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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 …

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 …

The Youth Empowerment Project: Strengthening Ngo Management, Research And Service Delivery Capabilities In Botswana, Mercy Rapelesega, Naomi Rutenberg

Reproductive Health

In an expansion of its efforts to fight a growing HIV epidemic and high teenage pregnancy rates, the Government of Botswana is encouraging nongovernmental organizations (NG0s) to be more active in providing reproductive health (RH) services, and especially HIV/AIDS education and care, to adolescents. NG0s have the potential to assume a larger role as health and education providers as well as implement pilot projects that the public health sector could learn from to increase the availability and quality of RH services for youth. The Africa OR/TA Project II designed and implemented the Youth Empowerment Project (YEP) to assist youth-oriented NG0s …

Proceedings Of The Workshop On Integrating Reproductive Tract Infection Case Management In Lgu Health Centers, Population Council

Reproductive Health

This report documents the proceedings of a training workshop on reproductive tract infection (RTI) case management for physicians, nurses, and midwives in selected health centers of the Philippines. The training started with presentation of focus group discussion results emphasizing existing beliefs and perceptions of the community regarding RTIs. The results of the situation analysis served as an eye opener for many in that clients with RTI-related symptoms were found to be rather rare and not systematically managed in the health clinics. Many providers report that since they are not trained to handle such cases, they refer whoever comes with symptoms …

Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Nakuru Municipal Council's Project On Strengthening Std/Aids Control, James Kariba Wabaru, Bedan Kiare Kariuki, Baker Ndugga Maggwa

Reproductive Health

Kenya’s Nakuru Municipal Council (NMC) operates five clinics located primarily in residential areas with high concentrations of people. The clinics provide basic antenatal, child welfare, STI, and other curative services, and family planning services are available at four of the clinics. One provincial referral hospital operated by the Ministry of Health also provides MCH-FP and HIV/STI services in a special STI treatment clinic. The seven public health facilities in Nakuru Municipality are participating in a collaborative project with the Department of Community Health at the University of Nairobi, the University of Manitoba in Canada, and the Nairobi Municipal City Council. …

Integration Of Sti And Hiv/Aids With Mch-Fp Services: A Case Study Of The Busoga Diocese Family Life Education Program, Uganda, Joy Mukaire, Florence Kalikwani, Baker Ndugga Maggwa

Reproductive Health

The Family Life Education Project (FLEP) was started in 1986 by the Busoga Diocese of the Anglican Church of Uganda with assistance from Pathfinder International. The project provides integrated MCH, FP, STD, and HIV/AIDS services to more than 500,000 individuals through 48 clinics and 162 trained village health workers (VHWs). Each clinic serves an estimated 11,000 people living in a sub-Parish. Each sub-Parish has a health subcommittee selected by the community that is responsible for hiring clinic staff, identifying VHWs, and mobilizing resources for clinic staff salaries. Data suggest that the program is reaching a large number of clients through …

Scaling-Up Improved Postabortion Care In Egypt: Introduction To University And Ministry Of Health And Population Hospitals, Laila Nawar, Dale Huntington, Ezzeldin Osman Hassan, Hala Youssef, Nahla G. Abdel-Tawab

Reproductive Health

In Egypt, the legal, religious, and societal restrictions on abortion have constrained the provision of high-quality emergency health care services provided to postabortion patients, including links with family planning (FP) services. In 1994, a small-scale pilot study was conducted by the Egyptian Fertility Care Society and the Population Council's ANE OR/TA Project (1995) to improve postabortion care in Egypt. The study intervention included an intensive training program for physicians on the use of Manual Vacuum Aspiration instruments under local anesthesia. Physicians were also instructed in infection-control practices and counseling postabortion patients about their medical condition and FP. The study findings …

Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend

Reproductive Health

Evidence from community studies indicates that significant proportions of Indian women (30 percent) may have reproductive tract infections (RTIs). Given that women are in general asymptomatic and that even symptomatic women may not seek care, the estimates are the minimum levels of prevalence. Most women do not seek treatment for RTIs for such reasons as lack of awareness, acceptance that RTIs are part of women's lives, and lack of treatment facilities. On the supply side, in the public sector the treatment for RTIs is limited with most services provided through STD clinics in urban areas. Seeking treatment at STD clinics …

Male Involvement In Family Planning: A Kabp Study Of Agra District, Uttar Pradesh, M.E. Khan, Bella C. Patel

Reproductive Health

Although lack of male involvement in family planning has been a topic of research and discussion since the early 1980s, during the last five years it has become an important issue for women advocates, researchers, and many international agencies that are committed to reproductive health and gender equality. The large number of articles on this subject and growing number of conferences, research projects, and debates are testimonies to the importance of the issue, both from the programmatic point of view and as a process for bringing about a gender balance in men's and women's reproductive rights and responsibility. This paper …

Sexual Violence Within Marriage: A Case Study Of Rural Uttar Pradesh, M.E. Khan, John Townsend, Ranjana Sinha, Seema Lakhanpal

Reproductive Health

Until recently the study of sexual behavior, despite being a very important area of human behavior, has remained an untouchable subject. The sensitivity of the subject and difficulties collecting required information discouraged social scientists from venturing into this area of human behavior. However, the advent of AIDS and its rapid spread in India has changed the scenario. Today the study of sexual behavior is an important subject and both national and international agencies, as part of the AIDS control program, are encouraging research on the subject. This paper addresses a totally neglected area, which is sexual coercion within marriage. The …

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 …

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 …

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 …

Postabortion Case Load Study In Egyptian Public Sector Hospitals, Egyptian Fertility Care Society, Population Council

Reproductive Health

There is an absence of reliable data on the incidence of incomplete abortion in Egypt. A diagnostic, descriptive study that neither tests an experimental intervention nor evaluates in a comprehensive manner the quality of postabortion medical care was undertaken to address this issue. The study is a cross-sectional observation of the volume and nature of the postabortion case load in Egyptian public-sector hospitals, and it responds to the following objectives: 1) Accurately estimate the number of women who present for postabortion treatment in ob/gyn in-patient facilities as a percentage of ob/gyn admissions in a representative sample of Egyptian public-sector hospitals …

Utilization Of Operations Research In Egypt, Sahar Hegazi

Reproductive Health

This study aims to maximize the utilization of operations research (OR) findings in Egypt to strengthen research efforts contributing to the improvement of the family planning (FP) and reproductive health (RH) care program. To date, the field of OR in Egypt has not conducted a systematic review of the utilization of the OR studies completed over the last decade. The long-term objective of this study, as noted in this report, was to maximize the utilization of OR and strengthen future efforts contributing to the improvement of the FP and RH care program in Egypt. The study’s sample included selected studies …

Experience With Clinical Training In Postabortion Care In Egypt: Improving Medical And Interpersonal Skills, Sahar Hegazi, Dale Huntington

Reproductive Health

The Population Council’s Asia and Near East Operations Research and Technical Assistance (ANE OR/TA) Project is collaborating with AVSC International to incorporate the addition of improved postabortion care procedures into the ongoing Safe Reproductive Health Care project. An element in the next phase of the program’s evolution was a two-day seminar held in Alexandria, Egypt. This seminar provided an opportunity for staff from ten hospitals that participated in the 1996–97 expansion program to present their own experience and impressions of the postabortion case-management procedures, and to discuss their strengths and weaknesses. This report presents an overview of this meeting’s presentations …

Implant Users: Over Five Years After Insertion (Further Analysis Of Previous Study Data), Jayanti Tuladhar, Joedo Prihartono

Reproductive Health

This secondary analysis report presents the characteristics of a subgroup of 235 women who are overdue in getting Norplant® implants removed after five years, factors related to the risk of nonremoval after five years, and issues related to accessing information about removal of implants. The main source of data for the present study is the “Norplant Implants® Assessment Study: Insertion, Use, and Removal” carried out in Indonesia in April 1996. This study consisted of a representative sample of 2,979 current and former Norplant users who had an insertion from April 1, 1987, to March 31, 1991, five or more years …

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 …

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.

Dmpa Provision In Pss Clinics In Uttar Pradesh: Costs And Prices, Saumya Ramarao, John Townsend, Leila Caleb-Varkey, Sudha Tiwari, Sneh Vishwanath, Harbans Singh

Reproductive Health

The injectable contraceptive DMPA was introduced in the private sector in India in 1993, contingent on completion of a post-marketing surveillance study of users. The commercial price of a dose of DMPA is about Rs. 150-180, exclusive of the fees of the medical provider. This price puts it beyond the reach of most Parivar Seva Sanstha (PSS) clients in need of safe and effective family planning (FP) services in Uttar Pradesh. Since April 1996, an experiment has been underway with three PSS clinics in Uttar Pradesh to study the effect of price on demand for DMPA. The study seeks to …

The Situation Analysis Approach To Assessing Family Planning And Reproductive Health Services: A Handbook, Robert A. Miller, Andrew A. Fisher, Kate Miller, Lewis Ndhlovu, Baker Ndugga Maggwa, Ian Askew, Diouratie Sanogo, Placide Tapsoba

Reproductive Health

Good family planning service delivery emphasizing both access and quality is key to the related goals of satisfying individual needs and achieving programmatic success. Situation Analysis (SA) provides a needed link between the manager and the client he or she is trying to serve. The data marshaled for SA offer a representative picture of how subsystems are working and provide a way to “see” the client’s experience. Situation Analyses assist managers in achieving the broadest management goal—that of efficient administration of a vital health care service while keeping in view the ultimate goal—providing good care for those who seek it. …

Youth Centres In Kenya: Evaluation Of The Family Planning Association Of Kenya Programme, Annabel Erulkar, Barbara Mensch

Reproductive Health

Since 1987, the Family Planning Association of Kenya (FPAK) has operated two youth centers, one in Nairobi and the other in Mombasa. The centers target unmarried youth aged 10–24 and their primary objective is reduction in incidence of sexual and reproductive-health-related problems. These centers offer recreational and sports facilities, counseling services, including reproductive health (RH) information, limited RH services, and referrals. In 1996, FPAK undertook a systematic evaluation of its youth-center program including a situation analysis of the centers, a survey in their catchment areas, and an analysis of program costs. The main strength of the program was found to …

Ajustement Des Valeurs D'Exposition Admissibles Pour Des Horaires De Travail Non Conventionnels, Jules Brodeur, Adolf Vyskocil, Robert Tardif, Guy Perrault, Daniel Drolet, Ginette Truchon, François Lemay

Rapports de recherche scientifique

Click here for the English version of this report

Le présent projet a été réalisé en réponse à la demande que le vice-président à la programmation et à l'expertise-conseil de la CSST a adressée à l'IRSST: produire une étude sur l'ajustement des valeurs d'exposition admissibles lors d'horaires de travail non conventionnels dans le but de supporter les travaux du comité paritaire 3. 33. 1 sur la révision de l'Annexe A du règlement sur la qualité du milieu de travail (Annexe 1). Au préalable, le comité paritaire avait établi que le principe de base de l'ajustement des valeurs d'exposition admissibles pour …

Effets De L'Horaire Rotatif De 12 Heures Sur La Santé Et La Sécurité Des Opérateurs D'Une Raffinerie De Produits Pétroliers. Phase 1 : Enquête, Diagnostic, Pistes De Réflexion Pour Des Aménagements : Résumé, Madeleine Bourdouxhe, Yvon Quéinnec, Denise Granger, Raymond Baril, Serge Guertin, Paul Massicotte

Rapports de recherche scientifique

Click here for the English version of this report

Le présent document est la synthèse du rapport détaillé de recherche Effets de l'horaire rotatif de 12 heures sur la santé et la sécurité des opérateurs d'une raffinerie de produits pétroliers. Phase 1 : enquête, diagnostic, pistes de réflexion pour des aménagements

Objectifs : À la demande de la direction et du syndicat d'une raffinerie de pétrole, qui s'interrogeaient sur la nécessité d'apporter des modifications à l'horaire de travail, l'équipe de recherche pluridisciplinaire a réalisé un premier bilan de l'impact de l'horaire rotatif de 12 heures, implanté depuis 20 ans dans …

The Relationship Between Vertical Leap And Eccentric Ground Force Time In Competitive University Men And Women Basketball Players, Cory Alan Ash

Physical Therapy Scholarly Projects

This study evaluated the relationship between vertical leap and eccentric ground force time as measured by the Cybex Fastex TM. Ten male and ten female competitive university basketball players volunteered to perform three maximum vertical jumps on the Fastex TM force platform. Pearson correlation coefficients were not significant between eccentric ground force time and vertical leap when all subjects on all jumps were assessed. When differences in gender were examined, pearson correlation coefficients showed a significant positive relationship between eccentric ground force time and vertical leap for men, but no such relationship was found for women. These results show that …

A Literature Review Of The Fundamentals Of Hippotherapy, Laura Weisberg

Physical Therapy Scholarly Projects

For centuries, horses have been used to help rehabilitate people with neuromuscular disorders. However, not until recently has it been recognized as a treatment modality utilized in the practice of physical therapy. Hippotherapy is implemented by a licensed therapist who uses the multifaceted movement of the horse as a treatment modality to address a broad range of special needs in individuals with disabilities. Unfortunately, there is limited information provided on this subject.

In a review of the literature, I will discuss the history, the different theories, the treatment techniques, and the research that has been done on hippotherapy. The purpose …

A Literature Review Of Alcohol Abuse And Dependence, Julie R. Vaughan

Physical Therapy Scholarly Projects

Alcohol abuse and/or dependence poses significant risks to a person's health. The negative effects and consequences of alcohol abuse and/or dependence has been well documented in the literature. Many people who are either alcohol abusers or alcohol dependent are admitted to hospitals with neurological deficits, medical complications and traumatic injuries. Often times an etiology related to alcohol abuse is ignored.

This population may be referred to physical therapy for rehabilitation. Functional outcomes and compliance are often unsatisfactory with this population. A better understanding of alcohol abuse and/or dependence could help identify persons at risk and improve functional outcomes.

The purpose …

Magnetic Therapy: An Alternative Approach To Treatment, Becky S. Rohr

Physical Therapy Scholarly Projects

Magnetic therapy has been a treatment of choice for hundreds of years in many European countries as well as in several areas of the Orient, but has only recently been gaining popularity in the United States and Canada. It is believed that applying static magnets to a painful body structure will bring relief to the patient. It is also proposed that a general feeling of well ness and increased energy will be gained from magnetic therapy. These benefits are theorized to be attained through the placement of a static magnet on the surface of the body, which blocks the transmission …

Temperament In Late Talkers, Rhea Paul, Loretta Kellogg

Communication Disorders Faculty Publications

This study examines the temperamental characteristics of children who were identified at age two as being slow in expressive language development, and those of peers with normal language history. When the children were in first grade (approximately age six), parents and clinicians rated subjects' temperamental characteristics, using a standardized temperament assessment instrument. Subjects with a history of slow expressive language development were rated significantly lower on Approach/Withdrawal--indicating shyness, aloofness, or reduced outgoingness--than peers with normal language history. Approach/Withdrawal scores were significantly correlated with average sentence length in spontaneous speech, and this measure also predicted Approach/Withdrawal scores in regression analyses. The …

Perceptions Of Stuttering Intervention Services Received At Portland State, Franklin Wayne Bender

Dissertations and Theses

As consumers become more knowledgeable and more demanding of accountability, health care workers, including speech-language pathologists, are being required to justify the effectiveness of their work by documenting the results of their treatment programs. There are different ways to measure treatment outcomes. Outcomes may be measured qualitatively and/or quantitatively. Qualitative or subjective outcomes are difficult to define and measure and few studies of this type have been reported in the literature. Because few studies have been reported in the literature regarding client satisfaction, this area was investigated in this research project. The focus of this project was to ascertain whether …