a back-up support to prevent unwanted pregnancy. EC …
Ecological Degradation, Rural Poverty, And Migration In Ethiopia: A Contextual Analysis, Markos Ezra
Ecological Degradation, Rural Poverty, And Migration In Ethiopia: A Contextual Analysis, Markos Ezra
Poverty, Gender, and Youth
The interrelationships between ecological degradation, poverty, and rural out-migration in Ethiopia are examined using data from a Household and Community Survey conducted in 1994-95. The survey, which covered a sample of 2,000 households, collected retrospective data on changes in household composition, including migration of household members, during the period 1984 to 1994. The study hypothesizes that the decision to out-migrate in the impoverished rural areas of northern Ethiopia is influenced by a combination of factors based on individual, household and community characteristics. A multilevel analysis is applied to determine the role of these factors in the decision. The findings show …
Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett
Social Networks And Contraceptive Dynamics In Southern Ghana, Mark R. Montgomery, Gebre-Egziabher Kiros, Dominic K. Agyeman, John B. Casterline, Peter Aglobitse, Paul C. Hewett
Poverty, Gender, and Youth
There is accumulating evidence that social diffusion processes affect the pace of the adoption of modern contraception in societies undergoing fertility transition. In settings where mortality has declined and many other social and economic changes are underway, decisions about contraception are fraught with uncertainty and risk. In such circumstances, couples may rely on other persons for information and guidance. In this paper, we examine the influence of informal social networks on the contraceptive behavior of reproductive-age women, using longitudinal data collected in six communities in southern Ghana. Our results confirm the hypothesis that adoption of modern contraception is strongly affected …
The End Of The Fertility Transition In The Developed World, John Bongaarts
The End Of The Fertility Transition In The Developed World, John Bongaarts
Poverty, Gender, and Youth
By the late 1990s fertility in the developed world had declined to 1.6 births per woman, a level substantially lower than projected in the 1980s. This study examines recent trends and patterns in fertility in the developed world with particular emphasis on the effects and implications of changes in the timing of childbearing. The main objective is to demonstrate that while fertility in these countries is indeed low, women’s childbearing levels are not as low as period measures such as the total fertility rate suggest. To obtain a full understanding of the various dimensions of fertility change, several indicators are …
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health
Reproductive Health
To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …
Youth Livelihood Opportunities In Egypt, Safaa El-Kogali, Nagah Hassan Al Bassusi
Youth Livelihood Opportunities In Egypt, Safaa El-Kogali, Nagah Hassan Al Bassusi
Poverty, Gender, and Youth
This report presents results from a quantitative and qualitative study on youth livelihood opportunities in Egypt. The study was motivated by growing evidence of increasing unemployment among the young at a time when new entrants into the labor force are also increasing at unprecedented rates. Egypt has a youth population of over 13 million aged 15–24—over a fifth of the total population. They constitute the largest segment of the economically active population. Whether this bulge of young workers entering the labor force is a “demographic gift” or a “demographic burden” depends in large measure on the policies that are in …
Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque
Obstacles To Contraceptive Use In Pakistan: A Study In Punjab, John B. Casterline, Zeba Sathar, Minhaj Ul Haque
Poverty, Gender, and Youth
The principal aim of this study is to assess the strength in Pakistan of a set of hypothesized obstacles to practicing contraception. Our concern is those factors that prevent women from translating a desire to avoid becoming pregnant into contraceptive practice, a common predicament in Pakistan in recent decades. We analyze survey data collected in Punjab province in 1996 that contain unusually detailed measurement of various perceived costs of practicing contraception, as well as focused measurement of fertility motivation. The framework guiding the research specifies six major obstacles to contraceptive use: the strength of motivation to avoid pregnancy, awareness and …
Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed
Testing Alternative Channels For Providing Emergency Contraception To Young Women, John P. Skibiak, Mangala Chambeshi-Moyo, Yusuf Ahmed
Reproductive Health
In September 1997, the Population Council and Lusaka’s University Teaching Hospital (UTH) launched a 15-month study to identify and explore the range of issues relating to the introduction of emergency contraception (EC) within a developing country context. The study allowed clinic-based family planning providers to accumulate enough first-hand experience to be able to identify strategies for overcoming difficulties associated with the introduction or delivery of EC services. One issue on most participants’ minds was the need to expand the delivery of EC services toward young women, especially out-of-school women, who are harder to reach. Participants recommended that future research activities …
Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing, Horizons Program
Hiv And Partner Violence: Implications For Hiv Voluntary Counseling And Testing, Horizons Program
HIV and AIDS
An important component of HIV voluntary counseling and testing (VCT) programs is encouraging clients to inform partners of their serostatus, yet many clients do not do so. Studies have found that a serious barrier to disclosure for women is fear of a violent reaction by male partners and that HIV-infected women are at increased risk for partner violence. Building on previous research, this study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending the Muhimbili Health Information Center (MHIC), a VCT clinic in Dar es Salaam, Tanzania. As noted in this summary, the study first …
Household Size And Composition In The Developing World, John Bongaarts
Household Size And Composition In The Developing World, John Bongaarts
Poverty, Gender, and Youth
This study uses data from recent household surveys in 43 developing countries to describe the main dimensions of household size and composition in the developing world. Average household size varies only modestly among regions, ranging from 5.6 in the Near East/North Africa to 4.8 in Latin America. These averages are similar to levels observed in the second half of the nineteenth century in Europe and North America. About four out of five members of the household are part of the nuclear family of the head of the household. Household size is found to be positively associated with the level of …
Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur
Immunization Status And Child Survival In Rural Ghana, Philomena Nyarko, Brian Wells Pence, Cornelius Debpuur
Poverty, Gender, and Youth
For three decades, the Expanded Programme on Immunization (EPI) has been promoted as one of the key child health interventions in developing countries. Vaccines for six childhood diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, and tuberculosis) have been shown to be efficacious in preventing disease-specific morbidity and mortality, yet not all commentators are convinced that the EPI reduces all-cause child mortality. Numerous studies have found that measles vaccination programs substantially reduce all-cause child mortality, but recent findings from Guinea-Bissau suggest that diphtheria, pertussis, and tetanus (DPT) vaccine may increase all-cause child mortality. The present study uses five years of data from …
The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar
The Reporting Of Sensitive Behavior Among Adolescents: A Methodological Experiment In Kenya, Barbara Mensch, Paul C. Hewett, Annabel Erulkar
Poverty, Gender, and Youth
This paper assesses whether audio computer-assisted self-interviewing (audio-CASI), a technique designed in the United States to collect data on sensitive behaviors, is a feasible method of survey data collection in a developing-country setting and whether it produces more valid reporting of sexual activity and related behaviors than traditional survey methods. The analysis is based on interviews with nearly 4,400 unmarried adolescents aged 15-21 in Nyeri, a rural district of Kenya that was selected because previous research had indicated a wide discrepancy in the reporting of premarital sexual behavior between boys and girls. The study was based on a quasi-experimental design …
Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya
Diverse Realities: Understanding Sexually Transmitted Infections And Hiv In India, Sarah Hawkes, K.G. Santhya
Reproductive Health
Sexually transmitted infections (STIs), including HIV, currently have high salience on the health care agendas of many countries, including India. Strategies for their control are ideally based on a number of well-recognised principles. These include: assessments of the burden of disease; the availability of interventions at policy and programme levels, to influence behaviour change and technical ‘solutions’; and the calculated cost-effectiveness of these interventions. In the case of India, data to inform these principles are often lacking in the case of STI control. In this paper we have reviewed the evidence base for STI control in the Indian context. The …
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Honduras: Postpartum And Postabortion Patients Want Family Planning, Frontiers In Reproductive Health
Reproductive Health
Approximately half of deliveries in Honduras take place in hospitals, however hospitals rarely offer family planning (FP) services to postpartum or postabortion patients. In 1999, the Honduran Ministry of Health and the Population Council began a two-year project to expand access to FP counseling and methods following childbirth or treatment for incomplete abortion. The intervention built upon a previous Population Council project that showed that 30 percent of women hospitalized for a delivery or an abortion-related complication were interested in adopting an FP method prior to discharge. In all five hospitals participating in the study, delivery was the principal reason …
South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health
South Africa: Who Uses Youth Centers And Why?, Frontiers In Reproductive Health
Reproductive Health
In 2000, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and 7 affiliated peer education programs. The 12 centers, located in urban, peri-urban, and rural areas, offer very different services. The two centers of the KwaZulu-Natal Department of Health focus on providing reproductive health (RH) information and services to adolescents. The six centers of the Youth and Adolescent Reproductive Health Project provide a broader range of youth-friendly RH services, including counseling and life skills education, as well as modest recreational activities. The four centers run by loveLife have large …
Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health
Bénin: Target Men To Increase Use Of Health Services, Frontiers In Reproductive Health
Reproductive Health
After initiating health sector reforms in 1994, the Bénin government established the Integrated Family Health Project, known as PROSAF. Funded by the U.S. Agency for International Development, PROSAF operates in the Borgou region, which is mostly rural and has the country’s most severe health problems. PROSAF managers wanted to understand why local people were not using health services, despite their poor health. As noted in this brief, managers requested that the African Population and Health Research Centre (APHRC) study the way households and communities make decisions on health care. In a study conducted in 2000 with support from the Population …
South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health
South Africa: Providers Should Encourage Sexually Active Youth To Use Condoms, Frontiers In Reproductive Health
Reproductive Health
To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, …
From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan
From Patna To Paris: Providing Safe And Humane Abortion, Carmen Barroso, Martha Brady, Batya Elul, Shelley Clark, Sneh Vishwanath, Sunanda Rabindranathan
Poverty, Gender, and Youth
With access to safe, legal abortion under severe constraint or debate in many parts of the world, less attention has been paid to the issue of quality of abortion care. This issue of Quality/Calidad/Qualité explores two programs that operate in very different settings but with a shared commitment to providing high-quality abortion care in a context of broader reproductive health services: the Clinique d’Orthogénie of Broussais Hospital in France and Parivar Seva Sanstha in India. In both programs, each woman or girl who arrives for abortion receives crucial basic care, including: appropriate medical treatment to ensure complete abortion and safe …